Caring for a Child with an Eating Disorder: Differences Among Mothers and Fathers and Parents of Adolescent and Adult Children

• Author / Creator

  Stillar, Amanda

• Background and Rationale: Eating disorders are among the most lethal and difficult psychiatric illnesses to treat. Existing research suggests that these illnesses can elicit strong emotional reactions on the part of parents, which may lead them to engage in behaviours that accommodate or enable their children’s illnesses. Recent innovations in the treatment process which include parents in caregiver roles as treatment targets have been linked to improved treatment outcomes, including reduced parental and child distress and significant weight restoration on the part of affected children. However, multiple studies suggest that parents’ reactions to their children’s eating pathology may not be uniform; the nature of their emotional reactions and their degree of perceived self-efficacy in caring for their children may vary depending on whether the parent is a mother or father due to gender differences in emotional expression, coping strategies, and parenting roles, as well as whether the parent is caring for an adolescent or adult children due to differences in parenting tasks/responsibilities and life stages when parenting ill youth versus adult offspring. The purpose of this study was to investigate whether mothers and fathers, as well as parents of adolescent and adult children with eating disorders, have differing degrees of fear and self-efficacy in relation to caring for a child with an eating disorder, and whether the emotional states and self-efficacy of parents of varying genders relate to their involvement in behaviours that accommodate or enable their children’s illnesses.
  
  Method: This quantitative study involved conducting a secondary analysis of pre-treatment data from a subsample of 143 parents (95 mothers and 48 fathers) from a Canada-wide multi-site study on Emotion-Focused Family Therapy for caregivers of individuals with eating disorders. Parental fear was measured using the Parent Traps Scale (PTS; Lafrance Robinson et al., 2014), parental self-efficacy was assessed using the Parents Versus Anorexia Scale (PVA; Rhodes, Baillie, Brown, & Madden, 2005) and accommodating and enabling behaviours were measured by the Accommodation and Enabling Scale for Eating Disorders (AESED; Sepulveda et al., 2009). Levels of fear and self-efficacy among mothers and fathers, as well as among parents of adolescent (<18) and adult children (≥18) were statistically compared via two-way between-subjects factorial Multivariate Analysis of Variance (MANOVA). The relationships among parental fear, self-efficacy, and accommodating and enabling behaviours were analyzed using mediation through linear regression, with mothers and fathers analyzed separately.
  Results & Implications: There was no significant interaction between parental gender and child developmental level. The main effect for gender was significant for fear: Mothers reported higher levels of fear about their children’s illnesses than fathers of children with eating disorders. There was no significant difference between mothers’ and fathers’ levels of perceived self-efficacy in caring for a child with an eating disorder. Furthermore, there were no differences in levels of fear or self-efficacy among parents of affected pediatric (<18) versus adult children (≥18). Among mothers, fear predicted self-efficacy and illness accommodating and enabling behaviours. The relationship between maternal fear and accommodating and enabling behaviours was not mediated by self-efficacy. Among fathers, neither fear nor self-efficacy predicted illness accommodating and enabling behaviours, nor did fear and self-efficacy levels predict each other. Collectively, these findings provide new and important information in the field of eating disorders, highlighting, for the first time ever, differences among mothers and fathers in terms of fear related to supporting their child’s recovery in addition to elucidating the relationships among variables that may directly impact children’s illnesses and treatment outcomes. This novel information can inform improvements to newly emerging family-based treatments for eating disorders and strategies for tailoring these treatments for parents of different genders to maximize family engagement and treatment success.

• Subjects / Keywords

  • eating disorders
  • family treatment

• Graduation date

  Fall 2018

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/R34T6FK0N

• License

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