How do families of adolescents with anorexia nervosa coordinate parenting?

Current guidelines for the treatment of anorexia nervosa (AN) in children and adolescents underline the central role of parents’ involvement for positive therapy outcomes. However, little is known about the influence of cooperation between the parental couple on family functioning and the maintenance of food symptoms in the anorexic child. This exploratory study reports preliminary data on coparenting and family functioning in families of adolescents with AN and their associations with food symptoms, in terms of body mass index (BMI). The sample consisted of 24 families of adolescents with AN, who had been admitted to a specialized tertiary level children’s hospital. Family coordination was evaluating using the Lausanne Trilogue Play (LTP) and coparenting style was measured using the Coparenting and Family Rating System (CFRS). Significant differences were found for different LTP functions (Friedman’s chi-square = 52.188; p < 0.001) and phases (Friedman’s chi-square = 10.277; p < 0.05). Families showed low coordination (66.7%) and a prevalence of dysfunctional co-parenting styles, including child-at-center (41.2%) and excluding (35.3%) styles. Families’ ability to participate in the third phase of the LTP was positively associated with BMI (rho = 0.558, p < 0.01). The coparenting relationship impacts the maintenance of eating pathology, though this association requires further investigation. Moreover, in line with clinical observations, the results show a prevalence of unexpressed parental conflict in the study sample. The LTP seems to be a more accurate observational tool for this kind of family dynamic than the CFRS, because it includes covert competitive and conflictual behaviors.