The psychotherapy of 25 normal weight bulimic adolescent and late adolescent women (age 15–32 years, mean = 21 years), was reviewed to evaluate developmental and diagnostic precursors and the outcome of psychoanalytically oriented long-term therapy (mean = 33 sessions). Psychotherapy outcome was scored in these categories: (1) bingeing and purging; (2) food obsession; (3) school/work satisfaction; (4) equilibration with family of origin, and (5) achievement of heterosexual closeness. On factor analysis, all factors loaded highly and a global outcome score was derived which was used as the dependent variable in a step-wise regression analysis with 18 family factors as independent variables. To identify family patterns that predicted degree of improvement, a multiple regression analysis was performed. Results indicated that family variables associated with maternal warmth explained an appreciable proportion of the variance in outcome. Such a finding is consistent with the formulation that patients with benign archaic maternal representations were better able than their counterparts with less benign maternal images to form a positive transference and better working alliance with the (female) therapist.

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© 1986 S. Karger AG, Basel
1986
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