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Alghanami BH, El Keshky MES. The Relationship between the Family Environment and Eating Disorder Symptoms in a Saudi Non-Clinical Sample of Students: A Moderated Mediated Model of Automatic Thoughts and Gender. Behav Sci (Basel) 2023; 13:818. [PMID: 37887468 PMCID: PMC10604237 DOI: 10.3390/bs13100818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/24/2023] [Accepted: 09/30/2023] [Indexed: 10/28/2023] Open
Abstract
Eating disorders are a global burden and present personal, family, and societal costs. Most evidence in the literature is based on the relationship between a poor family environment and eating disorders, and the evidence of gender interaction in eating disorders is inconsistent. This study aimed to investigate the relationship between family environment and eating disorder symptoms, the mediating role of negative automatic thoughts, and the moderating role of gender using a non-clinical sample of students. A sample of 440 (70.9% females, aged 18-21) participated in this study. They completed the Eating Attitudes Test (EAT-26), the Automatic Thoughts Questionnaire (ATQ negative), and the Brief Family Relationship Scale (BFRS). PROCESS MACRO was used to study these relationships. The main findings revealed that family environment was negatively associated with eating disorder symptoms and that this relationship was mediated by automatic thoughts. Moreover, gender moderated those relationships, and more intensely in females. The results of this study indicate that the prevention of eating disorders should be directed at training individuals to challenge negative thoughts and encourage healthy individuals to be gender mindful.
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Affiliation(s)
- Badra Hamdi Alghanami
- Department of Psychology, Faculty of Arts and Humanities, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Mogeda El Sayed El Keshky
- Department of Psychology, Faculty of Arts and Humanities, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Psychology, Faculty of Arts, Assiut University, Asyut 71515, Egypt
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2
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Bruysters NYF, Pilkington PD. Overprotective parenting experiences and early maladaptive schemas in adolescence and adulthood: A systematic review and meta-analysis. Clin Psychol Psychother 2023; 30:10-23. [PMID: 35927065 PMCID: PMC10088016 DOI: 10.1002/cpp.2776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 02/03/2023]
Abstract
Young's schema model identifies overprotection as a type of childhood experience associated with early maladaptive schemas. This review evaluated the evidence base examining overprotective parenting as a predictor of schema endorsement in adolescence and adulthood. A systematic review and meta-analysis were conducted in accordance with the PRISMA guidelines, and registered on PROSPERO (CRD42021258990). PsycINFO, CINAHL and PubMed databases were searched on 5 June 2021 for eligible studies reporting original data on unadjusted association(s) between overprotective parenting and schema endorsement in samples with a mean age of 12 years or older. Studies were excluded if they were not in English or peer reviewed or participants were exposed to an intervention. Meta-analyses using Meta-Essentials software examined the relationship between maternal and paternal overprotective parenting with Young's 18 schemas. An adapted version of the Appraisal tool for Cross-Sectional Studies (AXIS) was used to assess methodological quality. A total of 16 articles were included. Based on 36 meta-analyses (Pooled N = 1,496 to 3,218), several schemas demonstrated positive small correlations with maternal overprotective parenting (range: r = 0.15, 95% CI = 0.10, 0.19 [Entitlement] to r = 0.29, 95% CI = 0.13, 0.43 [Enmeshment]) and paternal overprotective parenting (range: r = 0.15, 95% CI = 0.10, 0.20 [Abandonment] to r = 0.24, 95% CI = 0.10, .36 [Enmeshment]). Considerable heterogeneity was detected, but subgroup analyses were not significant. Overall, recollections of overprotective parenting experiences were primarily associated with schemas relating to disconnection and rejection, and impaired autonomy and performance. However, the literature has thus far relied on retrospective measures of parenting, and longitudinal research is needed to establish causality.
