Although bulimics' family functioning usually is reported to be
abnormal, the present study examined whether these abnormalities are
specific to bulimia or whether they may be due to covariation with
another problem associated with abnormal family functioning, childhood
sexual abuse (CSA). Consistent with prior research, the family
environments of bulimic and normal eaters, as well as abused and
nonabused subjects, differed significantly. However, when eating
behavior and abuse status were analyzed concurrently, significant
differences between bulimics and normals failed to emerge. Abnormal
family environment was associated more closely with CSA than with
bulimia. The one abnormality unique to bulimia was the family's
heightened emphasis on achievement. The potential importance of
familial achievement orientation is discussed.