The use of food barcode scanner app among women: Associations with orthorexia, diet and emotions.

This cross-sectional study investigated the relationship between the use of food barcode scanner app (FBSA) and orthorexia, diet and emotions. A total of 1610 women from the general population were included in this study, 388 of whom were FBSA users. Participants completed questionnaires assessing socio-demographic and health characteristics, food barcode scanner use (Food Barcode Scanner App Questionnaire), orthorexia (Teruel Orthorexia Scale), food choice motivations (Food Choice Questionnaire), health anxiety (Health Anxiety Questionnaire), and emotional competence (Profile of Emotional Competence). The results showed no difference in socio-demographic characteristics between FBSA users and FBSA non-users. However, FBSA users scored higher on healthy orthorexia and health anxiety than non-users. FBSA users' food choice motivations were also more focused on natural food content, health, weight control and ethical concerns than non-users. Although no difference was found between FBSA users and non-users for orthorexia nervosa, orthorexia nervosa and pathological FBSA use scores were positively correlated. Moreover, health anxiety scores were positively correlated with FBSAQ "pathological use" subscale. While FBSA use may promote the adoption of a healthy diet, vigilance is required for individuals with orthorexic symptoms and health concerns. These two dimensions could be risk factors for problematic FBSA use.

Young carers supporting a relative with cancer: What is the healthcare professionals' knowledge in France? An exploratory study.

PURPOSE: Many children and adolescents support relatives with cancer. However, literature about young carers (YCs) shows a lack of awareness among professionals, especially in oncology. This quantitative study aims to explore the level of knowledge and perceptions of healthcare professionals working with cancer patients about the situations and characteristics of YCs. METHODS: 395 professionals participated in an online survey. Professionals reported sociodemographic and professional information and answered several questions evaluating their perceptions about YCs, such as the types of support provided and the consequences of being a YC. Descriptive analysis and group comparisons (Chi-square, Mann-Whitney U, and Kruskal-Wallis tests) by sex, occupation, and patients treated (adult and/or pediatric) are performed on the data collected. RESULTS: Overall, per the literature on YCs, professionals provide an adequate description of what a YC can be, even though one in two professionals have never heard the term. Several differences are observed: Men mention fewer types of support that YCs can provide, while women report more negative consequences of being a YC; psychologists and social workers report fewer positive impacts for these young people than the other professionals; professionals who work with pediatric patients mention fewer negative consequences than those who work with adults. CONCLUSION: Oncology healthcare professionals have sufficient awareness of YCs; however, several professionals struggle to fully understand the situation of YCs. These findings underline the need for awareness programs in oncology to improve health professionals' understanding of YCs and enhance their identification and support.

What characterizes adolescent young carers? A multigroup comparative study.

CONTEXT: To identify the characteristics of adolescent young carers (AYCs), studies in the literature have compared them with non-AYCs, but without considering that in the latter group, some face the illness of a relative whereas others do not. OBJECTIVES: The aims of the study were (1) to identify the characteristics of AYCs as compared with adolescents who are not young carers but are facing the illness/disability of a relative, or adolescents not facing the illness/disability of a relative, and (2) to identify factors associated with being a carer within adolescents facing a relative illness. METHODS: A total of 4000 high school students (grades 10-12, mainly aged 15-17 years, 568 identified as AYCs, 1200 as adolescents facing the illness/disability of a relative without being a carer and 2232 as adolescents not facing the illness/disability of a relative) completed a self-reported questionnaire assessing sociodemographic characteristics, illness/disability in the family, caregiving activities (MACA-YC18 and specific emotional support scale), quality of life (KIDSCREEN-10) and mental health (GHQ-12). Chi-square tests, ANOVAs and logistic regressions were performed. RESULTS: AYCs scored lower on the quality-of-life measure compared with adolescents not facing the illness/disability of a relative (p < .001) and had poorer mental health compared with adolescents facing the illness/disability of a relative without being a carer and adolescents not facing the illness/disability of a relative (p < .001). Logistic regressions showed that youth were more at risk to be an AYC when they were females (p < .001), when they had an extracurricular job (p < .001), spoke another language at home (p < .01), had siblings and were one of the oldest siblings (p < .001), and when the relative had a serious or chronic physical illness (p < .001) and lived with the youth (p < .001). CONCLUSIONS: These results highlight the importance of distinguishing AYCs, adolescents facing the illness/disability of a relative without being a carer and adolescents not facing the illness/disability of a relative to better describe AYCs, recognizing that as the level of care provided might change over time, adolescents facing the illness/disability of a relative without being a carer could become AYCs or inversely. The factors that emerged could be used by professionals to better identify AYCs.

