Singh Manya, Austin Amelia, Lindenbach David, Vander Steen Heidi, Habina Courtney, Marcoux-Louie Gisele, Loeb Katharine L, Engel Scott, Le Grange Daniel, Dimitropoulos Gina
Department of Psychiatry, University of Calgary, Calgary, Canada.
The Mathison Centre for Mental Health Research & Education, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Int J Eat Disord. 2025 Mar;58(3):608-623. doi: 10.1002/eat.24368. Epub 2025 Jan 3.
Studies have shown that early weight gain in family-based treatment (FBT) predicts treatment response in adolescents with anorexia nervosa (AN); however, research examining factors associated with early weight gain in FBT is limited. This study tested the feasibility and acceptability of ecological momentary assessment (EMA) in early FBT, particularly to capture momentary data on family climate during mealtimes.
Using multiple methods, quantitative (EMA) and qualitative (interviews) data were collected in the first 4 weeks of FBT. Participants (11 families; 9 adolescents, 19 parents/caregivers) completed EMA assessments daily on the emotional climate during meals, parental strategies and confidence/agreement in renourishment. Qualitative interviews obtained technological and procedural data using EMA. Completion rates and markers of change were explored using repeated measures ANOVA. Interviews were analyzed using reflexive thematic analysis.
The EMA completion rate for all family members was 78%: 84% for adolescents, 83% for mothers, 64% for fathers. Results demonstrated changes in caregivers' use of renourishment strategies and in the emotional climate (decreased anger) at mealtimes. No changes were observed in caregiver confidence/agreement in renourishment. Qualitative analyses revealed factors interfering with and facilitating the use of EMA.
EMA is an acceptable and feasible tool for use with adolescents and their families in early FBT, particularly to capture momentary data on family climate during mealtimes. Future research is needed with larger sample sizes to examine the mechanisms of change in early FBT, and the utility of EMA as a clinical tool in FBT.
研究表明，在基于家庭的治疗（FBT）中，早期体重增加可预测神经性厌食症（AN）青少年的治疗反应；然而，关于FBT中与早期体重增加相关因素的研究有限。本研究测试了生态瞬时评估（EMA）在早期FBT中的可行性和可接受性，特别是用于获取用餐期间家庭氛围的瞬时数据。
在FBT的前4周使用多种方法收集定量（EMA）和定性（访谈）数据。参与者（11个家庭；9名青少年，19名父母/照顾者）每天完成EMA评估，内容包括用餐时的情绪氛围、父母的策略以及在重新喂养方面的信心/一致性。定性访谈获取了使用EMA的技术和程序数据。使用重复测量方差分析探讨完成率和变化指标。访谈采用反思性主题分析进行分析。
所有家庭成员的EMA完成率为７８％：青少年为８４％，母亲为８３％，父亲为６４％。结果表明，照顾者在重新喂养策略的使用以及用餐时的情绪氛围（愤怒减少）方面发生了变化。在照顾者对重新喂养的信心/一致性方面未观察到变化。定性分析揭示了干扰和促进EMA使用的因素。
EMA是一种可接受且可行的工具，可用于早期FBT中的青少年及其家庭，特别是用于获取用餐期间家庭氛围的瞬时数据。未来需要更大样本量的研究来探讨早期FBT中的变化机制，以及EMA作为FBT临床工具的效用。
