Samenvatting
Eetstoornissen in het eetbuispectrum (boulimia nervosa, eetbuistoornis) ontstaan vaak tijdens de adolescentie en deze gaan gepaard met ernstige psychische en lichamelijke gevolgen. De huidige behandelingen voor adolescenten zijn sterk gedragstherapeutisch georiënteerd, en hoewel deze behandelingen werkzaam zijn, herstellen veel patiënten niet volledig van hun eetstoornis, een aanwijzing dat een belangrijke instandhoudende factor met deze therapieën niet wordt aangepakt. Een potentiële instandhoudende factor is een slecht gezinsfunctioneren. Met name hoge mates van conflicten in het gezin (bijv. ruzies, kritische opmerkingen) en een lage gezinscohesie (bijv. warmte en steun) staan bekend als factoren die eetstoornisgedragingen in stand houden. Een slecht gezinsfunctioneren kan (1) het gebruik van eetstoornisgedragingen als methode van coping met stress veroorzaken of verergeren en/of (2) ouders belemmeren om tijdens de behandeling van de eetstoornis een bron van steun te zijn voor hun adolescent. ‘Attachment-Based Family Therapy’ (ABFT; gezinstherapie met gehechtheidsrelaties als uitgangspunt, red.) is specifiek ontwikkeld voor het verbeteren van het gezinsfunctioneren en kan daarom een waardevolle aanvulling zijn op gedragstherapeutische interventiestrategieën voor eetstoornissen. ABFT is echter nog niet onderzocht bij adolescenten met een eetstoornis in het eetbuispectrum. Het hier beschreven onderzoek is dus de eerste studie waarin een 16 weken durende aangepaste ABFT-behandeling voor adolescenten met eetstoornissen wordt geëvalueerd (N = 8, Mleeftijd = 16,00, 71,43% meisjes, 71,43% wit), die wordt gecombineerd met een gedragstherapeutische behandeling voor eetstoornissen om een zo groot mogelijk effect te bereiken. In een open pilotexperiment zijn acht gezinnen behandeld met het doel te onderzoeken of deze behandeling geschikt, aanvaardbaar en ‘voorlopig werkzaam’ is als interventie voor het gezinsfunctioneren en de eetstoornisproblematiek. Over de hele linie waren de resultaten veelbelovend. De behandeling met ABFT en gedragstherapie was geschikt, aanvaardbaar en bleek voorlopig werkzaam in die zin dat de interventie tot verbetering kon leiden van het gezinsfunctioneren en de eetstoornisgedragingen. In toekomstig onderzoek wordt deze interventie onderzocht met een grotere steekproef en wordt verder gekeken naar de rol van het gezinsfunctioneren in de instandhouding van eetstoornissymptomen.
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This material was originally published in English as “Attachment-Based Family Therapy to Improve Family Functioning in Adolescent Binge-Spectrum Eating Disorders: An Initial Evaluation Via Case Series Design”. Clinical Child and Adolescent Psychiatry, 2024, 29(1), 45–62. Sage, copyright 2023 van de auteurs. https://doi.org/10.1177/13591045231187433. Vertaling: drs. Lieke Berkhuizen, Rijnsburg.
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Manasse, S.M., Russon, J., Lampe, E.W. et al. Attachment-based family therapy, ter verbetering van het gezinsfunctioneren bij problemen tijdens de adolescentie met eetstoornissen in het eetbuispectrum: een eerste evaluatie door middel van een casusreeks. Gezinstherapie Wereldwijd 35, 348–368 (2024). https://doi.org/10.1007/s12440-024-00230-x
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DOI: https://doi.org/10.1007/s12440-024-00230-x