Skip to main content Accessibility help
×
Home

Difficulties in family functioning and adolescent anorexia nervosa

  • Simon G. Gowers (a1) and Clive North (a2)

Abstract

Background

Difficulties in family functioning are often evident when an adolescent has anorexia nervosa, and the possible causative or contributory role of such difficulties in the illness is unclear.

Aims

To elucidate the relationship between severity of anorexia nervosa and difficulties in family functioning and whether clinical improvement results in diminution of self-rated family difficulties.

Method

Thirty-five adolescents with anorexia nervosa and their mothers completed the Family Assessment Device (FAD) while clinicians administered the McMaster's Structured Interview of Family Functioning (McSIFF). Severity of anorexia nervosa was rated at baseline and at one year follow-up using the Morgan–Russell Schedule.

Results

Clinicians and patients were more critical of the families' functioning than parents. There was an inverse association between the extent of family difficulties and severity of anorexia nervosa. Over time subjects improved clinically but this was not matched by improvement in family functioning.

Conclusions

Difficulties in family functioning do not appear to be directly associated with severity of anorexia nervosa nor do these difficulties reduce with clinical improvement, in the short term.

Copyright

Corresponding author

Professor S. Gowers, Academic Unit, Young People's Centre, Pine Lodge, 79 Liverpool Road, Chester CH2 1AW

Footnotes

Hide All

Declaration of interest

This study was supported by a grant from the North West Regional Health Authority.

Footnotes

References

Hide All
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.
Chambers, W. J., Puig-Antich, J., Hirsch, M., et al (1985) The assessment of affective disorders in children and adolescents by semistructured interview. Archives of General Psychiatry, 41, 696702.
Crisp, A. H. (1980) Anorexia Nervosa: Let Me Be. London: Academic Press.
Dare, C., Le Grange, D., Eisler, I., et al (1994) Redefining the psychometric family: family process of 26 eating disorder families. International Journal of Eating Disorders, 16, 211226.
Epstein, N. B., Baldwin, L. M. & Bishop, D. S. (1982) McMaster Clinical Rating Scale. Providence, RI: Brown University Family Research Programme.
Epstein, N. B., Bishop, D. S. & Levin, S. (1983) The McMaster Family Assessment Device. Journal of Marital and Family Therapy, 9, 171180.
Kabacoff, R. I., Miller, I. W., Bishop, D. S., et al (1990) A psychometric study of the McMaster Family Assessment Device in psychiatric, medical and non clinical samples. Journal of Family Psychology, 3, 431439.
Le Grange, D., Eisler, I., Dare, C., et al (1992) Family criticism and self-starvation: a study of expressed emotion. Journal of Family Therapy, 14, 177192.
Miller, I. W., Epstein, N. B., Bishop, D. S., et al (1985) The McMaster Family Assessment Device: reliability and validity. Journal of Marital and Family Therapy, 11, 345356.
Minuchin, S., Rosman, B. L. & Baker, L. (1978) Psychosomatic Families: Anorexia Nervosa in Context. Cambridge, MA: Harvard University Press.
Morgan, H. G. & Russell, G. F. M. (1975) Value of family background and clinical features as predictors of long-term outcome in anorexia nervosa: four-year follow-up study of 41 patients. Psychological Medicine. 5, 355371.
Morgan, H. G. & Hayward, A. E. (1988) Clinical assessment of anorexia nervosa. The Morgan – Russell outcome assessment schedule. British Journal of Psychiatry, 152, 367371.
North, C., Gowers, S. & Byram, V. (1995) Family functioning in adolescent anorexia nervosa. British Journal of Psychiatry. 167, 673678.
North, C., Gowers, S. & Byram, V. (1997) Family functioning and life events in the outcome of adolescent anorexia nervosa. British Journal of Psychiatry, 171, 545549.
Stevenson-Hinde, J. & Akister, J. (1995) The McMaster model of family function: observer and parental ratings in a non-clinical sample. Family Process, 34, 337347.
Thienemann, M. & Steiner, H. (1993) Family environment of eating disordered and depressed adolescents. International Journal of Eating Disorders, 14. 4348.
Waller, G., Calam, R. & Slade, P. (1989) Eating disorders and family interaction. British Journal of Clinical Psychology, 28, 285286.
Waller, G., Slade, P. & Calam, R. (1990a) Family adaptability and cohesion: relation to eating attitudes and disorders. International Journal of Eating Disorders. 9, 225228.
Waller, G., Slade, P. & Calam, R. (1990b) Who knows best? Family interaction and eating disorders. British Journal of Psychiatry, 156, 546550.

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Difficulties in family functioning and adolescent anorexia nervosa

  • Simon G. Gowers (a1) and Clive North (a2)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *