Family Interaction Environment and Psychopathology

Studies provide strong evidence for family dysfunction in BN. More conflict expression without resolution and distant fathers have been found to distinguish families with a BN daughter from families of healthy controls and families with restricting AN daughters [59]. Kendler et al. [11] reported low levels of paternal care as well as parental substance abuse and parental depression associated with definite and probable cases of BN. In another analysis, Kendler et al. [53] reported that familial-environmental influences substantially influenced the liability to BN. Fairburn et al. [51] recorded low parental contact, more negative comments from family members about appearance, eating habits and weight, and parental arguments in comparison to psychiatric controls. Rates of parental alcoholism, depression and drug abuse were also increased. A significant problem with Fairburn et al.'s risk factor studies in eating disorders [24,51] is that all information concerning the families, including the psychiatric diagnoses, was obtained from the patients and not derived from independent interviews of family members.

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