ArticleEuropean child & adolescent psychiatry2023
Attachment and mentalization as predictors of outcome in family therapy for adolescent anorexia nervosa.
Article in European child & adolescent psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Pooled it
- Moderators of treatment effect in a randomised controlled trial of single- and multi-family therapy for anorexia nervosa in adolescents and emerging adults.European eating disorders review : the journal of the Eating Disorders Association · 2026Trial
- Mentalization and Emotion Regulation in Adolescent Attachment: A Scoping Review.Children (Basel, Switzerland) · 2026Review
- What factors do parents/caregivers think impact change in family therapy for anorexia nervosa?: a qualitative study.Journal of eating disorders · 2025Article
- The Body as a Battlefield: Identity Development and Psychosomatic Expression in Eating Disorders Across Childhood and Adolescence.Children (Basel, Switzerland) · 2025Review
- Social function in adolescent eating disorders: lived experience framework for clinical practice.BJPsych open · 2025Article
- Weight gained during treatment predicts 6-month body mass index in a large sample of patients with anorexia nervosa using ensemble machine learning.The International journal of eating disorders · 2024Article
- How young people perceive change to occur in family therapy for anorexia nervosa: a qualitative study.Journal of eating disorders · 2024Article
- Complexity of mentalization.Frontiers in psychology · 2024Review
- The association between deficiencies in paternal and maternal reflective functioning and anorexia nervosa symptomatology.Journal of eating disorders · 2023Article
- Emotional dysregulation in childhood and disordered eating and self-harm in adolescence: prospective associations and mediating pathways.Journal of child psychology and psychiatry, and allied disciplines · 2023Article
- Impact of the Mediational Intervention for Sensitizing Caregivers on Mentalizing in Orphans and Vulnerable Children in South Africa.Journal of infant, child, and adolescent psychotherapy : JICAP · 2023Article
- Article
- Change processes during intensive day programme treatment for adolescent anorexia nervosa: a dyadic interview analysis of adolescent and parent views.Frontiers in psychology · 2023Article
- Weight restoration in adolescent anorexia: parents' goal-directed processes.Journal of eating disorders · 2022Article
- Formulation in eating disorder focused family therapy: why, when and how?Journal of eating disorders · 2021Review
- Is this the 'new normal'? A mixed method investigation of young person, parent and clinician experience of online eating disorder treatment during the COVID-19 pandemic.Journal of eating disorders · 2021Article
- Brief early adolescent multi-family therapy (BEAM) trial for anorexia nervosa: a feasibility randomized controlled trial protocol.Journal of eating disorders · 2021Article
- Moving online: young people and parents' experiences of adolescent eating disorder day programme treatment during the COVID-19 pandemic.Journal of eating disorders · 2021Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
Anorexia nervosa-focussed family therapy (FT-AN) is the first-line treatment for adolescent anorexia nervosa (AN), but the predictors of poor treatment response are not well understood. The main aim of this study was to investigate the role of attachment and mentalization in predicting treatment outcome. The secondary aims of the study were to investigate therapeutic alliance at 1 month as a predictor of outcome, and to test the associations between alliance and baseline attachment and mentalization. 192 adolescents with AN and their parents were recruited as they began family therapy in out-patient specialist eating disorder services. Self-report measures of attachment, mentalization, and emotion regulation were completed at the start of treatment by adolescent patients and one of their parents. Self-reported alliance scores were collected at one month. Higher scores on the Certainty Scale of the Reflective Functioning Questionnaire, completed by parents, which indicate over-certainty about mental states, were the strongest predictor of poor outcome (Odds Ratio: 0.42, CI: 0.20-0.87). Similarly, for adolescents, higher Lack of Clarity scores on the Difficulties in Emotion Regulation Scale, representing being unclear about one's feelings, were predictive of positive treatment outcome (OR: 1.10, CI: 1.00-1.21). Higher alliance scores at 1 month predicted positive outcome, and were associated with attachment security and mentalization. These novel findings suggest that, particularly in parents, a tendency towards excessive certainty about mental states in others may predict poor outcome in FT-AN. Further research is warranted to replicate the finding and characterise families at risk of poor outcome.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.