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.