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Female Adolescents with Eating Disorders, Parental Psychopathological Risk and Family Functioning

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Abstract

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.

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References

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Arlington, VA: American Psychiatric Publishing.

    Book  Google Scholar 

  • Baiocco, R., Cacioppo, M., Laghi, F., & Tafà, M. (2013). Factorial and construct validity of FACES IV among Italian adolescents. Journal of Child and Family Studies, 22, 962–970. doi:10.1007/s10826-012-9658-1.

    Article  Google Scholar 

  • Barnes, H. L., & Olson, D. H. (1985). Parent-adolescent communication and the circumplex model. Child Development, 56, 438–447.

    Article  Google Scholar 

  • Bearman, S. K., Presnell, K., Martinez, E., & Stice, E. (2006). The skinny on body dissatisfaction: a longitudinal study of adolescent girls and boys. Journal of Youth and Adolescence, 35, 217–229.

    Article  PubMed  PubMed Central  Google Scholar 

  • Benninghoven, D., Raykowski, L., Solzbacher, S., Kunzendorf, S., & Jantschek, G. (2007). Body images of patients with anorexia nervosa, bulimia nervosa and female control subjects: a comparison with male ideals of female attractiveness. Body Image, 4(1), 51–59. doi:10.1016/j.bodyim.2006.12.002.

    Article  PubMed  Google Scholar 

  • Berge, J. M., Loth, K., Hanson, C., Croll-Lampert, J., & Neumark‐Sztainer, D. (2012). Family life cycle transitions and the onset of eating disorders: a retrospective grounded theory approach. Journal of Clinical Nursing, 21(9-10), 1355–1363. doi:10.1111/j.1365-2702.2011.03762.x.

    Article  PubMed  Google Scholar 

  • Berge, J. M., Wall, M., Bauer, K. W., & Neumark‐Sztainer, D. (2010). Parenting characteristics in the home environment and adolescent overweight: a latent class analysis. Obesity, 18(4), 818–825. doi:10.1038/oby.2009.324.

    Article  PubMed  Google Scholar 

  • Berge, J. M., Wall, M., Larson, N., Eisenberg, M. E., Loth, K. A., & Neumark-Sztainer, D. (2014). The unique and additive associations of family functioning and parenting practices with disordered eating behaviors in diverse adolescents. Journal of Behavioral Medicine, 37(2), 205–217.

    Article  PubMed  Google Scholar 

  • Brooks-Gunn, J. (1987). Pubertal processes and girls’ psychological adaptation. In R. Lerner & T. T. Foch (Eds.), Biological-psychosocial interactions in early adolescence: A life-span perspective (pp. 123–153). Hillsdale, NJ: Lawrence Erlbaum Associates.

  • Bühren, K., Schwarte, R., Fluck, F., Timmesfeld, N., Krei, M., Egberts, K., & Herpertz-Dahlmann, B. (2014). Comorbid psychiatric disorders in female adolescents with first‐onset anorexia nervosa. European Eating Disorders Review, 22(1), 39–44. doi:10.1002/erv.2254.

    Article  PubMed  Google Scholar 

  • Catapano, R., Meroni, M. C., Costa, E., Alliani, D., & Loriedo, C. (2005). Binge eating disorder e relazioni familiari: uno studio con il Faces III. Rivista di Psicoterapia Relazionale, 21, 57–83.

    Google Scholar 

  • Cerniglia, L., Cimino, S., & Ballarotto, G. (2014). Mother-child and father-child interaction with their 24-month-old children during feeding, considering paternal involvement and the child’s temperament in a community sample. Infant Mental Health Journal, 35(5), 473–481. doi:10.1002/imhj.21466.

    Article  PubMed  Google Scholar 

  • Cerniglia, L., Cimino, S., Ballarotto, G., Casini, E., Ferrari, A., Carbone, P., & Cersosimo, M. (2015). Motor vehicle accidents and adolescents: an empirical study on their emotional and behavioral profiles, defense strategies and parental support. Transportation Research Part F: Traffic Psychology and Behaviour, 35, 28–36.

