Loeb Katharine L, Lock James, Le Grange Daniel, Greif Rebecca
School of Psychology, Fairleigh Dickinson University and Department of Psychiatry, Mount Sinai School of Medicine.
Cogn Behav Pract. 2012 Feb 1;19(1):17-30. doi: 10.1016/j.cbpra.2010.04.005.
This paper describes the transdiagnostic theory and application of family-based treatment (FBT) for children and adolescents with eating disorders. We review the fundamentals of FBT, a transdiagnostic theoretical model of FBT and the literature supporting its clinical application, adaptations across developmental stages and the diagnostic spectrum of eating disorders, and the strengths and challenges of this approach, including its suitability for youth. Finally, we report a case study of an adolescent female with eating disorder not otherwise specified (EDNOS) for whom FBT was effective. We conclude that FBT is a promising outpatient treatment for anorexia nervosa, bulimia nervosa, and their EDNOS variants. The transdiagnostic model of FBT posits that while the etiology of an eating disorder is unknown, the pathology affects the family and home environment in ways that inadvertently allow for symptom maintenance and progression. FBT directly targets and resolves family level variables, including secrecy, blame, internalization of illness, and extreme active or passive parental responses to the eating disorder. Future research will test these mechanisms, which are currently theoretical.
本文描述了针对患有饮食失调症的儿童和青少年的基于家庭治疗（FBT）的跨诊断理论及应用。我们回顾了FBT的基本原理、FBT的跨诊断理论模型以及支持其临床应用的文献，FBT在不同发育阶段和饮食失调症诊断范围内的适应性，以及这种方法的优势和挑战，包括其对青少年的适用性。最后，我们报告了一例未另行规定的饮食失调症（EDNOS）青少年女性的案例研究，FBT对其有效。我们得出结论，FBT是一种有前景的针对神经性厌食症、神经性贪食症及其EDNOS变体的门诊治疗方法。FBT的跨诊断模型假定，虽然饮食失调症的病因尚不清楚，但病理状况以不经意间导致症状维持和进展的方式影响家庭和家庭环境。FBT直接针对并解决家庭层面的变量，包括保密、指责、疾病内化以及父母对饮食失调症极端主动或被动的反应。未来的研究将检验这些目前尚属理论性的机制。
