Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California.
Sheppard Pratt Health System, Baltimore, Maryland.
Int J Eat Disord. 2018 Mar;51(3):275-280. doi: 10.1002/eat.22826. Epub 2018 Jan 4.
Family-based treatment (FBT) for adolescent anorexia nervosa (AN) promotes faster weight restoration when compared to other treatments. However, the mechanisms through which this occurs are not clarified. This study explored the trajectories of parental self-efficacy and perceived family flexibility during FBT and systemic family therapy (SyFT). We also explored whether parental self-efficacy mediates the effects of treatment on weight gain early in treatment.
158 adolescents (12-18 years old; 89% girls) and their parents were randomized to FBT or SyFT. Parental self-efficacy as well as adolescents' and parental perceptions of the family's flexibility were collected at baseline and at sessions 2, 4, 6, and 8.
Over time, only parents in FBT reported significantly greater self-efficacy. The change in maternal self-efficacy over the first 8 weeks of treatment was a significant mediator of session 10 weight gain. There were no significant group differences in perceived flexibility by session 8.
Both parents in FBT and mothers in SyFT understand early the need to change their family's rules and roles. However, the specific strategies of FBT appear to mediate early weight gain in AN.
与其他治疗方法相比，基于家庭的治疗（FBT）可促进青少年厌食症（AN）更快地恢复体重。然而，其发生的机制尚不清楚。本研究探讨了 FBT 和系统家庭治疗（SyFT）期间父母自我效能感和感知家庭灵活性的轨迹。我们还探讨了治疗早期父母自我效能感是否可以调解治疗对体重增加的影响。
158 名青少年（12-18 岁；89%为女孩）及其父母被随机分配到 FBT 或 SyFT 组。在基线和第 2、4、6 和 8 次就诊时收集了父母自我效能感以及青少年和父母对家庭灵活性的看法。
随着时间的推移，只有 FBT 组的父母报告自我效能感显著提高。治疗前 8 周内母亲自我效能感的变化是第 10 次就诊时体重增加的一个重要中介因素。到第 8 次就诊时，两组在感知灵活性方面没有显著差异。
FBT 中的父母双方和 SyFT 中的母亲都能理解早期改变家庭规则和角色的必要性。然而，FBT 的具体策略似乎调解了 AN 患者的早期体重增加。