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Affiliation(s)
- Niki Yuen Fen Bruysters
- School of Behavioural and Health Sciences, Australian Catholic University, Sydney, Australia
| | - Pamela D Pilkington
- School of Behavioural and Health Sciences, Australian Catholic University, Sydney, Australia
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3
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Güler K, Özgörüş Z. Investigation of the relationship between early maladaptive schemas, temperament and eating attitude in adults. J Eat Disord 2022; 10:187. [PMID: 36447268 PMCID: PMC9710155 DOI: 10.1186/s40337-022-00711-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 11/17/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Current research on eating attitude has focused primarily on female perspective (Kapoor et al. in J Educ Health Promot 11(80):1-7, 2022; Piko et al. in J Prev Med Hyg. 63(1):83-89, 2022). To extend cross-gender approaches, this study aimed to examine the relationship between early maladaptive schemas, temperament, and eating attitude and to see whether these three concepts differ between men and women. METHODS The sample group consists of a total of 308 participants, 206 (66.9%) women and 102 (33.1%) men, living in Bursa and participating in the research voluntarily. In the study, Sociodemographic Data Form was used to obtain personal information of the participants, Young Schema Questionnaire-Short Form 3 was used to evaluate early maladaptive schemas, Temperament Evaluation of Memphis, Pisa, Paris and San-Diego Autoquestionnaire was used to evaluate temperament characteristics and Eating Attitude Test was used to evaluate eating attitudes. RESULTS As a result of the study, a moderate and positive relationship was found between the Defectiveness, Emotional Inhibition, Enmeshment/Dependence, Failure, Abandonment, Vulnerability to Harm or Illness, Negativity/Pessimism schemas and eating attitude. Among these schemas, Defectiveness was found to be the best predictor of deterioration in eating attitude. A weak and positive relationship was found between the scores obtained from the Eating Attitude Test and Cyclothymic and Irritable temperaments, and a moderate positive relationship with Anxious temperament. Among these temperaments, Anxious temperament was found to be the best predictor of deterioration in eating attitude. CONCLUSIONS When the results were examined, a relationship was observed between early maladaptive schemas and temperament types, and this relationship was examined in detail. The results obtained at the end of the study were discussed and suggestions were made for future studies.
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Affiliation(s)
- Kahraman Güler
- Psychology Department, Faculty of Economics and Administrative Social Sciences, Istanbul Gelisim University, Istanbul, Turkey.
| | - Zeynep Özgörüş
- Psychology Department, Faculty of Economics and Administrative Social Sciences, Istanbul Gelisim University, Istanbul, Turkey
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4
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Saunokonoko AJ, Mars M, Sattmann-Frese WJ. The significance of the father-daughter relationship to understanding and treating Bulimia Nervosa: a Hermeneutic Phenomenological Study. COGENT PSYCHOLOGY 2022. [DOI: 10.1080/23311908.2022.2095721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
| | - M. Mars
- Torrens University Australia, Pyrmont, New South Wales, Australia
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Ramalho JDAM, El Husseini M, Bloc L, Bucher-Maluschke JSNF, Moro MR, Lachal J. The Role of Food in the Family Relationships of Adolescents With Anorexia Nervosa and Bulimia in Northeastern Brazil: A Qualitative Study Using Photo Elicitation. Front Psychiatry 2021; 12:623136. [PMID: 33935829 PMCID: PMC8085302 DOI: 10.3389/fpsyt.2021.623136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/18/2021] [Indexed: 11/25/2022] Open
Abstract
Family components can play roles both as protective factors and maintenance mechanisms of eating disorders. We aimed to investigate the role of food in the family relationships of adolescents with anorexia nervosa and bulimia in northeastern Brazil. Using photo elicitation, a visual narrative method that gives insight into the participants' perspective through photograph, we conducted semi-structured interviews with 26 people: four teenage girls with anorexia, four with bulimia, eight mothers, four fathers, five grandmothers, and one sister. Data were analyzed using the principles of Interpretative Phenomenological Analysis, which highlighted the following themes: control of the parent-adolescent relationship through food; food as a mean of experiencing parental presence-absence; food as the focus of conflict in the nuclear family, and food as a source of three-generational conflict. Food seemed to be a means for teens and parents to express physical suffering and psychological violence. Moreover, mourning appeared to influence the girls' relationships with food. Conflict in these families is not focused solely on food, but extends to other subjects, and teenagers' emotional reactivity concerning their relationship with their parents and food during family mealtimes varied. These features reinforced the cultural aspect and influences of eating experiences among adolescent girls with eating disorders. Remarkable disparities exist in the generations' views on what rules and rituals these adolescents must follow at meals. These disparities can obfuscate generational boundaries in these families. Our data reinforce the need to focus on the adolescent's autonomy in the family setting and on family identity as related to food among three generations. These findings necessitate a reorganization of boundaries between these generations.
