Zwischen Selbstständigkeit und Zusammenhalt: Die Dynamik von Autonomie und emotionaler Verbundenheit in Familien mit essgestörten Kindern

This monocentric observational study, conducted at the Department of Psychosomatic Medicine and Psychotherapy at University Medical Center Göttingen, investigated the interplay between family relationships and eating disorders in a sample of 313 outpatient individuals diagnosed with anorexia nervosa or bulimia nervosa. Using a retrospective design, data were collected between 1991 and 2017 and captured participants’ subjective perceptions of autonomy and emotional connectedness within their primary families. Symptom severity was assessed using the Global Severity Index (GSI) of the Symptom Checklist-90-R, and family relationship characteristics were measured with the Subjektives Familienbild questionnaire. The study aimed to improve understanding of potentially pathogenetically relevant relational variables in anorexia and bulimia, an area that remains insufficiently explored. Psychometric analyses revealed significant differences between diagnostic groups in perceived family autonomy (potency) and emotional connectedness (valence). Participants with bulimia nervosa reported generally more negative evaluations of both dimensions compared with those with anorexia nervosa. Logistic regression analyses confirmed that perceived valence and potency significantly differentiated between the two diagnostic groups. Across the full cohort, significant negative correlations were observed between age, symptom burden, and overall family autonomy scores. When stratified by diagnosis, a negative association between age and perceived autonomy was found only in the anorexia nervosa group, whereas symptom severity was inversely associated with perceived autonomy in both groups. Regarding emotional connectedness, age, body mass index, and symptom severity were negatively correlated with perceived family valence. Notably, inverse associations of psychosomatic distress (GSI) and age with family connectedness were evident exclusively among participants with bulimia nervosa. Overall, this study identified significant associations between subjective perceptions of family connectedness and individual autonomy, adjusted for relevant psychometric indicators, in a large and heterogeneous outpatient eating-disorder sample. Further research is needed to validate these findings and to clarify the psychological mechanisms underlying the observed relationships.