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Family functioning and life events in the outcome of adolescent anorexia nervosa

Published online by Cambridge University Press:  02 January 2018

Clive North ,
Simon Gowers  and
Victoria Byram
Clive North*
Affiliation:
Department of Child and Adolescent Psychiatry, University of Manchester
Simon Gowers
Affiliation:
Section of Adolescent Psychiatry, University of Liverpool
Victoria Byram
Affiliation:
Department of Child and Adolescent Psychiatry, University of Manchester
*
Dr C. North, Child and Family Consultation Service, Reunion House, 35 Jackson Road, Clacton-on-Sea, Essex CO15 1JA
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Abstract

Background

This study investigates the outcome of anorexia nervosa in adolescents in relation to precipitating life events and changes in family functioning over time.

Method

Thirty-five adolescents with anorexia nervosa and their mothers were administered measures of life events and family functioning at initial assessment and 1 and 2 year follow-up, when outcome was also assessed.

Results

Fifty-five per cent of patients had a good outcome. Patients from initially well-functioning families or those with precipitating life events improved more in the first year, than those with dysfunctional families or without events. Subjects perceived a deterioration in family functioning at 1 year follow-up but an improvement at 2 years. Mothers reported no changes.

Conclusions

Approximately half of a series of early onset cases of anorexia nervosa can be expected to recover by 2 years. Healthy family functioning and presence of a precipitating life event predict good short-term outcome. The relationships between subjects' perceptions of family functioning and their recovery from anorexia nervosa is discussed.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 6 , December 1997 , pp. 545 - 549
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

Ambrotini, P. J., Metz, C., Prabucki, K., et al (1989) Videotape reliability of the third revised edition of the K-SADS. Journal of the American Academy of Child and Adolescent Psychiatry, 28, 723–728.CrossRefGoogle Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Blouin, J. H., Carter, J., Blouin, A. G., et al (1994) Prognostic indicators in bulimia nervosa treated with cognitive behavioural group therapy. International Journal of Eating Disorders, 15, 113–123.3.0.CO;2-W>CrossRefGoogle Scholar
Epstein, N. B., Bishop, D. S. & Levin, S. (1978) The McMaster model of family functioning. Journal of Marriage and Family Counselling, 3, 19–31.CrossRefGoogle Scholar
Epstein, N. B., Baldwin, L. M. & Bishop, D. S. (1982) McMaster Clinical Rating Scale. Providence, Rhode Island: Brown University Family Research Program.Google Scholar
Epstein, N. B., Baldwin, L. M. & Bishop, D. S. (1983) The McMaster Family Assessment Device. Journal of Marital and Family Therapy, 9, 171–180.CrossRefGoogle Scholar
Goodyer, I. M., Nicol, A. R., Eavis, D., et al (1982) The application and utility of a family assessment procedure in a child psychiatry clinic. Journal of Family Therapy, 4, 373–395.CrossRefGoogle Scholar
Gowers, S. G., North, C. D., Byram, V., et al (1998) Life event precipitants of adolescent anorexia nervosa. Journal of Child Psychology and Psychiatry, 37, 469–477.CrossRefGoogle Scholar
Halmi, K. A., Goldberg, S. C., Eckert, E., et al (1977) Pretreatment evaluation in anorexia nervosa. In Anorexia Nervosa (ed. Vigersky, R.). pp. 43–44. New York: Raven Press.Google ScholarPubMed
Kabacoff, R. I., Miller, I. W., Bishop, D. S., et al (1990) A psychometric study of the McMaster Family Assessment Device in psychiatric, medical and nonclinical samples. Journal of Family Psychology, 3, 431–439.CrossRefGoogle Scholar
Keitner, G. I., Ryan, C. E., Miller, I. W., et al (1995) Role of the family in recovery and major depression. American Journal of Psychiatry, 152, 1002–1008.Google ScholarPubMed
Kemsley, W. F. F. (1953/54) Body weight at different ages and heights. Annals of Eugenics, 16, 316–334.CrossRefGoogle Scholar
Kessler, R. C. & Wethington, E. (1991) The reliability of life event reports in a community survey. Psychological Medicine, 21, 723–738.CrossRefGoogle Scholar
Le Grange, D., Eisler, I., Dare, C., et al (1992) Family criticism and self-starvation: a study of expressed emotion. Journal of Family Therapy, 14, 177–192.CrossRefGoogle Scholar
McGlashan, T. H. (1988) A selective review of recent North American long-term follow up studies of schizophrenia. Schizophrenia Bulletin, 14, 515–542.CrossRefGoogle ScholarPubMed
Miller, I. W., Epstein, N. B., Bishop, D. S., et al (1985) The McMaster Family Assessment Device: reliability and validity. Journal of Marital and Family Therapy, 11, 345–356.CrossRefGoogle Scholar
Morgan, H. G. & Hayward, A. E. (1988) Clinical assessment of anorexia nervosa. The Morga–Russell outcome assessment schedule. British Journal of Psychiatry, 152, 367–371.CrossRefGoogle ScholarPubMed
Morgan, H. G. & Russell, G. F. M. (1975) Value of family background and clinical features as predictors of long-term outcome in anorexia nervosa: four-year follow-up study of 41 patients. Psychological Medicine, 5, 355–371.CrossRefGoogle ScholarPubMed
North, C. D. (1996) Life events and family functioning in anorexia nervosa. MD thesis, University of London.Google Scholar
North, C. D., Gowers, S. & Byram, V. (1995) Family functioning in adolescent anorexia nervosa. British Journal of Psychiatry, 167, 673–678.CrossRefGoogle ScholarPubMed
Steinhausen, H.-C. (1997) Annotation: outcome of anorexia nervosa in the younger patient. Journal of Child Psychology and Psychiatry, 38, 271–276.CrossRefGoogle Scholar
Steinhausen, H.-C., Rauss-Mason, C. & Seidel, R. (1991) Follow-up studies of anorexia nervosa: a review of four decades of outcome research. Psychological Medicine, 21, 447–454.CrossRefGoogle ScholarPubMed
Stevenson-Hinde, J. & Akister, J. (1995) The McMaster model of family function: observer and parental ratings in a non-clinical sample. Family Process, 34, 337–347.CrossRefGoogle Scholar
Tanner, J., Whitehouse, R. & Takaishi, M. (1968) Standards from birth to maturity for height, weight, height velocity and weight velocity: British children, 1965, Parts 1 and 2. Archives of Disease in Childhood, 41, 454–471: 613–635.CrossRefGoogle Scholar
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