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Examining change in mentalisation in adolescents and their parents going through Family Therapy for Anorexia Nervosa

Reflective function (RF) describes the ability to understand the mental state of oneself and others. It is important for psychological wellbeing, interpersonal function and effective parenting.

Recent evidence suggests that parent’s excessive certainty about mental states is a predictor of poor outcome in family therapy for adolescent anorexia nervosa (AN), using Morgan-Russel Outcome Scale and the Reflective Functioning Questionnaire (RFQ) (Jewell et al, 2020). In the same study, high clarity of feelings in young people also predicted poor outcome, using the Difficulties in Emotion Regulation Scale (DERS). It is not known whether parental and adolescent certainty about mental states changes, and whether this change itself might predict outcome.

The present study aimed to answer these questions through secondary analysis on the same dataset of and their parents undergoing family therapy for AN. Parents’ Certainty scores increased significantly over 9 months; significant change occurred between one month and six months and between one month and nine months. Young people’s Lack of Clarity scores on the DERS significantly decreased; significant change occurred between baseline and three months, and one month and three months. A binomial logistic regression indicated that changes in mental state certainty did not significantly predict treatment outcome at nine months. These results suggest that, as treatment progresses, parents become more certain about mental states while young people become more able to identify their own emotions. These changes, however, do not appear to predict how well young people respond to family therapy.

Cecily Donnelly

Cecily Donnelly is a PhD Researcher examining the relationship between mentalisation and eating disorders.