    Article  Google Scholar 

  • Cerniglia, L., Cimino, S., Ballarotto, G., & Monniello, G. (2014). Parental loss during childhood and outcomes on adolescents’ psychological profiles: a longitudinal study. Current Psychology, 33(4), 545–556. doi:10.1007/s12144-014-9228-3.

    Article  Google Scholar 

  • Ciao, A. C., Accurso, E. C., Fitzsimmons‐Craft, E. E., Lock, J., & Le Grange, D. (2015). Family functioning in two treatments for adolescent anorexia nervosa. International Journal of Eating Disorders, 48(1), 81–90. doi:10.1002/eat.22314.

    Article  PubMed  Google Scholar 

  • Cimino, S., Cerniglia, L., & Paciello, M. (2015). Mothers with depression, anxiety or eating disorders: outcomes on their children and the role of paternal psychological profiles. Child Psychiatry & Human Development, 46, 228–236. doi:10.1007/s10578-014-0462-6.

    Article  Google Scholar 

  • Cimino, S., Cerniglia, L., Paciello, M., & Sinesi, S. (2013). A six‐year prospective study on children of mothers with eating disorders: the role of paternal psychological profiles. European Eating Disorders Review, 21(3), 238–246. doi:10.1002/erv.2218.

    Article  PubMed  Google Scholar 

  • Cohen, J. (2013). Statistical Power Analysis for the Behavioral Sciences. Waltham, MA: Academic press.

    Google Scholar 

  • Cohn, L. D., Adler, N. E., Irwin, C. E., Millstein, S. G., Kegeles, S. M., & Stone, G. (1987). Body-figure preferences in male and female adolescents. Journal of Abnormal Psychology, 96(3), 276–279.

    Article  PubMed  Google Scholar 

  • Derogatis, L. R. (1994). Symptom Checklist-90-Revised: Administration, scoring and procedures manual. Minneapolis, MN: National Computer Systems.

    Google Scholar 

  • Eddy, K. T., Tanofsky-Kraff, M., Thompson-Brenner, H., Herzog, D.B., Brown, T. A., & Ludwig, D. S. (2007). Eating disorder pathology among overweight treatment-seeking youth: clinical correlates and cross-sectional risk modeling. Behaviour Research and Therapy, 45, 2360–2371.

    Article  PubMed  Google Scholar 

  • Enten, R. S., & Golan, M. (2009). Parenting styles and eating disorder pathology. Appetite, 52(3), 784–787. doi:10.1016/j.appet.2009.02.013.

    Article  PubMed  Google Scholar 

  • Ferguson, C. J., Muñoz, M. E., Garza, A., & Galindo, M. (2014). Concurrent and prospective analyses of peer, television and social media influences on body dissatisfaction, eating disorder symptoms and life satisfaction in adolescent girls. Journal of Youth and Adolescence, 43(1), 1–14. doi:10.1007/s10964-012-9898-9.

    Article  PubMed  Google Scholar 

  • Ferriter, C., & Ray, L. A. (2011). Binge eating and binge drinking: an integrative review. Eating Behaviors, 12(2), 99–107. doi:10.1016/j.eatbeh.2011.01.001.

    Article  PubMed  Google Scholar 

  • Franko, D. L., Thompson, D., Affenito, S. G., Barton, B. A., & Striegel-Moore, R. H. (2008). What mediates the relationship between family meals and adolescent health issues. Health Psychology, 27(2), S109–S117. doi:10.1037/0278-6133.27.2(Suppl.).S109.

    Article  PubMed  Google Scholar 

  • Garfinkel, P. E., Kaplan, A. S., Garner, D. M., & Darby, P. L. (1983). The differentiation of vomiting/weight loss as a conversion disorder from anorexia nervosa. American Journal of Psychiatry, 140, 1019–1022.

