title: Difficulties in family functioning and adolescent anorexia nervosa.
abstract: BACKGROUND
  Difficulties in family functioning are often evident when an adolescent has anorexia nervosa, and the possible causative or contributory role of such difficulties in the illness is unclear.
  
  
  OBJECTIVE
  To elucidate the relationship between severity of anorexia nervosa and difficulties in family functioning and whether clinical improvement results in diminution of self-rated family difficulties.
  
  
  METHODS
  Thirty-five adolescents with anorexia nervosa and their mothers completed the Family Assessment Device (FAD) while clinicians administered the McMaster's Structured Interview of Family Functioning (McSIFF). Severity of anorexia nervosa was rated at baseline and at one year follow-up using the Morgan-Russell Schedule.
  
  
  RESULTS
  Clinicians and patients were more critical of the families' functioning than parents. There was an inverse association between the extent of family difficulties and severity of anorexia nervosa. Over time subjects improved clinically but this was not matched by improvement in family functioning.
  
  
  CONCLUSIONS
  Difficulties in family functioning do not appear to be directly associated with severity of anorexia nervosa nor do these difficulties reduce with clinical improvement, in the short term.
authors.affiliation: Academic Unit, Young People's Centre, Chester.
authors.forename: S
authors.initials: S
authors.lastname: Gowers
authors.forename: C
authors.initials: C
authors.lastname: North
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000523:psychology*; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009034:Mother-Child Relations; D012650:Self Disclosure