The Influence of Mothers on the Development of Their Daughter's Eating Disorders: An Integrative Review

ABSTRACT Background: Eating disorders (ED) are characterized by changes in eating behavior, whose aetiology is multifactorial with an emphasis on family relations, especially in the mother-daughter relationship Objective: To analyse the national and international scientific literature about the influence of mothers on the development of their daughter's ED. Methods: Integrative review based on the search of publications from 2012 to 2019 through PubMed, LILACS and SciELO electronic databases. Results: It was found 181 articles, from which 26 were selected (21 in English, four in Portuguese and one in French) to comprise the research corpus. In addition, 155 were removed from the review due to the exclusion criteria, which included narrative review articles, theses, dissertations, monographs, editorial letters and responses to the editor. Discussion: The analyzed articles offer evidence that the type of influence exercised by the mother depends on her personality profile, the mother's eating behaviour and body attitudes, the bond between mother and daughter and the type of communication that is established between the dyad. Conclusion: Health promotion actions in the population are necessary to prevent ED. In addition, interventions for families, and especially for mothers, are recommended, in order to favour more effective therapeutic and prognostic results.

A decisão de uma mulher por parir naturalmente: contribuições psicanalíticas / A woman's decision to have a natural childbirth: psychoanalytic contributions / La decisión de una mujer por el parto natural: aportes psicoanalíticos

Pensando a decisão como um processo que depende muito menos do pensamento racional, como se costuma acreditar, posto que nele está implicada uma lógica subjetiva de cada sujeito, este estudo teve como objetivo identificar os motivos que subjazem à decisão de uma mulher por um parto natural, em um contexto social que ainda tem como modelo hegemônico o parto medicalizado e predominantemente hospitalar. Tratou-se de uma pesquisa clínico-qualitativa, em que foram realizadas entrevistas semidirigidas com dez mulheres que passaram pela experiência de um parto natural, que foram selecionadas pela técnica de amostragem por bola de neve. A interpretação dos resultados foi realizada segundo a técnica de análise temática de conteúdo por meio do aporte teórico da psicanálise. Foi possível concluir que a decisão de uma mulher por uma ou outra via de parto tem relação com seu processo de constituição enquanto mulher e mãe, que se encontra estreitamente vinculado à relação mãe e filha. Em outras palavras, a decisão por uma ou outra via de parto está para além de um pensamento racional e uma lógica consciente, pois tem relação com os traços de experiências primitivas de cada sujeito. Além disso, pode-se perceber o quanto a decisão por um parto natural aparentou se configurar como uma tentativa de singularização da mulher, isto é, tal decisão traz a marca de uma inventividade. Essas mulheres, ao decidirem por um parto natural, apresentavam como demanda uma nova forma de parir - parir à sua maneira. (AU)

From a conception of decision as a process that depends less on rationality than usually thought, for it implies each person's subjective thinking, this study aimed to identify the reasons underlying a woman's decision for having a natural childbirth, in a social context where the hegemonic model is a medicalized delivery within the hospital setting. This clinical-qualitative research was conducted with data collected using semi-structured interviews with ten women who had a natural childbirth, selected by snowball sampling. Results were interpreted in the light of thematic analysis with the theoretical contribution of psychoanalysis. A woman's decision for a different birth method was found to be related to the construction of her identity as both a woman and a mother, which is directly associated with the mother-daughter relationship. In other words, such a decision is beyond rational sense and conscious logic, being related to each subject's primitive experiences. Moreover, the decision for a natural childbirth represents an attempt for women's singularization, thus reflecting some inventiveness. When opting for a natural birth, these women demanded for a new way of giving birth - giving birth in their own way. (AU)

Considerando la decisión como un proceso que depende menos del pensamiento racional como se cree, lo que implica una lógica subjetiva de cada sujeto, este estudio tuvo por objetivo identificar las razones que subyacen en la decisión de una mujer por el parto natural en un contexto social que todavía sigue el modelo hegemónico del parto médico y hospitalario. Esta es una investigación clínico-cualitativa, en la que se realizaron entrevistas semidirigidas con diez mujeres que se sometieron a la experiencia del parto natural, seleccionadas bajo la técnica de muestreo de bola de nieve. La interpretación de los resultados se realizó con la técnica de análisis de contenido temático mediante la contribución teórica del psicoanálisis. Se concluye que la decisión de una mujer por una u otra forma de parto está relacionada con su proceso de constitución como mujer y madre, que está estrechamente vinculada a la relación madre e hija. Es decir, la decisión por un u otro tipo de parto va más allá de un pensamiento racional y una lógica consciente, pero está relacionada con los rasgos de las experiencias primitivas de cada sujeto. Además, se observó cómo la decisión por un parto natural parece ser un intento de singularización de la mujer, es decir, esta decisión lleva la marca de una inventiva. Estas mujeres al decidirse por el parto natural presentaron como demanda una nueva forma de parir: parir a su manera. (AU)

