Klüber Hannah Lea, Martin Annick, Schlensog-Schuster Franziska, Hiemisch Andreas, Kiess Wieland, Hilbert Anja, Schmidt Ricarda
Integrated Research and Treatment Center (IFB) AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.
Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Leipzig University Medical Center, Liebigstrasse 20a, 04103, Leipzig, Germany.
Child Adolesc Psychiatry Ment Health. 2025 Jun 6;19(1):66. doi: 10.1186/s13034-025-00929-x.
Family factors like parental psychopathology and parental expressed emotion, referring to the emotional atmosphere within a family, play a significant role in the maintenance and treatment outcome of anorexia nervosa. However, nothing is known about these parental characteristics in avoidant/restrictive food intake disorder (ARFID).
This study aimed to determine the proportion of parents exceeding clinical cutoffs for depression, eating disorder psychopathology, and expressed emotion, specifically criticism and emotional overinvolvement, in ARFID, anorexia nervosa (AN), and healthy controls (HC), and to evaluate group differences. Associations between parental characteristics and child illness characteristics were analyzed.
Treatment-seeking children and adolescents (0–17 years) with ARFID ( = 42) were compared to those with AN ( = 25) and HC ( = 42) in parental eating disorder psychopathology (Eating Disorder Examination-Questionnaire 8), parental depression (Patient Health Questionnaire-9), and parental expressed emotion (Family Questionnaire).
When comparing ARFID with AN and HC, the proportions of parents exceeding clinical cutoffs for depression (26% vs. 20% vs. 14%), eating disorder psychopathology (7% vs. 12% vs. 9%), and criticism (26% vs. 32% vs. 29%) did not differ significantly. For emotional overinvolvement (41% vs. 52% vs. 0%), differences emerged between ARFID and HC, but not AN. Dimensionally, levels of parental depressive symptoms and emotional overinvolvement were higher in those with ARFID versus HC only. More parental depressive symptoms, criticism, and emotional overinvolvement were significantly related to greater children’s restrictive eating behaviors, lower standardized body-mass-index, and lower number of accepted foods.
ARFID and anorexia nervosa were found to share similar distributions in parental psychopathology and parental expressed emotion. Future studies may focus on the role of those family factors in development and outcome of ARFID.
The online version contains supplementary material available at 10.1186/s13034-025-00929-x.
诸如父母精神病理学和父母表达性情绪（指家庭中的情感氛围）等家庭因素在神经性厌食症的维持和治疗结果中起着重要作用。然而，对于回避/限制性食物摄入障碍（ARFID）中这些父母特征却一无所知。
本研究旨在确定在ARFID、神经性厌食症（AN）和健康对照组（HC）中，父母抑郁、饮食失调精神病理学以及表达性情绪（具体为批评和情感过度卷入）超过临床临界值的比例，并评估组间差异。分析了父母特征与儿童疾病特征之间的关联。
将寻求治疗的ARFID儿童和青少年（0 - 17岁，n = 42）与AN儿童和青少年（n = 25）以及HC儿童和青少年（n = 4）在父母饮食失调精神病理学（饮食失调检查表问卷8）、父母抑郁（患者健康问卷9）和父母表达性情绪（家庭问卷）方面进行比较。
将ARFID与AN和HC进行比较时，父母抑郁（26%对20%对14%）、饮食失调精神病理学（7%对12%对9%）以及批评（26%对32%对29%）超过临床临界值的比例无显著差异。对于情感过度卷入（41%对52%对0%），ARFID与HC之间存在差异，但与AN之间无差异。从维度上看，仅ARFID组的父母抑郁症状和情感过度卷入水平高于HC组。更多的父母抑郁症状、批评和情感过度卷入与儿童更严重的限制性饮食行为、更低的标准化体重指数以及更少的可接受食物数量显著相关。
发现ARFID和神经性厌食症在父母精神病理学和父母表达性情绪方面具有相似的分布。未来的研究可能聚焦于这些家庭因素在ARFID发展和结局中的作用。
在线版本包含可在10.1186/s13034 - 025 - 00929 - x获取的补充材料。
