Hogg E, Krebs G, Mataix-Cols D, Jassi A
Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, UK.
Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, UK.
Child Psychiatry Hum Dev. 2024 Sep 3. doi: 10.1007/s10578-024-01754-7.
Family accommodation (FA) is widely-recognised as an important clinical phenomenon in obsessive-compulsive disorder (OCD) and anxiety disorders, and is related to poorer treatment outcomes. However, FA has not been quantitatively explored in Body Dysmorphic Disorder (BDD). The aim of this study was to investigate the patterns and correlates of maternal accommodation in adolescent BDD, and its association with treatment outcomes. Participants were 131 adolescents with BDD and their mothers who completed the Family Accommodation Scale-Parent Report (FAS-PR) as part of routine clinical practice in a National and Specialist Service for Young People at the Maudsley Hospital, London. Seventy-six (58%) young people received specialist cognitive behavioural therapy for BDD and had post-treatment data available. All mothers engaged in at least one form of accommodation. Providing reassurance (98.5%) and assisting avoidance (88.5%) were the most commonly endorsed behaviours. Levels of accommodation were positively associated with clinician-rated BDD symptom severity (r = 0.18, p = 0.041) and maternal symptoms of anxiety, depression and stress (r = 0.41, p < 0.001), and negatively associated with child global functioning (r = -0.38, p < 0.001). Maternal accommodation did not predict treatment outcomes (β = 0.055, p > 0.05). The findings indicate that maternal accommodation is common and has important clinical correlates, but does not impact on treatment response. Consequently, the relationship between maternal accommodation and BDD symptoms may differ to that evidenced in paediatric OCD. Future longitudinal research exploring maternal and paternal accommodation, and assessing variables of interest at multiple time-points throughout treatment, is needed to advance understanding of the role of FA in adolescent BDD.
家庭迁就（FA）在强迫症（OCD）和焦虑症中被广泛认为是一种重要的临床现象，并且与较差的治疗结果相关。然而，家庭迁就尚未在身体变形障碍（BDD）中得到定量研究。本研究的目的是调查青少年BDD中母亲迁就的模式及其相关因素，以及它与治疗结果的关联。参与者是131名患有BDD的青少年及其母亲，他们作为伦敦莫兹利医院国家青少年专科服务机构常规临床实践的一部分，完成了家庭迁就量表-家长报告（FAS-PR）。76名（58%）年轻人接受了针对BDD的专科认知行为疗法，并拥有治疗后的数据。所有母亲都至少参与了一种形式的迁就。给予安慰（98.5%）和协助回避（88.5%）是最常被认可的行为。迁就程度与临床医生评定的BDD症状严重程度呈正相关（r = 0.18，p = 0.041），与母亲的焦虑、抑郁和压力症状呈正相关（r = 0.41，p < 0.001），与儿童的整体功能呈负相关（r = -0.38，p < 0.001）。母亲的迁就并不能预测治疗结果（β = 0.055，p > 0.05）。研究结果表明，母亲的迁就很常见且具有重要的临床相关因素，但并不影响治疗反应。因此，母亲迁就与BDD症状之间的关系可能与儿科OCD中所证明的不同。未来需要进行纵向研究，探讨母亲和父亲的迁就情况，并在整个治疗过程中的多个时间点评估感兴趣的变量，以增进对家庭迁就在青少年BDD中作用的理解。
