期刊论文详细信息
BMC Psychiatry
Parent-focused treatment for adolescent anorexia nervosa: a study protocol of a randomised controlled trial
Susan M Sawyer3  Katharine L Loeb5  Ross D Crosby4  Erica Allan3  Stephanie Campbell2  Michele SM Yeo2  Andrew Court2  Daniel Le Grange1  Elizabeth K Hughes3 
[1] Psychiatry & Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Ave., MC3077 Chicago, IL 60637, USA;Centre for Adolescent Health, Royal Children’s Hospital, 50 Flemington Road, Parkville, Melbourne, VIC 3052, Australia;Murdoch Childrens Research Institute, Melbourne, Australia;Neuropsychiatric Research Institute and University of North Dakota School of Medicine and Health Sciences, 700 First Avenue South, Fargo 57103, North Dakota, USA;Fairleigh Dickinson University, 1000 River Road T-WH1-01, Teaneck, Hackensack, NJ 07666, USA
关键词: Randomised controlled trial;    Family therapy;    Adolescents;    Eating disorders;    Anorexia nervosa;   
Others  :  1123651
DOI  :  10.1186/1471-244X-14-105
 received in 2014-03-20, accepted in 2014-03-28,  发布年份 2014
PDF
【 摘 要 】

Background

Family-based treatment is an efficacious outpatient intervention for medically stable adolescents with anorexia nervosa. Previous research suggests family-based treatment may be more effective for some families when parents and adolescents attend separate therapy sessions compared to conjoint sessions. Our service developed a novel separated model of family-based treatment, parent-focused treatment, and is undertaking a randomised controlled trial to compare parent-focused treatment to conjoint family-based treatment.

Methods/Design

This randomised controlled trial will recruit 100 adolescents aged 12–18 years with DSM-IV anorexia nervosa or eating disorder not otherwise specified (anorexia nervosa type). The trial commenced in 2010 and is expected to be completed in 2015. Participants are recruited from the Royal Children’s Hospital Eating Disorders Program, Melbourne, Australia. Following a multidisciplinary intake assessment, eligible families who provide written informed consent are randomly allocated to either parent-focused treatment or conjoint family-based treatment. In parent-focused treatment, the adolescent sees a clinical nurse consultant and the parents see a trained mental health clinician. In conjoint family-based treatment, the whole family attends sessions with the mental health clinician. Both groups receive 18 treatment sessions over 6 months and regular medical monitoring by a paediatrician. The primary outcome is remission at end of treatment and 6 and 12 month follow up, with remission defined as being ≥ 95% expected body weight and having an eating disorder symptom score within one standard deviation of community norms. The secondary outcomes include partial remission and changes in eating pathology, depressive symptoms and self-esteem. Moderating and mediating factors will also be explored.

Discussion

This will be first randomised controlled trial of a parent-focused model of family-based treatment of adolescent anorexia nervosa. If found to be efficacious, parent-focused treatment will offer an alternative approach for clinicians who treat adolescents with anorexia nervosa.

Trial registration

Australian and New Zealand Clinical Trials Registry ACTRN12610000216011.

