title: The Objective and Subjective Caregiving Burden and Caregiving Behaviours of Parents of Adolescents with Anorexia Nervosa.
abstract: The study aimed to examine caregiving burden and levels of distress, accommodating behaviours, expressed emotion (EE) and carers' skills, in parents of adolescents with anorexia nervosa.
  
  
  
  A semi-structured interview assessed the objective burden (time spent across caregiving tasks) in parents (n = 196) of adolescents (n = 144) receiving outpatient treatment for anorexia nervosa. Subjective burden (carers' distress), accommodating behaviours, EE and carers' skills were measured by self-report.
  
  
  
  Mothers, on average, spent 2.5 h/day of care, mainly providing food and emotional support, compared with 1 h/day by fathers. The level of distress and accommodating behaviour was significantly lower in fathers than in mothers. Accommodating behaviours mediated the relationship between objective burden and subjective burden in mothers, whereas EE and carers' skills did not mediate this relationship for either parent.
  
  
  
  The objective burden for most mothers is high. In order to reduce subjective burden, it may be helpful to target accommodating behaviours.
  
  
  
  ISRCTN83003225 - Expert Carers Helping Others (ECHO). Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
authors.affiliation: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Rhind
authors.affiliation: Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Salerno
authors.affiliation: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hibbs
authors.affiliation: Behavioural and Brain Sciences Unit, Institute of Child Health, University College London, London, UK.|Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, US.
authors.forename: Nadia
authors.initials: N
authors.lastname: Micali
authors.affiliation: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Schmidt
authors.affiliation: Adolescent Psychiatry, University of Liverpool, Chester, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Gowers
authors.affiliation: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Pamela
authors.initials: P
authors.lastname: Macdonald
authors.affiliation: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Goddard
authors.affiliation: South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Gillian
authors.initials: G
authors.lastname: Todd
authors.affiliation: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|Ilia State University, Tbilisi, Georgia.
authors.forename: Kate
authors.initials: K
authors.lastname: Tchanturia
authors.affiliation: Department of Psychological and Educational Sciences, University of Palermo, Palermo, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Lo Coco
authors.affiliation: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D000856:Anorexia Nervosa / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D003863:Depression / Q000523:psychology; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D008297:Male; D008425:Maternal Behavior; D008875:Middle Aged; D009035:Mothers; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010332:Paternal Behavior; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: accommodating and enabling behaviours; anorexia nervosa; caregiving burden; carer skills; expressed emotion