    Article  PubMed  Google Scholar 

  • Goodier, G. H., McCormack, J., Egan, S. J., Watson, H. J., Hoiles, K. J., Todd, G., & Treasure, J. L. (2014). Parent skills training treatment for parents of children and adolescents with eating disorders: a qualitative study. International Journal of Eating Disorders, 47(4), 368–375. doi:10.1002/eat.22224.

    Article  PubMed  Google Scholar 

  • Gorall, D. M., Tiesel, J. W., & Olson, D. H. (2006). FACES-IV & the Circumplex Model. Minneapolis, MN: Life Innovations.

    Google Scholar 

  • Haslam, M., Mountford, V., Meyer, C., & Waller, G. (2008). Invalidating childhood environments in anorexia and bulimia nervosa. Eating Behaviors, 9(3), 313–318. doi:10.1016/j.eatbeh.2007.10.005.

    Article  PubMed  Google Scholar 

  • Hayaki, J. (2009). Negative reinforcement eating expectancies, emotion dysregulation, and symptoms of bulimia nervosa. International Journal of Eating Disorders, 42(6), 552–556. doi:10.1002/eat.20646.

    Article  PubMed  Google Scholar 

  • Haycraft, E., Goodwin, H., & Meyer, C. (2014). Adolescents’ level of eating psychopathology is related to perceptions of their parents’ current feeding practices. Journal of Adolescent Health, 54(2), 204–208. doi:10.1016/j.jadohealth.2013.08.007.

    Article  PubMed  Google Scholar 

  • Hollingshead, A. B. (1975). Four Factor Index of Social Status. New Haven, CT: Yale University. Unpublished manuscript.

    Google Scholar 

  • Kessler, R. C., Berglundb, P. A., Chiu, W. T., Deitz, A. C., Hudsond, J. I., Shahly, V., Aguilar-Gaxiola, S., Jordi-Alonso, Angermeyer, M. C., Benjet, C., Bruffaert, R., de Girolamo, G., de Graaf, R., Maria Haro, J., Koyess-Massfety, V., O’Neill, S., Posada-Villa, J., Sasu, C., Scott, K., Viana, M. C., & Xavier, M. (2013). The prevalence and correlates of binge eating disorder in the World Health Organization World Mental Health Surveys. Biological Psychiatry, 73, 904–914. doi:10.1016/j.biopsych.2012.11.020.

    Article  PubMed  PubMed Central  Google Scholar 

  • King, G., McDougall, J., DeWit, D., Hong, S., Miller, L., Offord, D., Meyer, K., & LaPorta, J. (2005). Pathways to children’s academic performance and prosocial behaviour: Roles of physical health status, environmental, family, and child factors. International Journal of Disability, Development and Education, 52, 313–344.

    Article  Google Scholar 

  • Lask, B., & Bryant-Waugh, R. (2013). Eating Disorders in Childhood and Adolescence. London: Routledge.

    Google Scholar 

  • Latzer, Y., Edmunds, L., Fenig, S., Golan, M., Gur, E., Hochberg, Z., Levin-Zamir, D., Zubery, E., & Stein, D. (2009). Managing childhood overweight: behavior, family, pharmacology, and bariatric surgery interventions. Obesity, 17(3), 411–423. doi:10.1038/oby.2008.553.

    Article  PubMed  Google Scholar 

  • Levine, M. P. (1987). How Schools Can Help Combat Student Eating Disorders. Washington, DC: National Education Association.

    Google Scholar 

  • Levine, M., & Smolak, L. (2013). Toward a model of the developmental psychopathology of eating disorders: the example of early adolescence. In J. H. Crowter, S. E. Hobfoll, M. A. Stephens, & D. L. Tennenbaum (Eds.), The etiology of bulimia nervosa: The individual and familial context (pp. 59–80). Taylor and Francis.

