An empirical exploration of the dynamics of anorexia nervosa: Representations of self, mother, and father (original) (raw)
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Trends in Psychiatry and Psychotherapy, 2012
INTRODUCTION: The complexity of factors involved in anorexia nervosa (AN) and the recommendations of prominent health organizations underscore the importance of reflecting on therapeutic interventions aimed at patients' family members. OBJECTIVE: To expand knowledge about the mother-daughter relationship in AN, with a focus on developing a conceptual framework that is able to improve the treatment of the disorder, reduce factors that perpetuate it and improve prognosis. METHOD: A clinical method, anchored by psychodynamic references, was employed in a group of family members of patients with eating disorders. The group met weekly, and sessions were led by psychologists from the eating disorder outpatient clinic of a university hospital. RESULTS AND DISCUSSION: Common characteristics in the mother-daughter relationship in cases of AN were identified. The issue of mutual control, the dialectic between omnipotence and impotence, and the relationship of devotion, passion and annihil...
Anorexia nervosa: divergent validity a prototype narrative among anorexia relatives
2006
The objective of this ex post facto study was to test the divergent validity (degree of discrimination) of anorexia prototype narrative according to anorectic close confidents (relatives), as well as explore different characteristics of the participants which may be associated with the degree of prototype discrimination. Sixty-four relatives of individuals with anorexia nervosa participated in the study and were asked to indicate their degree of identification, according to their relative, with five different narrative prototypes (depressive, agoraphobia, anorexic, alcoholic, and drug addiction prototypes). Results did not confirm the divergent validity of the anorexic prototype narrative. The participants tended to identify primarily their relative with the agoraphobia prototype. Once again, no significant differences were found between the identification with the anorexic prototype and depression, agoraphobia and alcoholism prototype. The only significant differences found were for the comparison between the anorexic and drug addiction prototype. However, anorectic mothers and illness duration were found to be associated with the degree of identification of prototype narrative. Results were discussed in terms of a systemic versus a prototype approach to the eating disorders.
Low Emotional Stability – Negative Parental Factor in Anorexia Nervosa
2014
A great number of theories related to the bio-psycho-social aspects of anorexia nervosa currently exist. Most of these theories have been proven by studies which showed that one of the causes of anorexia nervosa could be linked to the relationship the patient has with her parents, especially the mother. This study investigates (based on the Big Five model) the personality of two lots of mothers whose daughters suffer from anorexia nervosa (N=8), clinically diagnosed and treated, and another lot of mothers whose daughters do not present this disorder (N=8). The results obtained indicate the fact that the Emotional Stability (Neuroticism) personality dimension in the target lot is lower, reaching levels that could indicate the existence of anxiety/depressive disorders.
Anorexia Nervosa: Divergent Validity of a Prototype Narrative
2006
The objective of this ex post facto study was to test the divergent validity (degree of discrimination) of anorexia prototype narrative according to anorectic close confidents (relatives), as well as explore different characteristics of the participants which may be associated with the degree of prototype discrimination. Sixty-four relatives of individuals with anorexia nervosa participated in the study and were asked to indicate their degree of identification, according to their relative, with five different narrative prototypes (depressive, agoraphobia, anorexic, alcoholic, and drug addiction prototypes). Results did not confirm the divergent validity of the anorexic prototype narrative. The participants tended to identify primarily their relative with the agoraphobia prototype. Once again, no significant differences were found between the identification with the anorexic prototype and depression, agoraphobia and alcoholism prototype. The only significant differences found were for the comparison between the anorexic and drug addiction prototype. However, anorectic mothers and illness duration were found to be associated with the degree of identification of prototype narrative. Results were discussed in terms of a systemic versus a prototype approach to the eating disorders.
Follow-up investigation of family relations in patients with anorexia nervosa
1996
In a group of 22 formerly anorectic inpatients (follow-up 3.8 years after treatment) and in a control group of 24 paralleled young women, the subjective perception of the family structure was assessed using the "Subjective Family Image (SFI)', in order to investigate the question whether the family structure of former anorectics differs from the controls and whether individual development of the former inpatients is associated with the experienced family structure. Empirical results are in favor of the following two hypotheses: 1) Compared to the control group, formerly anorectic inpatients experience family relationships as more corn-plicated and less satisfying. The quality of family relationships in the patient group is reduced, even at the time of follow-up. 2) Individual outcome (individual course of the illness) and quality of family relationships at time of follow-up are associated. Patients with a good outcome experience family relationships as more positive than patients with a poor outcome. The accordance of these findings to other empirical results and their implications for clinical practice are discussed.
