Abstract Background Family functioning encompasses cultural values and behavioral patterns, with family dysfunction referring to pervasive and maladaptive interactions in the latter dimension. In Chinese culture, filial piety is a core familial value, comprising authoritarian filial piety (AFP), rooted in hierarchy and obedience, and reciprocal filial piety (RFP), based on mutual affection and care. This study examines the relationships between AFP, RFP, family dysfunction, and eating pathology among Chinese adults with anorexia nervosa (AN). Methods We employed a two-part design that included a cross-sectional analysis of 144 female adults with AN in Chinese mainland and, within the same cohort, a longitudinal follow-up of 75 patients to examine how filial piety and family dysfunction predict changes in eating pathology over time. Correlation, hierarchical multiple regression, and generalized least squares were used for data analysis. Results Cross-sectionally, AFP was associated with greater eating pathology (β = 0.161, p < .05). While RFP and family dysfunction were not significantly associated with eating pathology after controlling psychological and biological factors. Longitudinally, AFP did not independently predict symptom progression after controlling for baseline pathology, suggesting that AFP may act not as a primary driver of worsening symptoms. Conclusion AFP represents a stable cultural risk factor for eating pathology in Chinese adults with AN. These findings underscore the importance of integrating cultural values like AFP into therapeutic frameworks and developing culturally adapted interventions for Chinese populations.
Han et al. (Tue,) studied this question.