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Affiliation(s)
- Juniana de Almeida Mota Ramalho
- Université of Paris 13, Université Sorbonne Paris Cité, URTPP - Unité transversale de psychogénèse et psychopathologie, Villetaneuse, France.,University Grenoble Alpes, LIP/PC2S, Grenoble, France
| | - Mayssa' El Husseini
- University of Picardie Jules Verne, CHSSC, Amiens, France.,APHP, Hôpital Cochin, Maison de Solenn, Paris, France
| | - Lucas Bloc
- University of Fortaleza (UNIFOR), APHETO - Laboratório de Psicopatologia e Clínica Humanista-Fenomenológica, Fortaleza, Brazil
| | | | - Marie Rose Moro
- APHP, Hôpital Cochin, Maison de Solenn, Paris, France.,Université de Paris, PCPP, Boulogne-Billancourt, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France
| | - Jonathan Lachal
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Clermont-Ferrand, Clermont-Ferrand, France.,Université Clermont Auvergne, Clermont-Ferrand, France
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Simões MDM, Santos MAD. Paternity and Parenting in the Context of Eating Disorders: An Integrative Literature Review. PSICOLOGIA: TEORIA E PESQUISA 2021. [DOI: 10.1590/0102.3772e37459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Family relationships seem to have relevant contribution to the etiopathogenesis of Eating Disorders (EDs). This study aimed to analyze the scientific production about the paternity and parenting experiences of fathers whose daughters developed EDs. The literature review was conducted through the databases LILACS, PubMed, PsycINFO, Web of Science and EMBASE, in the period from 1999 to 2019. From the 878 retrieved papers, 23 were selected for the analysis. The results show that paternity and parenting experiences are influenced by father’s personality traits. The dominant representation is of an affectionless and not empathetic father, as well as punitive and insensitive to the daughter’s emotional needs. Knowing the paternal experiences is central to subside sensible care to both, daughters’ and fathers’ demands.
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Mensi MM, Orlandi M, Rogantini C, Provenzi L, Chiappedi M, Criscuolo M, Castiglioni MC, Zanna V, Borgatti R. Assessing Family Functioning Before and After an Integrated Multidisciplinary Family Treatment for Adolescents With Restrictive Eating Disorders. Front Psychiatry 2021; 12:653047. [PMID: 34149477 PMCID: PMC8211764 DOI: 10.3389/fpsyt.2021.653047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 04/16/2021] [Indexed: 01/01/2023] Open
Abstract
The present study presents an investigation of family functioning in the families of adolescents with severe restrictive eating disorders (REDs) assessed before and 6 months after a multidisciplinary family treatment program that combined psychodynamic psychotherapy, parental role intervention, and triadic or family-centered interventions. Nutritional counseling and neuropsychiatric monitoring of the overall treatment and care process were also provided. Family functioning was assessed using the clinical version of the Lausanne Trilogue Play (LTPc), a semi-structured procedure for observing family dynamics, previously validated for this patient population. The LTPc is divided into four phases. In phase 1, the mother interacts with the patient while the father assumes the role of observer. In phase 2, the father plans an activity with the patient while the mother observes. In phase 3, all the family members interact. Finally, in phase 4, the parents talk while the adolescent observes. A significant change emerged in family functioning after the treatment, but only for the interactive phase 2, when the father is required to interact with the daughter while the mother silently observes. The results of this study suggest that a relatively brief multidisciplinary treatment program may significantly improve family functioning in the families of patients diagnosed with severe REDs. Although appropriate clinical trials are needed to further test the efficacy of this treatment, the results also reinforce the concept that treatment programs targeting the individual patient and both the parents should be a first-line approach in adolescents with severe REDs.
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Affiliation(s)
- Martina M Mensi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Marika Orlandi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Chiara Rogantini
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Matteo Chiappedi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Michela Criscuolo
- Anorexia Nervosa and Eating Disorder Unit, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Maria C Castiglioni
- Anorexia Nervosa and Eating Disorder Unit, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Valeria Zanna
- Anorexia Nervosa and Eating Disorder Unit, Bambino Gesù Children Hospital IRCCS, Rome, Italy
| | - Renato Borgatti
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
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Pilkington PD, Bishop A, Younan R. Adverse childhood experiences and early maladaptive schemas in adulthood: A systematic review and meta-analysis. Clin Psychol Psychother 2020; 28:569-584. [PMID: 33270299 DOI: 10.1002/cpp.2533] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Schema Therapy is based on the theory that trauma and neglect in childhood lead to early maladaptive schemas and psychopathology in adulthood. The aim of this review was to evaluate support for this theory by synthesizing the literature on childhood adversity and schemas. METHODS A systematic review and meta-analysis were completed in compliance with PRISMA. PsycInfo, CINAHL and PubMed were searched to identify eligible studies that reported unadjusted association(s) between adverse childhood events and schema scores when participants were 18 years or older. Meta-analyses were conducted to estimate the pooled effect size of associations between schemas and experiences of childhood adversity. RESULTS A total of 33 studies met inclusion criteria and provided sufficient data for meta-analyses on childhood experiences relating to toxic frustration of needs (emotional neglect and physical neglect) and trauma and victimization (emotional abuse, physical abuse and sexual abuse). Of the 124 meta-analyses, 65 indicated that schemas show small to large correlations with emotional neglect (range: r = .16 [Failure] to r = .51 [Emotional Deprivation]); small to moderate correlations with emotional abuse (range: r = .20 [Vulnerability to Harm] to r = .44 [Emotional Deprivation]); and small correlations with physical neglect, physical abuse and sexual abuse (range: r = .16 [Vulnerability to Harm] to .26 [Emotional Deprivation and Social Isolation]). CONCLUSIONS Of the 33 included studies, only one used a longitudinal design. However, based on the correlational studies available, early maladaptive schemas in adulthood are associated with a history of childhood abuse and neglect.
