Ecological Momentary Assessment for Adolescents With Anorexia Nervosa and Their Parents/Caregivers in Family-Based Treatment.

Abstract

Introduction: Studies have shown that early weight gain in family-based treatment (FBT) predicts treatment response in adolescents with anorexia nervosa (AN); however, research examining factors associated with early weight gain in FBT is limited. This study tested the feasibility and acceptability of ecological momentary assessment (EMA) in early FBT, particularly to capture momentary data on family climate during mealtimes.

Methods: Using multiple methods, quantitative (EMA) and qualitative (interviews) data were collected in the first 4 weeks of FBT. Participants (11 families; 9 adolescents, 19 parents/caregivers) completed EMA assessments daily on the emotional climate during meals, parental strategies and confidence/agreement in renourishment. Qualitative interviews obtained technological and procedural data using EMA. Completion rates and markers of change were explored using repeated measures ANOVA. Interviews were analyzed using reflexive thematic analysis.

Results: The EMA completion rate for all family members was 78%: 84% for adolescents, 83% for mothers, 64% for fathers. Results demonstrated changes in caregivers' use of renourishment strategies and in the emotional climate (decreased anger) at mealtimes. No changes were observed in caregiver confidence/agreement in renourishment. Qualitative analyses revealed factors interfering with and facilitating the use of EMA.

Discussion: EMA is an acceptable and feasible tool for use with adolescents and their families in early FBT, particularly to capture momentary data on family climate during mealtimes. Future research is needed with larger sample sizes to examine the mechanisms of change in early FBT, and the utility of EMA as a clinical tool in FBT.