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Cel pracyW artykule zaprezentowano rezultaty projektu badawczego poświęconego ocenie zmian w procesie systemowej terapii rodzinnej prowadzonej w grupie klinicznej młodzieżowych pacjentów psychiatrycznych.MetodaDo oceny wykorzystano polską wersję kwestionariusza SCORE–15. Badanie przeprowadzono na grupie 109 rodzin, które wypełniły kwestionariusz przed pierwszą sesją. Przed czwartą sesją ankietę wypełniły 73 rodziny; a po ostatniej sesji ukończyło ją 28 rodzin.WynikiWyniki konsensualnych analiz jakościowych ujawniły zmiany w opisie rodziny, a także w opisie problemu. Analizy statystyczne wyników kwestionariusza SCORE–15 wykazały znaczące zmiany między pierwszą, czwartą i ostatnią sesją. Zmiany zostały zidentyfikowane w skali SCORE Total, a także w skalach VAS. Wskaźnik RCI wykazał 5 popraw i 2 pogorszenia po trzech sesjach oraz brak pogorszeń i 13 popraw pod koniec procesu terapii.WnioskiUzyskane wyniki wskazują na wiele istotnych zmian w badanych obszarach po przejściu rodzin przez systemową terapię. Badanie wykazało także, że spójna analiza jakościowa materiału opisowego może być bardzo użyteczna i może wzbogacić zarówno rozumienie procesu terapeutycznego, jak i sposób przekazywania rodzinom informacji o zmianach w ramach terapii.

CelAnaliza powiązań pomiędzy oceną bieżących relacji rodzinnych w rodzinach pacjentek z diagnozą zaburzeń odżywania się a oceną relacji w rodzinach pochodzenia ich rodziców.Metoda54 pacjentki z anoreksją restrykcyjną, 22 pacjentki z anoreksją żarłoczno-wydalającą, 36 pacjentek z bulimią. Uwzględniono 2 grupy kontrolne: 36 pacjentek z zaburzeniami depresyjnymi oraz 85 uczennic ze szkól krakowskich. Badaniem objęci byli również rodzice dziewcząt. Metoda: Skala Rodziny Pochodzenia oraz Kwestionariusz Oceny Rodziny FAM (wersja polska).WynikiW rodzinach uczennic szkół krakowskich lepsza ocena doświadczeń autonomii i bliskości z rodzin pochodzenia rodziców badanych dziewcząt wiązała się z ich oraz ich dzieci korzystniejszą percepcją relacji w obecnej rodzinie nuklearnej. Szczególnie znacząca okazała się transgeneracyjna percepcja doświadczeń ojców. We wszystkich grupach klinicznych zaobserwowano jedynie kilka istotnych statystycznie korelacji. U rodziców badanych pacjentek widoczny jest nikły związek oceny bieżących relacji małżeńskich z doświadczeniami transgeneracyjnymi, oraz istotny związek doświadczeń transgeneracyjnych z oceną relacji z córkami.WnioskiStwierdzono brak specyficznych powiązań pomiędzy oceną relacji transgeneracyjnych rodziców i percepcją bieżących relacji w rodzinie nuklearnej w grupie zaburzeń odżywania się. Wyniki w grupie zaburzeń odżywania się sugerują, że relacje rodziców z córkami charakteryzują się większą intensywnością niż relacje małżeńskie.

Background Disturbances in various elements of transgenerational family functioning patterns are not uncommon in studies of eating disorders. We examined the relationship between patients’ perception of autonomy and intimacy in their families of origin and that of their parents in their own families of origin. Material/Methods The sample consisted of 112 girls who had a diagnosis of an eating disoder and their parents; 54 of the girls were diagnosed with anorexia nervosa restrictive subtype, 22 as anorexia nervosa binge/purge subtype, and 36 were diagnosed with bulimia nervosa. We had 2 control groups: 1 group consisted of 36 girls diagnosed with a depressive episode, dysthymia, or adjustment disorder with depressed mood and the other group was 85 female students from schools in Cracow, Poland and their parents. We used the the Family of Origin Scale to assess perception of family relationships. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS 20.0.PL; Chicago, IL, USA). Results There was a significant association between daughters’ and fathers’ perceptions of autonomy in their families of origin in all groups. There was no significant association between daughters’ and mothers’ perceptions in all groups. The strongest correlation was between the non-clinical sample of girls and their fathers and for the bulimic group. Conclusions We did not detect any link indicating the specificity of transgenerational transmission of autonomy and intimacy in eating disorders. The results point to the importance of the father figure in studies of family systems, including the context of family transmission.

