Case of Sisters with Anorexia Nervosa which was Improved Significantly by Hospital Behavior Therapy at an Early Clinical Stage : Case Report of Anorexia Nervosa which Occurred in the context of a Broken Family

Abstract

We present a case of three sisters from a broken family, two of whom have anorexia nervosa (AN). These cases were expected to be difficult to treat and to have a poor prognosis, because the sisters' maladjusted behavior could easily be reinforced by their family situation. It was suggested that the middle sister suffered from AN because she modeled the eating behavior of the oldest sister and that the youngest sister might soon model the behavior of the two elder sisters. Therefore we decided to hospitalize the patients early in order to prevent progression of the disease in the second sister and onset of the disease in the third sister. The early hospital treatment (behavior therapy) removed the reinforcer of the maladjusted behavior from the sibling and the patients' conditions improved. In this report, we discuss the practical treatment of the two sisters with AN, factors of sibling onset with AN, and the relation between sibling onset and broken families.