Gupta M A, Johnson A M
Department of Psychiatry, University of Western Ontario, London, Ontario, Canada.
Int J Eat Disord. 2000 Apr;27(3):304-9. doi: 10.1002/(sici)1098-108x(200004)27:3<304::aid-eat7>3.0.co;2-i.
Eating disorders(ED) have been classically associated with a concern about body shape and size that manifests mainly as an intense fear of weight gain (DSM-IV criteria). To further examine the nature of the body image disturbance in ED, we surveyed the prevalence of nonweight-related body image concerns among ED patients and nonclinical controls.
We examined 53 women (M +/- SD age: 28.1 +/- 6.8 years) with anorexia nervosa and/or bulimia nervosa (DSM-III-R criteria) and 73 randomly selected nonclinical women (M +/- SD age: 30.2 +/- 6.6 years) from the community. The participants rated (by checking a "Yes" or "No") whether they were satisfied with the appearance of the following body regions: their skin, teeth, jaw, nose, eyes, ears, hair, and height and completed the Drive for Thinness (DT) and Body Dissatisfaction (BD) subscales of the Eating Disorders Inventory (EDI).
The frequencies of dissatisfaction with the appearance of various physical attributes among the ED patients versus the nonclinical controls were as follows: skin: 79.2% vs. 52.1%, p =.002; teeth: 62.3% vs. 39.7%, p =. 012; jaw: 24.5% vs. 9.7%, p =.026; nose: 45.3% vs. 24.7%, p =.015; eyes: 22.6% vs. 12.3%, p =.12; ears: 20.8% vs. 2.7%, p =.001; hair: 52.8% vs. 39.7%, p =.14; and height: 28.3% vs. 13.7%, p =.04. As expected, the M +/- SD DT (EDI): 14.0 +/- 6.1 vs.3.5 +/- 4.6, p <. 0001 and the M +/- SD BD (EDI): 19.7 +/- 5.8 vs. 10.1 +/- 7.3, p <. 0001, were both higher in the ED group. Furthermore, greater dissatisfaction with nonweight-related body image was associated with higher DT and BD scores.
The higher prevalence of dissatisfaction with appearance of most of the nonweight-related physical attributes is probably an indication of the core ego deficits that are often present in ED and an index of the severity of the overall body image disturbance in these patients, and not indicative of another condition (e.g., body dysmorphic disorder) as the current nosology (DSM-IV) suggests.
饮食失调（ED）传统上与对体型和体重的关注有关，主要表现为对体重增加的强烈恐惧（《精神疾病诊断与统计手册》第四版标准）。为了进一步研究饮食失调中身体意象障碍的本质，我们调查了饮食失调患者和非临床对照者中与体重无关的身体意象问题的患病率。
我们检查了53名患有神经性厌食症和/或神经性贪食症（《精神疾病诊断与统计手册》第三版修订版标准）的女性（平均年龄±标准差：28.1±6.8岁），以及从社区中随机选取的73名非临床女性（平均年龄±标准差：30.2±6.6岁）。参与者通过勾选“是”或“否”来评定她们是否对以下身体部位的外观感到满意：皮肤、牙齿、下巴、鼻子、眼睛、耳朵、头发和身高，并完成了饮食失调量表（EDI）中的追求瘦身（DT）和身体不满（BD）分量表。
饮食失调患者与非临床对照者对各种身体特征外观不满意的频率如下：皮肤：79.2%对52.1%，p = 0.002；牙齿：62.3%对39.7%，p = 0.012；下巴：24.5%对9.7%，p = 0.026；鼻子：45.3%对24.7%，p = 0.015；眼睛：22.6%对12.3%，p = 0.12；耳朵：20.8%对2.7%，p = 0.001；头发：52.8%对39.7%，p = 0.14；身高：28.3%对13.7%，p = 0.04。正如预期的那样，饮食失调组的平均±标准差DT（EDI）：14.0±6.1对3.5±4.6，p < 0.0001，平均±标准差BD（EDI）：19.7±5.8对10.1±7.3，p < 0.0001，均更高。此外，对与体重无关的身体意象的更大不满与更高的DT和BD得分相关。
对大多数与体重无关的身体特征外观不满意的较高患病率可能表明饮食失调中常存在的核心自我缺陷，以及这些患者整体身体意象障碍的严重程度指标，而不像当前疾病分类法（《精神疾病诊断与统计手册》第四版）所暗示的那样表明是另一种疾病（如身体变形障碍）。
