Exploring the Multifaceted Burdens and Experiences of Parents With a Child Diagnosed With Anorexia Nervosa: A Psychological Network Analysis

IF 4.3 2区 医学 Q1 NUTRITION & DIETETICS International Journal of Eating Disorders Pub Date : 2025-01-31 DOI:10.1002/eat.24389
Michael Zeiler, Julia Philipp, Stefanie Truttmann, Konstantin Kopp, Gabriele Schöfbeck, Dunja Mairhofer, Hartmut Imgart, Annika Zanko, Ellen Auer-Welsbach, Andreas Karwautz, Gudrun Wagner
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Abstract

Objective

Parents of children diagnosed with anorexia nervosa (AN) are facing multiple burdens when caring for their child. This study uses a psychological network approach to identify central factors among parental caregiving burdens and experiences which then can constitute promising targets for caregiver interventions.

Method

A total of 348 parents (247 mothers, 101 fathers) of children diagnosed with AN (96% female, 90% restrictive type) provided data including parental psychopathology, eating-disorder related burden, high-expressed emotion and perceived caregiver skills at baseline and after having participated in a parental skills training, multi-family therapy or systemic family therapy. Regularized partial correlation networks including 14 variables were estimated for baseline and follow-up data were estimated.

Results

High-expressed emotion, particularly parental emotional overinvolvement emerged as the most central variable in the network showing substantial correlations with depression and low self-care behavior. Emotional overinvolvement also functioned as a bridge variable between parental psychopathology, perceived caregiver skills, and eating disorder-related burden. Moreover, parental criticism was strongly associated with burden due to the child's confrontational behavior and low levels of parental frustration tolerance. Network comparison tests neither revealed statistically significant differences in network structure and global network strength between baseline and follow-up, nor between mothers and fathers.

Discussion

This study highlights the importance of parental high-expressed emotion as a promising treatment target. Adding or intensifying intervention components promoting parental emotion regulation strategies as well as intensified training in Motivational Interviewing may be useful therapeutic approaches to decrease overall parental burden.

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神经性厌食症患儿父母的多重负担与经历:心理网络分析。
目的:神经性厌食症(AN)患儿的家长在照顾孩子时面临多重负担。本研究使用心理网络方法来确定父母照顾负担和经历之间的中心因素,然后可以构成照顾者干预的有希望的目标。方法:对348名确诊为AN患儿的家长(女性96%,限制性型90%)(247名母亲,101名父亲)提供父母精神病理、饮食障碍相关负担、高表达情绪和感知照顾者技能等资料,并分别参加父母技能培训、多家庭治疗或全身性家庭治疗。对基线和随访数据估计了包括14个变量的正则化偏相关网络。结果:高表达情绪,特别是父母情绪过度投入是网络中最核心的变量,与抑郁和低自我照顾行为有显著的相关性。情绪过度投入也在父母精神病理、感知照顾者技能和饮食失调相关负担之间起着桥梁变量的作用。此外,由于孩子的对抗行为和父母对挫折的低容忍水平,父母的批评与负担密切相关。网络比较测试既没有显示基线和随访之间,也没有显示母亲和父亲之间在网络结构和全球网络强度方面的统计学显著差异。讨论:本研究强调了父母高表达情绪作为一个有希望的治疗目标的重要性。增加或加强干预成分,促进父母情绪调节策略以及强化动机访谈训练可能是减轻父母整体负担的有效治疗方法。
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来源期刊
CiteScore
10.00
自引率
12.70%
发文量
204
审稿时长
4-8 weeks
期刊介绍: Articles featured in the journal describe state-of-the-art scientific research on theory, methodology, etiology, clinical practice, and policy related to eating disorders, as well as contributions that facilitate scholarly critique and discussion of science and practice in the field. Theoretical and empirical work on obesity or healthy eating falls within the journal’s scope inasmuch as it facilitates the advancement of efforts to describe and understand, prevent, or treat eating disorders. IJED welcomes submissions from all regions of the world and representing all levels of inquiry (including basic science, clinical trials, implementation research, and dissemination studies), and across a full range of scientific methods, disciplines, and approaches.
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