The families of anorexia nervosa and cystic fibrosis patients

Abstract

SYNOPSISThe 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.

Family Functioning in Children with Chronic Illness Compared with Healthy Controls: A Critical Review

“…Many families appear to adapt and thrive in light of their child's illness by developing improved problems solving skills, shifts in how they value external achievement and higher levels of family cohesion. 18,22,25 Taking the limitations into account, there does seem to be initial support for the notion that families with a child with chronic illness encounter barriers to optimal family functioning, however, most families function similarly to families of healthy children. Whether families with a child with chronic illness learn and use effective coping skills, have high resiliency, focus on the positive, have the ability to adapt to stressors, or possess other adaptive characteristics are intriguing ideas that deservers further investigation.…”

“…Specifically, researchers found no significant differences between the family functioning of families with children with CF compared to families of physically healthy children on parent-report measures of families functioning. 18,19 Other researchers have demonstrated improved family functioning in families of children with CF as compared to healthy control families. On an in-vivo problem solving task, families of adolescents with CF were more likely to be categorized as good problem solvers than were families of physically healthy adolescents.…”

“…On an in-vivo problem solving task, families of adolescents with CF were more likely to be categorized as good problem solvers than were families of physically healthy adolescents. 18 A possible explanation of the improved functioning in families of children with CF is that families of children with CF may encounter challenges, such as logistical problems associated with managing medical care, on a more frequent basis. As such, families with an adolescent with CF may have developed greater proficiency in resolving these challenges over the years.…”

Bonding and Expressed Emotion: Two Interlinked Concepts?

“…Indeed, the Final EE is a combination of EOI-EE and Critical EE. EOI may be a response by the parent trying to cope with the particular clinical states of the patient [51], and it may be considered as a typical familial reaction [52]. Likewise, criticism could be a result of parental difficulties in coping with the pathology, exacerbating the symptoms [50,51,52,53].…”

“…EOI may be a response by the parent trying to cope with the particular clinical states of the patient [51], and it may be considered as a typical familial reaction [52]. Likewise, criticism could be a result of parental difficulties in coping with the pathology, exacerbating the symptoms [50,51,52,53]. EE has also been hypothesized as a reflection of parental psychological distress (depression and anxiety) [50], which could lead parents to be reluctant to give their children any autonomy.…”