The bidirectional connection between family functioning and psychopathology: A network analysis in a large sample of adolescents with anorexia nervosa and their parents
Corresponding Author
Alessio Maria Monteleone
Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
Correspondence
Alessio Maria Monteleone, Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie, Naples 80138, Italy.
Email: [email protected]
Search for more papers by this authorChiara Marchetto
Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, Department of Neuroscience, Bambino Gesù Childrens' Hospital IRCCS, Rome, Italy
Search for more papers by this authorGiammarco Cascino
Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, Section of Neurosciences, University of Salerno, Salerno, Italy
Search for more papers by this authorMichela Criscuolo
Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, Department of Neuroscience, Bambino Gesù Childrens' Hospital IRCCS, Rome, Italy
Search for more papers by this authorMarco Carfagno
Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
Search for more papers by this authorMaria Chiara Castiglioni
Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, Department of Neuroscience, Bambino Gesù Childrens' Hospital IRCCS, Rome, Italy
Search for more papers by this authorAnnamaria Caramadre
Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, Department of Neuroscience, Bambino Gesù Childrens' Hospital IRCCS, Rome, Italy
Search for more papers by this authorEugenia Barone
Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
Search for more papers by this authorValeria Zanna
Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, Department of Neuroscience, Bambino Gesù Childrens' Hospital IRCCS, Rome, Italy
Search for more papers by this authorCorresponding Author
Alessio Maria Monteleone
Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
Correspondence
Alessio Maria Monteleone, Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie, Naples 80138, Italy.
Email: [email protected]
Search for more papers by this authorChiara Marchetto
Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, Department of Neuroscience, Bambino Gesù Childrens' Hospital IRCCS, Rome, Italy
Search for more papers by this authorGiammarco Cascino
Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, Section of Neurosciences, University of Salerno, Salerno, Italy
Search for more papers by this authorMichela Criscuolo
Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, Department of Neuroscience, Bambino Gesù Childrens' Hospital IRCCS, Rome, Italy
Search for more papers by this authorMarco Carfagno
Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
Search for more papers by this authorMaria Chiara Castiglioni
Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, Department of Neuroscience, Bambino Gesù Childrens' Hospital IRCCS, Rome, Italy
Search for more papers by this authorAnnamaria Caramadre
Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, Department of Neuroscience, Bambino Gesù Childrens' Hospital IRCCS, Rome, Italy
Search for more papers by this authorEugenia Barone
Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
Search for more papers by this authorValeria Zanna
Anorexia Nervosa and Eating Disorder Unit, Child Neuropsychiatry, Department of Neuroscience, Bambino Gesù Childrens' Hospital IRCCS, Rome, Italy
Search for more papers by this authorAbstract
Family functioning is a risk and maintaining factor for anorexia nervosa (AN). This study aims to identify specific areas of family functioning according to adolescents and parental perspectives associated with eating and general psychological symptoms in people with AN. Four-hundred-forty-five adolescents with AN or atypical AN and their parents were enrolled. Adolescents completed the Eating Disorder Inventory-3, the Youth Self-Report questionnaire, and the Family Assessment Device (FAD). Their parents filled in the FAD. A network analysis was conducted including all subscales. The bridge function analysis was applied to identify the bridge nodes connecting each community constituted of family functioning perception with the communities of adolescents' eating and general psychological symptoms. Family communication was the node most strongly connecting fathers and mothers' perception of family functioning and adolescents' eating symptoms. Problem solving was the node with the highest bridge expected influence between mothers' family functioning and adolescents' general psychopathology. General functioning and problem solving were the bridge nodes between adolescents' view of family functioning and eating and general psychopathology. Maturity fear, interpersonal insecurity, and interpersonal alienation were the bridge nodes between adolescents' eating symptoms and mothers, fathers, and adolescents' family functioning communities respectively. Family members must be involved in the therapeutic process to improve family communication and problem solving diverting their attention toward emotional needs and interpersonal difficulties of adolescents with AN. Developing autonomy and independence from parents and building trustworthy relationships with peers may be favored by improving familiar dynamics and may contribute to prevent the maintenance of AN.
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