Il quadro clinico dell’anoressia infantile in una prospettiva transculturale: un confronto tra un campione di madri e di bambini italiani e del Bangladesh.

ABSTRACT: Background: Zero-to-Three Classification enlightens that children with infantile anorexia show a persistent food refusal, do not express clear signals of hunger/satiety, while they are intensely involved in the interaction with the caregiver (Zero-to-Three, 2005). Objective: Given the paucity of empirical researches on feeding difficulties among immigrant children in the Italian context, our work aims to offer some information about children from Bangladesh who received a diagnosis of infantile anorexia, with the aim to explore cultural differences approach towards the dyadic relationship in the context of feeding. Method: The sample consists of N=81 pairs of mothers and children, of which N=27 from Bangladesh with a diagnosis of infantile anorexia, N=27 Italian couples with a diagnosis of infantile anorexia and N=27 pairs of Italian control in which the child has an age-appropriate mental and physical development. Relational patterns between mother and child during feeding were videotaped and codified through the observational procedure of the Italian version of Feeding Scale (Chatoor, Getson, Menvielle, Bresseaux, O’Donnel, Rivera, Mrazek, 1997). Moreover, a report-form questionnaire was administered (CBCL/1 ½ -5, Achenbach e Rescorla, 2000) to evaluate the emotional and adaptive profile of the child, using two self-report questionnaires to examine the psychological functioning of the mothers (SCL-90-R, Derogatis, 1994; EAT-40, Garner e Garfinkel, 1979). Results: Regarding the characteristics of mother-child interactions during the meal emerges that both clinical samples differ from the control group and present scores exceeding the cut-off in all four dimensions observational evaluated. Furthermore, our study found that children of both clinical samples have features in their dysfunctional emotional-adaptive functioning. In particular, the Italian children show a more maladaptive psychological state which is evident in the presence of specific difficulties in internalizing and dimension anxiety / depression, while children from Bangladesh have an emotional and adaptive functioning characterized by externalizing behaviors, specifically related a difficult management of aggression. Finally, it seems important to focus on one last issue: the absence of difficulties in the diet of mothers in Bangladesh with children with infantile anorexia, despite marked anxiety traits. Conclusion: We believe that the originality of this work, albeit partial and incomplete, may lie in having tried to emphasize the importance of transcultural on clinical studies on early childhood to be fulfilled, in order to plan appropriate and differentiated interventions according to the specific characteristics in children’s symptomatology and in the context of its significant relationships.