Prevalence and quality of life of 11-15-year-old adolescent young carers in France: a school-based study.

Our study aimed to establish the prevalence of adolescent young carers (AYCs) among 11-15-year-old French adolescents and explore the impacts of caring on these youths through a comprehensive evaluation of their quality of life. A total of 1983 middle school pupils (mean age = 12.89; 56.23% females) completed self-reported questionnaires evaluating their sociodemographic characteristics, illness/disability in their family, caring activities (MACA-YC18), quality of life (KIDSCREEN-52), perceived health, and academic performance. Descriptive analyses, Chi-square tests of independence, Student's t-tests, and analysis of variance and of covariance were conducted. The results showed that 12.25% of middle school pupils were AYCs. They were mostly females, coming from disadvantaged economic backgrounds. The ill/disabled relative was typically a parent, and 23.87% of respondents reported having more than one ill/disabled relative. The AYCs more often declared an illness or a disability and reported lower quality of life scores than their peers in several dimensions: Physical Well-Being, Psychological Well-Being, Moods and Emotions, Self-Perception, Autonomy, Relations with Parents and Home Life, Financial Resources, School Environment, Social Acceptance. No differences were identified in the Social Support and Peers dimension. Given the high prevalence of AYCs in middle schools and the impact of the situation on their lives, special support should be provided for AYCs, and professionals at school should be trained to better identify and assist AYCs.

Three reasons why parental burnout is more prevalent in individualistic countries: a mediation study in 36 countries.

PURPOSE: The prevalence of parental burnout, a condition that has severe consequences for both parents and children, varies dramatically across countries and is highest in Western countries characterized by high individualism. METHOD: In this study, we examined the mediators of the relationship between individualism measured at the country level and parental burnout measured at the individual level in 36 countries (16,059 parents). RESULTS: The results revealed three mediating mechanisms, that is, self-discrepancies between socially prescribed and actual parental selves, high agency and self-directed socialization goals, and low parental task sharing, by which individualism leads to an increased risk of burnout among parents. CONCLUSION: The results confirm that the three mediators under consideration are all involved, and that mediation was higher for self-discrepancies between socially prescribed and actual parental selves, then parental task sharing, and lastly self-directed socialization goals. The results provide some important indications of how to prevent parental burnout at the societal level in Western countries.

Who uses food barcode scanner apps and why? Exploration of users' characteristics and development of the Food Barcode Scanner App Questionnaire.

BACKGROUND: Food barcode scanner apps (FBSAs) are increasingly being used to verify food quality. By scanning a product's barcode, they can provide a range of information, including nutritional quality or information on the toxicity of food components. Although they seem to be widely used, no study has yet examined their use in the general population. The objectives of this study were therefore twofold: (a) to identify who the users of FBSA are and (b) to evaluate behaviours and cognitions associated with use of these apps through the development and validation of the Food Barcode Scanner App Questionnaire (FBSAQ). METHOD: A total of 1626 women (average age of 37.51 years; SD = 12.67) from the general population were included in this study, with 25.7% reporting themselves as using at least one FBSA. Participants completed questionnaires assessing socio-demographic and health characteristics, the use of health apps and the FBSAQ, when relevant. RESULTS: The users of FBSAs did not differ from nonusers in regard to key socio-demographic characteristics, but they were more likely to use healthcare services and other health apps than nonusers of FBSAs. Psychometric analyses allowed validation of the FBSAQ through three factors: pathological use, dietary concerns and exclusion of unhealthy components. CONCLUSION: Data showed that the use of FBSAs can be beneficial for many individuals, as they help with food choices. However, some user may develop more problematic behaviours and have difficulties in not using these apps.

