REDEFINING THE PSYCHOSOMATIC FAMILY - FAMILY PROCESS OF 26 EATING DISORDER FAMILIES

This paper reports part of the data from a comparative trial of two fo rms of family intervention for the management of eating disorders in a dolescents. Measures of family process at the beginning of treatment i ncluded Expressed Emotion (EE) and the Family Adaptability and Cohesio n Evaluation Scales (FACES). EE in the families of both anorexic and b ulimic patients were, on the whole, at low levels. The low levels of p arental Critical Comments might be taken to represent the conflict avo iding character of the families of psychosomatic patients. However, th e families showed low levels of Emotional Overinvolvement, which contr adicts the clinical descriptions. The FACES scores revealed patterns t hat were superficially contradictory to the accepted clinical descript ions in that the patients appeared to have perceived their families as not close and as highly structured. The parents experienced their fam ily structure as more similar to the clinical descriptions, scoring th eir families as more flexible and cohesive than do the patients. The F ACES ideals for family organization scored by patients and parents mor e nearly equate with the clinical descriptions of enmeshment and lack of boundary structure. The relationship between the research findings and the clinical evaluation will be discussed. (C) 1994 by John Wiley & Sons, Inc.