van Furth E F, van Strien D C, Martina L M, van Son M J, Hendrickx J J, van Engeland H
Robert-Fleury Foundation, Eating Disorder Unit, Leidschendam, The Netherlands.
Int J Eat Disord. 1996 Jul;20(1):19-31. doi: 10.1002/(SICI)1098-108X(199607)20:1<19::AID-EAT3>3.0.CO;2-7.
This study examines whether parental Expressed Emotion (EE) ratings, based on the Camberwell Family Interview (CFI), are predictive of the course of illness in a sample of Dutch families with an adolescent eating disorder patient. Levels of EE at first assessment and at the termination of treatment are reported.
The study was designed as a prospective follow-up study and involved 49 adolescent eating disorder patients (DSM-III-R) and their parents. Patient and family assessments were conducted at intake (T1), at the termination of treatment (T2), and at follow-up (T3) 1 year later. The Morgan-Russell Outcome Assessment Schedule, which was adjusted to accommodate bulimics, yielded the average outcome score (AOS) which served as our outcome measure.
The levels of parental EE at first assessment were low. During the treatment period the levels decreased further. We used a stepwise multiple regression analysis, with the parental EE variables as independent variables, to predict the AOS at T2 and T3. This way we showed that the mothers' Critical Comments (CC) rating explained 28 to 34% of the outcome variance. The mothers' CC rating was also the best predictor of outcome when compared to other possible predictor variables.
The results underscore the importance of involving the family in the treatment of adolescent eating disorders. Specific attention should be given to the mother's thoughts, feelings, and behavior concerning her ill daughter. Helping the mother and daughter to differentiate and separate through a constructive noncritical approach to the presenting problems may be a crucial factor in breaking through the perpetuating cycle of criticism and illness.
本研究探讨基于坎伯韦尔家庭访谈（CFI）得出的父母情感表达（EE）评分，是否能预测荷兰患有青少年饮食失调症患者家庭样本中的疾病进程。报告了首次评估和治疗结束时的EE水平。
该研究设计为前瞻性随访研究，涉及49名青少年饮食失调症患者（DSM-III-R）及其父母。在入院时（T1）、治疗结束时（T2）以及1年后的随访时（T3）对患者和家庭进行评估。经调整以适应贪食症患者的摩根-拉塞尔结果评估量表得出平均结果分数（AOS），作为我们的结果衡量指标。
首次评估时父母的EE水平较低。在治疗期间，这些水平进一步下降。我们使用逐步多元回归分析，将父母的EE变量作为自变量，来预测T2和T3时的AOS。通过这种方式，我们表明母亲的批评性评论（CC）评分解释了28%至34%的结果差异。与其他可能的预测变量相比，母亲的CC评分也是结果的最佳预测指标。
结果强调了让家庭参与青少年饮食失调症治疗的重要性。应特别关注母亲对生病女儿的想法、感受和行为。通过对所呈现问题采取建设性的非批评性方法，帮助母亲和女儿区分并分离，可能是打破批评和疾病持续循环的关键因素。
