title: Family Functioning and Anorexia Nervosa: The Issue of Control
Creators: name: Hartmann, Peta B.
Publisher: name: Griffith University
Year: 2003
Subjects: subject: anorexia nervosa
subject: anorexic girls
subject: family relationships

description: This thesis aimed to examine the functioning of families with a sufferer of Anorexia Nervosa (AN), using self-report measures and a direct observation family discussion task. Researchers and clinicians have long been interested in the interactional patterns of these sufferers within the family unit, although few have furthered our understanding of the interplay between family functioning, cohesion and emotional expression and issues such as control, by directly examining these interactions. The construct of control has been another area of interest in recent research, although how it is constructed and operates within this disorder remains unclear and ambiguous. Thus the purpose of this research was to expand the study of adolescents suffering Anorexia Nervosa who still resided within the family unit, from merely studying self-report measures and retrospective surveys of recovery, to include a direct examination of sufferers and their families at the time of the disorder. Participants included 16 female sufferers of Anorexia Nervosa and their parents, 17 drug and alcohol sufferers, and 18 non-clinic families. Both parents and their daughters completed self-report inventories assessing their clinical status as well as family functioning and marital happiness. In addition, family members participated in a series of family discussion tasks which were coded for the dimensions of autonomy, cohesiveness, avoidance and control. In Study 1 (Chapter 7), the self-report measures of the anorexic families were examined specifically in relation to the construct of control acting as a mediating variable between level of dysfunction and severity of the disorder. Consistent with previous research, levels of marital happiness and family cohesion influenced the severity level of the daughter's Anorexia Nervosa. This study also explored the construct of control within the family system and found that the more moral-religious emphasis in the family, the more concerned the daughter was with her weight. At the same time daughters were reporting higher levels of moral-religious emphasis, they were reporting higher levels of self-control. The daughters in this study appeared to be inconsistent in their behavioural responses. The daughters' weight concern increased with their own reported levels of moral-religious emphasis in the family. However, as this emphasis increased, so too did their control scores. It was supposed that conflict may be created in a family when strong religious and/or strong moral values are emphasized, particularly when one of the family members suffers AN. This issue is discussed in depth. Study 2 sought to examine these variables further by using a direct observation family discussion task to compare an independent observer's ratings to the family's ratings of the discussion, across the three groups. The study examined the daughters' and mothers' perceptions and compared significant results to the observer's ratings. This study highlighted that the mothers of sufferers appeared not to be concerned about their own bodies and weight, and not distressed when discussing with their daughters the issues of control in the areas of family, body, school and friends. Furthermore, the anorexic daughters presented as more sad and anxious than the two other groups and indicated that their parents had more control over their bodies than they did themselves. Finally, for the majority of participating families, the fathers were absent and this issue is explored.