Interacción de los rasgos de personalidad de los padres con hijas adolescentes al inicio de la anorexia nerviosa: un estudio de casos y controles / Interaction of parental personality traits with adolescent daughters at the onset of anorexia nervosa: a case-control study

El objetivo del estudio fue examinar la relación entre los rasgos de personalidad de los padres y sus hijas con anorexia nerviosa (AN) mediante un estudio de casos y controles. Fueron evaluadas 50 chicas adolescentes con AN (G-AN) y 50 chicas sanas (GC), junto con sus padres, con el “Inventario de temperamento y carácter revisado” y el “Inventario de trastornos de la conducta alimentaria-2”. El G-AN y el GC no difirieron en los rasgos de personalidad. Los padres del G-AN mostraron diferencias significativas en los rasgos temperamentales y de carácter en comparación con los padres del GC. Se encontraron relaciones complementarias en la evitación del daño de las madres con la cooperación y la fantasía de las hijas en el G-AN, mientras que en los padres y las hijas se encontraron asociaciones entre la dependencia de la recompensa, la persistencia y la autodirección. La única escala que discriminó entre el G-AN y GC fue la obsesión por la delgadez (clasificación: 74,7%). La identificación de los rasgos de personalidad de padres y adolescentes al inicio de la AN permitirá mejorar la intervención. (AU)

ENTREN-F family-system based intervention for managing childhood obesity: Study protocol for a randomized controlled trial at primary care.

BACKGROUND: Pediatric obesity is a primary public health concern, and designing effective programs for managing it is of the utmost importance. The objective of this study was to describe the protocol study of a three-arm, parallel, randomized controlled trial aimed at assessing the efficacy of a family-system-based intervention ("ENTREN-F" program) for managing childhood obesity, compared to the "ENTREN" program (no "F" - without specific family-system-based workshop) and a control group (behavioral monitoring). METHODS/DESIGN: The ENTREN-F program was a multicomponent family-system-based intervention carried out by a multidisciplinary team in the primary health care setting. The program targeted children between 8 and 12 years with overweight and obesity (P ≥ 85th). Parents were actively involved in the process. The contents were designed using the Cognitive Behavioral Therapy (CBT) principles. The program comprised individual behavioral monitoring, a healthy habits workshop for children and their parents, a CBT workshop for children, and a family-system-based workshop for parents, enhancing parental management skills plus family functioning. The trial's primary outcomes included changes in child body mass index (BMI) z-scores, child's psychological well-being, and family functioning over six months. Secondary outcomes included changes in eating behavior, physical activity, self-esteem, parental distress, parental feeding practices, and parental modeling. DISCUSSION: To our knowledge, this is one of the few randomized controlled trials to assess the efficacy of a multicomponent program that considers health from a comprehensive perspective, trying to improve children's psychological well-being and family functioning besides weight loss. This study, therefore, addresses a gap in the literature. If found to be efficacious, it suggests a new potential health service for translation into National Primary Health Care services in Spain, one of the ten countries with the highest prevalence of obesity in Europe.

Biological, psychological and familial specific correlates in eating disorders at onset: a control-case study protocol (ANOBAS).

The complexity in the development of an eating disorder (ED) pose methodological challenges when addressing risk factors of this pathology. Pike et al. (2008) proposed to use a case-control design for this type of research.

Physical Appearance Perfectionism: Psychometric Properties and Factor Structure of an Assessment Instrument in a Representative Sample of Males.

Perfectionism is a multidimensional construct with both positive and negative aspects. Recently, the concept of appearance-oriented perfectionism has been introduced, which is associated with body image dissatisfaction and weight and shape control behaviors. The Physical Appearance Perfectionism Scale (PAPS) is a 12-item two-factor instrument developed to assess this new dimension of perfectionism. The aim of the study is to validate the Spanish version of PAPS among a representative sample of 850 male university students in Spain (M = 20 years old; SD = 2.7). Exploratory and confirmatory factorial structure, internal consistency, convergent and concurrent validity, and associated predictor variables analyses have been carried out. Results showed that the Spanish version of the PAPS maintains the original factor structure with all items and proves to be a reliable instrument. Physical appearance-oriented perfectionism is associated with general perfectionism, higher body dissatisfaction, Eating Disorders and Muscle Dysmorphia symptomatology, and compulsive exercise, particularly in the Worry about Imperfection subscale. These variables also act as predictors of physical appearance perfectionism. The use of the PAPS-S and the analysis of its subscales is recommended in the context of body image-related pathologies such as Eating Disorders and Muscle Dysmorphia.

