Academic journal article Journal of Eating Disorders

Maternal and Family Factors and Child Eating Pathology: Risk and Protective Relationships

Academic journal article Journal of Eating Disorders

Maternal and Family Factors and Child Eating Pathology: Risk and Protective Relationships

Article excerpt

Author(s): Karina L Allen[sup.1,2], Lisa Y Gibson[sup.1], Neil J McLean[sup.2], Elizabeth A Davis[sup.1,3] and Susan M Byrne[sup.2]

Background

It is recognised that families do not cause eating disorders[1] and there is robust evidence to support a strong genetic component to these conditions[2]. Nonetheless, certain family characteristics may increase risk for eating disorders and/or problematic eating behaviours in childhood and adolescence (e.g.,[3-5]). This study sought to extend previous research by elucidating risk and protective factors in the relationships between family variables and eating disorder symptoms in children, with attention to the specificity of any identified effects.

Previous research has focused on two main categories of family characteristics, including maternal eating disorder history, maternal eating disorder symptoms and a family emphasis on eating, weight and shape; and general family functioning and parenting practices, which incorporate family conflict, family support and the frequency and nature of parent-child interactions. Moreover, studies have considered two main categories of child eating behaviour, including feeding patterns and difficulties in infancy and early childhood; and eating, weight and shape concerns, dieting, binge eating and purging in later childhood and adolescence. The following sections review key findings across these areas.

Maternal and family emphasis on eating, weight and shape

Available data suggest that mothers with an eating disorder history are more likely to have infants with feeding difficulties, to restrict their child's eating in early and middle childhood, and to use food for non-nutritive purposes (e.g., reward, distraction) when compared to mothers without an eating disorder history[6-11]. Mothers with an eating disorder history may also be more likely to experience concern about their child's eating and weight, and to have children who themselves report elevated concerns about eating, weight and shape[6, 12]. There is some evidence that these effects are gender-specific, with female children of mothers with an eating disorder history being affected to a greater degree than male children[6]. There is little evidence for associations between maternal eating disorder history and children's body mass index (BMI), self-esteem, or parent-reported emotional and behavioural problems[12].

Maternal and/or familial emphasis on eating, weight and shape (e.g., parental dieting, comments about weight and shape in the home environment) may also predict weight loss attempts, weight and shape concerns, binge eating and purging in children and adolescents. Data suggest that these links apply cross-sectionally[13, 14] and longitudinally[15-20], but may only occur when other predisposing factors (such as neuroticism or a general vulnerability to psychological difficulties) are present in children[21] or mothers[22]. Again, there appear to be gender differences in the strength of associations between variables, with girls, in particular, more likely to experience (or perceive) family-based pressures regarding eating or weight than boys[23-25].

Results in this area are consistent with sociocultural theories of eating disorders, which view internalisation of the 'thin ideal' and/or perceived pressure to be thin as key contributors to body dissatisfaction and eating pathology[26]. In childhood and adolescence, the family environment is an important source of information about cultural values and ideals. Mothers with an eating disorder history, or current eating disorder symptoms, may also find it difficult to know when and how to feed their children, or doubt their judgement in this area[10]. As noted by others[10, 27, 28], it is likely that these family environmental factors work in conjunction with genetic vulnerability to increase eating disorder risk.

Family functioning and relationships

The second category of research has focused on associations between family functioning and parenting style (e. …

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