Clinical Psychology Unit, The University of Sydney, Sydney, Australia.
Int J Eat Disord. 2012 May;45(4):609-14. doi: 10.1002/eat.22000. Epub 2012 Jan 24.
Family-based treatment for anorexia nervosa (FBT) has demonstrated efficacy in the treatment of adolescents with anorexia nervosa (AN) in a number of randomized control trials (RCT). The aim of the current research was to determine whether adherence to the key components of the model as outlined in the treatment manual predict weight gain or dropout.
The 59 participants were under 19 years and had AN for less than 3 years. Five core treatment objectives and working alliance were measured across 20 sessions of FBT.
The core objectives of parents taking control, being united, not criticizing the patient and externalizing the illness predicted greater weight gain. Sibling support did not predict weight gain. The relationship between therapeutic alliance and weight gain was positive for mothers but negative for fathers. Dropout was predicted by low control and poor maternal-therapeutic alliance.
The results of this study lend further support for the efficacy of the FBT, demonstrating that the principles guiding clinical practice are those which lead to weight gain. The finding that parental control is the central predictor of change can also support the development of augmentations to the model.
基于家庭的治疗方法已被证明对治疗青少年厌食症有效，在多项随机对照试验中得到了验证。本研究旨在确定治疗手册中概述的模型关键要素的依从性是否能预测体重增加或脱落。
59 名参与者年龄在 19 岁以下，且厌食症患病时间少于 3 年。在 20 次家庭为基础的治疗中，对 5 个核心治疗目标和工作联盟进行了测量。
父母控制、团结一致、不批评患者和外化疾病的核心目标预测体重增加更多。兄弟姐妹的支持并不能预测体重增加。治疗联盟与体重增加之间的关系对母亲呈正相关，对父亲呈负相关。脱落预测因素是低控制和不良的母子治疗联盟。
本研究结果进一步支持了 FBT 的疗效，表明指导临床实践的原则是导致体重增加的原则。父母控制是变化的核心预测因素的发现也可以支持对该模型的增强。
