{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T13:13:24Z","timestamp":1780060404600,"version":"3.54.0"},"reference-count":46,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T00:00:00Z","timestamp":1593216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Gemeinsame Gesundheitsziele \u2013 Pharma Master Agreement","award":["99901002500"],"award-info":[{"award-number":["99901002500"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>High expressed emotion (EE) is common in caregivers of patients with anorexia nervosa (AN) and associated with poorer outcome for patients. In this study, we examined the prevalence of high EE in caregivers of adolescents with AN and analyzed predictors for EE using multivariate linear regression models. We further analyzed whether EE is reduced by the \u201cSupporting Carers of Children and Adolescents with Eating Disorders in Austria\u201d (SUCCEAT) intervention using general linear mixed models and whether a reduction of EE predicts patients\u2019 outcomes. Caregivers were randomly allocated to the SUCCEAT workshop (N = 50) or online intervention (N = 50) and compared to a comparison group (N = 49). EE and patients\u2019 outcomes were assessed at the baseline, post-intervention, and at the 12-month follow-up. Up to 47% of caregivers showed high EE. Lower caregiver skills, higher AN symptom impact, higher levels of depression and motivation to change in caregivers were significant predictors for high EE. EE significantly decreased in the SUCCEAT groups and the comparison group according to the caregivers\u2019, but not the patients\u2019 perspective. The level of reduction could partially predict subjective improvement and improvement in clinically assessed AN symptoms and body mass index of patients. Implementing interventions for caregivers addressing EE in the treatment of adolescents with AN is strongly recommended.<\/jats:p>","DOI":"10.3390\/jcm9072021","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T14:24:24Z","timestamp":1593527064000},"page":"2021","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Reduction of High Expressed Emotion and Treatment Outcomes in Anorexia Nervosa\u2014Caregivers\u2019 and Adolescents\u2019 Perspective"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0992-6865","authenticated-orcid":false,"given":"Julia","family":"Philipp","sequence":"first","affiliation":[{"name":"Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7374-4559","authenticated-orcid":false,"given":"Stefanie","family":"Truttmann","sequence":"additional","affiliation":[{"name":"Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7087-6134","authenticated-orcid":false,"given":"Michael","family":"Zeiler","sequence":"additional","affiliation":[{"name":"Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7640-8921","authenticated-orcid":false,"given":"Claudia","family":"Franta","sequence":"additional","affiliation":[{"name":"Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7358-4842","authenticated-orcid":false,"given":"Tanja","family":"Wittek","sequence":"additional","affiliation":[{"name":"Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Sch\u00f6fbeck","sequence":"additional","affiliation":[{"name":"Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Mitterer","sequence":"additional","affiliation":[{"name":"Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dunja","family":"Mairhofer","sequence":"additional","affiliation":[{"name":"Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Zanko","sequence":"additional","affiliation":[{"name":"Parkland Clinic, Clinic for Psychosomatic Medicine and Psychotherapy, 34537 Bad Wildungen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hartmut","family":"Imgart","sequence":"additional","affiliation":[{"name":"Parkland Clinic, Clinic for Psychosomatic Medicine and Psychotherapy, 34537 Bad Wildungen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Auer-Welsbach","sequence":"additional","affiliation":[{"name":"Department for Neurology and Child and Adolescent Psychiatry, 9020 Klagenfurt am W\u00f6rthersee, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Treasure","sequence":"additional","affiliation":[{"name":"Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology &amp; Neuroscience, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudrun","family":"Wagner","sequence":"additional","affiliation":[{"name":"Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas F. K.","family":"Karwautz","sequence":"additional","affiliation":[{"name":"Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"84","DOI":"10.2174\/1573400514666180808115637","article-title":"Expressed Emotion and Eating Disorders: An Updated Review","volume":"14","author":"Rienecke","year":"2018","journal-title":"Curr. Psychiatry Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1007\/s10578-014-0526-7","article-title":"Parental Expressed Emotion and Youth Psychopathology: New Directions for an Old Construct","volume":"46","author":"Peris","year":"2015","journal-title":"Child Psychiatry Hum. 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