  • Lewis, G., Collishaw, S., Thapar, A., & Harold, G. T. (2014). Parent–child hostility and child and adolescent depression symptoms: the direction of effects, role of genetic factors and gender. European Child & Adolescent Psychiatry, 23, 317–327.

    Article  Google Scholar 

  • Lucarelli, L., Cimino, S., D’Olimpio, F., & Ammaniti, M. (2013). Feeding disorders of early childhood: an empirical study of diagnostic subtypes. International Journal of Eating Disorders, 46(2), 147–155.

    Article  PubMed  Google Scholar 

  • Meno, C. A., Hannum, J. W., Espelage, D. E., & Douglas Low, K. D. (2008). Familial and individual variables as predictors of dieting concerns and binge eating in college females. Eating Behaviors, 9(1), 91–101. doi:10.1016/j.eatbeh.2007.06.002.

    Article  PubMed  Google Scholar 

  • Minuchin, S., & Fishman, H. C. (1980). Psychosomatic Family in child psychiatry. Journal of the American Academy of Child Psychiatry, 18, 76–90.

    Article  Google Scholar 

  • Minuchin, S., Rosman, B. L., & Baker, L. (1978). Psychosomatic Families: Anorexia nervosa in context. Cambridge, MA: Harward University Press.

    Book  Google Scholar 

  • Munsch, S., Meyer, A. H., Quartier, V., & Wilhelm, F. H. (2012). Binge eating in binge eating disorder: a breakdown of emotion regulatory process? Psychiatry Research, 195(3), 118–124. doi:10.1016/j.psychres.2011.07.016.

    Article  PubMed  Google Scholar 

  • Nowakowski, M. E., McFarlane, T., & Cassin, S. (2013). Alexithymia and eating disorders: a critical review of the literature. Journal of Eating Disorders, 1–21. doi: 10.1186/2050-2974-1-21.

  • Olson, D. H. (1988). Family assessment and intervention: the Circumplex Model of family systems. Child & Youth Services, 11, 9–48.

    Article  Google Scholar 

  • Olson, D. H. (1995). Family Satisfaction Scale. Minneapolis, MN: Life Innovations.

    Google Scholar 

  • Olson, D. H. (2008). Faces IV Manual. Minneapolis, MN: Life Innovations.

    Google Scholar 

  • Olson, D. H. (2010). Data analysis using Faces IV scores. Minneapolis, MN: Life Innovations.

    Google Scholar 

  • Olson, D. H. (2011). FACES IV and the Circumplex Model: validation study. Journal of Marital and Family Therapy, 37(1), 64–80. doi:10.1111/j.1752-0606.2009.00175.x.

    Article  PubMed  Google Scholar 

  • Olson, D. H., & Gorall, D. M. (2006). Faces IV and the Circumplex model. Minneapolis, MN: Life Innovations.

    Google Scholar 

  • Olson, D. H., Sprenkle, D. H., & Russel, C. S. (1979). Circumplex Model of marital and family systems I: cohesion and adaptability dimensions, family types, and clinical applications. Family Process, 18, 3–28.

    Article  PubMed  Google Scholar 

  • Paciello, M., Fida, R., Cerniglia, L., Tramontano, C., & Cole, E. (2013). High cost helping scenario: the role of empathy, prosocial reasoning and moral disengagement on helping behavior. Personality and Individual Differences, 55(1), 3–7. doi:10.1016/j.paid.2012.11.004.

    Article  Google Scholar 

  • Paciello, M., Fida, R., Tramontano, C., Cole, E., & Cerniglia, L. (2013). Moral dilemma in adolescence: the role of values, prosocial moral reasoning and moral disengagement in helping decision making. European Journal of Developmental Psychology, 10(2), 190–205. doi:10.1080/17405629.2012.759099.

    Article  Google Scholar 

  • Pope, H. G., & Hudson, J. I. (1989). Are eating disorders associated with borderline personality disorder? A critical review. International Journal of Eating Disorders, 8, 1–9. doi:10.1002/1098-108X(198901)8:1<1::AID-EAT2260080102>3.0.CO;2-#.