Associations between vegetarianism, body mass index, and eating disorders/disordered eating behaviours: a systematic review of literature.

The vegetarian diet is becoming increasingly popular among the general population and has been accompanied by an increasing number of publications in the last twenty years. However, the spread of selective diets raises some questions, especially with regard to health. This review examines studies on vegetarianism published between 2000 and 2022 that investigated the associations between this diet, weight, and eating disorders. The descriptive studies conclude that vegetarians have a lower body mass index, and the interventional studies show the value of a vegetarian diet for weight loss. While some studies suggest that vegetarianism may be associated with orthorexia nervosa, the results regarding the association between vegetarianism and eating disorders are more heterogeneous and depend on the type of samples and dimensions studied. The heterogeneity of these findings is discussed in light of the methodological limitations of the studies to provide perspectives for future research.

Encountering young caregivers: Attitudes and practices of healthcare professionals caring for cancer patients.

INTRODUCTION: Cancer and its treatments severely limit patients' daily lives. Relatives of patients may provide caregiving assistance to help patients cope with these limitations. Many children and adolescents-referred to as young caregivers (YCs)-provide support for patients. However, healthcare professionals do not always recognize YCs, and when they do, healthcare professionals are unsure how to support them. OBJECTIVE: This study aimed to explore healthcare professionals' attitudes toward and practices when encountering YCs and to compare these aspects according to their experiences with YCs. METHODS: In total, 395 oncology healthcare professionals (mean age 43.3 years; 84.8% females) participated in the study and completed an online survey. RESULTS: Only 1 in 2 professionals reported ever meeting a YC. The majority identified YCs by YCs' frequent presence in the department. No significant difference in attitudes was observed between professionals who had met a YC and those who had never met one. The support provided by professionals to YCs generally consisted of vigilance and exchanges. However, many professionals expressed a need to know where they can refer YCs for assistance. CONCLUSIONS: These findings underline the importance of improving the practices of healthcare professionals to help them better identify and support the YCs they meet.

The experience of relatives and friends of patients with moderate to advanced chronic kidney disease: Insights from the CKD-REIN cohort study.

OBJECTIVES: The transition from chronic kidney disease (CKD) to kidney failure requiring kidney replacement therapy (KRT; i.e., dialysis or transplantation) to sustain life is a stressful event for patients. Families play a role in patients' treatment decision-making, but little is known about how they are involved. This study aimed to explore the experience of CKD among relatives and friends, their views and involvement in KRT choice. DESIGN/METHODS: We conducted a qualitative study among 56 relatives or friends of patients with moderate to advanced CKD who were enrolled in the CKD-REIN cohort study. A psychologist conducted semi-structured interviews about their experience with CKD, treatment decision-making and their role in this process. Data were analysed using statistical text analysis. RESULTS: The mean age of participants was 56.4 ± 14 years; 75% were women, 61% were patients' partners and 48% had a relative or friend with stage G4 CKD. The analysis yielded four lexical classes: listeners with an opinion, coping with CKD on a daily basis, narrating patients' nephrological monitoring and emotions behind facts. Participants reported a listening role in the decision-making period and information needs. Some reported that CKD had no impact on their own daily lives, but others talked about its current and future physical, psychological and social consequences on them, the patients and their relationships. CONCLUSIONS: Most relatives/friends reported having little influence on KRT decision-making but expressed opinions on these treatments. Including relatives/friends in education on KRT and providing them with decision aids, especially when family members are supportive, may allow for more suitable decisions.

Professionals' Awareness of Young Carers in Schools: Results from a French Survey.

