Family environment is a significant factor in the development of eating disorders in young-adult females. Clinical experience, research and theories about eating disorders indicate that constrictive implicit process rules within a family are correlated with eating-disordered families. This study identified implicit family process rules that are unique to eating-disordered families and how well these rules predict membership in eating-disordered and non-eating-disordered families. One hundred and two families (51 eating-disordered and 51 comparison families) participated in the study. Mothers, fathers, young-adult female children, and siblings in each family completed the Family Implicit Rules Profile (FIRP). The design included cluster analysis of all 85 rules to determine which implicit rules clustered in eating-disordered families, and discriminant analysis to determine how well the rules from the cluster analysis predicted membership in the groups of eating-disordered vs. control families. Results indicated that two clusters emerged related to eating-disordered families. The first included rules regarding inappropriate protection of parents (ex. "Protect your parent even if they do not deserve it"), not upsetting or inconveniencing parents, the triangulation of a child (eg.. "Listen to a parent when they complain about the other parent"), avoiding pain at any cost, and blaming self for others' anger. Cluster 2 included rules about appearances (eg,. "Do whatever you have to do to look good to others") and rules about keeping family matters private. Discriminant analysis showed that these 15 implicit family rules predicted membership in either the eating-disordered or the non-eating-disordered family groups with 93% accuracy. Implications for family therapy are discussed.

Introduction: Eating disorders are serious psychiatric disorders that often require specialized care. Associated psychiatric comorbidity is frequent, with the most common comorbid conditions being anxiety and mood disorders. Eriksbergsgården in Örebro is one of Sweden’s specialized eating disorder treatment units.Aim: Primary aims were to describe clinical characteristics of the adult patient group at Eriksbergsgården and to evaluate treatment outcome and patient satisfaction at the one-year follow-up. An additional aim was to examine if factors such as psychiatric comorbidity affected treatment outcome.Methods: This study used data from Riksät and Stepwise, two large-scale Swedish registers for eating disorder treatment. Data for this study was registered into Stepwise and Riksät at Eriksbergsgården between August 2010 and December 2017 and 489 adult patients of both genders constituted the study group. Patient characteristics and DSM-IV axis I psychiatric comorbidity were assessed at the initial evaluation. At the one-year follow-up, treatment outcome and patient satisfaction were evaluated.Results: The most common diagnoses in this patient material were eating disorder not otherwise specified, 56.6 %, followed by bulimia nervosa, 26.4 %. At the initial evaluation, 62.0 % of the patients suffered from psychiatric comorbidity. Of the patients with initial comorbidity, 43.3 % were recovered at the one-year follow-up, compared to 62.8 % of the patients with no initial comorbidity, p=0.021.Conclusion: Our results confirm the previously known fact that psychiatric comorbidity among eating disorder patients is common. Also, the results identify psychiatric comorbidity as a possible factor to have negative effect on the treatment outcome.

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