Evidence map›Paper›PMID 41449476›Full record

ArticleJournal of eating disorders2025

Perceived carer skills and psychological distress in fathers and mothers of adults with anorexia nervosa: a longitudinal study.

Melahat Nur Akkese, Johanna Keeler, John Hodsoll, Suman Ambwani, Hubertus Himmerich, Katie Rowlands, Valentina Cardi, Janet Treasure

Abstract read
In one paragraph

Article in Journal of eating disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Melahat Nur AkkeseDepartment of Psychological Medicine, Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK. melahat_nur.akkese@kcl.ac.uk.ORCID http://orcid.org/0009-0009-2866-4849
Johanna KeelerDepartment of Psychological Medicine, Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.ORCID http://orcid.org/0000-0002-3905-9857
John HodsollDepartment of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.ORCID http://orcid.org/0000-0001-7546-9901
Suman AmbwaniDIS Study Abroad in Scandinavia, Copenhagen, Denmark.ORCID http://orcid.org/0000-0001-7975-1971
Hubertus HimmerichDepartment of Psychological Medicine, Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.ORCID http://orcid.org/0000-0003-1209-6073
Katie RowlandsDepartment of Psychological Medicine, Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.ORCID http://orcid.org/0000-0002-9671-4344
Valentina CardiDepartment of Psychological Medicine, Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.ORCID http://orcid.org/0000-0002-7763-7099
Janet TreasureDepartment of Psychological Medicine, Centre for Research in Eating and Weight Disorders (CREW), Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.ORCID http://orcid.org/0000-0003-0871-4596

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundParents often remain the primary carers for their adult children with anorexia nervosa (AN) for an extended time. Carer strain and unhelpful behaviours have been extensively investigated as contributors to the maintenance of the illness and suggested several differences between fathers and mothers. However, the skilful dimensions of parental caregiving have been overlooked, and no longitudinal research has examined the caregiver abilities and psychological well-being of parents during their child's transition from an intensive treatment. This exploratory study compares the trajectories of change in perceived carer skills and psychological distress between fathers and mothers of adult patients with AN over an 18-month period during the transition from intensive hospital care.

methodsFifty two fathers and 224 mothers of adult AN patients were included in this study. A secondary analysis was conducted on data from the TRIANGLE trial using linear mixed-effects models. Outcomes were the total and subscale scores from the Caregiver Skills Scale (CASK) and the Depression, Anxiety, and Stress scale (DASS-21) in fathers and mothers at baseline, 6, 12, and 18 months.

resultsPost-hoc tests revealed that fathers and mothers did not show significant differences in the CASK scores at any time-point (except for higher paternal "Self-Care" and "Biting-your-tongue" skills at baseline). However, the trajectories of change in their abilities differed between parents. Mothers showed significant increases over time in the overall CASK and in several of the subscales from baseline to month 18 (but not months 6 or 12), whereas fathers did not show significant changes in the total or subscale scores at any time point. In contrast, the changes in distress levels (DASS-21) followed similar trajectories for fathers and mothers over time.

conclusionsFathers and mothers may have distinct needs in order to enhance their caregiving skills in the long-term. Although the findings require validation in future research involving father-mother dyads, effort should be made to ensure that carer support is tailored to be fit-for-purpose for both fathers and mothers.

trial registrationThe TRIANGLE trial whose parental data was used in this study was pre-registered on the ISRCTN registry (ISRCTN14644379).

Indexed as

Anorexia nervosaCarer skillsFathersLongitudinalMothersPsychological distressTransition

Identifiers

PMID41449476
PMCPMC12849123

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Registered trials

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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.