Few studies have investigated professionals' awareness of young carers (YCs). Therefore, the main aim of this study was to explore school professionals' awareness of YCs. The secondary aim was to compare professionals' responses according to their occupation. A total of 2658 professionals took part in this study by completing an online questionnaire. The results indicated that the mean for the perceived age for care beginning was 10.3 years old, with parents being perceived as the most frequent care recipient. The main caring activities reported were domestic chores, emotional support and sibling care, while care provided directly to the care recipient was perceived as less frequent. Many suggestions for improving the identification, referral and support of YCs were seen as relevant, but professionals were less supportive of suggestions for adjustments within schools. The key training needs centered around better identifying YCs and developing better knowledge of their difficulties. Differences were observed according to occupation, with administrative staff and teachers having less accurate perceptions than school counsellors as well as social and health professionals. This study shows that it can be difficult for school professionals to imagine a child providing care. Specific training, therefore, needs to be proposed according to school professionals' occupations.

Young adult carers' identification, characteristics, and support: A systematic review.

Young Adult Carers (YAC) are informal carers aged 18-25 years. This is an unrecognized population. The present systematic review aims to respond to: (1) how YAC are identified in research; (2) the prevalence of YAC; (3) the characteristics of YAC; and (4) how to support YAC. Five electronic databases (Google Scholar, PsycArticle, PsycInfo, Psychology and Behavioral Sciences Collection, and PubMed) were searched for studies, scientific articles, and gray literature on YAC published prior to January 18, 2021. The quality of included studies was assessed using the Crow Critical Appraisal Tool, and a narrative method was used to underline major findings. Twenty-three studies were included and revealed that there were several ways to identify YAC, resulting in heterogeneous prevalence. Nine themes were highlighted for YAC characteristics (way into caring; care receiver; caring responsibilities; amount of caring; self-identification as a carer; living arrangement; physical, psychological, and adaptative outcomes; interpersonal relationships; education and employment); and three for YAC support (needs, available support services, and recommendations). The findings showed the diversity of YAC experiences. Although YAC expressed several needs, there are few or no support services devoted to them. More research is needed to improve political awareness. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021231882, identifier: CRD42021231882.

Vegetarianism and weight status: What are the differences in eating styles, impulsivity, and emotional competences? A preliminary study.

Recent studies suggest that vegetarian diets may be recommended to promote weight loss in individuals living with obesity. However, limited studies have examined psychological factors (e.g., eating styles, impulsivity) among individuals who have adopted this type of diet, even though these factors are known to play a role in being overweight. The primary objective of the present study was to compare these characteristics in participants living with obesity or those with normal-weight across diet types. Participants were recruited from two hospital nutrition departments and the general population. They completed a diagnostic interview assessing the presence of an eating disorder, followed by self-administered questionnaires measuring dysfunctional eating styles (DEBQ), impulsivity (UPPS), and emotional competence (PEC). Vegetarian participants living with obesity engaged in more dysfunctional eating styles than did normal-weight omnivores and experienced more emotional difficulties than did both normal-weight omnivores and vegetarians. In contrast, there were no significant differences between omnivore participants living with obesity and those in the other groups. Moreover, participants living with obesity had comparable emotion regulation abilities to normal-weight participants. These results suggest that emotion regulation deficits can more likely be explained by the presence of psychopathological traits than by being overweight or one's choice of diet.

Quality of Life of Adolescents Facing a Parental Illness: A Person-Oriented Approach.

Studies that have investigated the health-related quality of life (HRQoL) of adolescents facing a parental illness showed inconsistent results, and none used a person-oriented approach allowing for a deeper understanding of their experience. The aim of this study was to compare the HRQoL of adolescents facing a parental illness to that of their peers, and to explore their HRQoL through a person-oriented approach. The sample consisted of 1324 adolescents recruited in secondary schools (11-15 years old). Adolescents completed questionnaires assessing sociodemographic characteristics, parental illness, HRQoL (KIDSCREEN-52), and academic performance and caring activities (MACA-YC18). Adolescents facing a parental illness showed significantly lower HRQoL than their peers on all dimensions. The cluster analysis yielded five patterns of HRQoL among adolescents facing a parental illness: Low HRQoL; High HRQoL; Moderate HRQoL with High Social Acceptance; High Well-Being, High Moods and Emotions, and High Social Support and Peers. These clusters differed according to demographics, the type of parental illness, illness perception, academic performance, and level of caring activities. The Low HRQoL cluster showed especially low academic performance and high level of caring activities. This multidimensional HRQoL evaluation thus helps to foreground the diversity of these adolescents' experiences in order to better address their needs.