【 授权许可】

   
2014 Hughes et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150216041326884.pdf 299KB PDF download
Figure 1. 64KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]American Psychiatric Association: Diagnostic and statistical manual of mental disorders. 5th edition. Washington DC: American Psychiatric Publishing; 2013.
  • [2]Herpertz-Dahlmann B: Adolescent eating disorders: Definitions, symptomatology, epidemiology and comorbidity. Child Adolesc Psychiatr Clin N Am 2009, 18:31-47.
  • [3]Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR: Prevalence and correlates of eating disorders in adolescents: Results from the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatry 2011, 68:714-723.
  • [4]Russell GF, Szmukler GI, Dare C, Eisler I: An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Arch Gen Psychiatry 1987, 44:1047-1056.
  • [5]Le Grange D, Eisler I, Dare C, Russell GF: Evaluation of family treatments in adolescent anorexia nervosa: A pilot study. Int J Eat Disord 1992, 12:347-358.
  • [6]Eisler I, Dare C, Hodes M, Russell GFM, Dodge E, Le Grange D: Family therapy for adolescent anorexia nervosa: The results of a controlled comparison of two family interventions. J Child Psychol Psychiatry 2000, 41:727-736.
  • [7]Lock J, Agras S, Bryson S, Kraemer H: A comparison of short- and long-term family therapy for adolescent anorexia nervosa. J Am Acad Child Adolesc Psychiatry 2005, 44:632-639.
  • [8]Lock J, Le Grange D, Agras WS, Moye A, Bryson SW, Jo B: Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa. Arch Gen Psychiatry 2010, 67:1025-1032.
  • [9]Lock J, Le Grange D: Treatment manual for anorexia nervosa: A family-based approach. 2nd edition. New York: Guilford Press; 2013.
  • [10]Le Grange D, Eisler I, Dare C, Hodes M: Family criticism and self-starvation: A study of expressed emotion. J Fam Ther 1992, 14:177-192.
  • [11]Eisler I, Simic M, Russell GF, Dare C: A randomised controlled treatment trial of two forms of family therapy in adolescent anorexia nervosa: A five-year follow-up. J Child Psychol Psychiatry 2007, 48:552-560.
  • [12]Couturier J, Kimber M, Jack S, Niccols A, Van Blyderveen S, McVey G: Understanding the uptake of family-based treatment for adolescents with anorexia nervosa: Therapist perspectives. Int J Eat Disord 2012, 46:177-188.
  • [13]Morgan HG, Russell GFM: Value of family background and clinical features as predictors of long-term outcome in anorexia nervosa: Four-year follow-up study of 41 patients. Psychol Med 1975, 5:355-371.
  • [14]Kazdin AE: Parent management training: Treatment for oppositional, aggressive, and antisocial behavior in children and adolescents. New York, NY: Oxford University Press; 2005.
  • [15]Hughes EK, Le Grange D, Court A, Yeo M, Campbell S, Whitelaw M, Atkins L, Sawyer SM: Implementation of family-based treatment for adolescents with anorexia nervosa. J Pediatr Health Carein press, Accepted 17 July 2013
  • [16]American Psychiatric Association: Diagnostic and statistical manual of mental disorders. 4th edition. Washington DC: American Psychiatric Press; 2000.
  • [17]Centres for Disease Control: Clinical Growth Charts. http://www.cdc.gov webcite
  • [18]American Academy of Pediatrics: Identifying and treating eating disorders. Pediatr Rev 2003, 111:204-211.
  • [19]Hughes EK, Sawyer SM, Loeb KL, Le Grange D: Parent-focused treatment. In Family therapy for adolescent eating and weight disorders: New applications. Edited by Loeb KL, Le Grange D. New York, NY: Routledge/Taylor & Francis Group; 2014.
  • [20]Cooper Z, Fairburn C: The eating disorder examination: a semi-structured interview for the assessment of the specific psychopathology of eating disorders. Int J Eat Disord 1987, 6:1-8.
  • [21]Fairburn CG, Cooper Z: The eating disorder examination (Twelfth Edition). In Binge Eating: Nature, Assessment and Treatment. Edited by Fairburn CG, Wilson GT. New York, NY: The Guilford Press; 1993:317-360.
