Early Response to Adolescent and Parent Treatment (APT) in Adolescents with Anorexia Nervosa

Abstract

Background: Anorexia Nervosa (AN) in adolescents is a complicated and life-threatening mental illness emaciating the body and distorting the mind. Often long-lasting and given its complexity, AN is challenging to treat. Family-Based Treatment (FBT), the most widely used and well-established adolescent treatment, predominantly focuses on weight restoration. It achieves remission – as ³95% Ideal Body Weight (IBW) – in about half the adolescents presenting with AN. The large proportion not benefitting necessitates an alternative, more effective treatment to address physical and psychological issues of the illness. Objective: Adolescent and Parent Treatment (APT) is a novel treatment combining family and individual treatment components. Although utilized in outpatient clinical settings, its effectiveness and feasibility have not been tested empirically. The present study’s overarching aim is to provide initial data on the feasibility of, and early response to, APT among adolescents with AN. Method: Twenty-one adolescent patients meeting DSM 5th Edition criteria for AN were recruited from a private eating disorder (ED) clinic in New Zealand. Anthropometrics were collected at baseline and two-month follow-up treatment. Clinical diagnosis and questionnaire data were obtained at admission from psychological measures. All patients received APT. The primary hypothesis was that participants would gain clinically significant weight by followup. The secondary hypothesis was that their weight change would be related to baseline participant questionnaire measures. Results: Twelve patients aged 15 to 18 years completed online self-report clinical questionnaires and anthropometrics. There was a statistically and clinically significant Running head: TREATMENT FOR ADOLESCENTS WITH ANOREXIA NERVOSA increase in participant’s weight from baseline (M = 51.78, SD = 4.84) to follow-up (M = 54.00, SD = 5.81), t(11) = 4.21, p = .001. The effect size was large, with a Cohen’s d of 1.83. There was a relationship between anxiety and weight change (kg), and anxiety and BMI change. Conclusion: This study provides preliminary data on the feasibility of and response to APT in a private clinic. Findings suggest APT may prove a suitable alternative to FBT for adolescent patients with AN in an outpatient setting. It also demonstrates that while weight is being restored, psychological work can simultaneously be delivered from the beginning of treatment.