Family perception of interpersonal behavior as a predictor in eating disorders: a prospective, six-year followup study

This study assessed family perception patterns of interpersonal behavior in families with a daughter diagnosed with an eating disorder 6 years after treatment that used a prospective design. Family perception patterns of patients found to have a poor outcome at followup (n = 15) were compared with patients with a good outcome (n = 23), as well as a control group (n = 36). Using the system of multiple level observation of groups (SYMLOG), all 238 family members evaluated themselves and each other. The index patients with a poor outcome perceived themselves as friendlier and more positive than they were perceived by their families. In comparison to parents of daughters with a good outcome and the control group, parents of daughters in the poor outcome group perceived themselves to be less friendly than their partners perceived them to be. A rigid polarization of the perception of the index patient by family members and a discrepancy in this perception between the index patient and the rest of the family were found to be indicative of a poor prognosis. Implications for treatment based on family perception patterns of interpersonal behavior are discussed.