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Open AccessArticle

Reduction of High Expressed Emotion and Treatment Outcomes in Anorexia Nervosa—Caregivers’ and Adolescents’ Perspective

1
Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria
2
Parkland Clinic, Clinic for Psychosomatic Medicine and Psychotherapy, 34537 Bad Wildungen, Germany
3
Department for Neurology and Child and Adolescent Psychiatry, 9020 Klagenfurt am Wörthersee, Austria
4
Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2021; https://doi.org/10.3390/jcm9072021
Received: 28 May 2020 / Revised: 18 June 2020 / Accepted: 22 June 2020 / Published: 27 June 2020
(This article belongs to the Special Issue Advances in Eating Disorders)
High expressed emotion (EE) is common in caregivers of patients with anorexia nervosa (AN) and associated with poorer outcome for patients. In this study, we examined the prevalence of high EE in caregivers of adolescents with AN and analyzed predictors for EE using multivariate linear regression models. We further analyzed whether EE is reduced by the “Supporting Carers of Children and Adolescents with Eating Disorders in Austria” (SUCCEAT) intervention using general linear mixed models and whether a reduction of EE predicts patients’ outcomes. Caregivers were randomly allocated to the SUCCEAT workshop (N = 50) or online intervention (N = 50) and compared to a comparison group (N = 49). EE and patients’ outcomes were assessed at the baseline, post-intervention, and at the 12-month follow-up. Up to 47% of caregivers showed high EE. Lower caregiver skills, higher AN symptom impact, higher levels of depression and motivation to change in caregivers were significant predictors for high EE. EE significantly decreased in the SUCCEAT groups and the comparison group according to the caregivers’, but not the patients’ perspective. The level of reduction could partially predict subjective improvement and improvement in clinically assessed AN symptoms and body mass index of patients. Implementing interventions for caregivers addressing EE in the treatment of adolescents with AN is strongly recommended. View Full-Text
Keywords: anorexia nervosa; high expressed emotion; children and adolescents; intervention; caregivers anorexia nervosa; high expressed emotion; children and adolescents; intervention; caregivers
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Philipp, J.; Truttmann, S.; Zeiler, M.; Franta, C.; Wittek, T.; Schöfbeck, G.; Mitterer, M.; Mairhofer, D.; Zanko, A.; Imgart, H.; Auer-Welsbach, E.; Treasure, J.; Wagner, G.; Karwautz, A.F.K. Reduction of High Expressed Emotion and Treatment Outcomes in Anorexia Nervosa—Caregivers’ and Adolescents’ Perspective. J. Clin. Med. 2020, 9, 2021.

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