The aims of this study were to evaluate the reliability, validity and factorial structure of Family Adaptability and Cohesion Evaluation Scale, Version IV (FACES IV), investigate the relevance of sex and age on family functioning and study the relationship between family functioning and adolescents' perception of parent and peer attachment. The sample consisted of 1,416 participants (672 women, 744 men, M-age = 17.38 years; age range = 13-22 years) divided into three age groups: 13-15, 16-18, and 19-22 years. Factor analysis confirmed the dimensions formulated to define the construct of family functioning: all the items of each dimension were loaded in the same factor with a correlation of at least 0.30. Groups differed with regard to the age on Cohesion, Enmeshed and Rigid scales: Younger adolescents (age 13-15 years) showed significantly higher scores than adolescents (age 16-18 and 19-22). Sex differences revealed that females had a higher mean score on Cohesion and Flexibility, whereas males had a higher mean score on Disengaged, Enmeshed and Chaotic. Correlations between FACES IV and Parent and Peer Attachment Scale demonstrated the convergent validity of the FACES IV. Data confirmed the validity of FACES IV's Italian version and suggested that the Circumplex Model has a cross-cultural applicability and it could be a useful instrument in the Italian context

Research has studied family functioning in families of patients suffering from eating disorders (EDs), particularly investigating the associations between mothers’ and daughters’ psychopathological symptoms, but limited studies have examined whether there are specific maladaptive psychological profiles characterizing the family as a whole when it includes adolescents with anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Through the collaboration of a network of public and private consultants, we recruited n=181 adolescents diagnosed for EDs (n=61 with AN, n=60 with BN, and n=60 with BEDs) and their parents. Mothers, fathers, and youths were assessed through a self-report measure evaluating family functioning, and adolescents completed a self-report questionnaire assessing psycho-pathological symptoms. Results showed specific family functioning and psychopathological profiles based on adolescents’ diagnosis. Regression analyses also showed that family functioning characterized by rigidity predicted higher psychopathological symptoms. Our study underlines the importance of involving all members of the family in assessment and intervention programs when adolescent offspring suffer from EDs.

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Epidemiological studies on adolescents with eating disorders demonstrate a high prevalence of disordered eating behaviors, with a higher prevalence of eating disorders among girls. Several studies have recently demonstrated an association between female adolescents' eating disorders, parental psychopathological risk, and an impaired family functioning with poor quality of the relationships among family members. On the basis of these premises, we conducted a cross-sectional study initially recruiting 243 families of female adolescents affected by anorexia nervosa (Group A), bulimia nervosa (Group B), and binge eating disorder (Group C) (average age 14-17) to assess their psychological profile (SCL90-R), specific representations of their family functioning (FACES-IV), and the possible effect of adolescents' psychological profiles and parents' psychopathological risk on family functioning. Our results indicate that adolescents and parents in Groups A, B, and C show an unequivocal psychopathological profile; in particular, adolescents with anorexia present the most severe psychopathological risk. Further, our results show that adolescents and their parents differ in their perception of their family functioning. More specifically, adolescents with anorexia perceive their family as highly disengaged, poorly interwoven, and rigid, in addition cohesion and communication qualities are perceived as low. Interestingly, parental psychopathological risk predicts adolescents' specific perception of their family functioning. These findings may guide clinical interventions as they suggest that distinct maternal psychopathological symptoms can be associated with a variety of clinical configurations in their offspring, whereas paternal psychopathological risk may be present in adolescents suffering from all forms of eating disorders.

Background: Several studies have suggested that the early loss of parents is a potentially traumatic experience, exposing adolescents to a higher risk for the onset of psychopathological symptoms. Furthermore, research has shown an association between the loss of a parent in childhood and subsequent physical illnesses, but much less attention has been given to the predictive role of loss in the development of physical illness in adolescence.Methods: From a larger normative sample, we selected 418 early adolescents (and their surviving parents) each of whom had lost a parent in their first 3 years of life. We evaluate the offspring’s and parents’ psychopathological symptoms, dissociation, and physical problems over a 6-year period. Univariate and multivariate Cox proportional hazard regression analyses with time-dependent variables were used to examine the predictive values of the adolescents’ and surviving parents’ psychopathological symptoms, and youths’ demographic characteristics (sex and age) for the occurrence of physical illness during a 6-year period of follow-up.Results: Independently of sex, the psychopathological risk of the surviving parents’ and adolescents’ affective problems and dissociation has been found to predict the occurrence of physical illnesses. Furthermore, dissociation was the most significant predictor of significant physical problems.Conclusion: These results may be relevant and an addition to the previous literature, opening up new possibilities for prevention and intervention that are oriented toward greater support for children who have experienced the loss of one parent and for surviving parents.