Beales D L, Dolton R
University of Birmingham.
Br J Gen Pract. 2000 Jan;50(450):21-6.
Eating disorders are becoming more apparent in primary care. Descriptions of character traits related to people with eating disorders are rarely reported in the primary care literature and there is little awareness of the implications of alexithymia--a concept that defines the inability to identify or express emotion. We hypothesised that many individuals with active eating disorders have alexithymic traits and a tendency to somatize their distress.
To analyse the character traits and degree of alexithymia of a selected group of women with active eating disorders and in recovery, and to recommend responses by members of the primary care team that might meet the needs of such individuals.
Letters were sent to 200 female members of the Eating Disorders Association who had agreed to participate in research. Seventy-nine women volunteered to complete four postal questionnaires. This gave a response rate of 38.5%. Responders were categorised into three groups--anorexic, bulimic, and recovered--using the criteria of the Eating Disorders Inventory (EDI-2). The results of the 16PF5 Personality Inventory (16PF5) and the Toronto Alexithymia Scale (TAS-20) were analysed using one-way analysis of variance (ANOVA) and correlated using Pearson's correlation. A biographical questionnaire was also completed.
In all three subgroups, high scores were achieved on the 16PF5 on 'apprehension and social sensitivity', while there were significant differences in the scores for 'privateness': a scale that measures the ability to talk about feelings and confide in others. On the TAS-20, 65% of the anorexic and 83% of the bulimic group scored in the alexithymic range compared with 33% of the recovered group. There was a significant negative correlation between alexithymia and social skills such as 'social and emotional expressivity' on the 16PF5.
The results of this study emphasise the difference between those with active eating disorders who achieved high scores for privacy, introversion, and alexithymia, and those who have recovered. These character traits give potential helpers an important indication of the areas that can both block and facilitate recovery, and they act as a reminder that the presenting symptoms in eating disorders and other psychosomatic conditions are the outward presentation of internal conflict. It is suggested that effective screening and needs assessment will facilitate a more appropriate and prompt therapeutic response. This may be provided in the primary care setting where appropriate training has occurred.
饮食失调在初级保健中愈发明显。初级保健文献中很少报道与饮食失调患者相关的性格特征描述，而且对于述情障碍（一种定义为无法识别或表达情感的概念）的影响也鲜有关注。我们推测，许多患有活跃性饮食失调的个体具有述情障碍特征，且倾向于将痛苦躯体化。
分析一组患有活跃性饮食失调及处于康复期的女性的性格特征和述情障碍程度，并为初级保健团队成员可能满足此类个体需求的应对措施提供建议。
向饮食失调协会的200名同意参与研究的女性成员发送信件。79名女性自愿完成四份邮寄问卷。回复率为38.5%。根据饮食失调量表（EDI - 2）的标准，将回复者分为三组——厌食症组、贪食症组和康复组。使用单因素方差分析（ANOVA）分析16PF5人格量表（16PF5）和多伦多述情障碍量表（TAS - 20）的结果，并使用皮尔逊相关性进行关联分析。还完成了一份传记式问卷。
在所有三个亚组中，16PF5量表上“担忧和社会敏感性”得分较高，而在“隐私性”得分上存在显著差异，“隐私性”量表用于衡量谈论感受和向他人倾诉的能力。在TAS - 20量表上，65%的厌食症组和83%的贪食症组得分处于述情障碍范围内，而康复组为33%。述情障碍与16PF5量表上的“社交和情感表达能力”等社交技能之间存在显著负相关。
本研究结果强调了患有活跃性饮食失调且在隐私性、内向性和述情障碍方面得分较高的个体与康复个体之间的差异。这些性格特征为潜在的帮助者提供了重要指示，表明哪些方面可能阻碍或促进康复，同时也提醒人们，饮食失调和其他身心疾病的现有症状是内部冲突的外在表现。建议进行有效的筛查和需求评估，以促进更合适、更及时的治疗反应。这可以在经过适当培训的初级保健环境中提供。
