Eco‐systemic analysis of anorexia nervosa

Abstract

Aspects of the eco‐systemic approach were used to provide a framework for the understanding of anorexia nervosa and were empirically tested by comparing 30 anorexics and their parents to 34 matched control subjects and their parents. The theoretical model employed was an adaptation of Conger's Ecological‐Systems approach which was based on the principles of Bronfenbrenner's theory of human development. The subjects were compared on selected variables arising from the individual, parent, family, and community systems using (a) the California Psychological Inventory (CPI), (b) the Structural Analysis of Social Behavior (SASB), (c) the Family Environment Scale (FES), and (d) the Pattison Psychological Inventory (PPI). Discriminant analysis revealed that the Affiliation score (SASB) for the anorexic and the control subjects and the Psychopathic Deviancy score (CPI‐Clinical) of the mothers of the anorexics and the controls were the variables which contributed most to the discrimination between the groups. With the Affiliation and the Psychopathic Deviancy scores alone it was possible to correctly classify 87·5 per cent of the research subjects. Analyses also showed statistically significant results at the individual, parent, and family levels. Interactions within the family, as perceived by the anorexics, were characterized by overprotection and control by the mothers, while the anorexics themselves responded with significantly less affiliation to both their mothers and their fathers. The mothers of the anorexics also viewed their daughters as being less friendly in the relationship. The families of the anorexics were less supportive, helpful, and committed to each other than were the families of the control subjects as measured by the FES.

Interpersonal profiles in eating disorders: Ratings of SASB self‐image

“…As a whole, the present results suggest that eating disorder patients appear to have decidedly negative interpersonal pro®les compared to relevant controls. Results support earlier ®ndings concerning anorexics and bulimics that have utilized the SASB (Friedman et al, 1997;Humphrey, 1988;Sheppy et al, 1988;Strauss & Ryan, 1987;Swift et al, 1986;Wonderlich et al, 1996), as well as ®ndings concerning EDNOS patients that have been based on the use of other measures (Mendelson et al, 2002). In particular, the pro®les of self-image among eating disorder patients appear to be distinguished by low levels of self-af®rmation and high levels of self-blame and self-hate.…”

“…Swift, Bushnell, Hanson, and Logeman (1986) examined 30 hospitalized adolescent anorexics, and found them to have considerably more negative self-image than normal controls. Sheppy, Friesen, and Hakstian (1988) studied 30 anorexics between 15 and 23 years of age, and found them to have signi®cantly more negative forms of self-image compared to 34 matched controls. Friedman, Wil¯ey, Robinson Welch, and Kunce (1997) compared 37 adult binge eaters and 37 adult bulimics involved in in-patient treatment on all three SASB surfaces, and found that bulimics had greater levels of self-directed hostility compared to normal controls.…”

Anorexic self‐control and bulimic self‐hate: Differential outcome prediction from initial self‐image

“…1,2 Interpersonal factors are increasingly in focus in research on eating disorders (ED), where self-image negativity is a consistent finding, as are problematic relationships and family interaction patterns. [3][4][5][6] In this study, self-image was used to predict outcome in anorexia nervosa (AN) and bulimia nervosa (BN), respectively.…”

“…19 In another study, an AN sample rated their mothers as expressing less affiliation and more control than normal controls, using a SASB measure of dyadic behavior. 20 Other forms of control such as perfectionism and obsessionality have been suggested as risk factors in AN, 21 and longitudinal findings suggest that different prospective risk factors relate to AN and BN, respectively. 22 In the latter study, young adulthood onset of AN was predicted by self-reported perfectionism during the teen years, whereas for BN, the predictor was negative or depressive affect.…”