Dimitropoulos Gina, Landers Ashley L, Freeman Victoria E, Novick Jason, Cullen Olivia, Engelberg Marla, Steinegger Cathleen, Le Grange Daniel
1Faculty of Social Work, Matheson Centre for Mental Health Research, University of Calgary, 4212-2800 University Way N.W., Calgary, Alberta Canada.
8Hotchkiss Brain Institute, University of Calgary, 4212-2800 University Way N.W., Calgary, Alberta Canada.
J Eat Disord. 2018 Jun 6;6:13. doi: 10.1186/s40337-018-0196-0. eCollection 2018.
Family-Based Treatment (FBT) is the first line of care in paediatric treatment while adult programs focus on individualized models of care. Transition age youth (TAY) with Anorexia Nervosa (AN) are in a unique life stage and between systems of care. As such, they and their caregivers may benefit from specialized, developmentally tailored models of treatment.
The primary purpose of this study was to assess if parental self-efficacy and caregiver accommodation changed in caregivers during the course of FBT-TAY for AN. The secondary aim was to determine if changes in parental self-efficacy and caregiver accommodation contributed to improvements in eating disorder behaviour and weight restoration in the transition age youth with AN. Twenty-six participants (ages 16-22) and 39 caregivers were recruited. Caregivers completed the Parents versus Anorexia Scale and Accommodation and Enabling Scale for Eating Disorders at baseline, end-of-treatment (EOT), and 3 months follow-up.
Unbalanced repeated measures designs for parental self-efficacy and caregiver accommodation towards illness behaviours were conducted using generalized estimation equations. Parental self-efficacy increased from baseline to EOT, although not significantly ( .398). Parental self-efficacy significantly increased from baseline to 3 months post-treatment ( = .002). Caregiver accommodation towards the illness significantly decreased from baseline to EOT ( = 0.0001), but not from baseline to 3 months post-treatment ( = 1.000). Stepwise ordinary least squares regression estimates of eating disorder behaviour and weight restoration did not show that changes in parental-self efficacy and caregiver accommodation predict eating disorder behaviour or weight restoration at EOT or 3 months post-treatment.
Our findings demonstrate, albeit preliminary at this stage, that FBT-TAY promotes positive increases in parental self-efficacy and assists caregivers in decreasing their accommodation to illness behaviours for transition age youth with AN. However, changes in the parental factors did not influence changes in eating and weight in the transition age youth.
基于家庭的治疗（FBT）是儿科治疗的一线治疗方法，而成人项目则侧重于个体化的治疗模式。患有神经性厌食症（AN）的过渡年龄青年（TAY）处于独特的生命阶段，且处于不同的护理体系之间。因此，他们及其照顾者可能会从专门的、根据发育阶段量身定制的治疗模式中受益。
本研究的主要目的是评估在针对AN的FBT-TAY治疗过程中，照顾者的父母自我效能感和照顾者适应情况是否发生变化。次要目的是确定父母自我效能感和照顾者适应情况的变化是否有助于改善患有AN的过渡年龄青年的饮食失调行为和体重恢复。招募了26名参与者（年龄在16 - 22岁之间）和39名照顾者。照顾者在基线、治疗结束时（EOT）和3个月随访时完成了《父母与厌食症量表》以及《饮食失调的适应与促成量表》。
使用广义估计方程对父母自我效能感和照顾者对疾病行为的适应情况进行了不平衡重复测量设计。父母自我效能感从基线到EOT有所增加，但不显著（p =.398）。从基线到治疗后3个月，父母自我效能感显著增加（p =.00２）。照顾者对疾病的适应情况从基线到EOT显著下降（p = 0.0001），但从基线到治疗后3个月没有下降（p = 1.000）。饮食失调行为和体重恢复的逐步普通最小二乘回归估计未显示父母自我效能感和照顾者适应情况的变化能预测EOT或治疗后3个月的饮食失调行为或体重恢复情况。
我们的研究结果表明，尽管现阶段只是初步的，但FBT-TAY促进了父母自我效能感的积极提高，并帮助照顾者减少对患有AN的过渡年龄青年疾病行为的适应。然而，父母因素的变化并未影响过渡年龄青年饮食和体重的变化。
