(PS7-46) Exploring the Impact of Adjunctive Cognitive Remediation Therapy on the Caregiving Experience in Parents of Adolescents with Anorexia Nervosa

Objective: Anorexia nervosa (AN) during adolescence has a multi-faceted impact on caregivers. Existing data on caregiver strain suggests that parents of youth with AN, particularly mothers, exhibit heightened anxiety when compared to parents of healthy controls. Family-based treatment (FBT) is the first line approach for adolescents with AN, empowering parents to take charge of the recovery process and renourish their child. Existing interventions to target caregiver burden have demonstrated preliminary effectiveness; however, it is unclear whether adjunctive treatments provide additional benefits above treatment-as-usual (TAU). To understand the potential of caregiver-specific interventions, we investigated whether adjunctive delivery of cognitive remediation therapy (CRT) to p</span>arents of adolescents receiving FBT for AN impacted change in caregiver burden beyond TAU.  

Method: We examined caregiver burden via the Experience of Caregiving Inventory (ECI). Participants were 59 mother-father dyads of youth diagnosed with AN (M= 15 years). Of the sample, 90% of mothers and 92% of fathers identified as White. We randomized 20 parent dyads to receive CRT in addition to FBT and 39 to receive TAU. Parents received 15 sessions of CRT and TAU each over 6 months and ECI was collected at baseline and end-of-treatment. We used repeated measures analysis of variance to examine the effects of time and condition on caregiver ECI.  

Results: For mothers, we saw a significant reduction in negative symptoms by end of treatment, F(1,36) = 41.38, p < .001, partial h2 = .54; there was no significant interaction between time and condition F(1,36) = 1.11, p =.30, partial h2 = .03. Maternal report of positive symptoms increased over treatment, F(1,36) = 8.30, p < .01, partial h2 = .19; however, there was no significant interaction with condition F(1,36) = 3.54, p =.07, partial h2 = .09. Fathers reported a significant decrease in negative symptoms over the course of treatment F(1,37) = 36.10, p < .001, partial h2 = .49; however, this did not differ by condition F(1,37) = 0.03, p =.87, partial h2 = .00. Finally, there was no change in paternal report of positive aspects of caregiving across time or condition (all ps > .05).  

Discussion: Parents experienced significant reduction in negative caregiving experiences (i.e., report of stigma and loss) from pre- to post-treatment. Only mothers reported an improvement in positive aspects of caregiving (i.e., report of positive relationships), potentially reflecting the greater role that mothers typically play in renourishment during FBT. Importantly, the addition of CRT did not impact changes in caregiver burden beyond improvements from FBT alone. Future work should explore whether other interventions with preliminary efficacy can improve outcomes for caregivers beyond TAU alone.