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Affiliation(s)
- Pamela D Pilkington
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Amy Bishop
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Rita Younan
- School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia.,Schema Therapy Institute of Australia, Carlton, Victoria, Australia
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Basso LA, Fortes AB, Maia CPE, Steinhorst E, Wainer R. The effects of parental rearing styles and early maladaptive schemas in the development of personality: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2019; 41:301-313. [PMID: 31644695 DOI: 10.1590/2237-6089-2017-0118] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 01/17/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The present paper aims to identify and characterize studies that assess the repercussions of parental rearing styles on development of psychopathological symptoms and to examine the possible relations between parental rearing behaviors and development of early maladaptive schemas (EMS). METHODS A systematic search was conducted on the PsychNet, BVS, Scopus, Web of Science and PubMed databases for empirical studies published up to 2018 in Portuguese, English, or Spanish that investigated and characterized the effects of parental rearing styles. RESULTS The electronic search identified 321 articles on the various different databases, only 22 of which met the criteria for inclusion and were read in full. Correlations were found between EMS and maternal rejection, parental rearing styles and depression in the studies. EMS were also found to act as mediators in the relationship between parental rearing styles and/or education and dysfunctional symptoms during personality development. CONCLUSIONS In the studies selected, parental rearing styles stood out from other variables that influence personality development and activation of schematic patterns. It is therefore important to highlight the importance of conducting studies in this area to provide information that can promote care and prevention strategies in early childhood.
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Affiliation(s)
| | - Amanda Borges Fortes
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Cintia Pacheco E Maia
- Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
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Santos MAD, Costa-Dalpino LRDS. Relação Pai-Filha e Transtornos Alimentares: Revisando a Produção Científica. PSICOLOGIA: TEORIA E PESQUISA 2019. [DOI: 10.1590/0102.3772e35nspe3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Investigou-se a produção científica dedicada ao estudo da relação entre pai e filha com transtornos alimentares. Foi realizada uma revisão integrativa nas bases PsycINFO, CINAHL, PubMed e LILACS, no período de janeiro de 2000 a junho de 2014. Foram selecionados 27 artigos, a maioria proveniente de países europeus e constituída de estudos quantitativos. A vinculação pouco segura com a figura paterna e o relacionamento emocionalmente distante entre pai e filha foram aspectos recorrentes nas publicações selecionadas. Os estudos apontaram a importância de se investigar e assegurar a participação do pai no tratamento. Porém, nenhum dos artigos revisados investigou o envolvimento paterno no contexto da assistência. Destaca-se a necessidade de investir em estudos qualitativos e no contexto brasileiro.
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Balottin L, Mannarini S, Rossi M, Rossi G, Balottin U. The parental bonding in families of adolescents with anorexia: attachment representations between parents and offspring. Neuropsychiatr Dis Treat 2017; 13:319-327. [PMID: 28203082 PMCID: PMC5295792 DOI: 10.2147/ndt.s128418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION The attachment theory is widely used in order to explain anorexia nervosa origin, course and treatment response. Nevertheless, very little literature specifically investigated parental bonding in adolescents with anorexia, as well as the parents' own bonding and intergenerational transmission within the family. PURPOSE This study aims to identify any specific pattern of parental bonding in families of adolescents newly diagnosed with restricting-type anorexia, comparing them to the families of the control group. PATIENTS AND METHODS A total of 168 participants, adolescents and parents (78 belonging to the anorexia group and 90 to the control one), rated the perceived parental styles on the parental bonding instrument. The latent class analysis allowed the exploration of a maternal bonding latent variable and a paternal one. RESULTS The main findings showed that a careless and overcontrolling parental style was recalled by the patients' parents, and in particular by the fathers. As far as the adolescents' responses were concerned, patients with anorexia did not seem to express differently their parental bonding perception from participants of the control group. CONCLUSION Clinical implications driven from the results suggest that a therapeutic intervention working on how the parents' own attachment representations influence current relationships may help to modify the actual family functioning and thus the outcome of patients with anorexia.
