This study reports on a pilot study of a family group intervention with or without patient participation adjunctive to a specialized inpatient treatment for eating disorders (EDs). Participants were 112 female adolescent ED inpatients and one or both of their parents. The parents were invited to participate in an adjunctive multi-family group with patient (MFT) or in a similar multi-parent group without patient participation (MPT). Questionnaires assessing ED symptoms, family functioning and caregiving experiences were administered before and after intervention. Post-intervention results obtained from both patient and parent(s) indicated that improvement in ED symptoms and parental burden occurred after both types of interventions. Family functioning improved differently according to the informant: fathers reported an improvement of general family functioning, patients reported an improvement of problem solving and mothers reported a decrease in problem solving across both formats. This study emphasized the importance of including a multi-informant approach in family interventions. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
A multi-family group intervention has been developed in a group-oriented inpatient treatment programme for eating-disordered adolescents. In the inpatient unit the opportunity for patients to have autonomy and sense of choice concerning the treatment are structurally embedded. Consequently, the multi-family group promotes an autonomy-supportive parental style. This article reports on the therapeutic model of the group and its consequences for the role of the parents in the treatment of eating disorders. The process of the multi-family format treatment is also explained and clinical vignettes given to illustrate the different therapeutic techniques. Finally, the benefits and limitations of the multi-family group are discussed. Practitioner points A multi-family group offers an excellent therapeutic context for changing role exercises, family sculpting and goldfish bowl discussions. Multi-family groups primarily make use of the resources of the different families and their discussions. Parents may experiment with autonomy-supportive parental behaviour in multi-family groups. Therapists play a more peripheral and less central role in multi-family groups than in single family therapy
Eating disorder (ED) patients show alarmingly high prevalence rates of Non-Suicidal Self-Injury (NSSI). Adolescents seem to be particularly at risk, as EDs and NSSI both have their onset in mid-adolescence. It has been suggested that personality could be a transdiagnostic mechanism underlying both EDs and NSSI. However, little attention has been given to adolescent clinical samples compared to adult and/or community samples. Therefore, the current study investigated the role of personality in a sample of 189 female inpatients with an ED (M = 15.93, SD = 0.98). Our results confirmed the high prevalence of NSSI in EDs, specifically in patients with bingeing/purging behaviours (ED-BP). Temperamental differences were found between ED-BP and the restrictive ED subtype (ED-R). Namely, ED-BP patients showed more harm avoidance and less self-directedness compared to ED-R. Temperamental differences were found in NSSI as well, regardless of ED subtype: ED patients who had engaged in NSSI during their lifetime reported less self-directedness and more harm avoidance. Interestingly, only ED patients who recently engaged in NSSI showed less novelty seeking. These temperamental profiles should be recognised as key mechanisms in the treatment of adolescent ED patients with and without NSSI.
Background and Aims In the present study, we investigated differences in obsessive–compulsive (OC) symptoms in patients with an eating disorder (ED) with or without recent/lifetime impulsive non‐suicidal self‐injury (NSSI). We included 429 female inpatients with an ED, of whom 31.9% engaged in recent impulsive NSSI and 56.4% in lifetime impulsive NSSI. Materials They filled out the Eating Disorder Evaluation Scale, the Self‐Injury Questionnaire‐Treatment Related and the Padua Inventory‐Revised (OC symptoms). Methods and Results Patients with anorexia nervosa, binge‐eating/purging type (AN‐BP) and bulimia nervosa (BN) engaged more frequently in recent/lifetime impulsive NSSI compared to patients with anorexia nervosa, restrictive‐type (AN‐R). Two MANCOVAs with OC symptoms as dependent variables, and ED subtypes and recent/lifetime impulsive NSSI as independent variables controlling for age and body mass index showed the main effects of ED subtypes and recent/lifetime impulsive NSSI. Patients with AN‐BP reported significantly more impulses (i.e., being afraid of losing control over motor behaviours) compared to patients with AN‐R and BN. ED patients with impulsive recent/lifetime NSSI scored significantly higher on all OC scales compared to patients without NSSI. Discussion and Conclusion In sum, the presence of recent/lifetime impulsive NSSI in patients with an ED seems to be related to more severe OC symptoms. Hence, this comorbidity needs to be addressed in psychotherapy, such as in transdiagnostic cognitive behavioural therapy for EDs.
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