Parent-Daughter Discrepancies in Perception of Family Function in Bulimia Nervosa

Abstract

Eating disorders have traditionally been associated with disturbed family function. Most empirical data regarding this issue, however, were gathered from eating disorders patients. Attitudes, function, and inter-personal relationships were examined within 16 families with a member suffering from bulimia nervosa (BN) and compared to 16 matched healthy families. Perception of family function was significantly more derogatory in bulimic subjects than in their parents, while in control subjects and parents, perception was largely congruent. Subjects suffering from BN perceived their families as less cohesive, adaptable, and supportive than did healthy subjects. No such difference in perception of family function was observed between parents of respective groups. This preliminary study shows that parent-daughter discrepancy in perception of family function may prove more characteristic of eating disorder families than any particular deficit. Future research should aim to replicate these findings, incorporate them into treatment paradigms, and employ them to monitor treatment outcome.

Parental bonding and eating disorders: A systematic review

“…Similarly, higher paternal protection was reported in 25% of comparisons involving women with BN (4,13,2), 31% of comparisons involving women with AN (6,16,17,8), 0% of comparisons involving women with BED (18), and 60% of comparisons involving women with an eating disorder diagnosis (19,23,24). In addition to this, a comparison of parental control more generally suggests that it is higher in a group of women with both AN and BN (socalled mixed AN and BN) (15).…”

“…Specifically, lower maternal care was reported in 50% for comparisons involving women with BN (2,4,13,14), 46% of comparisons involving women with AN (5,6,10,11,13,17), 100% of comparisons involving women with BED (18), and 100% of women characterised more generally as having an eating disorder diagnosis (19,20,24). Similarly, lower paternal care was reported in 38% of comparisons involving women with BN (2,13,14), 53% of comparisons involving women with AN (5,6,7,10,11,13),100% of comparisons involving women with BED (18), and 100% of women characterised more generally as having an eating disorder (19,20,21,22,24). In addition to this, CECA-parental antipathy was lower in women diagnosed with both AN and BN (socalled mixed AN and BN) (15).…”

“…Specifically, higher maternal protection was reported in 38% of comparisons involving women with BN (2,4,13), 38% of comparisons involving women with AN (10,12,13,17,8),100% of comparisons involving women with BED (18), and 75% of comparisons involving women characterised more generally as having an eating disorder diagnosis (19,23,24). Similarly, higher paternal protection was reported in 25% of comparisons involving women with BN (4,13,2), 31% of comparisons involving women with AN (6,16,17,8), 0% of comparisons involving women with BED (18), and 60% of comparisons involving women with an eating disorder diagnosis (19,23,24).…”

The relationship between dysfunctional family patterns and symptom severity among adolescent patients with eating disorders: A gender-specific approach

“…Regardless, some theoretical models and data have led to the assumption that impaired family structure and functioning can play an important part in the etiology and maintenance of the ED (Bonne, et al, 2003;Cook-Darzens, et al, 2005). Studies following this model have shown that families of patients with an ED generally tend to be less cohesive, more 5 overprotective, more rigid and to have poorer communication than healthy control families (Eisler, 2005;Szabo, Goldin, & Le Grange, 1999;Vidović, et al, 2005).…”

“…These models consider the quality of family functioning to be a factor preceding the onset of EDs, possibly playing a role in bringing about the disorder, or serving as a risk factor in the course and outcome of the disorder (North, Gowers, & Byram, 1997;Strober, Freeman, & Morrell, 1997), rather than merely being a consequence of the disease. Some of these studies have suggested that parent's perception of low cohesion and flexibility (Bonne et al, 2003;Kluck, 2008) is related to the development of EDs. Other studies have described a highly cohesive and flexible family style as more favorable for the son or daughter's physical and emotional wellbeing and his/her move into maturation and independence, whereas an enmeshed, overprotective and rigid family engenders and maintains EDs (Eisler, 2005).…”