Charting the Path: Psychological Factors and Diet Adherence in Adolescents With Celiac Disease

Methodological Approaches to Assess Disordered Eating Behaviors Related to Gluten-Free Diet Management in Children and Adolescents with Celiac Disease: A Scoping Review

“…Results indicate that dietary restrictions for one family member can lead to changes in family eating practices, including increased consumption of ultra-processed foods and less structured eating patterns. The analysis also identified consistent differences between adolescents’ self-reports and parental proxy-reports, highlighting that the dietary burden varies by caregiving role and underscoring the importance of using multiple information sources to assess the psychosocial impact of treatment [ 33 , 39 ].…”

“…There is currently no consensus on the most suitable instruments to capture the complexities of a context in which strict, lifelong adherence to a GFD is the sole treatment option. Consequently, the literature has employed a diverse range of assessment instruments, reflecting both the complexity of the phenomenon, the evolution of the methodological strategies adopted and different analytical priorities, which can be grouped into: disease-specific experiences of living with CD [ 31 , 45 ]; eating pathology and maladaptive patterns [ 37 , 38 , 40 , 43 , 46 , 48 ]; broader psychosocial functioning screening [ 23 , 26 , 36 , 39 ]; quality-of-life assessments [ 11 , 24 ]; and dietary habits and adherence behavior [ 33 , 41 ].…”

“…These instruments revealed that dietary transgressions are mainly linked to anger about restrictions and shame in social situations [ 23 , 26 ], and that these feelings often persist even after clinical improvement and reduced overall stress [ 36 ]. More recently, a prospective study examined psychosocial functioning by exploring resilience and mindfulness in disease self-management [ 39 ]. Sequential assessments of mindfulness, resilience, psychosocial difficulties, and dietary adherence revealed a paradox: while dietary adherence improved, mindfulness and resilience declined, suggesting possible psychological resource depletion from sustained dietary control [ 39 ].…”

“…More recently, a prospective study examined psychosocial functioning by exploring resilience and mindfulness in disease self-management [ 39 ]. Sequential assessments of mindfulness, resilience, psychosocial difficulties, and dietary adherence revealed a paradox: while dietary adherence improved, mindfulness and resilience declined, suggesting possible psychological resource depletion from sustained dietary control [ 39 ].…”

“…Across the included studies, an additional methodological distinction emerges regarding the source of information, ranging from a single subject responding to children and caregivers as sources. The simultaneous application of instruments to children/adolescents and caregivers was used to assess quality of life, psychopathological symptoms, and family habits [ 31 , 33 , 39 , 45 , 48 ], also including the combination of interviews with children and parental questionnaires [ 23 ]. In contrast, exclusive parental reports were more prevalent in psychosocial screenings or with younger children [ 26 , 36 , 43 ], while self-reporting was preferred in investigations of eating experiences and behaviors among adolescents [ 11 , 24 , 37 , 38 , 40 , 41 , 46 ].…”

Methodological Approaches to Assess Disordered Eating Behaviors Related to Gluten-Free Diet Management in Children and Adolescents with Celiac Disease: A Scoping Review

“…Results indicate that dietary restrictions for one family member can lead to changes in family eating practices, including increased consumption of ultra-processed foods and less structured eating patterns. The analysis also identified consistent differences between adolescents’ self-reports and parental proxy-reports, highlighting that the dietary burden varies by caregiving role and underscoring the importance of using multiple information sources to assess the psychosocial impact of treatment [ 33 , 39 ].…”

“…There is currently no consensus on the most suitable instruments to capture the complexities of a context in which strict, lifelong adherence to a GFD is the sole treatment option. Consequently, the literature has employed a diverse range of assessment instruments, reflecting both the complexity of the phenomenon, the evolution of the methodological strategies adopted and different analytical priorities, which can be grouped into: disease-specific experiences of living with CD [ 31 , 45 ]; eating pathology and maladaptive patterns [ 37 , 38 , 40 , 43 , 46 , 48 ]; broader psychosocial functioning screening [ 23 , 26 , 36 , 39 ]; quality-of-life assessments [ 11 , 24 ]; and dietary habits and adherence behavior [ 33 , 41 ].…”

“…These instruments revealed that dietary transgressions are mainly linked to anger about restrictions and shame in social situations [ 23 , 26 ], and that these feelings often persist even after clinical improvement and reduced overall stress [ 36 ]. More recently, a prospective study examined psychosocial functioning by exploring resilience and mindfulness in disease self-management [ 39 ]. Sequential assessments of mindfulness, resilience, psychosocial difficulties, and dietary adherence revealed a paradox: while dietary adherence improved, mindfulness and resilience declined, suggesting possible psychological resource depletion from sustained dietary control [ 39 ].…”

“…More recently, a prospective study examined psychosocial functioning by exploring resilience and mindfulness in disease self-management [ 39 ]. Sequential assessments of mindfulness, resilience, psychosocial difficulties, and dietary adherence revealed a paradox: while dietary adherence improved, mindfulness and resilience declined, suggesting possible psychological resource depletion from sustained dietary control [ 39 ].…”

“…Across the included studies, an additional methodological distinction emerges regarding the source of information, ranging from a single subject responding to children and caregivers as sources. The simultaneous application of instruments to children/adolescents and caregivers was used to assess quality of life, psychopathological symptoms, and family habits [ 31 , 33 , 39 , 45 , 48 ], also including the combination of interviews with children and parental questionnaires [ 23 ]. In contrast, exclusive parental reports were more prevalent in psychosocial screenings or with younger children [ 26 , 36 , 43 ], while self-reporting was preferred in investigations of eating experiences and behaviors among adolescents [ 11 , 24 , 37 , 38 , 40 , 41 , 46 ].…”

