Affiliation:
1. Department of Children and Youth Psychiatry and Center for Clinical Research, Falun Hospital, Falun, Sweden.
2. Karolinska Institute, Department of Clinical Neuroscience, Stockholm, Sweden
3. Department of Psychology, Umeå University; Umeå, Sweden
Abstract
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 for indicating progress in treatment of ED-adolescents.
Level of evidence Level IV: Evidence obtained from multiple time series with the intervention.
Publisher
Research Square Platform LLC