The bidirectional connection between family functioning and psychopathology: A network analysis in a large sample of adolescents with anorexia nervosa and their parents.

Family functioning is a risk and maintaining factor for anorexia nervosa (AN). This study aims to identify specific areas of family functioning according to adolescents and parental perspectives associated with eating and general psychological symptoms in people with AN. Four-hundred-forty-five adolescents with AN or atypical AN and their parents were enrolled. Adolescents completed the Eating Disorder Inventory-3, the Youth Self-Report questionnaire, and the Family Assessment Device (FAD). Their parents filled in the FAD. A network analysis was conducted including all subscales. The bridge function analysis was applied to identify the bridge nodes connecting each community constituted of family functioning perception with the communities of adolescents' eating and general psychological symptoms. Family communication was the node most strongly connecting fathers and mothers' perception of family functioning and adolescents' eating symptoms. Problem solving was the node with the highest bridge expected influence between mothers' family functioning and adolescents' general psychopathology. General functioning and problem solving were the bridge nodes between adolescents' view of family functioning and eating and general psychopathology. Maturity fear, interpersonal insecurity, and interpersonal alienation were the bridge nodes between adolescents' eating symptoms and mothers, fathers, and adolescents' family functioning communities respectively. Family members must be involved in the therapeutic process to improve family communication and problem solving diverting their attention toward emotional needs and interpersonal difficulties of adolescents with AN. Developing autonomy and independence from parents and building trustworthy relationships with peers may be favored by improving familiar dynamics and may contribute to prevent the maintenance of AN.

Parental Emotional Availability and Family Functioning in Adolescent Anorexia Nervosa Subtypes.

Emotional availability (EA) is a complex construct describing the emotional bond between parents and child, and it refers to support, sensitivity, warmth and closeness. Few studies have investigated the perception of parental EA and its association with dysfunctional eating pattern. The aim of the study is to explore the perception of mothers' and fathers' EA of adolescents with anorexia nervosa (AN) and any differences between the two subtypes of binge-purge (B/P) or restrictive (R) AN. Furthermore, it investigates the association of parental EA with AN symptomatology and with patients' perception of family functioning, which is identified as a maintenance factor for AN. A total of 60 adolescents between 12 and 18 years and their parents (n = 120) were recruited in two eating disorder (ED) specialized care centers. Patients completed the LEAP and the FACES IV questionnaires evaluating parental EA and family functioning, respectively. Results showed no difference between AN subtypes, but a greater perception of mother when compared to father EA was found. Moreover, the EA construct was found not to be associated with ED symptomatology but with a greater positive family functioning. Our study is the first that explores EA in AN, and results suggest the importance of considering parents' emotional engagement as part of the treatment core, together with the eating symptomatology management.

Coping With Adolescents Affected by Anorexia Nervosa: The Role of Parental Personality Traits.

INTRODUCTION: Anorexia nervosa (AN) promotes psychological distress in caregivers who adopt different coping strategies. Dysfunctional caregiving styles exacerbate further distress in the patient promoting the maintenance of the illness. We aimed to assess the possible contribution of personality traits of caregivers to the adoption of different coping strategies to deal with the affected relative. METHODS: About 87 adolescents with AN were recruited. Their parents completed the Family Coping Questionnaire for Eating Disorders (FCQ-EDs) and the Temperament and Character Inventory-Revised (TCI-R). Differences between mothers and fathers were assessed through the independent sample t-test. Multivariate regression analyses were run to assess if personality traits, the occurrence of psychiatry conditions in the parents, the marital status, and the duration of the illness predicted parental coping strategies. RESULTS: The group of mothers showed higher levels of avoidance and seeking for information coping strategies than the sample of fathers. Lower illness duration predicted higher collusion with the illness in both parents. Harm avoidance, cooperativeness, and self-directedness positively predicted parental coercion, collusion, and seeking for information strategies with some differences between mothers and fathers. DISCUSSION: Illness duration and personality traits of parents affect the type of parental coping strategies developed to face AN in adolescents. These variables should be considered in the assessment of families of adolescents with AN and may be addressed to promote more fine-tuned clinical interventions for caregivers.

