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Infantile Anorexia and Co-parenting: A Pilot Study on Mother-Father-Child Triadic Interactions during Feeding and
Loredana Lucarelli1, Massimo Ammaniti2, Alessio Porreca3
1Department of Pedagogy, Psychology, Philosophy, University of Cagliari Cagliari, Italy.
Insights
Infantile Anorexia (IA) involves feeding difficulties and growth issues in children. This study found that families with IA children struggle with positive interactions and structure, highlighting the need for family-focused assessments.
Area of Science:
- Developmental Psychology
- Family Studies
- Pediatric Psychiatry
Background:
- Infantile Anorexia (IA) is defined by persistent food refusal, growth deficiency, and lack of hunger cues, often emerging during self-feeding transitions.
- Previous research on IA has primarily focused on mother-child interactions, with limited understanding of fathers' roles and broader family dynamics.
- Maternal depression and eating disorders are frequently associated with IA, underscoring the complexity of familial influences.
Purpose of the Study:
- To investigate mother-father-child triadic interactions in families with children diagnosed with IA.
- To compare these interactions with those in families of typically developing children during feeding and play.
- To explore the impact of IA on co-parental and family subsystems.
Main Methods:
- Pilot study involving 10 families (5 with IA, 5 control), matched for child's age and gender.
- Assessment of triadic interactions using the Lausanne Trilogue Play (LTP) in feeding and play contexts.
- Adaptation of LTP to observe the father-mother-infant triangle in feeding situations.
Main Results:
- Families with IA children exhibited difficulties in expressing positive affect and establishing predictable, flexible interactional contexts.
- Children with IA showed reduced autonomy and challenges in engaging with and attuning to their parents.
- Significant differences were observed in the structuring and emotional tone of interactions between IA and control families.
Conclusions:
- Dysfunctional family interactions are a critical factor in Infantile Anorexia, impacting co-parental and family subsystems.
- The study emphasizes the importance of assessing broader family dynamics, not just the mother-child dyad, for effective IA diagnosis and treatment.
- Future research should further explore these triadic and family-level interactions to develop targeted interventions.
Abstract:
Infantile Anorexia (IA), defined by the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood Revised (DC: 0-3R, Zero To Three, 2005), occurs when the child (a) refuses to eat adequate amounts of food for at least 1 month, and shows growth deficiency, (b) does not communicate hunger and lacks interest in food, and (c) the child's food refusal does not follow a traumatic event and is not due to an underlying medical illness. IA usually emerges during the transition to self-feeding, when the child issues of autonomy are played out daily in the feeding situation. Studies evidence that the feeding interactions between children with IA and their mothers are characterized by low reciprocity, greater interactional conflict and negative affects (Chatoor et al., 2000; Ammaniti et al., 2010, 2012). Moreover, these studies pointed out that maternal depression and eating disorders are frequently associated with IA (Cooper et al., 2004; Ammaniti et al., 2010; Lucarelli et al., 2013). To date, research has focused almost exclusively on the mother-child dyad, while fathers' involvement, co-parental and family interactions are poorly studied. The current study is a pilot research that investigated mother-father-child triadic interactions, during feeding and play, in families with children diagnosed with IA, in comparison to families with normally developing children. Until now, at the study participated N = 10 families (five with a child with IA diagnosis and five with lack of child's IA diagnosis, matched for child's age and gender). The parents-child triadic interactions were assessed in feeding and play contexts using the Lausanne Trilogue Play (Fivaz-Depeursinge and Corboz-Warnery, 1999), adapted to observe father-mother-infant primary triangle in the feeding context, compared to the play context (Lucarelli et al., 2012). Families of the IA-group showed difficulties in expressing and sharing pleasure and positive affects, and in structuring a predictable and flexible context. Children showed little autonomy and difficulty in being actively engaged and tune with parents. Dysfunctional family interactions are a critical issue for IA that affects co-parental and family subsystems, stressing the importance of an articulated diagnostic assessment in order to target effective treatment approaches.