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Affiliation(s)
- Laura Balottin
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova
| | - Stefania Mannarini
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova
| | - Maura Rossi
- Child Neuropsychiatry Unit, C Mondino National Neurological Institute, Pavia
| | - Giorgio Rossi
- Child Neuropsychiatry Unit, Department of Experimental Medicine, University of Insubria, Varese
| | - Umberto Balottin
- Child Neuropsychiatry Unit, C Mondino National Neurological Institute, Pavia; Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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van Brummen-Girigori O, Buunk AP, Dijkstra P, Girigori A. Father abandonment and jealousy: A study among women on Curaçao. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.02.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Elmquist J, Shorey RC, Anderson SE, Stuart GL. The relationship between early maladaptive schemas and eating-disorder symptomatology among individuals seeking treatment for substance dependence. ADDICTION RESEARCH & THEORY 2015; 23:429-436. [PMID: 27375373 PMCID: PMC4930153 DOI: 10.3109/16066359.2015.1025063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Numerous studies have examined early maladaptive schemas (EMS) and their relationship to psychological disorders, including eating disorders (EDs) and substance use disorders (SUDs). However, to date, there are no empirical investigations that have examined the relationship between EMS and EDs among individuals seeking treatment for substance use. In an attempt to further elucidate this relationship, the purpose of the current, exploratory study was to examine the relationship between EMS, ED symptomatology (i.e., bulimia and binge-eating but not anorexia), and substance use and to directly compare EMS among individuals with and without a probable ED diagnosis. Participants were 387 men and 132 women seeking residential treatment for substance use. Results demonstrated that 11 of the 18 EMS were significantly associated with ED. Moreover, patients with a probable ED scored significantly higher than patients without a probable ED on 8 of the 18 EMS. Results suggest that EMS are prevalent among individuals with ED pathology seeking treatment for substance use. Thus treatment programs could potentially benefit from the assessment and treatment of EMS among dually-diagnosed patients. Given the exploratory and preliminary nature of the study, continued research is needed to further examine the relationship between EMS, EDs, and substance use.
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Affiliation(s)
- JoAnna Elmquist
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
| | - Ryan C. Shorey
- Department of Psychology, Ohio University, Athens, GA, USA
| | | | - Gregory L. Stuart
- Department of Psychology, University of Tennessee, Knoxville, TN, USA
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14
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Eating Psychopathology in Athletes and Nonathletes: The Effect of Situational and Dispositional Interpersonal Difficulties. JOURNAL OF CLINICAL SPORT PSYCHOLOGY 2014. [DOI: 10.1123/jcsp.2014-0043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In the current study, we had two aims. First, we investigated the associations between eating psychopathology, situational interpersonal difficulties, and dispositional interpersonal difficulties among athletes and nonathletes. Second, we examined the mediating role of self-critical perfectionism, self-esteem, and depression in these associations. A total of 152 athletes and 147 nonathletes completed self-report instruments pertaining to relationship quality with significant others, as well as social anxiety, loneliness, self-critical perfectionism, self-esteem, depression, and eating psychopathology. Social anxiety and loneliness were found to be the only significant independent predictors of eating psychopathology among both athletes and nonathletes. However, such associations were indirectly mediated through depression for athletes and through self-critical perfectionism, self-esteem, and depression for nonathletes. The findings of this study suggest that the psychosocial mechanisms involved in the eating psychopathology of athletes are relatively similar to that of nonathletes. Thus, it can be tentatively proposed that treatments and interventions that target reducing interpersonal conflicts currently available for the general population should also be offered to athletes.
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Miles-McLean H, Liss M, Erchull MJ. Fathers, daughters, and self-objectification: does bonding style matter? Body Image 2014; 11:534-42. [PMID: 25194310 DOI: 10.1016/j.bodyim.2014.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 07/29/2014] [Accepted: 08/09/2014] [Indexed: 10/24/2022]
Abstract
As women are exposed to objectification and the "male gaze," they self-objectify, which predicts negative psychological outcomes. Given the centrality of the "male gaze," positive father/child relationships may have a buffering effect. In this study, women (N=447) completed a survey measuring paternal bonding (care and overprotection), self-objectification, negative eating attitudes, and depression. Women were categorized into four groups based on bonding style. Analyses indicated an interaction such that women who reported high care and low overprotection reported the fewest negative eating attitudes. A path model was tested for each group. The fit of the high care/high overprotection group's model significantly differed from that of the high care/low overprotection group. The relationships between body surveillance and shame as well as between shame and negative eating attitudes were stronger in the former group. These findings suggest that caring but overprotective fathers may exacerbate the negative effects of body surveillance and shame.
