Family Interaction Environment and Psychopathology

The family characteristics identified by Bruch [19], Selvini-Palazzoli [36] and Minuchin et al. [37] - 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 [38], by contrast with families of bulimic AN patients, in which in particular fathers tend towards affective dyscontrol with expressions of hostility [39].

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 [40]. 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 [41].

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Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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