Predictive factors for outcome in adolescents with anorexia nervosa: To what extent does parental Expressed Emotion play a role?

PLoS One. 2018 Jul 31;13(7):e0196820. doi: 10.1371/journal.pone.0196820. eCollection 2018.

Abstract

In studies on family therapy in Anorexia Nervosa, family relationships, as assessed by Expressed Emotion, have been associated with outcome. Our aim was to explore the contribution of Expressed Emotion as a predictor of 18-month outcome, above and beyond the usual predictive factors. Sixty adolescent girls suffering from Anorexia Nervosa and their parents were assessed at baseline and 18 months later. Levels of Expressed Emotion were evaluated in both parents with the Five-Minute Speech Sample. After controlling for treatment group and initial clinical status, high maternal Emotional Over-Involvement at baseline was significantly associated with better clinical state. More precisely, high maternal Emotional Over-Involvement was associated with higher nutritional status, lower eating disorder severity and fewer re-hospitalizations 18 months later. No associations were found with paternal levels of Expressed Emotion. Therefore, our study confirmed the importance of taking into account both maternal and paternal Expressed Emotion. Our results also underlined that high maternal Emotional Over-Involvement plays a positive role in the outcome of Anorexia Nervosa and needs to be explored further.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anorexia Nervosa / diagnosis*
  • Anorexia Nervosa / therapy
  • Expressed Emotion*
  • Family Therapy / methods*
  • Father-Child Relations
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mother-Child Relations / psychology*
  • Parents / psychology*
  • Prognosis
  • Treatment Outcome

Grants and funding

This study was funded by the Projet Hospitalier de Recherche Clinique (CRC, PHRC, 1997, AOM97133 AP-HP to Nathalie Godart) and promoted by Assitance Publique des Hôpitaux de Paris (AP-HP). Jeanne Duclos receives grants from the Convention Industrielle pour la Formation par la REcherche (CIFRE, 049/2009) and Association Nationale de la Recherche et de la Technologie (ANRT). The funding source had no involvement in the writing of the review article and in the decision to submit the paper for publication.