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Zeiler M, Truttmann S, Philipp J, Kahlenberg L, Wittek T, Franta C, Schneider A, Imgart H, Zanko A, Karwautz A, Wagner G. An investigation of the factor structure of a German version of the Eating Disorder Symptom Impact Scale (EDSIS) among parents of adolescents and young adults with anorexia nervosa. Eat Behav 2023; 48:101695. [PMID: 36495623 DOI: 10.1016/j.eatbeh.2022.101695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/02/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
The aim of this study was to explore the factor structure, scale characteristics and convergent validity of a German version of the Eating Disorder Symptom Impact Scale (EDSIS). A total of 335 parents of adolescents and young adults with anorexia nervosa in inpatient or outpatient treatment completed the 24-item German translation of the EDSIS and other measures of caregiving burden and psychological distress. We tested a 4 vs. 6-factor model of the EDSIS using confirmatory factor analyses. The 6-factor model treating items as ordinal variables showed the best fit to the data (CFI = 0.949, RMSEA = 0.064). Strong invariance of this model was shown between the sample of mothers and fathers. Internal consistencies of the EDSIS scales were in the acceptable-to-good range. Bottom effects were observed for the 'Binge-Purge-Impacts' subscale only. Mothers had significantly higher EDSIS scores compared to fathers. The EDSIS total score and most of the subscores showed substantial positive correlations with caregivers' psychological distress, level of depression, anxiety and expressed emotion as well as negative associations with the level of perceived caregiving skills. The German version of the EDSIS is a useful tool to assess caregiving burden in mothers and fathers of patients with anorexia nervosa.
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Affiliation(s)
- Michael Zeiler
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Stefanie Truttmann
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Julia Philipp
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Leonie Kahlenberg
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Tanja Wittek
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Claudia Franta
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Andrea Schneider
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Hartmut Imgart
- Parkland Clinic, Clinic for Psychosomatic Medicine and Psychotherapy, Bad Wildungen, Germany.
| | - Annika Zanko
- Parkland Clinic, Clinic for Psychosomatic Medicine and Psychotherapy, Bad Wildungen, Germany.
| | - Andreas Karwautz
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
| | - Gudrun Wagner
- Department for Child and Adolescent Psychiatry, Eating Disorders Unit, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
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Bertelli S, Ferrara P, Di Modica S, Bergamelli E, Gambini O, D'Agostino A, Destrebecq A, Terzoni S. Adaptation and validation of the Caregiver Burden Inventory in eating disorders. J Eat Disord 2022; 10:34. [PMID: 35255998 PMCID: PMC8903570 DOI: 10.1186/s40337-022-00560-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 02/27/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Living with people diagnosed with a mental disorder is known to increase the risk of developing high levels of so-called "caregiver burden" in informal caregivers. In-depth analysis of this phenomenon and specific assessment tools for caregivers of patients diagnosed with Eating Disorders (EDs) are lacking. In this study, we aimed to evaluate the psychometric properties of the Caregiver Burden Inventory in EDs and employ this adapted tool in this category of caregivers. METHODS A cross-sectional study was conducted in the Eating Disorders outpatient unit of an Italian University hospital. Face and content validity were investigated by calculating standard Content Validity Indices (CVI-I and CVI-S) after administering the Inventory to 6 expert nurses with at least 5 years of experience in mental health services assisting people diagnosed with Eating Disorders. Internal consistency was evaluated with Cronbach's α coefficient for the overall scale and subscales. An exploratory factor analysis (EFA) was performed to explore latent constructs. The adapted CBI was then administered to 62 informal caregivers of ED patients. RESULTS The EFA yielded a 5-factor structure. The CVI-S was 97.2%; the Cronbach α coefficient was 0,90 (> 0.74 in each subscale). The median burden level in the experimental population was 40.0 [range = 21 to 54], in a theoretical range from 0 (no burden) to 96 (highest level of burden). CONCLUSION The Caregiver Burden Inventory appears to be a valid and reliable instrument to assess caregiver burden in individuals diagnosed with Eating Disorders. Further research is needed to evaluate this tool's efficiency in improving individually tailored interventions on families.