Source of support: The presented research is part of a larger research project entitled “Socio-cultural, familial, and individual factors in anorexia and bulimia nervosa”, which is financed by a scientific grant from the State Committee for Scientific Research (Grant Number: 6 POSE 09021) Summary Background: The aim of this study was to assess attitudes towards eating as measured by the Eating Attitude Test (EAT26) among mothers of girls diagnosed with various types of eating disorders, in comparison with mothers of depressive girls and their relationship with daughters’ results 14 years after the beginning of the Polish political and cultural transformation of 1989. Material/Methods: The data of 68 mothers and their daughters were used in statistical analysis (anorexia nervosa restrictive type: 18, anorexia nervosa binge/purge type: 12, bulimia: 14, depression: 24). The mean age in the group of mothers was 43.5 (SD 5.3), daughters: 16.7 (SD 1.4). Results: In the group of mothers, the results of EAT26 test were lower than results of the general population of Polish females or patients’ mothers obtained in a different cultural context. Results from girls with an eating disorder diagnosis considerably exceed the mean result of Polish population studies of teenagers. There were no statistically significant differences between the EAT26 results of mothers of girls with various types of eating disorders and mothers of depressive girls. Sociocultural variables such as education and place of residence of mothers also did not differentiate the studied groups and did not have a significant influence on attitudes towards weight and body shape presented by the studied mothers. Conclusions: The obtained results may suggest that in the studied population, the social background of mothers and disturbances of their own mothers’ attitudes towards weight and body shape were not an important and specific risk factor in the development of their daughters’ eating disorders.

To assess the correlations between the perception of relations in parents' families of origin and the assessment of the current family by the parents and their daughters suffering from eating disorders. STUDIED GROUP: Statistical analyses were applied to the results obtained from 54 patients diagnosed with restrictive anorexia nervosa, from 22 with binge-purge anorexia, from 36 with bulimia and from two control groups: 36 patients diagnosed with depressive disorders and 85 Krakow schoolgirls. The study also covered the parents of the investigated girls.Family of Origin Scale and Family Assessment Questionnaire (FAM Polish version) were used in the study.The procreative family assessment made by the mothers was correlated with the assessment of their own generational family and the assessment of own generational family made by their husbands. Procreative family assessment made by the fathers was correlated only with their assessment of their family of origin. Family of origin assessment made by patients with diagnosed eating disorders, particularly bulimia, was correlated only with the family of origin assessment made by their fathers. The last correlation did not occur in the control groups.The research shows a correlation between the experience of the families of origin and the current functioning of the family. They show the impact of the fathers' trangenerational experience on the perception of family relations of daughters with diagnosed anorexia and bulimia nervosa.

The goal of this study was to assess the perception of marital relationship and its mutual connections by parents of(female) patients diagnosed with eating disorders. Data from: 54 (female) patients diagnosed with restrictive anorexia nervosa (ANR), 22 with binge-purge anorexia nervosa (ANBP), 36 with bulimia (BUL), and two control groups: 36 (female) patients diagnosed with depressive disorders (DEP) and 85 Krakow schoolgirls (NOR).The study employed the Dyadic Relations Scale, a part of the Family Assessment Measure (Polish version).Wives in the BUL group, compared to wives in the NOR group, rated their husbands worse when assessing their husbands in terms of how well they functioned in the marital relationship, their performance of duties, affective involvement, and the integrity of values and rules of conduct. Wives in the ANR group, compared to wives in the NOR group, negatively rated the affective involvement of their husbands in the marital relationship. Husbands in the DEP group, compared to husbands in the NOR group, rated their wives worse when assessing their wives' general functioning in the marital relationship, degree of communication within it, degree of understanding, how well they performed their spousal duties, and the coherence of their system of values and rules of conduct. The image of the marital relationship held by parents of Krakow schoolgirls was characterized by a strong correlation, in contrast to the image of the relationship held by parents of (female) patients, regardless of the nature of the diagnosis.Comparison of the results of parents of(female) patients with eating disorders and parents of(female) patients with a diagnosis of major depressive disorder revealed no difference in the image of the marital relationship, whether in the mutual assessment of spouses towards each other or in connection with the assessments.

The aim of the study was to assess the relationship between depressive symptoms and girls' assessment of their family relations in a group of (female) patients with a diagnosis of various subtypes of eating disorders in comparison with (female) patients with a diagnosis of depressive disorders (episode of major depression, dysthymia, adjustment reaction with depressive mood) and female students in Krakow, Poland schools.Data from 54 (female) patients with a diagnosis of restrictive anorexia (ANR), 22 with a diagnosis of binge-purge anorexia (ANB), 36 with a diagnosis of bulimia (BUL), 36 with a diagnosis of depressive disorders (DEP) and a 85 (female) Krakow school students (CON) were used in the statistical analyses. There were no significant differences between age of the girls in studied groups. In analyses, results of the Polish version of the Beck Depression Inventory (BDI) and also the Family Assessment Questionnaire (KOR) were used.In the CON group, correlations attesting to a link between depressiveness and a negative assessment of the family were observed on all scales of the questionnaire with the exception of the Values and Norms scale. In the DEP group, such a dependence was ascertained on scales: Completing Tasks, Communication, Emotionality, Control, Defence, Positive Statements. In the case of the ANR group, no statistically significant relationship between results of the questionnaires was noted. In group ANB, correlations attesting to a link between depressiveness and a negative picture of the family were ascertained on scales: Communication and Defence. The same dependence was ascertained in the BUL group on scales: Completing Tasks, Emotionality, Emotional involvement, Control, General result, Negative Statements.An increase in depressiveness is linked in a significant way with a worsening assessment of the family relations amongst girls with a diagnosis of bulimia, depressive disorders and students.

