Consent to treatment in adolescents with anorexia nervosa

OBJECTIVE: This study examined the ability of adolescents with anorexia nervosa (AN) to make treatment decisions. METHOD: The MacArthur Competence Assessment Tool-Treatment (MacCAT-T) was used to compare the decision making abilities of 35 adolescents with AN who were receiving inpatient treatment with that of 40 healthy, community-based adolescents. Vignettes of both a medical and psychiatric illness were provided, requiring participants to work through the process of making a hypothetical treatment decision. The MacCAT-T was also administered to participants with AN to examine decision-making about their own illness, which allowed for comparison of competencies across contexts. RESULTS: Group differences were found, with the community group showing superior reasoning skills to the adolescents with AN. DISCUSSION: The results provide evidence to suggest that adolescents with AN tend toward a thinking disposition that is concrete and lacking in abstract reasoning and reflection, which may negatively affect their ability to reason about treatment options.