Binge-spectrum eating disorders (EDs; bulimia nervosa, binge eating disorder) often develop during adolescence and are associated with serious psychological and physical consequences. Current treatments for adolescents are highly behavioral in nature and while efficacious, many patients do not reach remission indicating that current treatments fail to target a key maintenance factor for EDs. One potential maintenance factor is poor family functioning (FF). In particular, high family conflict (e.g., arguing, critical comments) and low family cohesion (e.g., warmth, support) are known to maintain ED behaviors. Poor FF can (1) cause or exacerbate an adolescent's use of ED behaviors to cope with life stress and/or (2) inhibit parents from being a resource to adolescents during ED treatment. Attachment-Based Family Therapy (ABFT) is specifically designed to improve FF, and thus may be a promising adjunct to behavioral ED intervention strategies. ABFT, however, has not been tested in adolescents with binge-spectrum EDs. Thus, the current study is the first to evaluate a 16-week adapted ABFT treatment for adolescents with EDs (N = 8, Mage = 16.00, 71.43% female, 71.43% White) fusing together behavioral treatment for EDs with ABFT for highest possible impact. Eight families were treated in an open pilot trial to examine treatment feasibility, acceptability, and preliminary efficacy on FF and eating pathology. Overall, findings were promising. ABFT + B treatment was feasible and acceptable and showed preliminary evidence that it could improve FF and ED behaviors. Future research will test this intervention in a larger sample and further examine the role of FF in maintaining ED symptoms.

中文翻译：

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基于依恋的家庭疗法改善青少年暴饮暴食症的家庭功能：通过病例系列设计进行初步评估。

暴食症（ED；神经性贪食症、暴食症）通常在青春期发生，并与严重的心理和身体后果相关。目前对青少年的治疗本质上是高度行为性的，虽然有效，但许多患者没有达到缓解，这表明当前的治疗未能针对 ED 的关键维持因素。一个潜在的维持因素是家庭功能不佳（FF）。特别是，众所周知，高家庭冲突（例如争吵、批评性评论）和低家庭凝聚力（例如温暖、支持）会维持 ED 行为。不良的 FF 可能 (1) 导致或加剧青少年使用 ED 行为来应对生活压力和/或 (2) 抑制父母在 ED 治疗期间成为青少年的资源。基于依恋的家庭疗法 (ABFT) 专门用于改善 FF，因此可能是行为 ED 干预策略的一个有前景的辅助手段。然而，ABFT 尚未在患有暴食症 ED 的青少年中进行过测试。因此，本研究首次评估了针对患有 ED 的青少年（N = 8，Mage = 16.00，71.43% 女性，71.43% 白人）的 16 周适应性 ABFT 治疗，将 ED 行为治疗与 ABFT 融合在一起，以获得最大可能的影响。八个家庭接受了一项开放试点试验，以检查治疗的可行性、可接受性以及对 FF 和饮食病理学的初步疗效。总体而言，研究结果很有希望。ABFT + B 治疗是可行且可接受的，并且初步证据表明它可以改善 FF 和 ED 行为。