title: A longitudinal examination of dyadic distress patterns following a skills intervention for carers of adolescents with anorexia nervosa.
abstract: Family interventions in anorexia nervosa (AN) have been developed to ameliorate maladaptive patterns of patient-carer interaction that can play a role in illness maintenance. The primary aim of this study is to examine the inter-relationship between baseline and post-treatment distress in dyads of carers and patients with AN to examine the interdependence between carers and patients. The secondary aim is to examine whether a carer skills intervention [Experienced Carer Helping Others (ECHO)] impacts on this inter-relationship. Dyads consisting of treatment-seeking adolescents with AN and their primary carer (n = 149; mostly mothers) were randomised to receive a carer skills intervention (ECHO) in addition to treatment as usual (TAU), or TAU alone, as part of a larger clinical trial. Carers and patients completed a standardised measure of psychological distress (The Depression, Anxiety, and Stress Scale) at baseline and 12 months post-treatment. The Actor Partner Interdependence Model was used to examine longitudinal changes in interdependence by treatment group. As expected, post-treatment levels of distress were related to baseline levels in both groups (actor effects). Moreover, carer distress at 12 months was related to patient distress at baseline for the TAU (partner effects), but not for the ECHO group. Finally, carers' distress change was not a significant predictor of patients' body mass index (BMI) change in the two treatment conditions. These findings are limited to predominantly mother-offspring dyads and may not generalise to other relationships. The ECHO intervention which is designed to teach carers skills in illness management and emotion regulation may be an effective addition to TAU for ameliorating interdependence of distress in patients and their primary carers over time.
authors.affiliation: Department of Psychology and Educational Sciences, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy. laurasalerno81@hotmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Salerno
authors.affiliation: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Rhind
authors.affiliation: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & 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, USA.
authors.forename: Nadia
authors.initials: N
authors.lastname: Micali
authors.affiliation: Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & 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 & 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 & 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 & 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 Psychology and Educational Sciences, University of Palermo, Viale delle Scienze, Edificio 15, 90128, 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 & Neuroscience, King's College London, London, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000523:psychology* / Q000628:therapy*; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D017028:Caregivers / Q000523:psychology* / Q000639:trends; D002648:Child; D003863:Depression / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D013315:Stress, Psychological / Q000523:psychology* / Q000628:therapy*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Actor–Partner Interdependence Model (APIM); Anorexia nervosa; Caregiving; Clinical trial; Distress; Longitudinal study