Subjektives Familienbild bei Anorexia nervosa und Bulimia nervosa im Jugendalter: Eine kontrollierte Studie
Abstract
Zusammenfassung:Fragestellung: Familienbeziehungen bei Essstörungen sind in den letzten Jahrzehnten intensiv beforscht worden. Subjektive Wahrnehmungen von familiären Beziehungen mittels des «Subjektiven Familienbildes», einem Instrument, das dazu entwickelt wurde, die unterschiedlichen Wahrnehmungen der Familienmitglieder bezüglich der entwicklungspsycho(patho)logisch relevanten Faktoren Autonomie und Verbundenheit in ihrer subjektiven Wertigkeit zu erfassen, wurden bei Adoleszenten mit Essstörungen allerdings nur in wenigen kleinen Gruppen untersucht. Methode: Unsere Studie hatte daher zum Ziel, (1) die subjektiven Wahrnehmungen von Familienbeziehungen in einer größeren klinischen Gruppe (n = 118) von weiblichen adoleszenten Patientinnen mit Magersucht beider Subtypen und Bulimie zu untersuchen, mit einer gesunden Kontrollgruppe (n = 96) zu vergleichen und (2) innerfamiliäre Unterschiede der Wahrnehmung des Familienbildes zu erfassen. Ergebnisse: Die Hauptergebnisse waren, dass Adoleszente mit Bulimia nervosa geringere Autonomie und geringere emotionale Verbundenheit in der Familie erlebten als alle anderen Gruppen. Die Adoleszenten mit Bulimie erlebten geringere Autonomie und emotionale Verbundenheit als ihre Väter dies wahrnahmen, und Adoleszente mit restriktiver Anorexie erlebten höhere emotionale Verbundenheit in den Familien als ihre Väter. Die Relevanz der Ergebnisse für das Verständnis der Familiendynamik wird diskutiert.
Summary:Objectives: The family environments of patients with eating disorders have been studied extensively in recent decades. The «Subjective Family Image Test» is an instrument developed especially to measure differential perceptions by family members. Assessments of subjective family image in families of adolescents by means of this test have been carried out in only a few samples. Methods: We aimed first to investigate subjective perceptions by adolescents of their family relations in a larger clinical sampleof female adolescents (n = 118) suffering from anorexia nervosa of either subtype or from bulimia nervosa and to compare these perceptions with those of healthy controls (n = 96). Second we investigated intra-familial differences in perception. Results: The main findings were that bulimia nervosa patients perceived lower individual autonomy and lower emotional connectedness than all other groups, the adolescents with bulimia perceived significantly lower autonomy and emotional connectedness within the family than their fathers, and the restrictive anorexia nervosa patients perceived higher connectedness than their fathers. The relevance of these findings for understanding family dynamics are discussed.
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