    Article  Google Scholar 

  • Prunas, A., Sarno, I., Preti, E., Madeddu, F., & Perugini, M. (2012). Psychometric properties of the Italian version of the SCL-90-R: a study on a large community sample. European Psychiatry, 27(8), 591–597. doi:10.1016/j.eurpsy.2010.12.006.

    Article  PubMed  Google Scholar 

  • Salafia, E. H. B., Gondoli, D. M., Corning, A. F., Bucchianeri, M. M., & Godinez, N. M. (2009). Longitudinal examination of maternal psychological control and adolescents’ self-competence as predictors of bulimic symptoms among boys and girls. International Journal of Eating Disorders, 42(5), 422–428. doi:10.1002/eat.20626.

    Article  PubMed  Google Scholar 

  • Sellers, R., Collishaw, S., Rice, F., Thapar, A. K., Potter, R., Mars, B., Harold, G. T., Smith, D. J., Owen, M. J., Craddpck, N., & Thapar, A. (2013). Risk of psychopathology in adolescent offspring of mothers with psychopathology and recurrent depression. The British Journal of Psychiatry, 202(2), 108–114. doi:10.1192/bjp.bp.111.104984.

    Article  PubMed  Google Scholar 

  • Sherwood, N. E., Crowther, J. H., Wills, L., & Ben-Porath, Y. S. (2000). The perceived function of eating for bulimic, subclinical bulimic, and non-eating disordered women. Behavior Therapy, 31, 777–793.

    Article  Google Scholar 

  • Smink, F. R., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406–414. doi:10.1007/s11920-012-0282-y.

    Article  PubMed  PubMed Central  Google Scholar 

  • Smink, F. R., van Hoeken, D., Oldehinkel, A. J., & Hoek, H. W. (2014). Prevalence and severity of DSM‐5 eating disorders in a community cohort of adolescents. International Journal of Eating Disorders, 47(6), 610–619. doi:10.1002/eat.22316.

    Article  PubMed  Google Scholar 

  • Smolak, L., Levine, M. P., & Sullins, E. (1990). Are child sexual experiences related to eating‐disordered attitudes and behaviors in a college sample? International Journal of Eating Disorders, 9(2), 167–178. doi:10.1002/1098-108X(199003)9:2<167::AID-EAT2260090206>3.0.CO;2-W.

    Article  Google Scholar 

  • Soenens, B., Vansteenkiste, M., Vandereycken, W., Luyten, P., Sierens, E., & Goossens, L. (2008). Perceived parental psychological control and eating-disordered symptoms: Maladaptive perfectionism as a possible intervening variable. The Journal of Nervous and Mental Disease, 196(2), 144–152. doi:10.1097/NMD.0b013e318162aabf.

    Article  PubMed  Google Scholar 

  • Stice, E., Marti, C. N., & Durant, S. (2011). Risk factors for onset of eating disorders: Evidence of multiple risk pathways from an 8-year prospective study. Behaviour Research and Therapy, 49(10), 622–627. doi:10.1016/j.brat.2011.06.009.

    Article  PubMed  PubMed Central  Google Scholar 

  • Striegel-Moore, R. H., Fairburn, C. G., Wilfley, D. E., Pike, K. M., Dohm, F. A., & Kraemer, H. C. (2005). Toward an understanding of risk factors for binge-eating disorder in black and white women: a community-based case-control study. Psychological Medicine, 35(6), 907–917.

    Article  PubMed  Google Scholar 

  • Strober, M., & Katz, J. L. (1988). Depression in the eating disorders: a review and analysis of descriptive, family and biological findings. Diagnostic issues in anorexia nervosa and bulimia nervosa. In D. M. Garner & P. E. Garfinkel (Eds.), Diagnostic Issues in Anorexia Nervosa and Bulimia Nervosa (pp. 80–111). New York: Brunner/Mazel.