To assess cultural attitudes and beliefs among (female) patients being treated for various kinds of eating disorders in comparison with (female) patients diagnosed with depression and healthy girls.Version II of the Cultural Questionnaire by M. Pilecki and B. Józefik referring to issues linked with those aspects of dulture whose importance is described as significant in the development of eating disorders.Data from patients with the following diagnoses were used in the statistical analyses: 54 (female) patients with a diagnosis of restrictive anorexia (ANR), 22 with a diagnosis of binge-purge anorexia (ANB), 36 with a diagnosis ofbulimia (BUL) and 40 with a diagnosis of depressive disorders (DEP) and also 74 female pupils from Kraków schools (KON).Groups ANB and BUL obtained high scores, indicating the greater significance of 'ideals of thinness' in their lives than in groups KON, DEP and ANR. The BUL group was characterised by a sense of yielding to fashion pressure and also by a sense of the environmental and generational significance of the disorders in relation to groups KON and DEP. The females in group KON assessed that their parents attached greater importance to appearance than did (female) patients in group ANB. A negative evaluation of the position of women in the family was given by all the studied (female) patients in comparison with group KON.The obtained results may indicate the greater significance of cultural mechanisms in bulimia than anorexia nervosa. They may also be an expression of the limited possibility of introspection of girls with a diagnosis of restrictive anorexia. A negative perception of femininity in the family and culture accompanies not only eating disorders, but also depressive disorders.

The article discusses the preliminary results of a follow-up study carried out in 2009-2010 on former patients with a diagnosis of anorexia nervosa and bulimia nervosa, first seen in 2001-2004 at the Department of Child and Adolescent Psychiatry, the Jagiellonian University Medical College in Krakow. At that time they had been taking part in a research project, whose aim was to define the relationships among the psychopathological picture of eating disorders, self-image and family relations and also the influence of socio-cultural factors. The aim of the current study is to attempt to define factors influencing the course and prognosis of eating disorders in the studied group.Results from the Eating Disorder Inventory Questionnaire (EDI) and the Polish version of Family Assessment Measure (KOR) in the first study were juxtaposed with the clinical state and parameters of psychosocial functioning of the studied women assessed on the basis of the follow-up study.In the studied group, 13 girls suffered from anorexia nervosa--restricting type, 6 from anorexia nervosa binge-eating/purging type, and 6 from bulimia. In the studied group, there was complete symptomatic improvement in 12 persons (48%), subclinical symptoms continued to be observed in 9 persons (36%), and 4 persons (16%) met full diagnostic criteria for eating disorders. The most favourable course was observed in the group with a diagnosis of anorexia nervosa restricting type. The least favourable was observed in the group with a diagnosis of bulimia. Results. In the studied group, 13 girls suffered from anorexia nervosa - restricting type, 6 from anorexia nervosa binge-eating/purging type, and 6 from bulimia. In the studied group, there was complete symptomatic improvement in 12 persons (48%), subclinical symptoms continued to be observed in 9 persons (36%), and 4 persons (16%) met full diagnostic criteria for eating disorders. The most favourable course was observed in the group with a diagnosis of anorexia nervosa restricting type. The least favourable was observed in the group with a diagnosis of bulimia.The occurrence of symptoms of binging and purging turned out to be a negative prognostic factor in the whole group of patients suffering from eating disorders. A smaller starting declared intensity of aspiring to slimness and level of dissatisfaction with own body by patients measured with the EDI, and satisfaction in the area of communication and emotional commitment on the part of the mother (of the patient) in her relationship with her husband (the father of the patient) measured with the KOR were positive prognostic factors. The significant overrepresentation of patients with a diagnosis of restrictive anorexia in the group of persons with clinical improvement may have an influence on the obtained results.

The paper presents the attachment theory in relation to eating disorders. In the first part, the classic concepts of anorexia and bulimia nervosa are discussed taking into account assumptions of Bowlby's and his followers' model. In the second part, empirical data on anorexia and bulimia nervosa and attachment patterns are presented. The importance of methodological issues is stressed regarding the attachment model particularly in eating disorders. In the conclusion significant findings correlation of attachment patterns and eating disorders are indicated.

A lot of research indicates the importance of the family context in the occurrence of Eating Disorders. Authors present results of research in families with an adolescent suffering from Anorexia Nervosa according to ICD-10. The aim of this study was to examine relationships among family members. Anorectic girls (n = 37), their sisters (n = 16) and control girls (n = 41) completed the Polish version of The Family Assessment Measure standardised on a Polish sample. The questionnaire was constructed to measure some aspects of the family life such as task accomplishment, role performance, communication including affective expression, affective involvement, control, values and norms. The study revealed some interesting differences between samples. For example, anorectic girls and their sisters generally express dissatisfaction with the relationship with their parents, particularly with fathers, contrary to the control group of girls. Anorectic girls and their sisters more critically assess functioning of the family as a whole than control group girls. Anorectic girls and their sisters express dissatisfaction with their mutual relationship, contrary to the control group.