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The families of anorexia nervosa and cystic fibrosis patients

Published online by Cambridge University Press:  09 July 2009

C. Blair*
Affiliation:
Department of Psychiatry, University of Edinburgh
C. Freeman
Affiliation:
Department of Psychiatry, University of Edinburgh
A. Cull
Affiliation:
Department of Psychiatry, University of Edinburgh
*
1Address for correspondence: Dr Caroline Blair, Department of Psychiatry. University of Edinburgh, Royal Edinburgh Hospital, Morningside Park, Edinburgh EHI0 5HF.

Synopsis

The objective of the study was to determine whether the families of anorexia nervosa (AN) patients were more dysfunctional than those of cystic fibrosis (CF) patients and well controls. Data were collected from self-report questionnaires, from an interview rated for Expressed Emotion (EE) and from direct observation of a family problem solving task which was rated for evidence of Minuchin's ‘psychosomatic family’ dimensions. A total of 87 families participated. Most self-report measures of family functioning did not distinguish between groups. There were no differences in levels of EE criticism. AN and CF households showed more EE emotional over-involvement than did the well households. Over-involvement correlated with illness severity. More households in the AN group were enmeshed, over-protective and poor at problem solving than in the CF and well groups. Minuchin's conceptualization of the anorexia nervosa family was partly supported.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1995

