A controlled comparison of family versus individual therapy for adolescents with anorexia nervosa.
OBJECTIVE
To compare the effectiveness of behavioral family systems therapy (BFST) with that of ego-oriented individual therapy (EOIT) as treatments for adolescents with anorexia nervosa.


METHODS
Thirty-seven adolescents meeting DSM-III-R criteria for anorexia nervosa were randomly assigned to receive BFST or EOIT, in addition to a common medical and dietary regimen. In BFST, the family was seen conjointly, the parents were placed in control of the adolescent's eating, distorted beliefs were targeted through cognitive restructuring, and strategic/behavioral interventions were used to change family interactions. In EOIT, the adolescent was seen individually, with an emphasis on building ego strength and uncovering the dynamics blocking eating; parents were seen collaterally. Measures administered before, after, and at 1-year follow-up tapped body mass index, menstruation, eating attitudes, ego functioning, depression, and family interactions.


RESULTS
BFST produced greater weight gain and higher rates of resumption of menstruation than EOIT. Both treatments produced comparably large improvements in eating attitudes, depression, and eating-related family conflict, but very few changes occurred on ego functioning.


CONCLUSIONS
BFST and EOIT proved to be effective treatments for adolescents with anorexia nervosa, but BFST produced a faster return to health.
Robin
A L
AL
Wayne State University, Detroit, USA. arobin@med.wayne.edu
Siegel
P T
PT
Moye
A W
AW
Gilroy
M
M
Dennis
A B
AB
Sikand
A
A
D000293:Adolescent; D000856:Anorexia Nervosa / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001008:Anxiety Disorders / Q000150:complications / Q000175:diagnosis; D015992:Body Mass Index; D005195:Family Relations; D005196:Family Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000150:complications / Q000175:diagnosis; D010290:Parents / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012649:Self Concept; D016896:Treatment Outcome