Restrictive eating disorders in children and adolescents: a comparison between clinical and psychopathological profiles.

PURPOSE: DSM-5 describe three forms of restrictive and selective eating: Anorexia Nervosa-Restrictive (AN-R), Anorexia Nervosa-Atypical (AN-A), and Avoidant/Restrictive Food Intake Disorder (ARFID). While AN is widely studied, the psychopathological differences among these three diseases are not clear. The aim of this study was to (i) compare the clinical features of AN-R, AN-A, and ARFID, in a clinical sample recruited from a specialized EDs program within a tertiary care children's Hospital; (ii) identifying three specific symptom profiles, to better understand if restrictive ED share a common psychopathological basis. METHODS: Data were collected retrospectively. Psychometric assessment included: the Children's Depression Inventory (CDI), the Multidimensional Anxiety Scale for Children (MASC), the Child Behavior Checklist (CBCL), and the Eating Disorder Inventory-3 (EDI-3). RESULTS: A final sample of 346 children and adolescent patients were analyzed: AN-R was the most frequent subtype (55.8%), followed by ARFID (27.2%) and AN-A (17%). Patients with ARFID presented different features from AN-R and AN-A, characterized by lower weight and medical impairment, younger age at onset, and a frequent association with separation anxiety and ADHD symptoms. EDI-3 profiles showed specific different impairment for both AN groups compared to ARFID. However, no differences was detected for items: 'Interpersonal Insecurity', "Interoceptive Deficits", "Emotional Dysregulation", and "Maturity Fears". CONCLUSIONS: Different ED profiles was found for the three groups, but they share the same general psychopathological vulnerability, which could be at the core of EDs in adolescence. LEVEL OF EVIDENCE: III. Evidence obtained from case-control analytic studies.

Family functioning, coparenting, and parents' ability to manage conflict in adolescent anorexia nervosa subtypes.

INTRODUCTION: Studies about family functioning in adolescent anorexia nervosa (AN) are conflicting and often do not consider the possible differences between the restricting and binge/purging subtypes (AN-R and AN-B/P). Moreover, an underestimated element is the quality of the coparenting relationship, that is, the level of coordination and agreement between parents, as well as the methods of managing parental conflict. METHOD: The study aims to explore family functioning, coparenting and conflict management in a sample of 60 adolescents with AN-R and AN-B/P and their relations with AN severity in terms of body mass index (BMI). Patients and parents completed the following questionnaires: Family Adaptability and Cohesion Evaluation Scales, Coparenting Scale-Revised, and Conflict Management Questionnaire. RESULTS: No differences are found in general family functioning between the two groups, but mothers in the AN-R group show a higher coparental conflict and a tendency to use negative-passive ways of conflict management than mothers of the AN-B/P group. Moreover, the presence of a coparental conflict is associated to lower BMI and to more dysfunctional family functioning. DISCUSSION: These findings underline the importance of increasing knowledge on specific aspects of general family functioning. In particular, it seems that the way parents manage conflict between themselves as partners can have a role in the maintenance of AN. Clinical implications of these results are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Vlasov-Maxwell kinetic simulations of radio-frequency-driven ion flows in magnetized plasmas.

The generation of a coherent ion flow due to the injection in a plasma of a purely electrostatic wave of finite amplitude, propagating at right angle with the ambient uniform magnetic field, is investigated making use of a kinetic code which solves the fully nonlinear Vlasov equations for electrons and ions, coupled with the Maxwell equations, in one spatial and two velocity dimensions. A uniformly magnetized slab plasma is considered. The wave frequency is assumed in the range of the fourth harmonic of the ion cyclotron frequency, and the wave vector is chosen in order to model the propagation of an ion Bernstein wave. The computation of the first-order moment of the ion distribution function shows that indeed a quasistationary transverse average ion drift velocity is produced. The time evolution of the ion distribution function undergoes a "resonant" interaction of Cherenkov type, even if the plasma ions are magnetized (omega(ci)/omega(pi) approximately 0.5). During the wave-plasma interaction, the electron distribution function remains Gaussian-like, while increasing its energy content.