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References

Blair, C., Cull, A. & Freeman, C. P. (1994). Psychosocial functioning of young adults with cystic fibrosis and their families. Thorax 49, 798802.CrossRefGoogle ScholarPubMed
Bland, J. M. & Altman, D. G. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. Lancet i, 307310.CrossRefGoogle Scholar
Cadman, D., Rosenbaum, P., Boyle, M. & Offord, D. R. (1991). Children with chronic illness: family and parent demographic characteristics and psychosocial adjustment. Pediatrics 87, 884889.CrossRefGoogle ScholarPubMed
Cooper, Z. & Fairburn, C. (1987). The Eating Disorder Examination: a semi-structured interview for the assessment of the specific psychopathology of eating disorders. International Journal of Eating Disorders 6, 18.3.0.CO;2-9>CrossRefGoogle Scholar
Cooperman, E. M., Park, M., McKee, J. & Assad, J. P. (1971). A simplified cystic fibrosis scoring system (a preliminary report.). Canadian Medical Association Journal 105, 580582.Google ScholarPubMed
Dare, C., Eisler, I., Russell, G. F. & Szmukler, G. (1990). The clinical and theoretical impact of a controlled trial of family therapy in anorexia nervosa. Journal of Marital and Family Therapy 16, 3957.CrossRefGoogle Scholar
Doane, J. A., West, K. L., Goldstein, M. J., Rodnick, E. H. & Jones, J. E. (1981). Parental communication deviance and affective style. Predictors of subsequent schizophrenia spectrum disorders in vulnerable adolescents. Archives of General Psychiatry 38, 679685.CrossRefGoogle ScholarPubMed
Eiser, C. (1990). Psychological effects of chronic disease. Journal of Child Psychology and Psychiatry 31, 8598.CrossRefGoogle ScholarPubMed
Fadden, G. B., Bebbington, P. E. & Kuipers, L. (1987). The burden of care: the impact of functional psychiatric illness in the patient's family. British Journal of Psychiatry 150, 285292.CrossRefGoogle ScholarPubMed
Garfinkel, P. E., Garner, D. M., Rose, J., Darby, P. L., Brandes, J. S., O'Hanlon, J. & Walsh, N. (1983). A comparison of characteristics in the families of patients with anorexia nervosa and normal controls. Psychological Medicine 13, 821828.CrossRefGoogle ScholarPubMed
Garner, D. M., Garfinkel, P. E. & O'Shaughnessy, M. (1985). The validity of the distinction between bulimia with and without anorexia nervosa. American Journal of Psychiatry 142, 581587.Google ScholarPubMed
Gillberg, I. C., Rastam, M. & Gillberg, C. (1994). Anorexia nervosa outcome: six year controlled longitudinal study of 51 cases including a population cohort. Journal of the American Academy of Child and Adolescent Psychiatry 33, 729739.CrossRefGoogle ScholarPubMed
Goldberg, D. (1987). The User's Guide to the GHQ. NFER Publications: Windsor.Google Scholar
Goldstein, M. J. (1988). The family and psychopathology. Annual Review of Psychology 39, 283299.CrossRefGoogle ScholarPubMed
Hahlweg, K., Revenstorf, D. & Schindler, L. (1984). Effects of behavioral marital therapy on couples' communication and problem-solving skills. Journal of Consulting and Clinical Psychology 52. 553566.CrossRefGoogle ScholarPubMed
Harding, T. P. & Lachenmeyer, J. R. (1986). Family interaction patterns and locus of control as predictors of the presence and severity of anorexia nervosa. Journal of Clinical Psychology 42, 440448.3.0.CO;2-H>CrossRefGoogle ScholarPubMed
Humphrey, L. L.Apple, R. F. & Kirschenbaum, D. S. (1986). Differentiating bulimic-anorexic from normal families using interpersonal and behavioral observational systems. Journal of Consulting and Clinical Psychology 54, 190195.CrossRefGoogle ScholarPubMed
Kog, E. & Vandereycken, W. (1989). Family interaction in eating disorder patients and normal controls. International Journal of Eating Disorders 8, 1123.3.0.CO;2-1>CrossRefGoogle Scholar
Kog, E. & Vertommen, H. & Vandereycken, W. (1987). Minuchin's psychosomatic family model revised: a concept-validation study using a multitrait-multimethod approach. Family Process 26, 235253.CrossRefGoogle ScholarPubMed
Le Grange, D., Eisler, I., Dare, C. & Hodes, M. (1992 a). Family criticism and self starvation: a study of expressed emotion. Journal of Family Therapy 14, 177192.CrossRefGoogle Scholar
Le Grange, D., Eisler, I., Dare, C. & Russell, G. E. M. (1992 b). Evaluation of family treatment in adolescent anorexia nervosa: a pilot study. International Journal of Eating Disorders 12. 347357.3.0.CO;2-W>CrossRefGoogle Scholar
Leff, J. & Vaughn, C. (1985). Expressed Emotion in Families. Guilford Press: London.Google Scholar
Leon, G. R., Lucas, A. R., Colligan, R. C, Ferdinande, R. J. & Kamp, J. (1985). Sexual, body image, and personality attitudes in anorexia nervosa. Journal of Abnormal Child Psychology 13, 245258.CrossRefGoogle ScholarPubMed
Minuchin, S., Baker, L., Rosman, B. L., Liebman, R., Milman, L. & Todd, T. C. (1975). A conceptual model of psychosomatic illness in children. Family organization and family therapy. Archives of General Psychiatry 32, 10311038.CrossRefGoogle ScholarPubMed
Minuchin, S., Rosman, B. L. & Baker, L. (1978). Psychosomatic Families: Anorexia Nervosa in Context. Harvard University Press: Cambridge, M. A.CrossRefGoogle Scholar
Morgan, H. G. & Hayward, A. F. (1988). Clinical assessment of anorexia nervosa. The Morgan-Russell outcome assessment schedule. British Journal of Psychiatry 152, 367371.CrossRefGoogle ScholarPubMed
Rastam, M. & Gillberg, C. (1991). The family background in anorexia nervosa: a population-based study. Journal of the American Academy of Child and Adolescent Psychiatry 30, 283289.CrossRefGoogle ScholarPubMed
Report of the Royal College of Physicians (1990). Cystic Fibrosis in Adults. Recommendations for Care of Patients in the UK. Royal College of Physicians: London.Google Scholar
Russell, G. F. M., Szmukler, G. I., Dare, C. & Eisler, I. (1987). An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Archives of General Psychiatry 44, 10471056.CrossRefGoogle ScholarPubMed
Schmidt, U., Tiller, J. & Treasure, J. (1993). Setting the scene for eating disorders: childcare, classification and course of illness. Psychological Medicine 23, 663672.CrossRefGoogle Scholar
Selvini-Palazzoli, M. (1974). Self Starvation: From Individual to Family Therapy in the Treatment of Anorexia Nervosa. Chaucer-Human: London.Google Scholar
Skinner, H., Steinhauser, P. & Santa-Barbara, J. (1983). The Family Assessment Measure. Canadian Journal of Community Mental Health 2, 91105.CrossRefGoogle Scholar
Steiger, H., Liquornik, K., Chapman, J. & Hussain, N. (1991). Personality and family disturbances in eating-disorder patients: comparison of ‘restricters’ and ‘bingers’ to normal controls. International Journal of Eating Disorders 10, 501512.3.0.CO;2-Z>CrossRefGoogle Scholar
Stern, S. I., Dixon, K. N., Jones, D., Lake, M., Nemzer, E. & Sansone, R. (1989). Family environment in anorexia nervosa and bulimia. International Journal of Eating Disorders 8, 2531.3.0.CO;2-S>CrossRefGoogle Scholar
Strober, M. (1981). The significance of bulimia in juvenile anorexia nervosa: an exploration of possible etiological factors. International Journal of Eating Disorders 1, 2843.3.0.CO;2-9>CrossRefGoogle Scholar
Szmukler, G. I., Eisler, I., Russell, G. F. & Dare, C. (1985). Anorexia nervosa, parental ‘expressed emotion’ and dropping out of treatment. British Journal of Psychiatry 147, 265271.CrossRefGoogle ScholarPubMed
van Furth, E. (1991). Parental Expressed Emotion and Eating Disorders. University of Utrecht, published doctoral thesis: Utrecht.Google Scholar
Waller, G., Slade, P. & Calam, R. (1990). Who knows best? Family interaction and eating disorders. British Journal of Psychiatry 156, 546550.CrossRefGoogle ScholarPubMed
Wonderlich, S. A. & Swift, W. J. (1990). Perceptions of parental relationships in the eating disorders: the relevance of depressed mood. Journal of Abnormal Psychology 99, 353360.CrossRefGoogle ScholarPubMed
Yager, J. (1982), Family issues in the pathogenesis of anorexia nervosa. Psychosomatic Medicine 44, 4360.CrossRefGoogle ScholarPubMed