A German version of the Caregiver Skills scale for caregivers of patients with anorexia nervosa

Abstract

To investigate acceptance, reliability, convergent validity, factor structure and sensitivity to change of a German translation of the Caregiver Skills (CASK) scale measuring skills related to caring for patients with eating disorders. Methods: Two hundred and thirty-three parents (76% female) of adolescent patients (mean age 15.1) with anorexia nervosa (AN) completed the 27 items of the CASK. We calculated item/scale characteristics, internal consistencies and bivariate correlations with other measures of caregiving burden. We evaluated goodness-of-fit of the 6-factor model using confirmatory factors analysis and explored the sensitivity to change following two skills-based trainings. Results: The fit of the 6-factor model was acceptable (Root Mean Square Error of Approximation: 0.077, Standard Root Mean Square Residual: 0.080). Cronbach's alpha was excellent for the total (.94) and acceptable for all subscales (0.73-0.85). The total CASK score was 68.04 (max. 100) showing relatively high self-rated caregiver skills. Non-completion rates of most items were low (<3%) indicating high acceptance. Convergent validity was found with measures of psychological distress, depression, anxiety and expressed emotion. The total score significantly increased following an 8-week workshop/online skills training (d ¼ 0.70) and a 2-day multi-family intervention (d ¼ 0.47). Discussion: The German CASK version is a useful instrument to assess caregiver skills in parents of patients with AN and to evaluate outcomes of skills-based trainings.

Does a Skills Intervention for Parents Have a Positive Impact on Adolescents’ Anorexia Nervosa Outcome? Answers from a Quasi-Randomised Feasibility Trial of SUCCEAT

“…Therefore, there is an urgent need to provide parents with specific skills and communication strategies to improve their own mental health in order to better support their children and facilitate their recovery. A high number of studies confirm that interventions for parents based on the cognitive interpersonal model of maintaining factors for EDs [ 10 , 11 , 12 ], developed by Treasure et al, can reduce parental burden, high expressed emotion (HEE) and distress and also improve caregiver skills in parents [ 13 , 14 , 15 , 16 ]. Online interventions based on this model, although far less investigated than workshop-based interventions [ 17 ], seem to show similar effectiveness when compared to in person workshops for parents [ 14 , 15 , 18 ].…”

Characteristics, correlates of burden and support service use of a help‐seeking carers of loved ones with an eating disorder

“…Participants' scores on validated scales are displayed in Table 3. The average EDSIS (carer burden) scores was significantly lower compared with prior samples of carers of a loved one with an ED [ M = 46.04, SD = 15.80, t (244) = −4.66, p < 0.001, SMD = 0.30 (Zeiler et al., 2023)], including predominantly Australian‐based samples [for example, (Hoyle et al., 2013): M = 44.10, SD = 14.21, t (244) = −2.67, p < 0.01, SMD = −0.17 and (Pépin & King, 2016): M = 43.90, SD = 13.08, t (244) = −2.47, p = 0.01, SMD = −0.16].…”

“…It is also important to determine the impact of positive carer skills (e.g., acceptance of the illness, emotional intelligence) on perceived burden, given many carer support programs [for example, Experienced Caregivers Helping Others (ECHO) and Collaborative Care Skills training (Rhind et al., 2014)] are skills‐based, teaching helpful emotion regulation, communication and self‐care skills. Skills‐based carer support programs have been found to improve caregiver skills (Truttmann et al., 2020; Zeiler et al., 2023) and reduce burden (Hibbs, Magill, et al., 2015; Hoyle et al., 2013; Pépin & King, 2016; Quiles et al., 2018; Truttmann et al., 2020; Zeiler et al., 2023). While carer skills have been prospectively linked with improvements in loved one's ED outcomes (Salerno et al., 2016), no observational study has examined the effect of carer skills on perceived burden to date, despite carer skills being the proposed mechanism of change of many carer support programs (Hibbs, Rhind, et al., 2015).…”

Families tackling adolescent anorexia nervosa: family wellbeing in family-based treatment or other interventions. A scoping review

“…Burden, both measured as general and ED-related distress, decreased significantly in both groups [ 62 ]. A sample of the same study investigating the psychometric properties of the German version of the Carer Skills (CASK) showed the same trends [ 63 ].…”