Vínculo madre/hija y su relación con insatisfacción corporal, modelos estéticos y conductas alimentarias / Mother/daughter attachment and its relationship with body dissatisfaction, aesthetic models and eating behaviors

Resumen Se analizó la percepción de conductas y actitudes maternas en las hijas y sus niveles de satisfacción corporal, conducta alimentaria e influencia de modelos estéticos corporales. Se utilizó un enfoque cuantitativo, transversal, intencional, no probabilístico y de bola de nieve. Veintidós díadas madre/hija (n=44) completaron el IVP, CFC, CIMEC y E-TONA. Se efectuó un análisis estadístico descriptivo, cálculo de porcentajes y coeficientes de correlación mediante el programa SPSS. Las hijas percibieron principalmente un control materno sin afecto (31,8%); en el 18,2% ambas efectuaban dieta; 40,9% de las hijas versus 22,7% de las madres mostró alteración del esquema corporal, exhibiendo malestar, en el 63,6% (hijas) versus 45,5% (madres). La sobreprotección materna percibida por las hijas fue estadísticamente significativa (r=,513; p=,015). Los niveles de satisfacción corporal en ellas (r =,694; p=,000), la preocupación ponderal (r=,612; p=,002) y la imagen corporal (r=,707; p=,000), se correlacionaron directa y significativamente con los maternos y con agentes y situaciones que difunden el modelo estético de sus madres (r=,544; p=,009 y r=,625; p=,001, respectivamente). Se observó la percepción por las hijas de un control materno sin afecto con sobre-preocupación, además de alteración del esquema corporal de madres e hijas y una significativa influencia de modelos estéticos corporales.

Perception of maternal behaviors and attitudes in daughters and their levels of body satisfaction, eating behavior and influence of body aesthetic models were analysed. A quantitative, cross-sectional, intentional, non-probabilistic and snowball approach was used. Twenty-two mother/daughter dyads (n = 44) completed the PBI, BSQ, CIMEC and E-TONA. A descriptive statistical analysis, calculation of percentages and correlation coefficients were carried out using the SPSS programme. Daughters mainly perceived maternal control without affection (31.8%); in 18.2% both were on a diet; 40.9% of daughters versus 22.7% of mothers showed alteration of body scheme, exhibiting discomfort, in 63.6% and 45.5%, respectively. Maternal overprotection perceived by daughters was statistically significant (r =0.513, p = 0.015). Levels of body satisfaction in daughters (r = 0.694; p =0.000), weight concern (r =0.612; p =0.002) and body image (r =0.707; p =0.000), were correlated directly and significantly with those of mothers and with agents and situations that broadcast the aesthetic model of their mothers (r =0.544, p =0.009 and r =0.625, p =0.001, respectively). Daughters´ perception of a maternal control without affect with over-concern was observed, in addition to alteration of body scheme in mothers and daughters and a significant influence of body aesthetic models.

Uma paixão devastadora / A devastating passion / Une passion ravageante / Una pasión devastadora / Zusammenfassung: Eine verheerenden Leidenschaft

O presente artigo aborda o tema da “paixão devastadora” e indaga qual seria sua diferença de uma relação de amor, apoiando--se na teoria psicanalítica de Freud e de Lacan e na contribuição de Lessana. Apresenta dois fragmentos clínicos que desvelam como a relação com a mãe produz obstáculos na vida amorosa das jovens mulheres. Conclui que na paixão predomina o imaginário e, no amor, o simbólico. Por fim, ressalta que a devastação mãe-filha é menos nefasta que o arrebatamento.

The following article adresses the theme of “devastating passion” and discusses what would be its main differences to a love relationship, based on Freud’s and Lacan’s psychoanalytic theories as well as a Lessana’s contribution. It analyzes two clinical fragments that unveils how a mother-daughter relationship produces obstacles in the love life of young women. The conclusion is that in passion the imaginary prevails, whilst, in love, symbolism is fundamental. Finally, it emphasizes that the mother-daughter devastation is less nefarious than rapture.