  • Swanson, S. A., Crow, S. J., Le Grange, D., Swendsen, J., & Merikangas, K. R. (2011). Prevalence and correlates of eating disorders in adolescents: results from the national comorbidity survey replication adolescent supplement. Archives of General Psychiatry, 68, 714–723. doi:10.1001/archgenpsychiatry.2011.22.

    Article  PubMed  Google Scholar 

  • Tafà, M., & Baiocco, R. (2009). Addictive behavior and family functionig during adolescence. Journal of Family Therapy, 37, 388–395. doi:10.1080/01926180902754745.

    Article  Google Scholar 

  • Tafà, M. (2007). Il Faces III. In S. Mazzoni & M. Tafà. (Eds.), L’intersoggettività nella famiglia. Procedure multimetodo per l’osservazione e la valutazione delle relazioni familiari (pp. 163–179). Milano: Franco Angeli.

  • Tambelli, R., Cerniglia, L., Cimino, S., & Ballarotto, G. (2015a). Parent-infant interactions in families with women diagnosed with postnatal depression: a longitudinal study on the effects of a psychodynamic treatment. Frontiers in Psychology, 6, 1210.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tambelli, R., Cimino, S., Cerniglia, L., & Ballarotto, G. (2015b). Early maternal relational traumatic experiences and psychopathological symptoms: a longitudinal study on mother-infant and father-infant interactions. Scientific Reports, 5, 13984.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vardar, E., & Erzengin, M. (2011). The prevalence of eating disorders (EDs) and comorbid psychiatric disorders in adolescents: a two-stage community-based study. Türk Psikiyatri Dergisi, 22, 205–212.

    PubMed  Google Scholar 

  • Vidović, V., Jureša, V., Begovac, I., Mahnik, M., & Tocilj, G. (2005). Perceived family cohesion, adaptability and communication in eating disorders. European Eating Disorders Review, 13(1), 19–28. doi:10.1002/erv.615.

    Article  Google Scholar 

  • Visani, E. (2014). Studi sul funzionamento familiare: osservazioni complessive. In E. Visani, S. Di Nuovo, & C. Loriedo (Eds.), Faces IV. Il Modello Circonflesso di Olson nella clinica e nella ricerca (pp. 148–152). Milano: Franco Angeli.

  • Visani, E., Di Nuovo, S., & Loriedo, C. (2014). Faces IV. Il Modello Circonflesso di Olson nella clinica e nella ricerca. Milano: Franco Angeli.

    Google Scholar 

  • Waller, G. M., Slade, P. D., & Calam, R. (1990). Family adaptability and cohesion: Relation to eating attitudes and disorders. International Journal of Eating Disorders, 9, 225–228.

    Article  Google Scholar 

  • Wisotsky, W., Dancyger, I., Fornari, V., Katz, J., Wisotsky, W. L., & Swencionis, C. (2003). The relationship between eating pathology and perceived family functioning in eating disorder patients in a day treatment program. Eating Disorders, 11, 89–99.

    Article  PubMed  Google Scholar 

  • Wooldridge, T., & Lytle, P. P. (2012). An overview of anorexia nervosa in males. Eating disorders, 20(5), 368–378. doi:10.1080/10640266.2012.715515.

    Article  PubMed  Google Scholar 

  • Zucker, N., Moskovich, A., Vinson, M., & Watson, K. (2013). Emotions and empathic understanding: capitalizing on relationships in those with eating disorders. In J. Alexander & J. Treasure (Eds.), A Collaborative Approach to Eating Disorders (pp. 52–61). New York, NY: Routledge.

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Tafà, M., Cimino, S., Ballarotto, G. et al. Female Adolescents with Eating Disorders, Parental Psychopathological Risk and Family Functioning. J Child Fam Stud 26, 28–39 (2017). https://doi.org/10.1007/s10826-016-0531-5

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