Family representations in relationship episodes of patients with a diagnosis of bulimia nervosa.

The influence of the family on the development and the maintenance of bulimia nervosa can be seen both biologically and psychosocially. Genetic influences are discussed, but their effects do not explain the aetiology exclusively. Clinical observations and research findings support the role of family dynamics, family environment, and family functioning. In particular, a low level of cohesion, a lower degree of expressiveness, and more conflicts seem to characterize the family of patients with a diagnosis of bulimia nervosa. The present study addresses the question of how patients suffering from bulimia differ from other patients in psychotherapy and from non-clinical control subjects in the way they perceive their ongoing and their past family relationships. The Core Conflictual Relationship Theme method is applied to narrative material from patients belonging to these three groups. Results show expected differences between patients and normal control subjects and virtually no differences between the group of patients with a diagnosis of bulimia nervosa and the group of patients with diagnoses different from bulimia.