Breaking the Cycle of Risk: Intervention for Mothers with Eating Disorders

描述（由申请人提供）：虽然饮食失调，特别是神经性厌食症，会影响生育能力，但许多有饮食失调和饮食失调病史的女性正在成为母亲。这些妇女中的许多人在怀孕期间难以获得足够的营养，开始和维持母乳喂养，充分喂养他们的孩子，调节对他们孩子饮食的期望，以及判断他们孩子的正常和病态。这些母亲非常积极地寻求指导，以帮助减少孩子患饮食失调症的风险。这项拟议的探索性研究补助金（R34）旨在为目前或过去患有饮食失调症的母亲制定一项育儿干预措施，称为网络，团结和接触以提升关系和饮食。我们的干预措施是基于来自饮食失调母亲焦点小组和现有研究的初步信息。我们将系统地开发一个手动干预的母亲与阈值和阈下饮食失调的历史谁有0-2岁之间的孩子。该R34的具体目标是：1）为患有进食障碍的母亲制定和标准化模块化手动干预措施，以促进治疗师培训和治疗传播; 2）在一项小型、随机、延迟入组的对照试验中实施ADMTURE，以确定可行性和可接受性; 2）评估立即使用ARMITURE治疗是否上级延迟进入对照以改善目标结局，以及4）识别治疗的潜在调节剂和介导剂。我们的主要结果将是观察者对母亲与孩子进餐时间互动录像的评分，次要结果将包括一般育儿自我效能和母亲行为的测量，这些行为增强了孩子的社会和情感成长。本试验将明确设计为收集初步结局数据，为后续更大规模的随机对照试验提供样本量和把握度计算信息。这项调查的结果有可能制定一个有效的和可接受的干预措施，这将提高喂养相关的和一般的饮食失调的母亲养育子女的功效。干预措施的扩展将包括适合不同年龄儿童的母亲发展的模块以及基于网络的变体，以优化干预措施的传播。

DESCRIPTION (provided by applicant): Although eating disorders, particularly anorexia nervosa, can affect fertility, many women with eating disorders and eating disorder histories are becoming mothers. Many of these women have difficulty achieving adequate nutrition during pregnancy, initiating and maintaining breastfeeding, adequately nourishing their children, modulating expectations regarding eating in their children, and judging what is normative and what is pathological in their children. These mothers are highly motivated to seek guidance to help reduce their children's risk of eating disorders. This proposed Exploratory Research Grant (R34) aims to develop a parenting intervention for mothers with current or past eating disorders called NURTURE (Networking, Uniting, and Reaching out To Upgrade Relationships and Eating). Our intervention is based on preliminary information from focus groups with mothers with eating disorders and extant research. We will systematically develop a manualized intervention for mothers with histories of threshold and subthreshold eating disorders who have children between the ages of 0-2. The specific aims of this R34 are: 1) to develop and standardize a modular manualized intervention for mothers with eating disorders to facilitate therapist training and treatment dissemination; 2) to implement NURTURE in a small, randomized, delayed entry controlled trial to determine feasibility and acceptability; 2) to evaluate whether immediate treatment with NURTURE is superior to a delayed entry control for improving targeted outcomes, and 4) to identify potential moderators and mediators of treatment. Our primary outcome will be observer ratings of videotaped maternal-child mealtime interactions and secondary outcomes will include measures of general parenting self-efficacy and maternal behaviors that enhance the social and emotional growth of their children. This trial will be designed explicitly to gather preliminary outcome data to inform sample size and power calculations for a subsequent larger randomized controlled trial. Results of this investigation have the potential to develop an effective and acceptable intervention that will improve both feeding-related and general parenting efficacy in mothers with eating disorders. Extensions of the intervention will include developmentally appropriate modules for mothers of children of various ages as well as web-based variants to optimize dissemination of the intervention.