European Eating Disorders Review Eur. Eat. Disorders Rev. 13, 19–28 (2005) Perceived Family Cohesion, Adaptability and Communication in Eating Disorders Vesna Vidovic ´ 1 *, Vesna Jures ˇa 2 , Ivan Begovac 1 , Mirta Mahnik 3 and Gorana Tocilj 1 1 University Department for Psychological Medicine, University of Zagreb School of Medicine, Croatia 2 School of Public Health ‘Andrija S ˇ tampar’, University of Zagreb School of Medicine, Croatia 3 University Department of Psychiatry, University of Zagreb School of Medicine, Croatia Objective: We investigated the differences in perceived family cohesion, flexibility and communication in female patients with eating disorders and their mothers. Method: Seventy-six patients with eating disorders, 29 mothers, 50 matched controls with their mothers and 79 medical students comple- ted the FACES II and the Parent–Adolescent Communication Form. Results: The patients perceived that their families were less cohesive and less flexible and that communication with their mothers was impaired. The patients’ family perception differed by subtype of anorexia nervosa. The perception of restrictive anorectic patients did not differ from that of the control groups. Patients’ mothers reported less cohesion and flexibility with impaired mother–daughter communication in comparison with the mothers of healthy females. Daughters were more critical towards their families than mothers. Conclusion: The results confirmed significant differences between subtypes of anorexia nervosa and similarities between the bulimic form of anorexia nervosa and bulimia. Conflict avoidance and denial in restrictive anorexia nervosa patients may have caused their favourable perception of family cohesion and communication. Copyright # 2005 John Wiley & Sons, Ltd and Eating Disorders Association. Keywords: eating disorders; family; cohesion; adaptability; communication INTRODUCTION Families of anorectic patients have been a focus of attention for a long time. Early clinical descriptions of anorexia suggested a psychological basis for the disease and the influence of the mother and the family. Dysfunctional patterns of family interactions have been studied extensively by family therapists (Minuchin, Rosman, & Baker, 1978; Selvini Palazzoli, 1988; Dare, Eissler, Russell, & Szmukler, 1990). Describing the family types, Minuchin labelled two extreme poles of family functioning as ‘enmeshed’ and ‘disengaged’. These terms resemble Copyright # 2005 John Wiley & Sons, Ltd and Eating Disorders Association. Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/erv.615 * Correspondence to: V. Vidovic ´, University Department for Psychological Medicine, University of Zagreb School of Medicine, KBC Zagreb, Kis ˇpatic ´eva 12, 10000 Zagreb, Croatia. Tel/Fax: (385) 1 23 88 194. E-mail: vesna.vidovic@zg.htnet.hr