Family life cycle transitions and the onset of eating disorders: a retrospective grounded theory approach

Abstract

Aims and Objective The aim of this retrospective qualitative study is to understand how transitions in the family life cycle and responses to these events may relate to the onset of eating disorders in an attempt to generate new theoretical insights and inform future research in the area of eating disorder prevention. Background Little is known about the contextual factors that occur throughout the family life cycle that may be risk factors for the development of eating disorders. Design and Methods Semi-structured interviews were conducted with 27 individuals of varied ages (age range =17–64; Median = 27; SD 13.7) currently receiving treatment for eating disorders in an outpatient clinic specialising in eating disorder treatment. Data were analysed using grounded theory methods. Results Six themes were identified as family life cycle transitional events that preceded the onset of participants’ eating disorders: (a) School Transitions, (b) Death of a Family Member, (c) Relationship Changes, (d) Home and Job Transitions (e) Illness/Hospitalisation and (f) Abuse, Sexual Assault, or Incest. Conclusions Results indicated that transitional events in the family life cycle followed by a lack of needed support during these transitions may precipitate the onset of eating disorders. Thus, future research should use these findings to inform the creation of interventions that reduce the intensity of the stress brought about by these transitional periods and increase the adaptability and coping skills of individuals and family members to prevent eating disorders. Relevance to Clinical Practice Nurses and other healthcare professionals should be aware of the importance of transitional events occurring in the family life cycle of adolescents and young adults. Helping parents to be aware and supportive of difficult transitional events may be more important than trying to solve or fix the problem.

Relacionamentos Afetivo-Familiares em Mulheres com Anorexia e Bulimia

“…Além do funcionamento familiar em si, a literatura aponta que eventos estressores ocorridos dentro do ambiente familiar também podem estar relacionados com comportamentos alimentares disfuncionais e formas não saudáveis de controle de peso, que surgiriam como modos de lidar com os afetos disruptivos e estados psíquicos intoleráveis, ou como tentativas de reduzir a tensão suscitada pelas emoções negativas (Berge, Loth, Hanson, Croll-Lampert, & NeumarkSztainer, 2012).…”

Family Psychic Transmission and Anorexia Nervosa

“…She stated that she felt that she "jumped" a stage of life: (Mabel,daughter,aged 25 years) Mabel said that she lost the bonds with loved ones at this time, due to changing city, and because she did not know how to deal with these emotional disruptions. Significant changes in the family life may also have contributed to the outbreak of the ED condition (Berge et al, 2011;Ma, 2005Ma, , 2008. For Eiguer (1985), some families experience every kind of separation with intense pain, without the capacity for the elaboration of grief.…”

“…Some life events can potentialize this vulnerability, such as the death of a family member, drastic changes in the pattern of relationships (as in a divorce and/or remarriage of a parent), change of school, home or job, chronic illness and/or prolonged hospitalization, and sexual abuse (Berge, Loth, Hanson, Croll-Lampert, & Neumark-Sztainer, 2011;Ma, 2005Ma, , 2008. However, the destabilizing potential of stressful events depends on the configuration and effectiveness of the social support network, which can either serve as a protective factor or as a factor of vulnerabilization Leonidas, Crepaldi, & Santos, 2013).…”

Parents’ and daughters’ perception of family aspects associated with the onset of an eating disorder / Percepción de padres e hijas acerca de los aspectos familiares asociados con el inicio de un trastorno alimentario

“…Several studies have mentioned that families with a child with an ED experience difficulty in expressing emotions and resolving conflicts (Dring, 2015;Lampis et al, 2009;Minuchin et al, 1978;Ruíz, Vázquez, Mancilla, López & Alvarez, 2009); and even that family members' inability to communicate with each other, particularly in response to situations of crisis, is related to the onset of EDs (Berge et al, 2011;Brown & Geller, 2006;Dring, 2015;Lampis et al, 2013;Loth et al, 2009). In this study, respondents with an ED said that they did not feel confident enough to express their emotions, tastes or thoughts, for fear of being teased or rejected by their parents.…”

“…show that parents have limited skills for addressing problems or conflicts, implement rigid, unpredictable norms and tend to be demanding, unaffectionate and establish ambivalent bonds (Mateos-Agut et al, 2014;Ward, Ramsaid & Treasure, 2000). These are also families that exert parental control that prevents decision-making, individualization and autonomy in their children.Adolescents with eating disorder symptoms perceive their parents as controlling rather than as supportive figures who encourage family union (Berge, Loth, Hanson, Croll & Neumark-Sztainer, 2011;Brown & Geller, 2006;Dring, 2015;Lampis, Agus & Cacciarru, 2013;Loth et al, 2009), particularly in response to traumatic events such as a serious illness, the death of a family member or sexual abuse (Tagay, Schlottbohm, Reyes-Rodríguez, Repic & Snef, 2014). Dúo, López, Pastor and Sepúlveda (2014) state that promoting dependence in their daughters, parental conflict (in which the daughter is trapped by divided loyalties), conflict avoidance and parents' lack of involvement in…”