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Background <p>Psychological constructs of individual autonomy (IA) and emotional connectedness (EC) differ between patients with anorexia nervosa (AN) and bulimia nervosa (BN); however, it is unclear whether objective family factors modulate these associations.</p> Methods <p>In a&#xa0;cohort of 445 participants from the FamFINED study (FAMily Factors INvolved in Eating Disorders) with eating disorders (EDs) diagnosed as AN (<i>n</i> = 232) or BN (<i>n</i> = 213), we assessed objective psychosocial family factors as well as the IA and EC constructs using the self-rated Subjective Family Image Test (SFIT) questionnaire.</p> Results <p>While the two ED entities did not differ with respect to IA in univariate analysis (<i>p</i> = 0.355), patients diagnosed with AN had higher perceived EC than participants with BN, as assessed by a&#xa0;lower score for the difference between the actual and desired family image (16.0 ± 15.8 vs. 21.6 ± 17.6, <i>p</i> &lt; 0.001). In a&#xa0;regression model adjusted for age, body-mass index, living in parental home, and parental separation, we found that the EC score used as the dependent variable differed significantly between the two ED entities (expβ = 4.8, 95% confidence interval = 0.54–9.11, <i>p</i> = 0.028). In contrast, no association was observed between IA and ED diagnoses using the same set of confounders (<i>p</i> = 0.717).</p> Conclusion <p>The higher perceived EC in AN patients compared to those diagnosed with BN indicates more intense feelings of family solidarity, regardless of objective family factors.</p>

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Patients with anorexia nervosa perceive higher emotional connectedness to their parents than bulimia nervosa patients independent of objective family factors

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  • 发表日期：

    2025年11月26日

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  • Elias Fischer,
  • Noah Lensch,
  • Günter Reich,
  • Thomas Meyer

摘要

Background

Psychological constructs of individual autonomy (IA) and emotional connectedness (EC) differ between patients with anorexia nervosa (AN) and bulimia nervosa (BN); however, it is unclear whether objective family factors modulate these associations.

Methods

In a cohort of 445 participants from the FamFINED study (FAMily Factors INvolved in Eating Disorders) with eating disorders (EDs) diagnosed as AN (n = 232) or BN (n = 213), we assessed objective psychosocial family factors as well as the IA and EC constructs using the self-rated Subjective Family Image Test (SFIT) questionnaire.

Results

While the two ED entities did not differ with respect to IA in univariate analysis (p = 0.355), patients diagnosed with AN had higher perceived EC than participants with BN, as assessed by a lower score for the difference between the actual and desired family image (16.0 ± 15.8 vs. 21.6 ± 17.6, p < 0.001). In a regression model adjusted for age, body-mass index, living in parental home, and parental separation, we found that the EC score used as the dependent variable differed significantly between the two ED entities (expβ = 4.8, 95% confidence interval = 0.54–9.11, p = 0.028). In contrast, no association was observed between IA and ED diagnoses using the same set of confounders (p = 0.717).

Conclusion

The higher perceived EC in AN patients compared to those diagnosed with BN indicates more intense feelings of family solidarity, regardless of objective family factors.