Ce texte traite le thème da la “Passion ravageante” et il intérroge en quoi elle se différencie d’un rapport amoureux, en s’appuyant sur la théorie psychanalytique de Freud et Lacan et la contribution de Lessana. Il présente deux fragments cliniques qui dévoilent comment le rapport à la mère produit des obstacles à la vie amoureuse des jeunes femmes. Il souligne que, dans la passion, il y a la dominance de l’imaginaire, tandis que, dans l’amour, il s’agit du symbolique. Il conclut qu’il ya des distinctions encore plus importantes: entre l’amour et le désir, entre le désir et la jouissance.

El presente artículo aborda el tema “pasíon devastadora” y cuestiona cual seria la diferencia entre esta última y una relación de amor utilizando la teoría psicoanalítica de Freud y Lacan y la contribuición de Lessana. Presenta dos fragmentos clínicos que desvelan la relación con la madre produciendo obstáculos en la vida amorosa de las mujeres jóvenes. Concluye que predomina lo imaginario en la pasión, y en el amor, lo simbólico. Por último, resalta que la devastación madre-hija es menos nefasta que lo arrebatamiento.

Der folgende Artikel behandelt das Thema der “verheerenden Leidenschaft” und erörtert was der Unterschied zu einer Liebesbeziehung wäre. Er stützt sich dabei auf die psychoanalytischen Theorien von Freud und Lacan sowie einem Beitrag aus den Werken von Lessana. Es werden zwei klinische Fälle analysiert, die zeigen, inwiefern die Mutter-Tochter-Beziehung, Hindernisse im Liebesleben junger Frauen schafft. Schlussfolgernd legt der Text dar, dass in der Leidenschaft die Vortstellung dominiert, während es in der Liebe die Symbolik ist. Zuletzt, betont er, dass die Zerstörung Mutter-Tochter Beziehung weniger ruchlos ist als die Hingerissenheit.

Triste falo: uma imagem da relação mãe-filha / The melancholic phallus: a figure of the mother-daughter relationship

Segundo Freud, a relação mãe-filha é caracterizada por um eterno conflito de ambivalência. A inveja do pênis, nessa relação, desempenha um papel central, e a busca fálica é o refúgio secreto da relação com a mãe. Entretanto, no cerne da lógica fálica existe a angústia de perda do amor do objeto, que é revivida com a emergência da sexualidade genital adulta. O autor estuda os aspectos melancólicos, que são tanto defletidos quanto perpetuados, por esta configuração psíquica, em prol da fidelidade ao objeto materno.

According to Freud, the mother-daughter relationship is marked by a never-ending conflict of ambivalence. "Penis envy" plays a central role in this relationship and the phallic claim can be seen as its secret refuge. However, at the very core of the phallic logic, there is the anxiety of loss of the object's love, which is revived with the emergence of adult genital sexuality. The author studies the melancholic aspects which are both deflected and perpetuated by this psychic configuration, in order to remain faithful to the maternal object.

<b>Three Cases of the Same Kampo Treatment Applied to a Mother and Daughter with Different Complaints </b> / 日本東洋医学雑誌

We describe three cases in which the same Kampo formulas were applied to a mother and daughter with different complaints. In cases 1 a, b, a mother with general fatigue after an operation for gastric and colon cancer, and her daughter with migraine and menopausal symptoms were effectively treated with kamishoyosan. In cases 2 a, b, a mother with menstrual disorder, and her daughter with palmar eruption were effectively treated with hangekobokuto. In cases 3 a, b, a mother with lumbago and her daughter with back pain were effectively treated with keishikaryukotsuboreito. These Kampo formulas are thought to improve <i>qi </i>circulation.<br>It is considered that improving <i>qi </i>disturbance is important for the Kampo treatment of female patients. Taking into account parent-child genetic similarities, it is possible that application of the same Kampo formula to familiarly related patients with different complaints could be effective. It is important to consider not only the patient's complaints, but also the patient's condition, from the Kampo viewpoint so-called “Sho”. Therefore,since our cases all involved a mother-daughter relationships, it may be reasonable to assume that Kampo formulas improving <i>qi </i>circulation were effective for their different complaints.