  • [22]Berg KC, Peterson CB, Frazier P, Crow SJ: Psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. Int J Eat Disord 2011, 45:428-438.
  • [23]Eddy KT, Doyle AC, Hoste RR, Herzog DB, Le Grange D: Eating disorder not otherwise specified in adolescents. J Am Acad Child Adolesc Psychiatry 2008, 47:156-164.
  • [24]Loeb KL: Eating Disorder Examination: Parent Version. New York, NY: Mount Sinai Medical School; 2008.
  • [25]Loeb KL, Brown M, Goldstein MM: Assessment of eating disorders in children and adolescents. In Eating disorders in children and adolescents: A clinical handbook. Edited by Le Grange D, Lock J. New York, NY: The Guildford Press; 2011:156-198.
  • [26]Sheehan DV: Mini International Neuropsychiatric Interview v6.0. Jacksonville, FA: Medical Outcome Systems; 2010.
  • [27]Lecrubier Y, Sheehan DV, Weiller E, Amorim P, Bonora I, Sheehan KH, Janavs J, Dunbar GC: The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry 1997, 12:224-231.
  • [28]Sheehan DV, Lecrubier Y, Sheehan KH, Janavs J, Weiller E, Keskiner A, Schinka J, Knapp E, Sheehan MF, Dunbar GC: The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability. Eur Psychiatry 1997, 12:232-241.
  • [29]Scahill L, Riddle MA, McSwiggin-Hardin M, Sharon IO, King RA, Goodman WK, Cicchetti D, Leckman JF: Children’s Yale-Brown Obsessive Compulsive Scale: Reliability and validity. J Am Acad Child Adolesc Psychiatry 1997, 36:844-852.
  • [30]Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS: The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability. Arch Gen Psychiatry 1989, 46:1006-1011.
  • [31]Mazure CM, Halmi KA, Sunday SR, Romano SJ, Einhorn AM: The Yale-Brown-Cornell Eating Disorder Scale: Development, use, reliability and validity. J Psychiatr Res 1994, 28:425-445.
  • [32]Jordan J, Joyce PR, Carter FA, McIntosh VVW, Luty SE, McKenzie JM, Frampton CMA, Bulik CM: The Yale-Brown-Cornell Eating Disorder Scale in women with anorexia nervosa: What is it measuring? Int J Eat Disord 2009, 42:267-274.
  • [33]Magana AB, Goldstein MJ, Karno M, Miklowitz DJ: A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatry Res 1986, 17:203-212.
  • [34]Leeb B, Hahlweg K, Goldstein MJ, Feinstein E: Cross-national reliability, concurrent validity, and stability of a brief method for assessing expressed emotion. Psychiatry Res 1991, 39:25-31.
  • [35]Rein Z, Perdereau F, Curt F, Jeammet P, Fermanian J, Godart N: Expressed emotion and anorexia nervosa: The validation of the Five-Minute Speech Sample in reference to the Camberwell Family Interview. Int J Eat Disord 2006, 39:217-223.
  • [36]Leff JP, Vaughn CE: Expressed emotion in families. New York: Guilford Press; 1985.
  • [37]Derogatis LR: Symptom Checklist-90-Revised. San Antonio, TX: Pearson Assessments; 1994.
  • [38]Caparros-Caparros B, Villar-Hoz E, Juan-Ferrer J, Vinas-Poch F: Symptom Checklist-90-R: Psychometric properties in a representative sample of university students. Int J Clin Health Psychol 2007, 7:781-794.
  • [39]Schmitz N, Hartkamp N, Kiuse J, Franke GH, Reister G, Tress W: The Symptom Check-List-90-R (SCL-90-R): A German validation study. Qual Life Res 2000, 9:185-193.
  • [40]Moos RH, Moos BS: Family Environment Scale manual and sampler set: Development, applications and research. 4th edition. Menlo Park, CA: Mind Garden Inc.; 2009.
  • [41]Boyd CP, Gullone E, Needleman GL, Burt T: The Family environment scale: reliability and normative data for an adolescent sample. Fam Process 1997, 36:369-373.
  • [42]Poreh AM, Rawlings D, Claridge G, Freeman JL, Faulkner C, Shelton C: The BPQ: A scale for the assessment of borderline personality based on DSM-IV criteria. J Personal Disord 2006, 20:247-260.
  • [43]Fonseca-Pedrero E, Paino M, Lemos-Giraldez S, Sierra-Baigrie S, Gonzalez M, Bobes J, Muniz J: Borderline personality traits in nonclinical young adults. J Personal Disord 2011, 25:542-556.