Are We All the Same When Faced with an Ill Relative? A Person-Oriented Approach to Caring Activities and Mental Health in Emerging Adult Students.

Dealing with the illness/disability of a relative is part of everyday life for many students, who may have to take on caring responsibilities. Fulfilling a caring role during emerging adulthood has been associated with poorer mental health. This study adopts a person-oriented approach in exploring the caring experience in relation to mental health. The sample comprised 3273 students (Mage = 20.19 years, SDage = 1.89; 80.35% female) who answered a series of questionnaires. A cluster analysis identified six patterns of caregiving activities in terms of their nature and extent: few caring activities; household chores; household and financial/practical help; emotional care; sibling care; and many caring activities with emotional and personal care. A series of analyses showed that caring activities differed according to age, gender, living arrangements, financial status, the ill/disabled relative being supported, and the relative's type of illness/disability. A multivariate analysis of covariance showed that emerging adult students with patterns featuring household chores had better mental health than those with few caring activities. Overall, our findings indicate that having an ill/disabled relative can lead an individual to take on a wide range of caring responsibilities that may have varying consequences for emerging adult students' mental health.

Preliminary study of the social withdrawal (hikikomori) spectrum in French adolescents: focusing on the differences in pathology and related factors compared with Japanese adolescents.

BACKGROUND: Social withdrawal (hikikomori) has become an internationally recognized phenomenon, but its pathology and related factors are not yet fully known. We previously conducted a statistical case-control study on adolescent patients with hikikomori in Japan, which revealed the non-specificity of pathology in patients with hikikomori. Further, environmental factors, such as the lack of communication between parents and Internet overuse, were found to be significant predictors of hikikomori severity. Here, we aimed to conduct a similar preliminary case-control study in France and to compare the results with those from the study conducted in Japan. METHODS: Parents of middle school students who underwent psychiatric outpatient treatment for hikikomori (n = 10) and control group parents (n = 115) completed the Child Behavior Checklist to evaluate their child's psychopathological characteristics and the Parental Assessment of Environment and Hikikomori Severity Scales, as in our previous study in Japan. We compared the descriptive statistics and intergroup differences in France with those from the previous study conducted in Japan. In the multiple regression analysis to find predictors of hikikomori severity in French and also Japanese subjects, the same dependent and independent variables were chosen for the present study (both differed from the previous study). These were used in order to make accurate intercountry comparisons. RESULTS: The comparisons revealed no differences in the pathology of hikikomori between Japan and France. Specifically, both studies found similarly increased scores for all symptom scales, with no specific bias. However, the statistical predictors of hikikomori severity in France (lack of communication between parents and child and lack of communication with the community) differed from those in Japan (lack of communication between parents). CONCLUSION: Hikikomori in Japan and France could be considered essentially the same phenomenon; moreover, our findings demonstrated the universal non-specificity and unbiasedness of the hikikomori pathology. This suggests that hikikomori is not a single clinical category with a specific psychopathology; instead, it is a common phenotype with various underlying pathologies. However, different strategies may be required in each country to prevent the onset and progression of hikikomori.

Patient perspectives on chronic kidney disease and decision-making about treatment. Discourse of participants in the French CKD-REIN cohort study.

