TY - JOUR
T1 - The association between deficiencies in paternal and maternal reflective functioning and anorexia nervosa symptomatology
AU - Goshen, Dor
AU - Stein, Daniel
AU - Kurman, Jenny
AU - Farbstein, Dan
AU - Enoch-Levy, Adi
AU - Aival-Naveh, Erez
AU - Gur, Eitan
AU - Yoeli, Neta
AU - Bretler, Tali
AU - Koren, Danny
AU - Rothschild-Yakar, Lily
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background: A large theoretical body of knowledge exists emphasizing the importance of parental mentalizing in the context of anorexia-nervosa (AN). However, the empirical support to these assumptions is still scarce. The aim of the present study was to examine whether parents of patients with AN are characterized by a lower mentalizing ability, and whether it is associated with impaired mentalizing, AN symptomatology and eating disorder (ED) related psychological traits in the daughters. Methods: Thirty-two family triads (fathers, mothers, and daughters) of female adolescent and young adult inpatients with AN were compared with thirty-three non-clinical family triads (N = 195). The mentalizing ability of all the participants was assessed using semi-structured interviews and coded using the Reflective Functioning Scale (RFS). Self-report questionnaires were administered to the daughters to evaluate ED symptomatology and ED related psychological traits (e.g., low self-esteem, interpersonal insecurity, emotional dysregulation). Results: Decreased reflective functioning (RF) levels were found among mothers and fathers of patients with AN compared to their control peers. Examining the entire sample, clinical and non-clinical groups together, showed that both paternal and maternal RF were associated with the daughters' RF and each were found to have a significant and distinct contribution to the daughters' RF. Significant associations were found between lower levels of maternal and paternal RF and increased ED symptoms and ED related psychological traits. The use of a mediation model suggested a serial relationship in which low maternal and paternal RF contributes to the daughters' low RF, which in turn is associated with higher levels of psychological maladjustment, and ultimately contributes to the increased severity of ED symptoms. Conclusions: The present results provide strong empirical support for theoretical models that suggest that deficits in parental mentalizing may represent important correlates of the presence and severity of ED symptoms in AN. Furthermore, the results highlight the relevance of fathers' mentalizing ability in the context of AN. Finally, clinical and research implications are discussed.
AB - Background: A large theoretical body of knowledge exists emphasizing the importance of parental mentalizing in the context of anorexia-nervosa (AN). However, the empirical support to these assumptions is still scarce. The aim of the present study was to examine whether parents of patients with AN are characterized by a lower mentalizing ability, and whether it is associated with impaired mentalizing, AN symptomatology and eating disorder (ED) related psychological traits in the daughters. Methods: Thirty-two family triads (fathers, mothers, and daughters) of female adolescent and young adult inpatients with AN were compared with thirty-three non-clinical family triads (N = 195). The mentalizing ability of all the participants was assessed using semi-structured interviews and coded using the Reflective Functioning Scale (RFS). Self-report questionnaires were administered to the daughters to evaluate ED symptomatology and ED related psychological traits (e.g., low self-esteem, interpersonal insecurity, emotional dysregulation). Results: Decreased reflective functioning (RF) levels were found among mothers and fathers of patients with AN compared to their control peers. Examining the entire sample, clinical and non-clinical groups together, showed that both paternal and maternal RF were associated with the daughters' RF and each were found to have a significant and distinct contribution to the daughters' RF. Significant associations were found between lower levels of maternal and paternal RF and increased ED symptoms and ED related psychological traits. The use of a mediation model suggested a serial relationship in which low maternal and paternal RF contributes to the daughters' low RF, which in turn is associated with higher levels of psychological maladjustment, and ultimately contributes to the increased severity of ED symptoms. Conclusions: The present results provide strong empirical support for theoretical models that suggest that deficits in parental mentalizing may represent important correlates of the presence and severity of ED symptoms in AN. Furthermore, the results highlight the relevance of fathers' mentalizing ability in the context of AN. Finally, clinical and research implications are discussed.
KW - Anorexia nervosa
KW - Eating disorders
KW - Mentalizing
KW - Parental reflective functioning
KW - Reflective functioning
UR - http://www.scopus.com/inward/record.url?scp=85165151873&partnerID=8YFLogxK
U2 - 10.1186/s40337-023-00836-6
DO - 10.1186/s40337-023-00836-6
M3 - Article
C2 - 37434261
AN - SCOPUS:85165151873
SN - 2050-2974
VL - 11
JO - Journal of Eating Disorders
JF - Journal of Eating Disorders
IS - 1
M1 - 116
ER -