Family structure and eating behavior disorders.

INTRODUCTION: The modern way of life, characterized by the cult of individualism, discredited authority, and a proliferation of points of view about reality, has modified family structure. This social structure imbues families and the way that its members become ill, in such a way that eating behavior disorders (EDs) have become a typically postmodern way of becoming ill. METHODOLOGY: The aim is to understand the systemic structure and vulnerability of families by comparing 108 families with members who have ED to 108 families without pathology. A questionnaire administered by an interview with trained personnel was used. RESULTS: Families with ED have a different structure from the families in the control group. They have more psychiatric history and poor coping skills. The family hierarchy is not clearly defined and the leadership is diffuse, with strict and unpredictable rules, more intergenerational coalitions, and fewer alliances. The relationship between the parents is distant or confrontational, and their attitudes towards their children are complacent and selfish, with ambivalent and unaffectionate bonds. In the case of mothers, this is manifested by separation anxiety and dyadic dependence. Their expectations concerning their offspring are either very demanding and unrealistic, or indifferent, and there is less control of their behavior, in addition to poor organization of the family meals. CONCLUSIONS: The structural differences between the two groups of families seem to be important for the occurrence and maintenance of EDs, although they may not be the only cause. The results suggest strategies for clinical intervention in EDs.

La estructura familiar y los trastornos de la conducta alimentaria / Family structure and eating behavior disorders

Introducción. El estilo de vida moderno que se caracteriza por el culto al individualismo, el descrédito de la autoridad y la existencia de múltiples realidades, ha modificado la estructura de las familias. Esta estructura social impregna a las familias y la forma de enfermar de sus miembros, de forma que los TCA se convierten en una forma de enfermar típicamente posmoderna. Metodología. El objetivo es conocer la estructura sistémica y la vulnerabilidad de las familias, comparando 108 familias con TCA, con 108 sin patología. Se utilizó un cuestionarioadministrado mediante entrevista por personal entrenado. Resultados. Las familias TCA tienen una estructura distinta de las del grupo de control. Tienen más antecedentes psiquiátricos y escasas habilidades de afrontamiento. Sus jerarquías están poco definidas y el liderazgo es difuso, con normas imprevisibles y rígidas, existiendo más coaliciones intergeneracionales y menos alianzas. La relación entre los padres es distante o de enfrentamiento, y hacia sus hijos tienen actitudes complacientes y egoístas, con vínculos ambivalentes y poco afectuosos, que en el caso de las madres se manifiesta con ansiedad de separación y dependencia diádica. Las expectativas que tienen para su prole son o bien exigentes y poco realistas o bien despreocupadas, y menor control de su conducta, además de una peor organización de las comidas familiares. Conclusiones. Las diferencias estructurales que aparecen entre los dos grupos de familias parecen tener importancia en la aparición y mantenimiento de los TCAs, aunque posiblemente no sean su única causa. Los resultados indican estrategias para la intervención clínica en TCAs

Introduction. The modern way of life, characterized by the cult of individualism, discredited authority, and a proliferation of points of view about reality, has modified family structure. This social structure imbues families and the way that its members become ill, in such a way that eating behavior disorders (EDs) have become a typically postmodern way of becoming ill. Methodology. The aim is to understand the systemic structure and vulnerability of families by comparing 108 families with members who have ED to 108 families without pathology. A questionnaire administered by an interview with trained personnel was used. Results. Families with ED have a different structure from the families in the control group. They have more psychiatric history and poor coping skills. The family hierarchy is not clearly defined and the leadership is diffuse, with strict and unpredictable rules, more intergenerational coalitions, and fewer alliances. The relationship between the parents is distant or confrontational, and their attitudes towards their children are complacent and selfish, with ambivalent and unaffectionate bonds. In the case of mothers, this is manifested by separation anxiety and dyadic dependence. Their expectations concerning their offspring are either very demanding and unrealistic, or indifferent, and there is less control of their behavior, in addition to poor organization of the family meals. Conclusions. The structural differences between the two groups of families seem to be important for the occurrence and maintenance of EDs, although they may not be the only cause. The results suggest strategies for clinical intervention in EDs

Concepto actual de discapacidad intelectual / The current concept on intellectual disobility

Se expone a continuación una síntesis de las últimas aportaciones que sobre el "Retraso Mental" ha publicado la Asociación Americana sobre Retraso Mental. Dichas contribuciones se centran en aspectos significativos para la adecuada comprensión de las personas con esta discapacidad, la definición, los conceptos que la componen, los procesos de evaluación y el establecimiento de los apoyos. De igual manera, realizamos algunas consideraciones al respecto. Utilizamos para ello el último manual publicado en el 2002. En esta publicación se sigue manteniendo el termino de "retraso mental", si bien ésta es una terminología a la que estamos acostumbrados, preferiríamos usar otro vocablo que resulte algo más apropiado y, que al menos en nuestro país, está adquiriendo un mayor apoyo entre las personas con esta discapacidad y entre los profesionales, nos referimos al término "discapacidad intelectual"

This paper sets out a summary of the latest contributions on mental retardation published by the American Association on Mental Retardation (AAMR); contributions which centre on key issues for a more acceptable understanding of the people living with this disability, its definition, underlying concepts, evaluation processes and the implementation of support services. Likewise, it also includes some of our own reflections on these matters. Reference is made to the latest AAMR manual published in 2002, which continues to use the term "mental retardation". Despite this being a term with which we are familiar we prefer to use another one that is somewhat more appropriate and that, at least in Spain, is finding greater support among people living with this disability as well as among professionals: we are, of course, referring to "intellectual disability"