Rienecke Renee D, Sim Leslie, Lock James, Le Grange Daniel
Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
J Child Psychol Psychiatry. 2016 Dec;57(12):1407-1413. doi: 10.1111/jcpp.12594. Epub 2016 Jul 5.
This goal of this study was to understand the patterns of expressed emotions (EEs) in adolescent eating disorders. As such, this study compared EE among families of adolescents with anorexia nervosa (AN), bulimia nervosa (BN), and a psychiatric control group, major depressive disorder (MDD). This study also examined the influence of family status (intact vs. nonintact) and the presence of siblings on EE.
Two-hundred and fifteen adolescents (ages 12-19) and their families were recruited for this study including 121 adolescents with AN, 54 adolescents with BN, and 40 adolescents with MDD. Adolescents with at least one parent completed the Standardized Clinical Family Interview. Adolescents completed structured diagnostic interviews to assess eligibility for the study, as well as a standardized questionnaire to assess depression.
Analyses revealed that fathers showed higher levels of critical comments to adolescents with BN or MDD than those with AN, whereas mothers made more critical comments toward patients with BN. Mothers made the least number of positive remarks toward patients with MDD. In terms of the influence of family status, fathers from intact families showed more expressions of warmth and were less critical than fathers from nonintact families, whereas mothers from intact families were less critical but also made fewer positive remarks than mothers from nonintact families. The presence of siblings appeared to reduce mothers' expression of warmth and emotional overinvolvement.
Unique patterns of EE were found to characterize AN, BN, and MDD. Family status and the presence of siblings exert an influence on EE that should be taken into consideration in future research.
本研究的目的是了解青少年饮食失调中表达性情绪（EE）的模式。因此，本研究比较了神经性厌食症（AN）、神经性贪食症（BN）青少年家庭与精神科对照组重度抑郁症（MDD）家庭中的EE。本研究还考察了家庭状况（完整家庭与非完整家庭）和兄弟姐妹的存在对EE的影响。
本研究招募了215名青少年（12 - 19岁）及其家庭，包括121名患有AN的青少年、54名患有BN的青少年和40名患有MDD的青少年。至少有一位家长的青少年完成了标准化临床家庭访谈。青少年完成结构化诊断访谈以评估是否符合研究条件，以及一份评估抑郁的标准化问卷。
分析显示，与患有AN的青少年相比，父亲对患有BN或MDD的青少年表现出更高水平的批评性评论，而母亲对患有BN的患者有更多批评性评论。母亲对患有MDD的患者给予的积极评价最少。就家庭状况的影响而言，完整家庭的父亲表现出更多的温暖表达，且比非完整家庭的父亲批评性更少，而完整家庭的母亲批评性更少，但与非完整家庭的母亲相比，积极评价也更少。兄弟姐妹的存在似乎会减少母亲的温暖表达和情感过度卷入。
发现AN、BN和MDD具有独特的EE模式。家庭状况和兄弟姐妹的存在对EE有影响，在未来研究中应予以考虑。
