Attachment and perceived parental treatment reported by siblings discordant for eating disorder pathology
Abstract
THESIS :-
Title -
Attachment and perceived parental treatment reported by sisters discordant for
eating disorder pathology
Hypotheses -
The study tested theoretical predictions that attachment status would differ
between siblings discordant for eating disorder (ED) pathology. Differences in
perceptions of parental treatment, sibling interaction and parental construing were
expected to reflect differential attachment processes as follows:
1. It was predicted that higher levels of insecure attachment would be reported
by ED than non-ED sisters.
2. It was expected that ED siblings would report lower levels of parental
affection and higher levels of parental control during childhood compared to
non-ED sisters.
3. It was expected that ED siblings would report higher levels of sibling
jealousy toward their sisters than non-ED siblings.
4. It was predicted that differences would be found in parental construing of
daughters. Non-ED daughters were expected to be more positively
construed prior to and following development of the ED.
Design -
A cross-sectional case control design was employed. Patients (cases) were
assigned to the ED sister group and sisters (controls) were assigned to the non-ED
sister group. Additional investigation of parental perceptions was undertaken
where possible.
Setting -
Participants were recruited from two neighbouring community NHS Eating Disorder
Services based within the Home Counties. Both services were similar in terms of
patient eligibility (e. g. 18 years and above; out-patient), staffing (multidisciplinary)
and provision of treatments for a wide range of eating disorder pathology.
Participants -
Participants included all female patients currently being offered outpatient
treatment for eating disorder pathology (i. e. Anorexia Nervosa, Bulimia Nervosa
and EDNOS) with a sister meeting the following eligibility criteria: aged 16 years
and above, without a history or current presentation of ED pathology of clinical
severity. Non-ED sisters were also required to be of nearest age and to have lived
in the family home for at least eight years.
Biological parents who had lived in the family home up until and / or following the
onset of the eating disorder were also included.
Measures -
The Stirling Eating Disorder Scales (SEDS; Williams et al., 1994) and the Hospital
Anxiety and Depression Scale (HADS; Zigmond & Smith, 1983) were used to
screen for eating disorder pathology and additional co-morbid symptomatology.
The Reciprocal Attachment Questionnaire (RAQ; West & Sheldon, 1984) and
Sibling Inventory of Differential Experience (SIDE; Plomin & Daniels, 1984) were
used to compare attachment behaviours and perceptions of differential parental
treatment and sibling relationships between sister groups.
The Repertory Grid Technique (RGT) was used to explore and compare parental
construing of daughters prior to and post development of an eating disorder.
Method -
52 siblings (26 sister pairs discordant for eating disorder pathology) were sent
questionnaires by post with a stamped addressed envelope. Parents were
interviewed separately in the family home.
Main findings -
As predicted, differences were found in the attachment profiles of sister groups,
with ED sisters reporting higher levels of insecurity across all attachment
dimensions. However, no significant differences were found in sister groups'
perceptions of parental treatment during childhood, failing to support proposed
hypotheses regarding differential attachment and parental treatment. ED sisters
reported higher levels of jealousy directed toward non-ED sisters as expected.
Parents were found to retrospectively construe daughters as similar and equally
positively as children. ED daughters became significantly less positively construed
in adulthood (i. e. post development of ED) compared to non-ED sisters.
Whilst conclusions regarding the role of insecure attachment in the aetiology of ED
pathology cannot be drawn (i. e. whether ED pathology is a cause or a result of
insecure attachment), the study has furthered the investigation into the role of
attachment and eating disorder pathology by combining a number of theoretical
and empirical lines of enquiry. Results highlight a number of theoretical areas for
further investigation and implications for clinical practice. Recommendations for
future research are also discussed.
Publication date
2003Published version
https://doi.org/10.18745/th.14167https://doi.org/10.18745/th.14167