The mother-daughter relationship in eating disorders: the psychotherapy group of mothers / Relação mãe-filha nos transtornos alimentares: o grupo psicoterapêutico de mães / Relation mère-fille et troubles alimentaires: le groupe psychothérapeutique de mères / La relación madre-hija en los trastornos alimentarios: el grupo psicoterapéutico de madres / Mutter-tochter beziehung im zusammenhang mit essstörungen: die psychotherapeutische gruppe von mütter

Psychotherapeutic interventions that bring about differentiation, separation, individuation and autonomy in the mother-daughter relationship are recommended as treatment for eating disorders. With this goal in mind, a psychotherapy group for mothers was organized in an outpatient program for adolescents with eating disorders at a public institution, as one of the psychotherapeutic approaches in the multidisciplinary treatment of adolescent patients. Evidence suggests that this approach can be relevant and effective in the treatment of eating disorders.

Intervenções psicoterapêuticas que promovam a diferenciação, a separação, a individuação e a autonomia na relação mãe-filha são preconizadas e enfatizadas no tratamento dos transtornos alimentares. Com esse objetivo foi instituído o Grupo Psicoterapêutico de Mães no programa de transtornos alimentares de uma instituição pública , como uma das abordagens psicoterapêuticas no tratamento multidisciplinar dos pacientes adolescentes e que vem se mostrando uma intervenção pertinente e eficiente no tratamento desses transtornos.

Les interventions psychothérapeutiques qui favorisent la différenciation, la séparation, l'individuation et l'autonomie dans la relation mère-fille sont recommandées et mises en relief dans le traitement des troubles de l'alimentation. C'est avec ce but que le Groupe Psychothérapeutique de Mères a été inclus dans le programme des troubles de l'alimentation d'une institution publique comme une des approches psychothérapeutiques d'un traitement pluridisciplinaire de patients adolescents. Les résultats suggèrent qu'il s'agit d'une intervention pertinente et efficace pour le traitement des troubles alimentaires.

Las intervenciones psicoterapéuticas que promueven la diferenciación, la separación, la individuación y la autonomía en la relación madre-hija, son recomendadas y enfatizadas en el tratamiento de los trastornos alimentarios. Con este objetivo el Grupo Psicoterapéutico de Madres, se ha establecido en el programa de trastornos alimentarios de adolescentes de una institución pública, como uno de los enfoques psicoterapéuticos en el tratamiento multidisciplinario de los pacientes adolescentes. Las evidencias sugieren que es una intervención relevante y eficaz para ser utilizada en el tratamiento de trastornos de la alimentación.

In der Behandlung von Essstörungen werden psychotherapeutische Interventionen, die die Absonderung, Trennung, Individualisierung und Autonomie in der Mutter-Tochter Beziehung fördern, empfohlen und hervorgehoben. Die Grupo Psicoterapêutico de Mães (Psychotherapeutische Gruppe von Mütter) wurde mit diesem Ziel im Programm für Essstörungen einer öffentlichen Einrichtung gebildet. Sie stellt eine der psychotherapeutischen Ansätze in der multidisziplinären Behandlung von Teenager-Patienten dar und erweist sich als eine angemessene und erfolgreiche Intervention in der Behandlung dieser Störungen.

The Relationship Among Mother-Daughter Relationship, Husband-Wife Relationship and Prenatal Attachment according to Pregnant Women's Internal Working Model / 여성건강간호학회지

PURPOSE: The purpose of this study was to identify the relationship among mother-daughter relationship, husband-wife relationship, and prenatal attachment according to pregnant women's internal working model. METHOD: A convenience sample of 68 pregnant women was recruited from two OBGYN hospitals in M city. Data collection was conducted through the use of an Adult Attachment Interview and questionnaires. This study used a descriptive correlational design and the period of investigation was from July 3-20, 2002. 41 of the 68 women were in a secure pregnant women's internal working model and 27 of the 68 in insecure ones. The data were analyzed by Chi-square test, t-test, and Pearson Correlation Coefficient. RESULT: The results of this study were as follows: Mean score of the prenatal attachment of the secure pregnant women and mean score of the mother-daughter relationship of the secure pregnant women was significantly higher than that of insecure ones. 3) Prenatal attachment was negatively and significantly related to mother-daughter attachment and husband-wife attachment in the secure pregnant women's internal working model. However it was not significantly relationship in insecure pregnant women's internal working model. CONCLUSION: It is found in this study that there is an intergenerational attachment relationship during pregnancy. Further findings support the development of creative strategies to enhance positive attachment relationships for pregnant women. It is recommended to develop nursing education of attachment for the insecure pregnant women's internal working model.