Background: The current study investigates determinants of treatment evaluation by adolescent outpatients with anorexia nervosa (AN) and the accordance with their parents' and psychotherapists' evaluation.
Sampling and methods: The sample included 50 female adolescent outpatients (mean age: 16.9 ± 1.8) with AN (DSM-IV). They were randomly assigned to either cognitive-behavior therapy (CBT) or dialectical-behavior therapy (DBT). Before (T1) and after treatment (T2) diagnostic interviews as well as self-report questionnaires were administered measuring eating disorder-specific and general psychopathology. The subjective evaluation of the therapy was assessed by a self-report questionnaire. Data on the evaluation of treatment of 42 parents were considered as well as treatment evaluations of the therapists for 48 patients.
Results: Our results revealed significant correlations of treatment satisfaction between parents and therapists, whereas patients and therapists as well as patients and parents did not agree in their treatment evaluation. The change in body mass index (BMI) was a significant predictor of the patients' treatment satisfaction.
Conclusion: Adolescent patients displaying high severity of AN at the beginning of treatment put little emphasis on the importance of body weight even after treatment. Satisfaction ratings of this special group of patients could be heavily distorted and have to be interpreted carefully.
Level of evidence: Level I, randomized controlled trial.
Keywords: Adolescents; Anorexia nervosa; CBT, cognitive-behavior therapy; DBT, dialectical-behavior therapy; Treatment satisfaction.