Parental psychopathology and expressed emotion in children with avoidant/restrictive food intake disorder

Abstract Background Family factors like parental psychopathology and parental expressed emotion, referring to the emotional atmosphere within a family, play a significant role in the maintenance and treatment outcome of anorexia nervosa. However, nothing is known about these parental characteristics...

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Main Authors: Hannah Lea Klüber, Annick Martin, Franziska Schlensog-Schuster, Andreas Hiemisch, Wieland Kiess, Anja Hilbert, Ricarda Schmidt
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Child and Adolescent Psychiatry and Mental Health
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Online Access:https://doi.org/10.1186/s13034-025-00929-x
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author Hannah Lea Klüber
Annick Martin
Franziska Schlensog-Schuster
Andreas Hiemisch
Wieland Kiess
Anja Hilbert
Ricarda Schmidt
author_facet Hannah Lea Klüber
Annick Martin
Franziska Schlensog-Schuster
Andreas Hiemisch
Wieland Kiess
Anja Hilbert
Ricarda Schmidt
author_sort Hannah Lea Klüber
collection DOAJ
description Abstract Background Family factors like parental psychopathology and parental expressed emotion, referring to the emotional atmosphere within a family, play a significant role in the maintenance and treatment outcome of anorexia nervosa. However, nothing is known about these parental characteristics in avoidant/restrictive food intake disorder (ARFID). Objective This study aimed to determine the proportion of parents exceeding clinical cutoffs for depression, eating disorder psychopathology, and expressed emotion, specifically criticism and emotional overinvolvement, in ARFID, anorexia nervosa (AN), and healthy controls (HC), and to evaluate group differences. Associations between parental characteristics and child illness characteristics were analyzed. Method Treatment-seeking children and adolescents (0–17 years) with ARFID (n = 42) were compared to those with AN (n = 25) and HC (n = 42) in parental eating disorder psychopathology (Eating Disorder Examination-Questionnaire 8), parental depression (Patient Health Questionnaire-9), and parental expressed emotion (Family Questionnaire). Results When comparing ARFID with AN and HC, the proportions of parents exceeding clinical cutoffs for depression (26% vs. 20% vs. 14%), eating disorder psychopathology (7% vs. 12% vs. 9%), and criticism (26% vs. 32% vs. 29%) did not differ significantly. For emotional overinvolvement (41% vs. 52% vs. 0%), differences emerged between ARFID and HC, but not AN. Dimensionally, levels of parental depressive symptoms and emotional overinvolvement were higher in those with ARFID versus HC only. More parental depressive symptoms, criticism, and emotional overinvolvement were significantly related to greater children’s restrictive eating behaviors, lower standardized body-mass-index, and lower number of accepted foods. Conclusion ARFID and anorexia nervosa were found to share similar distributions in parental psychopathology and parental expressed emotion. Future studies may focus on the role of those family factors in development and outcome of ARFID.
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spelling doaj-art-af9201eefa5f46f2bcb544e9fe422dd02025-08-20T03:10:38ZengBMCChild and Adolescent Psychiatry and Mental Health1753-20002025-06-011911910.1186/s13034-025-00929-xParental psychopathology and expressed emotion in children with avoidant/restrictive food intake disorderHannah Lea Klüber0Annick Martin1Franziska Schlensog-Schuster2Andreas Hiemisch3Wieland Kiess4Anja Hilbert5Ricarda Schmidt6Integrated Research and Treatment Center (IFB) AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical CenterDepartment of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Leipzig University Medical CenterDepartment of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Leipzig University Medical CenterLIFE Leipzig Research Center for Civilization Diseases, Leipzig UniversityLIFE Leipzig Research Center for Civilization Diseases, Leipzig UniversityIntegrated Research and Treatment Center (IFB) AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical CenterIntegrated Research and Treatment Center (IFB) AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Leipzig University Medical CenterAbstract Background Family factors like parental psychopathology and parental expressed emotion, referring to the emotional atmosphere within a family, play a significant role in the maintenance and treatment outcome of anorexia nervosa. However, nothing is known about these parental characteristics in avoidant/restrictive food intake disorder (ARFID). Objective This study aimed to determine the proportion of parents exceeding clinical cutoffs for depression, eating disorder psychopathology, and expressed emotion, specifically criticism and emotional overinvolvement, in ARFID, anorexia nervosa (AN), and healthy controls (HC), and to evaluate group differences. Associations between parental characteristics and child illness characteristics were analyzed. Method Treatment-seeking children and adolescents (0–17 years) with ARFID (n = 42) were compared to those with AN (n = 25) and HC (n = 42) in parental eating disorder psychopathology (Eating Disorder Examination-Questionnaire 8), parental depression (Patient Health Questionnaire-9), and parental expressed emotion (Family Questionnaire). Results When comparing ARFID with AN and HC, the proportions of parents exceeding clinical cutoffs for depression (26% vs. 20% vs. 14%), eating disorder psychopathology (7% vs. 12% vs. 9%), and criticism (26% vs. 32% vs. 29%) did not differ significantly. For emotional overinvolvement (41% vs. 52% vs. 0%), differences emerged between ARFID and HC, but not AN. Dimensionally, levels of parental depressive symptoms and emotional overinvolvement were higher in those with ARFID versus HC only. More parental depressive symptoms, criticism, and emotional overinvolvement were significantly related to greater children’s restrictive eating behaviors, lower standardized body-mass-index, and lower number of accepted foods. Conclusion ARFID and anorexia nervosa were found to share similar distributions in parental psychopathology and parental expressed emotion. Future studies may focus on the role of those family factors in development and outcome of ARFID.https://doi.org/10.1186/s13034-025-00929-xEating disordersARFIDExpressed emotionParentsFamily factors
spellingShingle Hannah Lea Klüber
Annick Martin
Franziska Schlensog-Schuster
Andreas Hiemisch
Wieland Kiess
Anja Hilbert
Ricarda Schmidt
Parental psychopathology and expressed emotion in children with avoidant/restrictive food intake disorder
Child and Adolescent Psychiatry and Mental Health
Eating disorders
ARFID
Expressed emotion
Parents
Family factors
title Parental psychopathology and expressed emotion in children with avoidant/restrictive food intake disorder
title_full Parental psychopathology and expressed emotion in children with avoidant/restrictive food intake disorder
title_fullStr Parental psychopathology and expressed emotion in children with avoidant/restrictive food intake disorder
title_full_unstemmed Parental psychopathology and expressed emotion in children with avoidant/restrictive food intake disorder
title_short Parental psychopathology and expressed emotion in children with avoidant/restrictive food intake disorder
title_sort parental psychopathology and expressed emotion in children with avoidant restrictive food intake disorder
topic Eating disorders
ARFID
Expressed emotion
Parents
Family factors
url https://doi.org/10.1186/s13034-025-00929-x
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