A network analysis in adolescent anorexia nervosa exploring the connection between both patient and carer reactions and outcome

TY - JOUR

T1 - A network analysis in adolescent anorexia nervosa exploring the connection between both patient and carer reactions and outcome

AU - Monteleone, Alessio Maria

AU - Cascino, Giammarco

AU - Salerno, Laura

AU - Schmidt, Ulrike

AU - Micali, Nadia

AU - Cardi, Valentina

AU - Treasure, Janet

N1 - Funding Information: Janet Treasure and Ulrike Schmidt acknowledge the salary support from the National Institute of Health Research (NIHR) Mental Health Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust and King's College London. Ulrike Schmidt is also supported by an NIHR Senior Investigator Award. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Contract/grant sponsor: National Institute for Health Research (NIHR) under its Research for Patient Benefit programme (PB‐PG‐0609‐19025); Contract/grant sponsor: King's College London; Contract/grant sponsor: Psychiatry Research Trust (Grant reference 29). Funding Information: Janet Treasure and Ulrike Schmidt acknowledge the salary support from the National Institute of Health Research (NIHR) Mental Health Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust and King's College London. Ulrike Schmidt is also supported by an NIHR Senior Investigator Award. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Contract/grant sponsor: National Institute for Health Research (NIHR) under its Research for Patient Benefit programme (PB-PG-0609-19025); Contract/grant sponsor: King's College London; Contract/grant sponsor: Psychiatry Research Trust (Grant reference 29). Open Access Funding provided by Universita degli Studi della Campania Luigi Vanvitelli within the CRUI-CARE Agreement. Publisher Copyright: © 2022 The Authors. European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.

PY - 2023/1

Y1 - 2023/1

N2 - Objective: This paper used network analysis to test the associations between eating disorder-related psychopathology and carers’ responses to anorexia nervosa symptoms in adolescents. Additionally, the prognostic value of central and bridge network nodes was explored. Method: This is a secondary analysis of a three-armed randomised-controlled-trial of adolescents with anorexia nervosa (n = 149) and their primary carer (n = 149) who were allocated to either treatment as usual (TAU), or one of two versions of a carer skills intervention (ECHO) added to TAU. A network analysis was run in the full sample. The prognostic role of central and bridge nodes was tested through multiple regression analyses. Results: Carers’ depression and emotional over-involvement, as well as patients' depression showed the highest strength centrality. Patients' depression and carers’ accommodation exhibited the highest bridge expected influence. Across the full sample, and in the ECHO group, carers’ accommodation predicted patients' higher body mass index (BMI), while patients' depression predicted worse psychosocial functioning at 1-year follow-up. In the ECHO group, higher carers’ depression also predicted lower BMI. Conclusions: Carers’ accommodation and depression in both carers and patients were involved in the maintenance of psychopathology in adolescents with anorexia nervosa. Depression in both patients and carers is a potential treatment target for family interventions.

AB - Objective: This paper used network analysis to test the associations between eating disorder-related psychopathology and carers’ responses to anorexia nervosa symptoms in adolescents. Additionally, the prognostic value of central and bridge network nodes was explored. Method: This is a secondary analysis of a three-armed randomised-controlled-trial of adolescents with anorexia nervosa (n = 149) and their primary carer (n = 149) who were allocated to either treatment as usual (TAU), or one of two versions of a carer skills intervention (ECHO) added to TAU. A network analysis was run in the full sample. The prognostic role of central and bridge nodes was tested through multiple regression analyses. Results: Carers’ depression and emotional over-involvement, as well as patients' depression showed the highest strength centrality. Patients' depression and carers’ accommodation exhibited the highest bridge expected influence. Across the full sample, and in the ECHO group, carers’ accommodation predicted patients' higher body mass index (BMI), while patients' depression predicted worse psychosocial functioning at 1-year follow-up. In the ECHO group, higher carers’ depression also predicted lower BMI. Conclusions: Carers’ accommodation and depression in both carers and patients were involved in the maintenance of psychopathology in adolescents with anorexia nervosa. Depression in both patients and carers is a potential treatment target for family interventions.

KW - anorexia nervosa

KW - carers

KW - depression

KW - family intervention

KW - network analysis

UR - http://www.scopus.com/inward/record.url?scp=85132338049&partnerID=8YFLogxK

U2 - 10.1002/erv.2933

DO - 10.1002/erv.2933

M3 - Article

C2 - 35717595

AN - SCOPUS:85132338049

SN - 1072-4133

VL - 31

SP - 65

EP - 75

JO - European Eating Disorders Review

JF - European Eating Disorders Review

IS - 1

ER -