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Affiliation(s)
- Sara Bertelli
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Paolo Ferrara
- Bachelor School of Nursing, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Sharon Di Modica
- Bachelor School of Nursing, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Emilio Bergamelli
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy.,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Orsola Gambini
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy.,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.,CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan Medical School, Milan, Italy
| | - Armando D'Agostino
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy. .,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Anne Destrebecq
- Bachelor School of Nursing, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Stefano Terzoni
- Bachelor School of Nursing, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
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Quiles Y, Quiles MJ, León EM, Roncero M, Ruiz Á, España M, Romero C, Elvira V. Adaptation and Implementation of an Intervention Programme on Spanish Carers and Adolescent Patients With an Eating Disorder: Study Protocol of a Randomized Controlled Trial. Front Psychol 2021; 12:697916. [PMID: 34744864 PMCID: PMC8569943 DOI: 10.3389/fpsyg.2021.697916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 09/20/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: One of the major problems with inpatient treatment of adolescent girls with an eating disorder (ED) is that the strategies learned during their hospital stay are not easily applied or maintained in their daily lives, and this has been related to high rates of relapse and readmission. The ECHOMANTRA programme was developed to optimize outcomes during and following inpatient or day-patient treatment. ECHOMANTRA is based on interventions for carers (Experienced Carers Helping Others, ECHO) and patients (Maudsley Model of Anorexia Nervosa Treatment for Adults, MANTRA) and is developed from the cognitive interpersonal model of anorexia (Schmidt and Treasure, 2006; Treasure and Schmidt, 2013). This study aims to describe the study protocol of a randomized controlled trial (RCT) for evaluating the efficacy of an adaptation of a novel intervention for patients and carers (ECHOMANTRA) to be implemented as an add-on to treatment-as-usual (TAU). Method: In a multi−center pilot RCT, 80 female adolescent patients with a DSM-5 diagnosis of an ED and their carers will be invited to participate in the study. They will then be randomized to receive either the ECHOMANTRA intervention as an add-on to TAU or TAU alone. A repeated measures design will be conducted across four time points. Primary outcomes will be patient psychological well-being and eating disorder symptoms, and secondary outcomes will include body mass index, obsessive-compulsive symptoms, perfectionism, motivation to change and psychosocial adjustment. For carers, outcome variables will include psychological well-being, expressed emotion, accommodation and enabling behaviors, burden, and care skills. Discussion: The results from this trial will establish the effectiveness of ECHOMANTRA and may reveal whether and to what extent this novel intervention can optimize outcomes during and following inpatient treatment. This study will also provide the adaptation of the ECHOMANTRA in the Spanish context for inpatient/day-care treatment.
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Affiliation(s)
- Yolanda Quiles
- Department of Behavioral Sciences and Health, University Miguel Hernández, Elche, Spain
| | - María José Quiles
- Department of Behavioral Sciences and Health, University Miguel Hernández, Elche, Spain
| | - Eva María León
- Department of Behavioral Sciences and Health, University Miguel Hernández, Elche, Spain
| | - María Roncero
- Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Álvaro Ruiz
- Department of Behavioral Sciences and Health, University Miguel Hernández, Elche, Spain
| | - Maite España
- Department of Personality, Assessment and Psychological Treatment, University of Murcia, Murcia, Spain
| | - Cristina Romero
- Unit of Eating Disorders, University Hospital of San Juan de Alicante, Alicante, Spain
| | - Vicente Elvira
- Unit of Eating Disorders, University Hospital of San Juan de Alicante, Alicante, Spain
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Sepúlveda AR, Anastasiadou D, Parks M, Gutiérrez E. A controlled study of the Collaborative Care Skills Workshops versus Psycho‐educational Workshops among Spanish caregivers of relatives with an eating disorder. EUROPEAN EATING DISORDERS REVIEW 2018; 27:247-262. [DOI: 10.1002/erv.2658] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 10/16/2018] [Accepted: 11/04/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Ana R. Sepúlveda
- Department of Biological and Health Psychology, Faculty of PsychologyAutonomous University of Madrid Madrid Spain
| | - Dimitra Anastasiadou
- Department of Biological and Health Psychology, Faculty of PsychologyAutonomous University of Madrid Madrid Spain
| | - Melissa Parks
- Department of Biological and Health Psychology, Faculty of PsychologyAutonomous University of Madrid Madrid Spain
| | - Elena Gutiérrez
- Usera Mental Health Center12 de Octubre University Hospital Madrid Spain
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