The family characteristics identified by Bruch , Selvini-Palazzoli  and Minuchin et al.  - rigidity, overprotectiveness, enmeshment, avoidance of conflict - may be somewhat more common in anorectic families than in families with psychosomatically or psychiatrically ill children, yet overall family dynamics show a great deal of variability. Parental styles and parent-child interactions differ between families of different AN subtypes. Families of restricting AN patients present high levels of cohesion, a calm, orderly, ''perfect'' environment not different from healthy controls , by contrast with families of bulimic AN patients, in which in particular fathers tend towards affective dyscontrol with expressions of hostility .
Controlled family studies of AN have described strong familial aggregation in AN families, with intergenerational transmission, but there was no clustering of affective disorders, unless AN coexisted with a depressive disorder . These findings were confirmed in a study of males with AN, which observed a twenty-fold increase of AN in female relatives. Conversely, bulimia nervosa was relatively uncommon among relatives of males with AN .
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