Differing Perceptions of Family Functioning Among Adolescents with Eating Disorders and Their Family Members in a Hungarian Sample

Introduction: Family functioning is closely linked to adolescent anorexia nervosa, yet family members often differ in how they perceive family relationships and processes. Aim: To examine differences in perceived family functioning among adolescents with anorexia nervosa and their family members, and to explore associations with well-being and perceived stress. Methods: The sample included 72 Hungarian families entering family therapy (N = 243), comprising adolescents with anorexia nervosa, mothers, fathers, and siblings. Family functioning was assessed with the McMaster Family Assessment Device (FAD), well-being with the WHO Well-Being Index (WBI-5), and perceived stress with the Perceived Stress Scale (PSS-4). Linear mixed models with random family intercepts were used to account for clustering within families. Results: Significant family-level clustering was found for overall family functioning and all FAD subscales. Patients reported poorer family functioning than mothers, fathers, and siblings, particularly in Communication, Behaviour Control, and General Functioning. Poorer perceived family functioning was associated with lower well-being and higher perceived stress. Family role remained a significant predictor of both outcomes. Conclusions: Family members of adolescents with anorexia nervosa differ systematically in their perceptions of family functioning, with patients reporting the greatest difficulties. These findings support the value of multi-informant assessment and suggest that discrepancies in family perceptions may