Minuchin's psychosomatic family model revised: a concept-validation study using a multitrait-multimethod approach.

The convergent and discriminant validity of three operationalizations of the psychosomatic family features--enmeshment, rigidity, overprotectiveness, and lack of conflict resolution, as described by Minuchin and colleagues--are tested in families that include patients with eating disorders, especially anorexia nervosa and bulimia. We redefined the family features as dimensions and measured them with two behavioral methods (direct observation and behavioral product) and a self-report method. The two behavioral methods showed convergent as well as discriminant validity for the intensity of intrafamilial boundaries, the degree of the family's adaptability, and the family's way of handling conflicts. The self-report method showed only convergent validity for the latter dimension and discriminant validity for none of them. Besides intrafamilial conflict, the self-report method seemed to measure other constructs. A factor analysis of the family questionnaire indeed yielded three more evaluative constructs: conflict, cohesion, and disorganization. We interpreted these findings according to two usually interwoven mechanisms: the different research context (insider/outsider evaluation) in self-report and behavioral observation, and the different level of specification (micro/global evaluation) of certain operationalizations. We draw some conclusions about the psychosomatic family model and discuss the clinical implications of our findings.