Observed family interactions among subtypes of eating disorders using structural analysis of social behavior.

Compared observations of family interactions among anorexic, bulimic-anorexic, bulimic, and normal families. A total of 74 family triads participated, including father, mother, and teenage daughter. Each family was videotaped during a 10-min discussion of the daughter's separation from the family. These tapes were coded using Benjamin's structural analysis of social behavior (SASB) model and observational schema. The results showed that the SASB methodology differentiated clinical from normal families and that there were unique patterns among subtypes of eating disorders. Specifically, parents of anorexics communicated a double message of nurturant affection combined with neglect of their daughter's needs to express themselves and their feelings. Anorexic daughters, in turn, were ambivalent about disclosing their feelings versus submitting to their parents. In contrast, bulimics and their parents were hostilely enmeshed and, for them, this appeared to undermine the daughter's separation and self-assertion. These findings are consistent with current theory and research on anorexia and bulimia.