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Affiliation(s)
| | - Miriam Liss
- University of Mary Washington, Fredericksburg, VA, United States.
| | - Mindy J Erchull
- University of Mary Washington, Fredericksburg, VA, United States
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16
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Horesh N, Sommerfeld E, Wolf M, Zubery E, Zalsman G. Father-daughter relationship and the severity of eating disorders. Eur Psychiatry 2014; 30:114-20. [PMID: 24908149 DOI: 10.1016/j.eurpsy.2014.04.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 04/20/2014] [Accepted: 04/21/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Mother-daughter relationship was the focus of studies on the development of eating disorders (ED) for many years. This study aimed to examine the association between the father-daughter relationship and ED and depressive symptoms. METHODS Fifty-three women diagnosed with ED were compared to a psychiatric control group (n=26) and to healthy participants (n=60) regarding their perception of their fathers and the relationship with them. Assessments were done using the Parental Bonding Instrument, the Eating Disorders Questionnaire, the Body Shape Questionnaire, the Eating Attitude Test, and the Beck Depression Inventory as well as narrative-based methods. RESULTS Fathers' negative attributes were significantly associated with ED and depressive symptom. Two profiles of father-daughter relationship were found, the "caring and benevolent" relationship and the "overprotective and avoidant" one. In the latter, patients displayed significantly higher levels of food-restraint, more concerns about eating and about their body shape and appearance, and higher levels of depression. DISCUSSION Negative perception of the father's parenting style as well as the quality of the relationship with him are crucial for the understanding of the development and persistence of ED. Therapeutic programs for ED should focus not only on the relationship with the mother but must also address the relationship with the father.
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Affiliation(s)
- N Horesh
- Bar Ilan University, Ramat Gan, Israel
| | - E Sommerfeld
- Ariel University, Ariel, Israel; Child and Adolescents Division, Geha Mental Health Center, Tel Aviv University, P.O. Box 102, 49100 Petah Tikva, Israel
| | - M Wolf
- Bar Ilan University, Ramat Gan, Israel
| | - E Zubery
- Shalvata Mental Health Center, Hod HaSharon, Israel
| | - G Zalsman
- Child and Adolescents Division, Geha Mental Health Center, Tel Aviv University, P.O. Box 102, 49100 Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Division of Molecular Imaging and Neuropathology, Psychiatry Department, Columbia University, NY, USA.
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Tetley A, Moghaddam NG, Dawson DL, Rennoldson M. Parental bonding and eating disorders: a systematic review. Eat Behav 2014; 15:49-59. [PMID: 24411750 DOI: 10.1016/j.eatbeh.2013.10.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 08/11/2013] [Accepted: 10/09/2013] [Indexed: 11/18/2022]
Abstract
This article systematically reviewed studies of parental bonding in people with eating disorders. MEDLINE, PsychINFO, EMBASE and CINAHL were searched to identify studies that compared parental bonding in people diagnosed with an eating disorder relative to non-clinical controls. Twenty-four studies were identified. Women with eating disorders typically reported lower parental care and higher parental protection compared to non-clinical, but not psychiatric, controls. Interestingly, a modest number of studies found that these relationships were mediated by avoidant problem solving style and several schemas from the Young Schema Questionnaire (YSQ; Schmidt, Joiner, Young, & Telch, 1995). While there are methodological limitations associated with the reviewed studies, they do offer some support for the proposal that difficulties in parent-child relationships predispose women to eating disorders and other psychiatric diagnoses.
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Affiliation(s)
- Amanda Tetley
- Trent Doctorate in Clinical Psychology, University of Nottingham and University of Lincoln, Institute of Work, Health and Organisations, Yang Fuji Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, United Kingdom.
| | - Nima G Moghaddam
- Trent Doctorate in Clinical Psychology, University of Nottingham and University of Lincoln, Institute of Work, Health and Organisations, Yang Fuji Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, United Kingdom.
| | - David L Dawson
- Trent Doctorate in Clinical Psychology, University of Nottingham and University of Lincoln, Institute of Work, Health and Organisations, Yang Fuji Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, United Kingdom.
| | - Mike Rennoldson
- Trent Doctorate in Clinical Psychology, University of Nottingham and University of Lincoln, Institute of Work, Health and Organisations, Yang Fuji Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, United Kingdom.
