Application of the family relations scale to a sample of anorexics, bulimics and non-psychiatric controls: a preliminary study

Abstract

The role of the family in the pathogenesis and treatment of eating disorders is an area of extensive and ongoing research. Numerous scales for measuring various aspects of family functioning exist. The study employed the Family Relations Scale (FRS) in a sample of 17 eating disordered patients, and their families, diagnosed in a hospital setting using DSM IV criteria (anorexia nervosa: n 10; bulimia nervosa: n 7) and 20 non-psychiatric controls and their families. The families within the groups were remarkably similar; however, speci®c differences were demonstrated. These pertained to perceptions of hierarchy, boundary maintenance and idealization within the family as a whole. Further differences were found with respect to perceptions of the family from the patient's and father's perspectives. These differences may have implications for family as well as individual therapy. The study provides preliminary evidence of the potential utility of the FRS as a research instrument in eating disordered patients.

The Role of Family Relationships in Eating Disorders in Adolescents: A Narrative Review

“…As seen until now thanks to the contribution of empirical studies on family factors in eating disorders, in particular, those that have used the FACES-IV instrument [85][86][87] family models multi-determined and contextual psychopathological processes in developmental age is gaining ground. All the results of the studies indicate a shift from a focus on family deficits towards family resources, which is a gradual encouragement of family skills and positive connections between members [74].…”

“…Even in the most recent studies, results concerning the evaluation of family functioning among the different diagnostic categories of eating disorders are divergent. Some studies have shown no significant differences between the diagnostic categories of eating disorders [74,75]. Other studies have found significant differences between the types of eating disorders in relation to different elements of family functioning: For example, cohesion and orientation to achievement were found to be worse in families with anorexia, compared to bulimic families [73].…”

“…It is necessary to remark that the Olson Circumflex Model of Conjugal and Family Systems [84] represents one of the most widely used international models for assessing family functioning (as it is perceived by the members of the system) and it is based on the three dimensions of cohesion, adaptability, and communication. Recent studies focused on risk factors in the development of eating disorders have confirmed that family functioning plays an important role in the assumption and maintenance of dysfunctional eating behaviors in adolescence [56,74,89]. An important point in this regard is that the development of eating disorders in adolescence seems to be influenced by the perceptions of family members regarding family functioning, particularly concerning family cohesion, adaptability, and communication [56,90].…”

How adolescents with anorexia nervosa and their parents perceive family functioning?

“…Eisler et al, 2003;Le Grange and Eisler, 2008;Lock et al, 2006) Family functioning has been measured both as a unitary construct reflecting the general functioning of the family as a whole and as a set of several aspects, such as flexibility, cohesion, and communication. Existing evidence suggests that there is a substantial agreement within family members dealing with AN in perceiving an impairment of the general family functioning and a strong dissatisfaction with family life (Casper and Troiani, 2001;Ciao et al, 2015;Cook-Darzens et al, 2005;Emanuelli et al, 2004;McDermott et al, 2002;Szabo et al, 1999); on the other hand, when considering specific dimensions of family functioning, significant differences are found between girls with AN and their parents, even though research shows variable and sometimes conflicting results (Ciao et al, 2015;Holtom-Viesel and Allan, 2014).…”

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). Regarding gender differences, some studies gave shown that in comparison to fathers, mothers of patients with Anorexia Nervosa (AN) view their families to be more rigid, whereas fathers seem to be as more satisfied with their family life than other family members (Cook-Darzens, et al, 2005).…”