North C, Gowers S, Byram V
Department of Child and Adolescent Psychiatry, University of Manchester, Prestwich.
Br J Psychiatry. 1995 Nov;167(5):673-8. doi: 10.1192/bjp.167.5.673.
Difficulties in family functioning have been noted since early descriptions of anorexia nervosa and may be of importance aetiologically. Previous studies have a number of methodological problems.
Thirty-five anorexic adolescents were age/sex matched with psychiatric and community controls. A diagnostic interview and a questionnaire, the Family Assessment Device (FAD) were administered to control subjects and their mothers. Anorexic families only received the McMaster Structured Interview of Family Functioning.
Multivariate analyses of FAD scores showed pathological ratings for psychiatric control but not anorexic families, compared with community controls. By contrast objective ratings revealed marked dysfunction in anorexic families (greater in the purging subgroup).
Family functioning in anorexic families is normal by self-report but not by an objective measure. Anorexic families in the purging subgroup appear most dysfunctional.
自对神经性厌食症的早期描述以来，人们就注意到家庭功能存在困难，且这在病因学上可能具有重要意义。以往的研究存在一些方法学问题。
35名患有厌食症的青少年在年龄和性别上与精神科及社区对照组相匹配。对对照组及其母亲进行了诊断访谈和一份问卷——家庭评估量表（FAD）。仅对厌食症患者家庭进行了麦克马斯特家庭功能结构化访谈。
对FAD评分的多变量分析显示，与社区对照组相比，精神科对照组的评分呈病理性，但厌食症患者家庭并非如此。相比之下，客观评分显示厌食症患者家庭存在明显功能障碍（在清除型亚组中更严重）。
通过自我报告，厌食症患者家庭的家庭功能正常，但客观测量结果并非如此。清除型亚组中的厌食症患者家庭似乎功能障碍最为严重。