  • [44]Chanen A, Jovev M, Djaja D, McDougall E, Yuen H, Rawlings D, Jackson H: Screening for borderline personality disorder in outpatient youth. J Personal Disord 2008, 22:353-364.
  • [45]Kovacs M: Children’s Depression Inventory technical manual. Ontario, Canada: Multi-Health Systems; 1992.
  • [46]Craighead WE, Smucker MR, Craighead LW, Ilardi SS: Factor analysis of the Children’s Depression Inventory in a community sample. Psychol Assess 1998, 10:156-165.
  • [47]Smucker MR, Craighead WE, Craighead LW, Green BJ: Normative and reliability data for the Children’s Depression Inventory. J Abnorm Child Psychol 1986, 14:25-39.
  • [48]Rosenberg M: Society and the adolescent self-image. Princeton, NJ: Princeton University Press; 1965.
  • [49]Huang C, Dong N: Factor structures of the Rosenberg Self-Esteem Scale: A meta-analysis of pattern matrices. Eur J Psychol Assess 2012, 28:132-138.
  • [50]Fairburn CG, Belgin S: Eating Disorder Examination Questionnaire (EDE-Q 6.0). 2008.
  • [51]Luce KH, Crowther JH: The reliability of the Eating Disorder Examination-Self-Report Questionnaire Version (EDE-Q). Int J Eat Disord 1999, 25:349-351.
  • [52]Binford RB, Le Grange D, Jellar CC: Eating disorder examination versus eating disorder examination-questionnaire in adolescents with full and partial-syndrome bulimia nervosa and anorexia nervosa. Int J Eat Disord 2005, 37:44-49.
  • [53]Watson D, Clark LA: Manual for the Positive and Negative Affect Schedule - Expanded Form. In Book Manual for the Positive and Negative Affect Schedule - Expanded Form. City: The University of Iowa; 1994.
  • [54]Watson D, Clark LA, Tellegen A: Development and validation of brief measures of Positive and Negative Affect: The PANAS Scales. J Pers Soc Psychol 1988, 54:1063-1070.
  • [55]Rhodes P, Baillie A, Brown J, Madden S: Parental efficacy in the family-based treatment of anorexia: Preliminary development of the Parents Versus Anorexia Scale (PVA). Eur Eat Disord Rev 2005, 13:399-405.
  • [56]Zaitsoff SL, Doyle AC, Hoste RR, le Grange D: How do adolescents with bulimia nervosa rate the acceptability and therapeutic relationship in family-based treatment? Int J Eat Disord 2008, 41:390-398.
  • [57]Luborsky P: Principles of psychoanalytic psychotherapy. New York: Basic Books; 1984.
  • [58]Agras WS, Walsh BT, Fairburn CG, Wilson GT, Kraemer HC: A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa. Arch Gen Psychiatry 2000, 57:459-466.
  • [59]Gibbons RD, Hedeker D, Elkin I, Waternaux C, Kraemer HC, Greenhouse JB, Shea MT, Imber SD, Sotsky SM, Watkins JT: Some conceptual and statistical issues in analysis of longitudinal psychiatric data: application to the NIMH treatment of depression collaborative research program dataset. Arch Gen Psychiatry 1993, 50:739-750.
  • [60]Hayes AF: Introduction to mediation, moderation, and conditional process analysis. London: Guilford Press; 2013.
  • [61]Stiles-Shields C, Hoste RR, Doyle PM, Le Grange D: A review of family based treatment for adolescents with eating disorders. Rev Recent Clin Trials 2012, 7:133-140.
  • [62]Couturier J, Kimber M, Szatmari P: Efficacy of family-based treatment for adolescents with eating disorders: A systematic review and meta-analysis. Int J Eat Disord 2013, 46:3-11.
  • [63]Dalle Grave R, Calugi S, Doll HA, Fairburn CG: Enhanced cognitive behaviour therapy for adolescents with anorexia nervosa: An alternative to family therapy? Behav Res Ther 2013, 51:R9-R12.
  • [64]Le Grange D, Lock J, Agras WS, Moye A, Bryson SW, Jo B, Kraemer HC: Moderators and mediators of remission in family-based treatment and adolescent focused therapy for anorexia nervosa. Behav Res Ther 2012, 50:85-92.
  • [65]Whitelaw M, Gilbertson H, Lee KJ, Creati MB, Sawyer SM: A new phenotype of anorexia nervosa: The changing shape of eating disorders. J Eat Disord 1:O44. in press
  文献评价指标  
  下载次数:1次 浏览次数:9次