Conflict avoidance in anorexia nervosa: An observational study of mothers and daughters

Adolescents with anorexia nervosa (n=20) and emotional and developmental di sorders (n=14) were observed, during low- and high-conflict family problem solving tasks with their mothers. An observational coding scheme designed f or the study was used to identify verbal (e.g., criticism or support) and n onverbal behaviour indicative of constructive and destructive communication . The frequency and sequential context of observed behaviour was compared b etween and within groups using t-tests. It was predicted that during the hi gh conflict task: (1) anorexia dyads would be conflict avoiding compared to controls; (2) that in both groups one family member would show more destru ctive communication than the other and (3) that the rate of, and reciprocat ion of destructive communication would be greater than constructive communi cation in mother-daughter pairs in the anorexia group only. Results indicat ed that anorexia dyads showed more destructive communication than compariso n dyads. Within anorexia dyads, daughters showed more destructive communica tion than their mothers, and the mean frequency of destructive communicatio n was greater than constructive communication. in the anorexia group only. Furthermore, mothers and their daughters in the anorexia dyads reciprocated each other's destructive communication to a greater extent than constructi ve communication. The results do not support the notion that conflict avoid ance characterizes the interactions of 'anorexic families'. By examining th e behaviour of both the patient and a key relative, this study demonstrates that deficiencies in communication skills may underpin disrupted family fu nctioning associated with anorexia nervosa. Family counselling techniques m ay provide an opportunity to support constructive approaches to resolving f amily problems associated with symptoms. Copyright (C) 2000 John Wiley & So ns, Ltd and Eating Disorders Association.