Supporting <scp>C</scp>arers of <scp>C</scp>hildren and <scp>A</scp>dolescents with <scp>E</scp>ating <scp>D</scp>isorders in <scp>A</scp>ustria (<scp>SUCCEAT</scp>): Study protocol for a randomised controlled trial

et al. 2020

JCM

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High expressed emotion (EE) is common in caregivers of patients with anorexia nervosa (AN) and associated with poorer outcome for patients. In this study, we examined the prevalence of high EE in caregivers of adolescents with AN and analyzed predictors for EE using multivariate linear regression models. We further analyzed whether EE is reduced by the “Supporting Carers of Children and Adolescents with Eating Disorders in Austria” (SUCCEAT) intervention using general linear mixed models and whether a reduction of EE predicts patients’ outcomes. Caregivers were randomly allocated to the SUCCEAT workshop (N = 50) or online intervention (N = 50) and compared to a comparison group (N = 49). EE and patients’ outcomes were assessed at the baseline, post-intervention, and at the 12-month follow-up. Up to 47% of caregivers showed high EE. Lower caregiver skills, higher AN symptom impact, higher levels of depression and motivation to change in caregivers were significant predictors for high EE. EE significantly decreased in the SUCCEAT groups and the comparison group according to the caregivers’, but not the patients’ perspective. The level of reduction could partially predict subjective improvement and improvement in clinically assessed AN symptoms and body mass index of patients. Implementing interventions for caregivers addressing EE in the treatment of adolescents with AN is strongly recommended.

Section: Methodsmentioning

confidence: 99%

Section: Recruitment and Randomisationmentioning

confidence: 99%

Section: Interventionsmentioning

confidence: 99%

“…In addition, self-assessments for caregivers were used to explore predictors of high EE and associations with perceived changes as described below (for details, see Franta et al [28]).…”

Section: Assessment Measuresmentioning

confidence: 99%

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Reduction of High Expressed Emotion and Treatment Outcomes in Anorexia Nervosa—Caregivers’ and Adolescents’ Perspective

et al. 2020

JCM

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“…The aim of this study was to compare the feasibility and explore the potential long-term efficacy of "Supporting Carers of Children and Adolescents with Eating Disorders in Austria" (SUCCEAT) programme delivered as a workshop or online programme for carers (usually parents) of adolescent patients. The objective of SUCCEAT is to decrease carers' burden by accrediting them with skills and knowledge, in order to increase their ability to better support their affected children and adolescents [26]. We hypothesise that parents participating in SUCCEAT show a statistically significant reduction of distress, burden and psychiatric symptoms at the post-intervention and at 12-month FU.…”

Section: Introductionmentioning

confidence: 98%

Long-Term Efficacy of the Workshop Vs. Online SUCCEAT (Supporting Carers of Children and Adolescents with Eating Disorders) Intervention for Parents: A Quasi-Randomised Feasibility Trial

et al. 2020

JCM

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Interventions for main carers of adult patients with anorexia nervosa (AN) can reduce the caregiving burden and increase caregiver skills. However, the effectiveness and feasibility for carers of adolescent patients, the optimal form of the intervention and long-term outcomes are largely unknown. We evaluated the efficacy and feasibility of the “Supporting Carers of Children and Adolescents with Eating Disorders in Austria” (SUCCEAT) workshop vs. online intervention. Main caregivers (parents) of adolescent patients with AN were randomly allocated to a workshop (n = 50) or online version (n = 50). Participants were compared to a non-randomised comparison group (n = 49) receiving multi-family or systemic family therapy. Primary (General Health Questionnaire) and secondary outcomes were obtained at baseline, three-month and 12-month follow-up. Adherence was high for workshop and online participants (6.2 and 6.7 sessions completed out of 8). Intention-to-treat analyses revealed significant pre–post reductions in the primary outcome for the workshop (d = 0.87 (95%conficence interval (CI): 0.48; 1.26)) and online (d = 0.65 (95%CI: 0.31; 0.98)) intervention that were sustained at the 12-month follow-up. There was no significant group difference (p = 0.473). Parental psychopathology and burden decreased and caregiver skills increased in all groups; the improvement of caregiver skills was significantly higher in SUCCEAT participants than in the comparison group. Online interventions for parents of adolescents with AN were equally effective as workshops. The improvements remained stable over time.

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

Euro Eating Disorders Rev

et al. 2020

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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.