Family coalitions and restrictive eating disorders in adolescence: a lausanne trilogue play study

Coparenting, defined as the ability of mothers and fathers to coordinate and provide mutual support in parenting, plays a key role in children's social, emotional, and behavioral adjustment. While previous research has highlighted its influence on internalizing and externalizing problems, comparatively less is known about how children contribute to and respond to coparenting at a relational level.

This study investigates coparenting behaviors in families of adolescents with restrictive eating disorders and examines their association with the patients' interactive styles during the Lausanne Trilogue Play. We also explore potential correlations of coalition patterns with age, BMI, and clinical diagnosis.

Seventy-seven adolescents with restrictive Eating Disorders (DSM-5) and their parents participated. Most families (81%) were intact. Coparenting coordination was assessed using the Coparenting and Family Rating System, while children's interactive styles were coded using the Lausanne Trilogue Play reading grid adapted for preadolescents and adolescents.

Distinct coalition patterns emerged linking coparenting behaviors and adolescent interactive styles. Functional coparenting was associated with engaged child responses, whereas dysfunctional patterns corresponded to overinvolved responses. No significant correlations were found between coalition patterns and Body Mass Index, age, or specific Eating Disorders diagnosis, suggesting that these relational dynamics do not reflect current clinical status and needed more investigations.

Identifying coalition patterns between coparenting and adolescent interactive styles provides valuable insights for family-based interventions in restrictive Eating Disorders. Such patterns allow clinicians to recognize both challenges and resources within the family system, informing psychoeducational and therapeutic strategies that integrate parental support with clinical and nutritional care.