Methodological Approaches to Assess Disordered Eating Behaviors Related to Gluten-Free Diet Management in Children and Adolescents with Celiac Disease: A Scoping Review

“…Results indicate that dietary restrictions for one family member can lead to changes in family eating practices, including increased consumption of ultra-processed foods and less structured eating patterns. The analysis also identified consistent differences between adolescents’ self-reports and parental proxy-reports, highlighting that the dietary burden varies by caregiving role and underscoring the importance of using multiple information sources to assess the psychosocial impact of treatment [ 33 , 39 ].…”

“…There is currently no consensus on the most suitable instruments to capture the complexities of a context in which strict, lifelong adherence to a GFD is the sole treatment option. Consequently, the literature has employed a diverse range of assessment instruments, reflecting both the complexity of the phenomenon, the evolution of the methodological strategies adopted and different analytical priorities, which can be grouped into: disease-specific experiences of living with CD [ 31 , 45 ]; eating pathology and maladaptive patterns [ 37 , 38 , 40 , 43 , 46 , 48 ]; broader psychosocial functioning screening [ 23 , 26 , 36 , 39 ]; quality-of-life assessments [ 11 , 24 ]; and dietary habits and adherence behavior [ 33 , 41 ].…”

“…These instruments revealed that dietary transgressions are mainly linked to anger about restrictions and shame in social situations [ 23 , 26 ], and that these feelings often persist even after clinical improvement and reduced overall stress [ 36 ]. More recently, a prospective study examined psychosocial functioning by exploring resilience and mindfulness in disease self-management [ 39 ]. Sequential assessments of mindfulness, resilience, psychosocial difficulties, and dietary adherence revealed a paradox: while dietary adherence improved, mindfulness and resilience declined, suggesting possible psychological resource depletion from sustained dietary control [ 39 ].…”

“…More recently, a prospective study examined psychosocial functioning by exploring resilience and mindfulness in disease self-management [ 39 ]. Sequential assessments of mindfulness, resilience, psychosocial difficulties, and dietary adherence revealed a paradox: while dietary adherence improved, mindfulness and resilience declined, suggesting possible psychological resource depletion from sustained dietary control [ 39 ].…”

“…Across the included studies, an additional methodological distinction emerges regarding the source of information, ranging from a single subject responding to children and caregivers as sources. The simultaneous application of instruments to children/adolescents and caregivers was used to assess quality of life, psychopathological symptoms, and family habits [ 31 , 33 , 39 , 45 , 48 ], also including the combination of interviews with children and parental questionnaires [ 23 ]. In contrast, exclusive parental reports were more prevalent in psychosocial screenings or with younger children [ 26 , 36 , 43 ], while self-reporting was preferred in investigations of eating experiences and behaviors among adolescents [ 11 , 24 , 37 , 38 , 40 , 41 , 46 ].…”

Methodological Approaches to Assess Disordered Eating Behaviors Related to Gluten-Free Diet Management in Children and Adolescents with Celiac Disease: A Scoping Review

“…Results indicate that dietary restrictions for one family member can lead to changes in family eating practices, including increased consumption of ultra-processed foods and less structured eating patterns. The analysis also identified consistent differences between adolescents’ self-reports and parental proxy-reports, highlighting that the dietary burden varies by caregiving role and underscoring the importance of using multiple information sources to assess the psychosocial impact of treatment [ 33 , 39 ].…”

“…There is currently no consensus on the most suitable instruments to capture the complexities of a context in which strict, lifelong adherence to a GFD is the sole treatment option. Consequently, the literature has employed a diverse range of assessment instruments, reflecting both the complexity of the phenomenon, the evolution of the methodological strategies adopted and different analytical priorities, which can be grouped into: disease-specific experiences of living with CD [ 31 , 45 ]; eating pathology and maladaptive patterns [ 37 , 38 , 40 , 43 , 46 , 48 ]; broader psychosocial functioning screening [ 23 , 26 , 36 , 39 ]; quality-of-life assessments [ 11 , 24 ]; and dietary habits and adherence behavior [ 33 , 41 ].…”

“…These instruments revealed that dietary transgressions are mainly linked to anger about restrictions and shame in social situations [ 23 , 26 ], and that these feelings often persist even after clinical improvement and reduced overall stress [ 36 ]. More recently, a prospective study examined psychosocial functioning by exploring resilience and mindfulness in disease self-management [ 39 ]. Sequential assessments of mindfulness, resilience, psychosocial difficulties, and dietary adherence revealed a paradox: while dietary adherence improved, mindfulness and resilience declined, suggesting possible psychological resource depletion from sustained dietary control [ 39 ].…”

“…More recently, a prospective study examined psychosocial functioning by exploring resilience and mindfulness in disease self-management [ 39 ]. Sequential assessments of mindfulness, resilience, psychosocial difficulties, and dietary adherence revealed a paradox: while dietary adherence improved, mindfulness and resilience declined, suggesting possible psychological resource depletion from sustained dietary control [ 39 ].…”

“…Across the included studies, an additional methodological distinction emerges regarding the source of information, ranging from a single subject responding to children and caregivers as sources. The simultaneous application of instruments to children/adolescents and caregivers was used to assess quality of life, psychopathological symptoms, and family habits [ 31 , 33 , 39 , 45 , 48 ], also including the combination of interviews with children and parental questionnaires [ 23 ]. In contrast, exclusive parental reports were more prevalent in psychosocial screenings or with younger children [ 26 , 36 , 43 ], while self-reporting was preferred in investigations of eating experiences and behaviors among adolescents [ 11 , 24 , 37 , 38 , 40 , 41 , 46 ].…”