Previous research has shown that families with an anorexia nervosa patient are not a homogenous group. The purpose of this study was to see in what way these families differ from each other. Forty-nine families with a child suffering from anorexia nervosa were examined. They were rated by independent observers who, on the basis of a videotaped family task, evaluated family interaction using Beavers-Timberlawn's rating schedule. Family members completed the self-rrport questionnaires Family Climate, FARS and SCL-90. The subscale family style from the Beavers-Timberlawn schedule was found to provide a meaningful description of families with an anorexia nervosa patient. According to this subscale, anorexia nervosa families fall into three groups: centripetal, centrifugal and balanced. The centrifugal group differed from the two other groups in that the patients expressed more psychopathology and family dysfunction. This group of families probably requires a special form of treatment.
Nineteen consecutive case records of inpatients at a child psychiatric department with the diagnosis anorexia nervosa (AN) (DSM-III-R) were investigated to describe the family interaction pattern. To evaluate the families, the information from the case records was supplemented by interviews of the therapists and finally the result was discussed with the supervisors until agreement. The evaluation instrument used was Beavers' Scales for Family Style and Function. Level of aggression, dominance pattern among parents, socioeconomic stratification and psychiatric diagnosis among parents were also evaluated. The study shows 3 groups of AN families, centripetal (53%), centrifugal (24%) and mixed (24%), supporting a hypothesis that AN families are a heterogeneous group. Evaluated family functioning was highest in the mixed group, followed by the centripetal group. The poorest family functioning and severest psychopathology among the parents was found in the centrifugal group.
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