La qualité des relations interpersonnelles d’adolescent(e)s ayant un TCA : liens avec la sévérité des symptômes, les caractéristiques personnelles et l’évolution du trouble

Adolescence is recognized as a period of development where there is an increased risk of suffering from an Eating Disorder (ED). It is also an age where youth must adapt to an altered relational context in which they are expected to separate from parental figures, while keeping positive ties with them, and to develop meaningful relationships with peers. Few empirical studies have examined how the quality of interpersonal relationships with mother, father and peers are linked with the severity of ED symptoms in adolescents with these conditions. A better understanding of the mechanisms that could underlie these associations as well as of the impact that familial and social relationships can have on the evolution of psychopathological symptoms in adolescents with ED is needed in order to improve treatment for this population. On the basis of these considerations, the present thesis aims to examine the quality of relationships with parents and friends of adolescents receiving treatment for an ED in order to better understand how it is related to the severity and evolution of their ED symptoms and to identify individual characteristics that might explain these links. In order to meet this objective, two empirical studies have been conducted and are presented in this thesis.   The first study aimed to examine the associations between the perceived levels of trust, communication and alienation in the relationships with mother, father and peers and the severity of ED symptoms in a clinical sample. The mediating effects of low self-esteem and negative mood were also examined. A total of 186 adolescent females (12 to 18 years old) presenting a diagnosis of anorexia nervosa completed self-report measures evaluating the perceived quality of interpersonal relationships, ED symptom severity, low self-esteem and negative mood. The results indicated that adolescents who perceive more alienation in their relationships with their mother and with their peers also endorsed more severe ED symptoms. Low self-esteem and negative mood acted as mediators of these associations.   In the second study, the links between the positive (i.e., communication, trust) and negative aspects (i.e., alienation) of the quality of the relationships with mother, father and peers, the severity of ED symptoms and the levels of negative mood were examined using a longitudinal design. The sample consisted of 51 adolescents with a diagnosis of ED (anorexia nervosa, bulimia, ED not otherwise specified) who were receiving treatment in a specialized program. Self-report questionnaires were used to assess participants’ quality of relationships with their parents and friends, ED symptom severity and negative mood at their arrival in the services and fifteen months later. The results indicated that better communication with mother and father as well as less alienation in the relationship with the mother at baseline were associated with less severe ED symptoms at follow-up. Higher initial levels of communication with the father and more trust in the interactions with peers were associated with lower levels of negative mood fifteen months later. Exploratory regression analyses also revealed significant associations between improvements in specific aspects of the relationships with mother, father and peers and ED-specific symptoms and negative mood over time.

Keyphrases: Adolescence, Eating disorders, Parent-adolescent relationships, Peer relationships, Negative mood, Self-esteem