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Previous issue date: 2012-06-25 === Eating disorders such as anorexia and bulimia nervosa, considered as serious disturbances
in eating habits, are relevant causes of morbidity and mortality in adolescents. Patients with
these disorders have a mortality rate twelve times higher than the normal population in the
same age range. Obesity may be considered one of the world???s most serious public health
problems, because of the complications associated with it and the high rates of morbidity and
mortality. Eating disorders and obesity have been studied in past years, however most
researches focuses on the individual aspects of the patients. It was with the intent to broaden
the comprehension of these diagnosis, also involving the family context of individuals, that
this present study aims at establishing possible links between the answers given by the
adolescents with eating disorders (bulimia nervosa and anorexia nervosa) and obesity, in
regards to the parental figures in the Rorschach method and the characteristics of the family
dynamic, identified by means of systemic techniques. The project is part of a larger project
which aims at building a psychosocial care methodology for children and adolescents with
eating disorders and their families, which is in progress at Universidade Catolica de Brasilia,
under the coordination of this dissertation???s advisor and of which the author is also part of.
The participants were three families which resides in Administrative Regions of the Federal
District: the first has an adolescent with a diagnosis of anorexia nervosa, composed by the
mother, 46 years of age, and a sister who is 17, they live in a rental home and have a monthly
income of $2.700,00; the second has an adolescent with a bulimia nervosa diagnosis,
composed by the mother who is 42 years old, father, 43, and two brothers of 22 and 07, they
live in a home which they own and have a monthly income of two minimum wages; the third
which has a diagnosis of obesity is composed by the mother, 67 years old, two sisters of 26
and 21, and a brother of 23, they live in a home which they own and have an approximate
monthly income of two minimum wages. Qualitative research method was used by means of
case study. A semi-structured family interview ??? Family Life Cycle Interview was conducted,
with the elaboration of a genogram and, afterwards, the adolescents were submitted to the
Rorschach test. The data from the interviews were analysed based on the constructiveinterpretative
method of Gonz??les Rey and the data from the tests were analysed according
to the Rorschach protocols, based on the French School. The data found regarding the
Family Life Cycle and history showed a few characteristics of the family dynamic such as:
difficulties on the maternal side of the families; difficulties in the adolescents??? social
relationships; a disengaged family structure (in the family with anorexia nervosa), family with
diffused external borders (bulimia nervosa) and an enmeshed family structure (family with
obesity); current irregular eating habits (families with anorexia and obesity) and abundance
and variety in the current eating habits (family with bulimia); food as a gathering factor
(families with bulimia and obesity). The data from the Rorschach test showed the presence of
low self-esteem, insecurity, distortions of self-concept and self-image and sexual identification
problems among the adolescents. === Os transtornos alimentares (TA) - anorexia nervosa e bulimia nervosa, considerados
como graves perturba????es no comportamento alimentar, s??o causas importantes de
morbidade e mortalidade em adolescentes. Pacientes com esses transtornos t??m
um ??ndice de mortalidade doze vezes maior que o da popula????o normal da mesma
faixa et??ria. A obesidade pode ser considerada um dos mais graves problemas de
sa??de p??blica, em todo o mundo, devido ??s complica????es a ela associadas e ??s
altas taxas de morbidade e mortalidade. Os TA e a obesidade t??m sido estudados
nos ??ltimos anos, por??m a maioria das pesquisas enfoca os aspectos individuais
dos pacientes. Foi no sentido de ampliar a compreens??o sobre esses diagn??sticos,
envolvendo tamb??m o contexto familiar dos indiv??duos, que o presente estudo teve
como objetivo estabelecer poss??veis rela????es entre as respostas dadas por
adolescentes com TA e obesidade, referentes ??s figuras parentais no m??todo de
Rorschach e as caracter??sticas da din??mica familiar, identificadas por meio de
t??cnicas sist??micas. O projeto faz parte de um projeto maior que tem o objetivo de
construir uma metodologia de atendimento psicossocial a crian??as e adolescentes
com transtornos alimentares e suas fam??lias, em andamento na Universidade
Cat??lica de Bras??lia, sob a coordena????o da orientadora dessa disserta????o e do qual
a autora da mesma faz parte. Os participantes foram tr??s fam??lias residentes em
Regi??es Administrativas do Distrito Federal: uma adolescente com diagn??stico de
anorexia nervosa, formada pela genitora, 46 anos, e uma irm?? de 17, reside em
casa alugada e tem uma renda mensal aproximada de R$2.700,00; a segunda com
uma adolescente com diagn??stico de bulimia nervosa, formada pela genitora, 42
anos, o genitor, 43, e dois irm??os de 22 e 07, reside em casa pr??pria e renda
mensal de dois sal??rios m??nimos; a terceira que possui diagn??stico de obesidade ??
formada pela genitora, 67 anos, duas irm??s de 26 e 21, e um irm??o de 23, reside
em casa pr??pria e renda de dois sal??rios m??nimos. Utilizou-se o m??todo da pesquisa
qualitativa por meio do estudo de caso. Realizou-se entrevista familiar semiestruturada
??? Entrevista do Ciclo de Vida Familiar, com elabora????o do genograma
e, em seguida, os adolescentes foram submetidos ao teste de Rorschach. Os dados
das entrevistas foram analisados com base no m??todo construtivo-interpretativo de
Gonz??les Rey e os dados do teste foram analisados segundo os protocolos de
Rorschach, com base na Escola Francesa. Os dados levantados sobre a hist??ria e
Ciclo de Vida Familiar mostraram algumas caracter??sticas da din??mica familiar
como: dificuldades nas fam??lias de origem materna; dificuldades no relacionamento
social dos adolescentes; estrutura familiar do tipo desligada (na fam??lia com
anorexia nervosa), fam??lia com fronteiras externas difusas (bulimia nervosa) e
fam??lia com estrutura do tipo emaranhada (fam??lia com obesidade); padr??o
alimentar atual irregular (fam??lias com anorexia e obesidade) e fartura e variedade
na alimenta????o atual (fam??lia com bulimia); a comida como fator agregador (fam??lias
com bulimia e obesidade). Os dados do teste de Rorschach apontaram para a
presen??a de baixa autoestima, inseguran??a, distor????es acerca do autoconceito e
autoimagem e problemas de identifica????o sexual nos adolescentes.
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