BACKGROUND: Little is known about psychological issues in patients with chronic kidney disease (CKD) facing transition to kidney failure and the involvement of their family in decision-making about kidney replacement therapy (KRT). This study investigated patients' experience of their illness, their views on KRT choice and their perception of the influence of their relatives. METHODS: We conducted a qualitative study nested in the CKD-REIN prospective cohort study which included non-dialysis CKD patients from 40 nationally representative nephrology clinics. Among 1555 patients who returned a self-administered questionnaire, we used purposive sampling to select 50 participants who underwent semi-structured phone interviews with a psychologist. RESULTS: The patients' mean age was 62.2 ± 12 years, 42% were women, and 68% had CKD stage 4-5. The analysis yielded four lexical classes: "illness rhythm", "considering dialysis", "family and transplantation", and "disease, treatment choice and introspection". When experiencing few or mild symptoms, patients tended to avoid thinking about CKD, for the prospect of dialysis was the most stressful part of their experience. Surprisingly, the importance of family appeared when they talked about transplantation decision-making, but not about choice of dialysis modality. CONCLUSIONS: Cognitive avoidance seems common in patients with advanced CKD. Transplantation and dialysis decision-making appear to be two distinct processes, with different levels of family involvement. More research is needed to better understand the frequency and impact of cognitive avoidance on patients' well-being and decision-making.

Profiles of French young carers taking part in an arts and respite care program.

Young carers (YCs) are children and adolescents who provide meaningful, regular support to a relative with a health problem. In France, only one programme exists to support them: the arts and respite care programme of the national association JADE. The aim of this study is to describe the profiles of YCs who had participated in this programme and to evaluate their expectations, opinions, and the evolution of their quality of life over the course of the programme. All YCs enrolled in the programme between 2017 and 2020 were invited to participate in the study. Upon arrival, the youths completed a self-report questionnaire addressing their sociodemographic and family situations, their caregiving activities, their quality of life, and their expectations for the programme. At the end of each week, a questionnaire evaluating their opinion of the programme and their quality of life was completed. A hundred and seventeen children participated (average age: 12; 71.8% girls). Most YCs provided support to a parent or sibling with a chronic somatic disease. The support mainly concerned doing domestic tasks and providing emotional support for the relative and was significantly higher among adolescents. Their expectations were mainly about getting respite and meeting other young people. Their levels of satisfaction were high and aligned with their expectations. Their quality of life increased significantly. French YCs in this programme had characteristics comparable to those observed internationally. The results underline the importance of respite and the benefits such a programme can bring to YCs.

Prevalence and characteristics of adolescent young carers in France: The challenge of identification.

AIMS: The aim of this study was to explore the prevalence and characteristics of adolescent young carers in France, with an identification method based on the extent of caring activities including emotional support. DESIGN: Cross-sectional. METHODS: Between May 2018 and February 2021, 4037 adolescents (grades 10-12, mainly aged 15-17, 60.2% female) answered a self-reported questionnaire at school. The questionnaire assessed sociodemographic characteristics, illness/disability in the family, support provided by the adolescent (Multidimensional Assessment of Caring Activities, MACA-YC18, and a specific scale for emotional support), and quality of life (KIDSCREEN-10). RESULTS: Results showed that 42.5% of adolescents faced the illness/disability of a relative and 14.3% provided a high level of support and could be considered adolescent young carers. They were most commonly females caring for a parent. Adolescent young carers reported a lower quality of life than non carers. Results also highlighted differences in care and quality of life between adolescent young carers who shared the same household as their ill/disabled relative and those who did not, according to gender as well as type and perception of support provided. CONCLUSION: Identifying adolescent young carers is a challenge. Identification methods based on the extent of caring activities seem appropriate but not entirely satisfactory. Self-identification criteria also seems important. An international consensus on the best identification methods and tools should be proposed. In France, the prevalence of adolescent young carers is high. These results highlight the crucial need to enhance awareness about adolescent young carers in France in order to identify and support them through appropriate health services policy. WHAT PROBLEM DID THE STUDY ADDRESS?: Little is known about young carers in France and there is no prevalence study. However, it is difficult to know which methods and identification criteria to apply to assess the prevalence, because they differ between studies and have an impact on the prevalence observed in each country. WHAT WERE THE MAIN FINDINGS?: The prevalence of adolescent young carers in France is high with a rate of 14.3%. Among them, 74.9% were female, 74.2% lived in the same household as their ill/disabled relative and 70.2% were aware that they provided support. Female young carers or those sharing a household with their ill/disabled relative provided higher levels of caring activities and had a lower quality of life. Adolescent young carers who were aware they provided support were less likely to have a relative with a serious/chronic physical illness but were more likely to have a relative with a mental illness, be a carer for a sibling or a grandparent and share the same household. WHERE AND ON WHOM WILL THE RESEARCH HAVE IMPACT?: These results should enhance awareness about young carers in France. Health care and education professionals have a major role to play to identify and support young carers, but public policy has to sustain it. Thus, the high prevalence rates highlight the importance of this phenomenon and the need to be attentive to this hidden population. Results also suggest an international consensus should be proposed to identify young carers.

