The role of familial factors in bulimia nervosa

This research investigated three levels of family variables--general family dysfunction, family eating attitudes and behaviors, and negative familial communication regarding physical appearance and encouragement to diet--as predictors of the severity of bulimic symptomatology in a sample of 345 undergraduate women. Participants completed The Bulimia Test-Revised (Thelen, Farmer, Wonderlich, & Smith, 1991), the Family Environment Scale (Moos & Moos, 1984), and the Family Eating Attitude and Behavior Scale (Hogen, 1988) and rated the frequency with which family members made negative statements regarding their physical appearance and the need to diet. A hierarchical multiple regression analysis indicated that all three levels of family variables accounted for significant proportions of the variance in bulimic symptomatology. When the contribution of other variables to the regression equation was controlled, negative family communications, external control of food intake, and rules related to family mealtimes remained as significant predictors. These results illustrate the importance of investigating the relative contribution of different classes of familial variables to our understanding of bulimia nervosa and suggest important foci for the prevention of eating problems and eating disorders among young women.