Personal and gender identity development is considered one of the central problems in anorexic syndrome: among psychopathological hypotheses, failing evolution of Body- Self experience and resemblances to false-self organisation were underlined.

A twin's clinical observation allows some considerations on identity development in anorexia. A young girl, age 14, developed severe anorexic symptoms, while her monozygotic twin was healthy.

Her older sister (age 17) did not present eating disorders either: therefore, siblings were all deeply involved in adolescence conflicts and body image concerns.

With regard to the family background the mother's previous infertility is considered from the point of view of difficulties in primary mother-child functions, preceding and increasing anxiety about adolescent growth of her daughters.

The three sisters were studied by clinical interviews and projective methods (Rorschach, drawing tests ), the older sister acting as a control, as to family belonging and education, for twin girls.

All three showed a defensive attitude toward emotional stimuli and incoherent female identity evolution, stereotyped at surface levels and absent at deeper ones. The twin sisters, while differing from one another on many quantitative measures of Rorschach Tests, shared, by qualitative analysis, more fantasy contents and symbolic images with each other than with older sister.

In projective dimension the feeling of anorexic crisis as break in fusion and as downfall of defences in coping with in social world is present in both girls. Yet, stronger narcissistic traits (grandiose self), are evident in the healthy twin. Weight control seems to develop, in the patient, as an obsessional defence against similarity, while profound fusional anxiety arises by this spacing. Psychopathological differences between this pattern and identity problems in adolescence are discussed, as the possible function of twins as " present double " in personality structuring.

S. Daini, C. La Rosa, A.H. Henschel, S. De Risio: "Identity in development in anorexia: a psychopathological study on a twin's case". Paper presented at the First International Congress of Adolescentology, Assisi, Italy, October 22-24, 1993.

Key Words: Anorexia, Twin, Identity

Silvia Daini: psichiatra, ricercatore; Istituto di Psichiatria e Psicologia Università Cattolica Sacro Cuore - Roma.

Carmelo La Rosa: specializzando, psichiatria; Istituto di Psichiatria e Psicologia Università Cattolica Sacro Cuore - Roma.

Anne Heide Henschel: psichiatra; Istituto di Psichiatria e Psicologia Università Cattolica Sacro Cuore - Roma.

Sergio De Risio: psichiatra, psicoanalista, ordinario di clinica psichiatrica; Istituto di Psichiatria e Psicologia Università Cattolica Sacro Cuore - Roma.