Perception of Autonomy and Connectedness Prior to the Onset of Anorexia Nervosa and Bulimia Nervosa: A Retrospective Study in Sister Pairs Discordant for an Eating Disorder

TY - JOUR

T1 - Perception of Autonomy and Connectedness Prior to the Onset of Anorexia Nervosa and Bulimia Nervosa

T2 - A Retrospective Study in Sister Pairs Discordant for an Eating Disorder

AU - Huemer, Julia

AU - Haidvogl, Maria

AU - Mattejat, Fritz

AU - Wagner, Gudrun

AU - Nobis, Gerald

AU - Fernandez-Aranda, Fernando

AU - Collier, David A

AU - Treasure, Janet L

AU - Karwautz, Andreas F K

PY - 2012

Y1 - 2012

N2 - Objective: This study examines retrospective correlates of nonshared family environment prior to onset of disease, by means of multiple familial informants, among anorexia and bulimia nervosa patients. Methods: A total of 332 participants was included (anorexia nervosa, restrictive type (AN-R): n = 41 plus families); bulimic patients (anorexia nervosa, binge-purging type; bulimia nervosa: n = 59 plus families). The EATAET Lifetime Diagnostic Interview was used to establish the diagnosis; the Subjective Family Image Test was used to derive emotional connectedness (EC) and individual autonomy (IA). Results: Bulimic and AN-R patients perceived significantly lower EC prior to onset of disease compared to their healthy sisters. Bulimic patients perceived significantly lower EC prior to onset of disease compared to AN-R patients and compared to their mothers and fathers. A low family sum - sister pairs sum comparison - of EC had a significant influence on the risk of developing bulimia nervosa. Contrary to expectations, AN-R patients did not perceive significantly lower levels of IA compared to their sisters, prior to onset of disease. Findings of low IA in currently ill AN-R patients may represent a disease consequence, not a risk factor. Conclusions: Developmental child psychiatrists should direct their attention to disturbances of EC, which may be present prior to the onset of the disease.

AB - Objective: This study examines retrospective correlates of nonshared family environment prior to onset of disease, by means of multiple familial informants, among anorexia and bulimia nervosa patients. Methods: A total of 332 participants was included (anorexia nervosa, restrictive type (AN-R): n = 41 plus families); bulimic patients (anorexia nervosa, binge-purging type; bulimia nervosa: n = 59 plus families). The EATAET Lifetime Diagnostic Interview was used to establish the diagnosis; the Subjective Family Image Test was used to derive emotional connectedness (EC) and individual autonomy (IA). Results: Bulimic and AN-R patients perceived significantly lower EC prior to onset of disease compared to their healthy sisters. Bulimic patients perceived significantly lower EC prior to onset of disease compared to AN-R patients and compared to their mothers and fathers. A low family sum - sister pairs sum comparison - of EC had a significant influence on the risk of developing bulimia nervosa. Contrary to expectations, AN-R patients did not perceive significantly lower levels of IA compared to their sisters, prior to onset of disease. Findings of low IA in currently ill AN-R patients may represent a disease consequence, not a risk factor. Conclusions: Developmental child psychiatrists should direct their attention to disturbances of EC, which may be present prior to the onset of the disease.

KW - Adolescent

KW - Adult

KW - Anorexia Nervosa

KW - Bulimia Nervosa

KW - Family Relations

KW - Female

KW - Humans

KW - Internal-External Control

KW - Interview, Psychological

KW - Judgment

KW - Middle Aged

KW - Object Attachment

KW - Parenting

KW - Personal Autonomy

KW - Retrospective Studies

KW - Risk Factors

KW - Siblings

KW - Young Adult

U2 - 10.1024/1422-4917/a000150

DO - 10.1024/1422-4917/a000150

M3 - Article

C2 - 22161943

VL - 40

SP - 61

EP - 68

JO - ZEITSCHRIFT FUR KINDER UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE

JF - ZEITSCHRIFT FUR KINDER UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE

IS - 1

ER -