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Pilecki MW, Józefik B. Perception of transgenerational family relationships: comparison of eating-disordered patients and their parents. Med Sci Monit 2013; 19:1114-24. [PMID: 24309425 PMCID: PMC3867474 DOI: 10.12659/msm.889432] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Disturbances in various elements of transgenerational family functioning patterns are not uncommon in studies of eating disorders. We examined the relationship between patients’ perception of autonomy and intimacy in their families of origin and that of their parents in their own families of origin. Material/Methods The sample consisted of 112 girls who had a diagnosis of an eating disoder and their parents; 54 of the girls were diagnosed with anorexia nervosa restrictive subtype, 22 as anorexia nervosa binge/purge subtype, and 36 were diagnosed with bulimia nervosa. We had 2 control groups: 1 group consisted of 36 girls diagnosed with a depressive episode, dysthymia, or adjustment disorder with depressed mood and the other group was 85 female students from schools in Cracow, Poland and their parents. We used the the Family of Origin Scale to assess perception of family relationships. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS 20.0.PL; Chicago, IL, USA). Results There was a significant association between daughters’ and fathers’ perceptions of autonomy in their families of origin in all groups. There was no significant association between daughters’ and mothers’ perceptions in all groups. The strongest correlation was between the non-clinical sample of girls and their fathers and for the bulimic group. Conclusions We did not detect any link indicating the specificity of transgenerational transmission of autonomy and intimacy in eating disorders. The results point to the importance of the father figure in studies of family systems, including the context of family transmission.
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Affiliation(s)
- Maciej Wojciech Pilecki
- Department of Child and Adolescent Psychiatry, Jagiellonian University Medical College, Kraków, Poland
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Frost U, Strack M, Kronmüller KT, Stefini A, Horn H, Winkelmann K, Bents H, Rutz U, Reich G. Scham und Familienbeziehungen bei Bulimie. PSYCHOTHERAPEUT 2013. [DOI: 10.1007/s00278-013-1010-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Amianto F, Daga GA, Bertorello A, Fassino S. Exploring personality clusters among parents of ED subjects. Relationship with parents' psychopathology, attachment, and family dynamics. Compr Psychiatry 2013; 54:797-811. [PMID: 23602391 DOI: 10.1016/j.comppsych.2013.03.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 02/16/2013] [Accepted: 03/04/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Eating disorders are some of the most difficult mental disorders to treat and manage. Family interacts with genetic dispositions and other pathogenic factors, and may influence the outburst, development and outcome of EDs. The present study explores with a cluster analysis the personality traits of parents of ED subjects. METHODS One-hundred-eight mothers and 104 fathers were tested with Temperament Character Inventory (TCI), Eating Disorder Inventory-2 (EDI-2), State-Trait Anger Expression Inventory (STAX), Family Assessment Device (FAD), Attachment Style Questionnaire (ASQ), Symptom Questionnaire (SQ), Psychological Well-Being scales (PWB). The cluster distribution of parents based on personality traits was explored. Parents' clusters TCI scores were compared as regards personality, psychopathology, attachment and family features. Cross distribution of temperament and character clusters in mothers and fathers, among couples and ED diagnoses of the daughters was explored. RESULTS Two clusters of mothers and fathers were identified with temperament clustering. Character traits led to two mothers and three fathers clusters. Mothers temperament cluster 1 (MTC1) correspond to a explosive/adventurous profile, MTC2 to a cautious/passive-dependent profile. Fathers temperament cluster 1 (FTC1) was explosive/methodic, FTC2 was independent/methodic. Character clustering distinguished very immature mothers (MCC1) and majority (65%) of character mature mothers with low self-transcendence (MCC2). A third of fathers was severely immature (FCC1), a third impaired as regards relationships (poor cooperativeness and self-transcendence; FCC2), and one third character mature fathers with low self-transcendence (FCC3). Each cluster evidences specific psychopathology and attachment characteristics. FTC1 was more frequently associated with character immaturity. No significant clusters' cross correlation was found in parental couples. CONCLUSION Parents' clusters analyze in depth the univocal picture of prototypical mothers and fathers of EDs. Parents not disturbed as regards personality traits are not exceptions. Since EDs are multifactor disorders family dynamics related to parents' personality may be very relevant or even marginal in their pathogenesis. Conversely, parenting may be negatively influenced by relatively marginal personality malfunctions of parents. The clustering approach to the complexity of personality-related dynamics of ED families improves the picture of ED parents. Psychoeducational, counseling and psychotherapeutic family interventions should consider the specific underlying personality of parents.
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Affiliation(s)
- Federico Amianto
- Department of Neuroscience, Psychiatry Section, Regional Pilot Centre for Eating Disorders, University of Turin.
