This study compares family features of 50 bulimic women with those of 40 non-eating-disordered women from the same defined catchment area. The parents of the patients were significantly older at the birth of the child and significantly more came from different ethnic backgrounds. Bulimics reported greater parental conflict despite similar divorce rates. The bulimics' reports of the emotion, attention, and interaction from their parents were significantly less positive than were those of the comparison group. We argue that these family features of disparate parental background and poor verbal communication between family members predispose the children to difficulties with the verbal expression of emotion and to bulimia as a nonverbal expression of distress and dysphoria. These findings are related, using systemic family theories, to the strikingly specific age range of onset of bulimia to propose a model of family contributions to the etiology of this condition. While these controlled self-report measures cannot prove or disprove such a hypothesis, they provide sufficient support to justify further testing of the model.
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