Shifting strains: Parenting daily burden in girls with eating disorders-Assessed via the Questionnaire-Children with Difficulties.

Aim: This study evaluated daily functional difficulties among girls with EDs via the Questionnaire-Children with Difficulties (QCD). We examined the associations between daily functioning and physical, psychosocial, and clinical factors. Furthermore, we explored how school attendance status affected functioning during school hours and evenings.

Methods: We used the QCD and compared time-specific functioning between 179 girls with EDs (aged 6-15) and 640 age- and gender-matched community controls. We conducted multiple regression analyses to examine associations between the QCD scores and clinical and psychosocial variables, which included percent median body mass index (%mBMI), depressive symptoms, inpatient history, sleep duration, and sibling presence.

Results: Girls with EDs had significantly lower QCD scores than controls across all time domains, with pronounced impairments during after-school and evening periods. Multivariate analyses revealed that behavioral difficulties were associated with poorer functioning. However, sibling presence and weekday sleep duration had protective effects. No significant associations were observed with %mBMI, depressive symptoms, or separation anxiety.

Conclusion: Daily functioning among girls with EDs is influenced by behavioral and familial factors, rather than nutritional status alone, and varies by time of day. Time-structured assessments, such as the QCD, may help clinicians tailor support strategies to vulnerable periods in their daily life.