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Gale CJ, Cluett ER, Laver-Bradbury C. A review of the father-child relationship in the development and maintenance of adolescent anorexia and bulimia nervosa. ACTA ACUST UNITED AC 2013; 36:48-69. [PMID: 23597275 DOI: 10.3109/01460862.2013.779764] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
There are disproportionately fewer studies examining the role of the father in the development of child and adolescent psychopathology. This is pertinent in the field of eating disorders, where there is a wealth of research related to family influences and the value of family-based interventions. This article reviews the key themes within the literature around the potential impact of the father-child relationship on the development and maintenance of Anorexia and Bulimia Nervosa in young people. The critical review searched relevant health and social care databases, as well as manually searching key journals in the eating disorder field. In these results, 13 studies met the inclusion/exclusion criteria and were critiqued, with 8 being taken forward for discussion. The 8 studies identified key themes within the relationship of the father and child (particularly daughters) around conflict and communication, parental protection and psychological control, emotional regulation and self-esteem, and self-perfectionism. All of these factors appear to influence the child's level of self-determining autonomy, which in turn can impact maladaptive eating attitudes and psychopathology. Tentative recommendations are made around working with fathers to encourage free expression of ideas and foster a sense of autonomy through compromise and collaboration with their adolescent child. Further research around these themes in relation to other family members is also suggested.
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Affiliation(s)
- Christopher J Gale
- Child and Adolescent Mental Health, Faculty of Health Sciences, University of Southampton, UK.
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Ty M, Francis AJP. Insecure attachment and disordered eating in women: the mediating processes of social comparison and emotion dysregulation. Eat Disord 2013; 21:154-74. [PMID: 23421698 DOI: 10.1080/10640266.2013.761089] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Few studies have examined potential intermediary processes linking insecure attachment with eating disorders. The purpose of this study was to compare the relative contributions of social comparison and emotion dysregulation on disordered eating symptoms within an attachment framework. Participants were 247 women living in Australia, aged between 18 and 35 years. All the study variables were moderately, positively correlated. Disordered eating was most highly correlated with emotion dysregulation, whilst correlation magnitudes with both attachment styles were comparable. Multiple mediation analysis was performed using bootstrapping procedures. Consistent with hypotheses, the mediating roles of social comparison and emotion dysregulation were supported, suggesting they may be processes through which insecure attachment influences disordered eating. Results highlight the need for intervention to focus not only on eating symptomatology, but also on the ways in which eating disorders are maintained through maladaptive self-regulatory and comparison processes.
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Affiliation(s)
- Melissa Ty
- Department of Psychology, RMIT University, Bundoora, Victoria, Australia
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Hooper A, Dallos R. Fathers and Daughters: Their Relationship and Attachment Themes in the Shadow of an Eating Disorder. CONTEMPORARY FAMILY THERAPY 2012. [DOI: 10.1007/s10591-012-9204-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Penelo E, Granero R, Krug I, Treasure J, Karwautz A, Anderluh M, Bellodi L, Cellini E, di Bernardo M, Nacmias B, Ricca V, Sorbi S, Tchanturia K, Wagner G, Collier D, Bonillo A, Fernández-Aranda F. Factors of risk and maintenance for eating disorders: psychometric exploration of the cross-cultural questionnaire (CCQ) across five European countries. Clin Psychol Psychother 2010; 18:535-52. [DOI: 10.1002/cpp.728] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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The dynamic relationship of parental personality traits with the personality and psychopathology traits of anorectic and bulimic daughters. Compr Psychiatry 2009; 50:232-9. [PMID: 19374967 DOI: 10.1016/j.comppsych.2008.07.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Revised: 07/28/2008] [Accepted: 07/30/2008] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Parenting and family dynamics influence the emergence, development, and maintenance of eating disorders (EDs). Although family interventions are relevant for therapeutic programs, knowledge of the relationship between parental personality traits and the eating psychopathology of daughters is scarce. This study explored the personality and psychopathology of women with EDs and correlated them with parental personality traits. METHOD The personality and eating psychopathology traits of 38 restricter anorectics, 30 bingeing/purging anorectics, 37 bulimics, and their parents' personality traits (87 fathers and 97 mothers) were measured with the Temperament and Character Inventory, the Clinical Global Impression Scale, the Eating Disorders Inventory-2, and the Beck Depression Inventory. The results were compared with matched controls (54 women, 50 fathers, 54 mothers). Personality and psychopathology were correlated with multiple regression. RESULTS Women with ED displayed high harm avoidance and low self-directedness, whereas restricter anorectic women had high persistence. Low persistence was common in fathers of daughters across all EDs. Fathers of restricter anorectics were highly harm avoidant. Fathers of both anorectic subtypes and mothers of bulimic women displayed low self-directedness. Parental personality traits were linearly correlated with their daughter's personality and psychopathology, but the correlation differed among EDs. CONCLUSION Parents of eating-disordered participants displayed personality characteristics that differed from controls and, among ED subgroups, these differences were related to their daughter's personality and psychopathology. The linear correlation did not fully explain the relationship of the parental personality traits to the presence of their daughter's ED, suggesting that a more complex personality-based family dynamic is involved. A Temperament and Character Inventory profile of the entire family may be used in the planning of family treatment.
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