Who responds to an adaptive intervention for adolescents with Anorexia Nervosa being treated with family-based treatment? Outcomes from a randomized clinical trial

Recognized as a severe psychiatric condition, Anorexia Nervosa (AN) is associated with substantial rates of morbidity and mortality. Current evidence supports family-based treatment (FBT), but the recovery rate remains around 40%. Enhancing treatment outcomes for adolescents with Anorexia Nervosa is crucial for saving lives, improving health, and preventing long-term issues. The efficacy of supplementing regular FBT with intense parental coaching (IPC) for patients who failed to acquire at least 2.4 kg by session 4, a crucial indicator of treatment success, was investigated in this research by Lock et al. (2024). For this study, the authors recruited 107 individuals and their families, of which, 69 demonstrated early nonresponse, and they were randomized to undergo three sessions of IPC or to continue with normal FBT. Participants were 12–18-year-olds who satisfied the DSM-5 criteria for anxiety disorders; 11% were Hispanic and 6.5% were male. The primary outcome measured was achieving a mean body mass index greater than 94% of what is expected for age, height, and sex. Secondary outcomes assessed changes in eating-related thoughts. The addition of IPC did not significantly improve outcomes, except for those whose parents had low self-efficacy at baseline. The finding that early weight gain of 2.4 kg by session 4 is a predictor of remission at the end of treatment was confirmed. The authors also noted that parental self-efficacy plays a moderating role in the efficacy of IPC for adolescents with Anorexia Nervosa. Assessing parental self-efficacy at the start can help identify families who are most likely to benefit from incorporating IPC into FBT. Future research should explore earlier interventions to enhance early response rates. [NPID: Adolescents, Anorexia Nervosa, eating disorders, family-based treatment, randomized clinical trial]

Year: 2024

Reference: Lock, J. D., Le Grange, D., Bohon, C., Matheson, B., & Jo, B. (2024). Who responds to an adaptive intervention for adolescents with Anorexia Nervosa being treated with family-based treatment? Outcomes from a randomized clinical trial. Journal of the American Academy of Child & Adolescent Psychiatry, 63(6), 605–614. https://doi.org/10.1016/j.jaac.2023.10.012