Long-term follow-up of a randomized controlled trial comparing systemic family therapy (FT-S) added to treatment as usual (TAU) with TAU alone in adolescents with anorexia nervosa.

BACKGROUND: Randomized controlled trials showed the efficacy of family therapy for anorexia nervosa during adolescence, but studies examining its long-term beneficial effect are still needed. This article presents the results of a 54-month post-randomization follow-up of a previously reported randomized controlled trial that compared two post-hospitalization outpatient treatment programs: Treatment As Usual alone versus Systemic Family Therapy added to Treatment As Usual. METHODS: A consecutive series of 60 female adolescents with anorexia nervosa (DSM-IV) were randomized (30 per group). During the first 18 months, in the Treatment As Usual group, subjects received a multidisciplinary treatment. In the other group, Systemic Family Therapy sessions targeting intra-familial dynamics were added to Treatment As Usual. At 54 months, the primary outcome was defined using the Morgan and Russell global Outcome Categories (Good or Intermediate versus Poor). Secondary outcomes were the Global Outcome Assessment Schedule score, body mass index, amenorrhea, number of hospitalizations, eating disorder symptoms, psychopathological features, and family functioning. Analyses were carried out using an Intention-To-Treat with the Last Observation Carried Forward procedure. Data of 59/60 subjects were available. RESULTS: At 54 months, significant effects in favor of adding Systemic Family Therapy to Treatment As Usual were shown for the Global Outcome Categories (60% of Good/Intermediate versus 31% in the control group, p = .026), mean body mass index (p = .048), resumption of menses (70.0% vs. 40% p = .020), and mental state score (p = .010). Family cohesion scores were lower in the Systemic Family Therapy group (p = .040). CONCLUSIONS: Adding Systemic Family Therapy focusing on intra-familial dynamics to a multidimensional outpatient treatment program appeared to lead to a better long-term outcome in young women who suffered from severe anorexia nervosa during adolescence.

Assessing caring activities in French adolescents and young adults: Relevance of the Multidimension Assessment of Caring Activities for Young Carers (MACA-YC18).

BACKGROUND: Young carers (YC) and young adult carers (YAC) have become of interest in research and practice. The 18-item Multidimensional Assessment of Caring Activities for Young Carers (MACA-YC18) was developed for identifying the extent and nature of caring activities across six domains: domestic chores, household management, financial/practical help, personal care, emotional care, and sibling care. The aim of this research was to investigate the psychometric properties of the French version of the MACA-YC18. METHODS: Two quantitative studies were conducted in a general population among adolescents and young adults. The sample was composed of 2688 adolescents (Mage = 16.08; SDage = 0.98; 60.60% girls) in Study 1 and 1192 young adults (Mage = 20.52; SDage = 1.89; 78.27% girls) in Study 2. The psychometric properties were examined via construct validity through internal consistencies, confirmatory factorial analysis, and invariance measurement regarding: gender (girls vs. boys), having a sick/disabled relative (having vs. not), relative's type of illness/disability (physical illness vs. mental illness vs. other illnesses/disabilities), providing support to a sick/disabled relative (providing vs. not), and living arrangement (with family vs. not). RESULTS: In both studies, internal consistencies were in line with those reported in the literature, the 6-factor structure was confirmed, and strict invariances were highlighted. CONCLUSIONS: Results show that the French version of the MACA-YC18 has good psychometric properties regarding construct validity not only among adolescents but also among young adults. This instrument appears to be a relevant screening tool for identifying and characterizing young carers in the general population.