An investigation into individuals with eating disorders and their perceptions of family functioning, depression, and seasonal affective disorder in an outpatient population
Research shows that dysfunctional family interactions have been associated with eating disorders. Different diagnostic categories of eating disorders have been associated with different levels of family functioning. Anorexics were reported to describe their family interactions as cohesive and organized with little tolerance for conflict. On the other hand, bulimics described their families, as more conflicted and less cohesive. Furthermore, family functioning in eating disordered patients have been associated with self-reported depression and a clinical diagnosis of Major Depressive Disorder (MDD). ^ This archival study will be an expansion of the Fornari and colleagues (1999) study, which investigated the relationship between the perception of family functioning and depressive symptomatology in individuals with eating disorders receiving outpatient services. Multiple assessment techniques were used to evaluate the subjects including: a diagnostic clinical interview using the DSM-III R criteria for eating disorders, the Family Assessment Device, the Beck Depression Inventory, Eating Disorder Inventory, and the Schedule for Affective Disorders and Schizophrenia-Life-time Version. The current expansion study will examine data from 236 subjects in comparison to the previous study's 106 subjects. The DSM-III R eating disorder classification will be updated and converted to DSM-IV eating disorder diagnostic categories. The Seasonal Patterns Assessment Questionnaire was not included in the original paper, but will be incorporated into the current study. The original study investigated self-perceptions of family functioning, but did not include the maternal and paternal perceptions of family functioning, which will in the current study be examined and compared to the individuals' perceptions. ^ Fornari and his colleagues (1999) found a significant relationship between self-reported depressive symptomatology and family dysfunction. The original study found self-reported depressive symptomatology to be a predictive variable for perceived family dysfunction. Receiving a diagnosis of an affective disorder namely Major Depressive Disorder (MDD), as assessed by the SADS-L, was also reported to predict family dysfunction. This study also found bulimia to come up as a significant predictor of family dysfunction more than the diagnosis of MDD, and depression and diagnostic category of eating disorders play different roles in contributing to perceived family dysfunction. ^ The current study replicated some of the findings. Self-reported depression, as measured by the BDI was predictive of overall family functioning. And while, a diagnosis of MDD was not predictive of overall family functioning it was predictive of family roles and various interaction effects (MDD x ED diagnosis). While the original study found bulimics to display more family dysfunction than the other eating disorder categories, this finding was not replicated. Also, the current study found that bulimics, in comparison with all other diagnostic categories, were not more affected by seasonal variations, as measured by the SPAQ. In addition, a statistically significant difference between self and parental perception of overall family functioning was found. ^ One important implication of this study is that family dysfunction may be associated with depression and eating disturbance, therefore, intervention strategies should include a family therapy component to enhance family interactions. The association between mood variability and seasonal variability may also have treatment implications. Light therapy has been cited as an effective method for treating those who suffer from Seasonal Affective Disorder. Furthermore, school personnel (including nurses, physicians, teachers, coaches, and counselors) should be aware of eating disorders because the earlier the disorder is detected and the patient referred for treatment, the better the prognosis for recovery. ^
Lisa Anne Scionti,
"An investigation into individuals with eating disorders and their perceptions of family functioning, depression, and seasonal affective disorder in an outpatient population"
(January 1, 2001).
ETD Collection for Pace University.