Perceived and observed family functioning in adolescents affected by restrictive eating disorders

Objective We used the self-reported questionnaire FACES-IV (Family Adaptability and Cohesion Evaluation Scale-IV) to depict the presence of a typical family-functioning profile in families with a daughter affected by a restrictive eating disorder. We compared mothers' and fathers' perceptions about their family with each other's and with the clinician's observations. Furthermore, we compared these results with a rigorous standardized evaluation of family functioning, the Lausanne Trilogue Play-clinical version (LTPc). Background Many studies have emphasized the role of family factors in the development and maintenance of eating disorders. Previous work using the LTPc have underscored that families with a member who is affected by anorexia nervosa show dysfunctional dynamics compared with control families. However, the FACES-IV questionnaire showed different results. Method We enrolled 40 female adolescents (M = 14.7 years, SD = 1.5) suffering from restrictive eating disorders and their parents. Each parent filled in the FACES-IV and participated with their daughter in the videotaped LTPc observation. Results We found balanced functioning and good agreement between parents on the FACES-IV. However, the LTPc results indicates that parents' perception differs from standardized evaluation. Conclusion Our results suggest using both self-reported and observational instruments to assess family functioning will improve the accuracy of the assessment of patients with restrictive eating disorders. Implications Clinicians should use self-reported questionnaires along with observational tools such as the LTPc to work with family members, facilitate their understanding of family difficulties, and thus improve family functioning and patient outcomes.