Correlatos biológicos, psicológicos yfamiliares específicos en el inicio delos trastornos alimentarios: Estudio caso-control (ANOBAS) / Biological, psychological and familial specific correlates in eating disorders at onset: A control-case study protocol (ANOBAS)

Introducción. La complejidad asociada al desarrollo de los trastornos alimentarios (TCA) supone un reto metodológico en la investigación sobre los factores de riesgo implicados en el trastorno, siendo el diseño caso-control el adecuado para investigarlos. El Estudio de Factores de Riesgo de los TCA (ANOBAS) es un estudio caso-control con tres grupos de control que tiene el objetivo de evaluar distintos correlatos relacionados con el inicio de un TCA. El objetivo de este estudio es mostrar una nueva propuesta metodológica de evaluación y comprobar si los grupos de control son adecuados para estudiar cuáles son los correlatos específicos. Metodología. Se usó un estudio caso-control con 50 adolescentes con TCA al inicio de la patología, emparejadas por edad y estatus socioeconómico de los padres con 40 adolescentes con trastorno afectivo al inicio, 40 adolescentes con patología asmática y 50 adolescentes sin patología. El diagnóstico se realizó a través de la entrevista K-SADS y se hizo una evaluación de los correlatos biológicos, psicológicos y familiares. Resultados. Como se esperaba, altas similitudes fueron encontradas entre el grupo TCA y el grupo con trastorno afectivo en los correlatos psicológicos, mientras que las similitudes entre el grupo TCA y el grupo con patología asmática fueron encontradas en el plano familiar. Las principales diferencias fueron encontradas con el grupo sin patología. Conclusiones. Esta rigurosa propuesta metodológica permite investigar qué correlatos se asocian específicamente al inicio de un TCA, siendo los grupos de control seleccionados adecuados para investigarlo. (AU)

Background. The complexity in the development of an eating disorder (ED) pose methodological challenges when addressing risk factors of this pathology. Pike et al. (2008) proposed to use a case-control design for this type of research. The eating disorders’ risk factor study (ANOBAS) is a case-control study with three control groups aiming to evaluate several variables related to the onset of ED, thus the aim was to illustrate a new methodology proposal and to assess whether the chosen control groups are appropriate to research correlates on ED. Methods. We used a case-control design of 50 female adolescents with ED at onset matched by age and their parents’ socioeconomic status with 40 patients with an affective disorder, 40 patients with asthma pathology and 50 without pathology. Diagnoses were completed with K-SADS interview and an evaluation of biological, psychological, environmental and family correlates. Results. Higher similarities were found between the ED group and the affective disorder group across psychological variables, whereas the similarities between the ED group and the asthma group were found at the familial level, as we expected. The biggest differences were found with the non-pathology group. Conclusions. This rigorous research design allows investigating correlates associated specifically to the onset of an ED and the chosen control groups are suitable to investigate it. (AU)

Toward a Biological, Psychological and Familial Approach of Eating Disorders at Onset: Case-Control ANOBAS Study.

Eating disorders (ED) are considered as heterogeneous disorders with a complex multifactor etiology that involves biological and environmental interaction. Objective: The aim was to identify specific ED bio-psychological-familial correlates at illness onset. Methods: A case-control (1:1) design was applied, which studied 50 adolescents diagnosed with ED at onset (12-17 years old) and their families, paired by age and parents' socio-educational level with three control samples (40 with an affective disorder, 40 with asthma, and 50 with no pathology) and their respective families. Biological, psychological, and familial correlates were assessed using interviews, standardized questionnaires, and a blood test. Results: After performing conditional logistic regression models for each type of variable, those correlates that showed to be specific for ED were included in a global exploratory model (R 2 = 0.44). The specific correlates identified associated to the onset of an ED were triiodothyronine (T3) as the main specific biological correlate; patients' drive for thinness, perfectionism and anxiety as the main psychological correlates; and fathers' emotional over-involvement and depression, and mothers' anxiety as the main familial correlates. Conclusion: To our knowledge, this is the first study to use three specific control groups assessed through standardized interviews, and to collect a wide variety of data at the illness onset. This study design has allowed to explore which correlates, among those measured, were specific to EDs; finding that perfectionism and family emotional over-involvement, as well as the T3 hormone were relevant to discern ED cases at the illness onset from other adolescents with or without a concurrent pathology.

Adding maintaining factors to developmental models of anorexia nervosa: An empirical examination in adolescents.

OBJECTIVE: A biopsychosocial approach has been proposed to explain the pathogenesis of anorexia nervosa (AN), despite only a few of the existing etiological models having received empirical support. The aim of this study was to empirically investigate Herpertz-Dahlmann, Seitz, and Konrad (2011, https://doi.org/10.1007/s00406-011-0246-y)'s developmental model and to consider if interpersonal reactions to the illness might serve as maintaining factors following the model proposed by Treasure and Schmidt (2013, https://doi.org/10.1186/2050-2974-1-13) METHOD: One hundred adolescents and their families were participated in the study: 50 diagnosed with AN, paired by age and parents' socio-economic status with 50 adolescents without a pathology. Biological, psychological and familial variables were assessed using ten questionnaires and a blood analysis test. Additionally, structural equation modeling was conducted to assess two hypothetical models. RESULTS: The fit of both models was good after the addition of two covariate parameters (e.g., Comparative Fit Index > 0.96 and Tucker-Lewis Index > 0.95). Premorbid traits were linked to body dissatisfaction and to the number of stressful life events; this in turn was linked to AN symptoms. Biological and familial consequences reinforced this pathology. CONCLUSIONS: Our findings provide support for both models, suggesting that inter relationships between bio-psycho-familial variables can influence the course of AN during adolescence.