Modifiable factors associated with mental health symptoms in siblings of adolescents with anorexia nervosa
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ORIGINAL ARTICLE
Modifiable factors associated with mental health symptoms in siblings of adolescents with anorexia nervosa Abigail Matthews1,2 · Claire M. Peterson1,2 · Katrina Lenz1 · Rachel A. Kramer1,2 · Constance Mara1,2 · Emily Copps1 · Laurie Mitan1,3 Received: 12 May 2020 / Accepted: 21 August 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose Research demonstrates that anorexia nervosa (AN) takes a significant toll on affected families, yet the well-being of siblings has been largely overlooked. This study examines mental health symptoms in siblings of adolescents with AN and seeks to identify modifiable factors associated with well-being. Method Participants included 34 siblings (aged 11–19) of adolescents with AN and 47 age and sex matched controls. Participants and their caregivers completed assessments of anxiety, depression, internalizing and externalizing problems, and parentification. Siblings of adolescents with AN also completed the Sibling Perception Questionnaire, an assessment of perceptions and attitudes about AN. Results Analyses indicated that siblings of adolescents with AN reported greater anxiety and parentification than controls. On caregiver reports of participants’ internalizing and externalizing symptoms, no significant differences were found across groups. In siblings of adolescents with AN, females were more vulnerable to anxiety, depression, and negative attitudes and perceptions about AN than males. Perceived negative interpersonal interactions, specific to having a brother or sister with AN, were associated with greater anxiety and depression among AN siblings. Conclusion Findings from this pilot study suggest that siblings of adolescents with AN are vulnerable to anxiety and parentification behaviors. Negative interpersonal interactions specific to having a brother or sister with AN may perpetuate risk for poorer well-being. Caregivers may not be attuned to these struggles, highlighting the importance of provider and family education about sibling vulnerabilities. Therapeutic interventions that target siblings of adolescents with AN are also indicated. Level of evidence Level III, case–control analytic study. Keywords Anorexia nervosa · Siblings · Adolescence · Well-being · Parentification
Introduction Anorexia nervosa (AN) is a serious health condition with the highest incidence among adolescents, ages 15–19 [1]. AN is often characterized by a chronic course, with a reported median illness duration of seven years in females [2] and the * Abigail Matthews [email protected] 1
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
2
Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
3
Division of Adolescent and Transition Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
highest mortality rate of any mental illness [3]. Living with and caring for an adolescent with AN can have a pervasive impact on fami
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