Familial contributions to the etiology and course of anorexia nervosa and bulimia.

Abstract

In this article, we summarize the current knowledge of familial influences in anorexia nervosa and bulimia. Three lines of evidence are reviewed: descriptions of family interaction, familial correlates of the course and phenomenology of symptoms, and studies of familial transmission. We conclude that although certain familial patterns are associated with eating disorders, there is no single mecha-nism or pathway of influence. Rather, it seems likely that certain personality factors, which may be genetically determined, predispose the individual to greater sensitivity and vulnerability to powerful familial and social experiences that impinge adversely on self-esteem and self-efficacy. Although the role played by familial factors in the etiology of eating disorders currently excites a great deal of theoretical interest, empirical data are fragmentary, and most ideas about the nature and extent of this role are highly speculative (Kog & Vandereycken, 1985; Yager & Strober, 1985). In this article, we review evidence on the familial factors that have been linked to the development and course of anorexia nervosa and bulimia. We do not imply that these factors are the most influential de-

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1. Binge eating as escape from self-awareness
   Heatherton, Todd F., Baumeister, Roy F. · 1991 · Psychological Bulletin
2. The genetic epidemiology of bulimia nervosa.
   1991 · American Journal of Psychiatry
3. Mothers, daughters, and disordered eating.
   Pike, Kathleen M., Rodin, Judith · 1991 · Journal of Abnormal Psychology
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   Vitousek, Kelly, Manke, Frederic · 1994 · Journal of Abnormal Psychology
5. Early Childhood Eating Behaviors and Adolescent Eating Disorders
   MARCHI, MARGARET, COHEN, PATRICIA · 1990 · Journal of the American Academy of Child & Adolescent Psychiatry

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