Relation between increasing attachment security and weight gain: a clinical study of adolescents and their parents at an outpatient ward.

IF 2.9 3区医学 Q2 PSYCHIATRY

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Pub Date : 2023-10-10 DOI:10.1007/s40519-023-01611-x

Christina M E Gezelius, Björn A Wahlund, Britt M Wiberg

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Abstract

Purpose: We wanted to evaluate the impact of a relational focus in the treatment of adolescent ED-patients and their parents at an intensive outpatient ward, based on attachment theory, combined with a family approach and psychodynamic principles. Our aim was to investigate the distribution of different attachment styles among the adolescent ED-patients and their parents, and to find out if they could change by the treatment.

Methods: Swedish adolescents (n = 33; 3 boys, 30 girls) and their parents (n = 60; 34 mothers, 26 fathers) participated.

Measures: Attachment Style Questionnaire (ASQ), Body Mass Index (BMI) and Children's Global Assessment Scale (CGAS) before and after treatment.

Results: The adolescents were high on Need for Approval (ASQ4) of the Insecure/Anxious scale before treatment (in contrast to the parents). The patients had a significant decrease in ASQ4 after treatment, which correlated inversely to the increase in BMI but not to CGAS. The mothers showed features of the Secure/Confident style, fathers of the Insecure/Avoidant with elevated Relationships as Secondary (ASQ2).

Conclusions: Treatment with a relational and a family focus has impact on attachment insecurity in adolescent ED-patients and outcomes in terms of BMI. It is important to engage the parents, who need to help the adolescents to separate at that developmental stage. A secure therapeutic context, which enables mentalizations and allows new relational experiences, is essential. The ASQ-instrument is useful in indicating how the treatment of ED-adolescents is proceeding.

Level of evidence: Level IV: evidence obtained from multiple time series with the intervention.

Abstract Image

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依恋安全感增强与体重增加之间的关系：门诊病房青少年及其父母的临床研究。

目的：我们想根据依恋理论，结合家庭方法和心理动力学原则，评估在重症门诊病房治疗青少年ED患者及其父母时关系焦点的影响。我们的目的是调查不同依恋风格在青少年ED患者及其父母中的分布，并了解他们是否会因治疗而改变。方法：瑞典青少年（n = 33；3名男孩，30名女孩）及其父母（n = 60；34位母亲、26位父亲）参加。测量方法：治疗前后依恋风格问卷（ASQ）、体重指数（BMI）和儿童整体评估量表（CGAS）。结果：治疗前，青少年在不安全/焦虑量表中的批准需求（ASQ4）较高（与父母相比）。治疗后，患者的ASQ4显著降低，这与BMI的增加呈负相关，但与CGAS无关。母亲表现出安全/自信型的特征，父亲表现出不安全/回避型的特点，次要关系提升（ASQ2）。结论：以关系和家庭为中心的治疗对青少年ED患者的依恋不安全感和BMI的结果有影响。重要的是要让父母参与进来，他们需要帮助青少年在那个发展阶段分开。一个安全的治疗环境是至关重要的，它可以使人精神化，并允许新的关系体验。ASQ工具有助于说明ED青少年的治疗进展情况。证据级别：第四级：通过干预从多个时间序列中获得的证据。

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来源期刊

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity 医学-精神病学

CiteScore

6.50

自引率

10.30%

发文量

170

审稿时长

>12 weeks

期刊介绍： Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity is a scientific journal whose main purpose is to create an international forum devoted to the several sectors of eating disorders and obesity and the significant relations between them. The journal publishes basic research, clinical and theoretical articles on eating disorders and weight-related problems: anorexia nervosa, bulimia nervosa, subthreshold eating disorders, obesity, atypical patterns of eating behaviour and body weight regulation in clinical and non-clinical populations.