Predictors of early response in conjoint and separated models of family-based treatment for adolescent anorexia nervosa
Predictors of early response in conjoint and separated models of family-based treatment for adolescent anorexia nervosa
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DOI：
10.1002/erv.2668
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发表时间：
2019-05-01
影响因子：
5.3
通讯作者：
Le Grange, Daniel
中科院分区：
文献类型：
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作者：
Hughes, Elizabeth K.;Sawyer, Susan M.;Le Grange, Daniel
目的 在青少年神经性厌食症 (AN) 的家庭治疗 (FBT) 中，早期反应（以早期体重增加为标志）可预测治疗结束时的缓解。然而，人们对哪些因素有助于早期反应知之甚少。此外，之前还没有研究考察过对单独形式的 FBT 的早期反应。方法 对联合 FBT 和单独 FBT（以父母为中心的治疗，PFT）随机临床试验的数据进行分析，以检查预测缓解的早期体重增加的时间和数量，并确定与早期反应相关的因素。结果第 5 节时，FBT（N = 55）体重增加至少 2.80 kg，PFT（N = 51）体重增加至少 2.28 kg，是治疗结束时缓解的最佳预测指标。 FBT 的早期反应是通过更多的父亲治疗联盟和更少的父亲批评来预测的。 PFT 的早期反应是通过基线时不太严重的饮食失调症状和负面影响、较低的母亲批评和更大的青少年治疗联盟来预测的。结论 结果证实，早期体重增加是联合 FBT 和 PFT 的重要预后指标，并表明在治疗早期解决负面情绪、父母批评和治疗联盟可以提高缓解率。
Objective Early response, as indicated by early weight gain, in family-based treatment (FBT) for adolescent anorexia nervosa (AN) predicts remission at end of treatment. However, little is known about what factors contribute to early response. Further, no previous studies have examined early response to separated forms of FBT. Method Data from a randomised clinical trial of conjoint FBT and separated FBT (parent-focused treatment, PFT) were analysed to examine the timing and amount of early weight gain that predicted remission and identify factors associated with early response. Results Weight gain of at least 2.80 kg in FBT (N = 55) and 2.28 kg in PFT (N = 51), by Session 5, were the best predictors of remission at end of treatment. Early response in FBT was predicted by greater paternal therapeutic alliance and lower paternal criticism. Early response in PFT was predicted by less severe eating-disorder symptoms and negative affect at baseline, lower maternal criticism, and greater adolescent therapeutic alliance. Conclusions The results confirm that early weight gain is an important prognostic indicator in both conjoint FBT and PFT and suggest that addressing negative emotion, parental criticism, and therapeutic alliance early in treatment could improve remission rates.