This ex post facto study explored the differences in perceived family characteristics between a group of 34 female patients with anorexia nervosa and 34 females without eating pathology. All participants filled out the following self-report scales: FACES II, F-COPES, IPPA and the Family Beliefs Questionnaire. The results showed that, in contrast with participants without pathology, patients perceived their families as less cohesive and less capable of redefining stressful events in order to make them more manageable. However, they perceived their families as being more able to acquire and accept help, and presented more family beliefs related to a sense of an individual responsibility/ self-blaming. In addition, patients seemed to trust less their mothers and peers and to communicate less with their peers, and to show more detachment to mothers, fathers, and peers. Of all studied variables, detachment from friends and mother, as well as perceived higher family capacity to seek out c...
General psychopathology in anorexia nervosa: the role of psychosocial factors
Clinical Psychology & Psychotherapy, 2010
The aim of the present study was to investigate psychosocial correlates of comorbid psychopathology. Data were collected from a total of 90 female inpatients with anorexia nervosa (AN). Higher levels of general psychopathology were detected in depression, interpersonal sensitivity, obsessive–compulsive and anxiety subscales of the Symptom Checklist (SCL)-90. Regression analysis also revealed that higher levels of psychopathology across SCL-90 subscales in AN patients are significantly associated with an earlier age of onset of the condition, higher levels of anorectic psychopathology as measured by Eating Disorders Examination, lower self-esteem as measured by Multidimensional Self-Esteem Inventory and social support levels as measured by Quality of Social Network and Social Support Questionnaire. Considering the high levels of general psychopathology in people with AN, routine clinical practice should aim for a comprehensive assessment of such. Given the strong association between psychosocial factors such as self-esteem, social support and general psychopathology, psychological therapies could play an important role in facilitating emotional recovery. Copyright © 2010 John Wiley & Sons, Ltd.Key Practitioner Message:• Levels of depressive and anxiety psychopathology are elevated in people with Anorexia Nervosa.• Routine clinical practice should involve a comprehensive assessment of general psychopathology in people with Anorexia Nervosa.• Psychological interventions targeting self-esteem and interpersonal difficulties may be useful in the treatment of general pathology in people with Anorexia Nervosa.
Journal of Eating Disorders
Background A large theoretical body of knowledge exists emphasizing the importance of parental mentalizing in the context of anorexia-nervosa (AN). However, the empirical support to these assumptions is still scarce. The aim of the present study was to examine whether parents of patients with AN are characterized by a lower mentalizing ability, and whether it is associated with impaired mentalizing, AN symptomatology and eating disorder (ED) related psychological traits in the daughters. Methods Thirty-two family triads (fathers, mothers, and daughters) of female adolescent and young adult inpatients with AN were compared with thirty-three non-clinical family triads (N = 195). The mentalizing ability of all the participants was assessed using semi-structured interviews and coded using the Reflective Functioning Scale (RFS). Self-report questionnaires were administered to the daughters to evaluate ED symptomatology and ED related psychological traits (e.g., low self-esteem, interpers...
Profiles in Anorexia Nervosa 1
2017
Objective: This study aimed to explore the neuroand social-cognitive profile of a consecutive series of adult outpatients with Anorexia Nervosa (AN) when compared to widely available age and gender matched historical control data. The relationship between performance profiles, clinical characteristics, service utilization, and treatment adherence was also investigated. Method: Consecutively recruited outpatients with a broad diagnosis of AN (restricting subtype AN-R: n=44, binge-purge subtype AN-BP: n=33 or Eating Disorder Not Otherwise Specified-AN subtype EDNOS-AN: n=23) completed a comprehensive set of neuro-cognitive (set-shifting, central coherence) and social-cognitive measures (Emotional Theory of Mind). Data were subjected to hierarchical cluster analysis and a discriminant function analysis. Results: Three separate, meaningful clusters emerged. Cluster 1 (n=45) showed overall average to high average neuro-and socialcognitive performance, Cluster 2 (n=38) showed mixed perfor...