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暴饮暴食症门诊患者童年期的心理、身体及性虐待:发生率及其与性别、肥胖和饮食相关精神病理学的关联

Childhood psychological, physical, and sexual maltreatment in outpatients with binge eating disorder: frequency and associations with gender, obesity, and eating-related psychopathology.

作者信息

Grilo C M, Masheb R M

机构信息

Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520, USA.

出版信息

Obes Res. 2001 May;9(5):320-5. doi: 10.1038/oby.2001.40.

Abstract

OBJECTIVE

To examine rates of reported childhood maltreatment in binge eating disorder (BED), and to explore associations with obesity, gender, eating disorder features, and associated functioning.

RESEARCH METHODS AND PROCEDURES

Subjects were 145 consecutive outpatients with BED as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition. Subjects were interviewed and they completed questionnaires to assess eating disorder features and functioning. The Childhood Trauma Questionnaire was given to assess childhood maltreatment in five domains (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect).

RESULTS

A total of 83% of BED patients reported some form of childhood maltreatment. A total of 59% of BED patients reported emotional abuse, 36% reported physical abuse, 30% reported sexual abuse, 69% reported emotional neglect, and 49% reported physical neglect. There were no differences in the distribution of any form of childhood maltreatment by gender or by obesity status. The different forms of maltreatment were not associated with variability in current body mass index, binge eating, or in the attitudinal features of eating disorders. Only one of the five forms of maltreatment (physical neglect) was associated with dietary restraint in women. Emotional abuse was significantly associated with greater body dissatisfaction, higher depression, and lower self-esteem in men and women and sexual abuse was associated with greater body dissatisfaction in men. The different forms of maltreatment were unrelated to the age at onset of overweight, dieting, or binge eating.

DISCUSSION

BED outpatients reported a wide range of childhood experiences of maltreatment that do not differ by gender or obesity status. Different forms of maltreatment were not associated with the onset of overweight, dieting, or binge eating, or with variability in current body mass index or eating disorder features (except for one association between physical neglect and dietary restraint). Reports of emotional abuse were associated with greater body dissatisfaction and depression and lower self-esteem in men and women and sexual abuse with greater body dissatisfaction in men.

摘要

目的

研究暴食症(BED)患者中报告的童年期受虐率,并探讨其与肥胖、性别、饮食失调特征及相关功能的关联。

研究方法与步骤

研究对象为145名连续就诊的符合《精神疾病诊断与统计手册》第4版中暴食症定义的门诊患者。对研究对象进行访谈,并让他们完成问卷以评估饮食失调特征及功能。使用儿童创伤问卷评估五个领域(情感虐待、身体虐待、性虐待、情感忽视和身体忽视)的童年期受虐情况。

结果

共有83%的暴食症患者报告曾遭受某种形式的童年期虐待。其中,59%的患者报告曾遭受情感虐待,36%报告身体虐待,30%报告性虐待,69%报告情感忽视,49%报告身体忽视。在任何形式的童年期虐待分布上,性别或肥胖状况均无差异。不同形式的虐待与当前体重指数、暴饮暴食或饮食失调的态度特征的变异性无关。五种虐待形式中只有一种(身体忽视)与女性的饮食限制有关。情感虐待与男性和女性更高的身体不满、更严重的抑郁和更低的自尊显著相关,性虐待与男性更高的身体不满相关。不同形式的虐待与超重、节食或暴饮暴食的发病年龄无关。

讨论

暴食症门诊患者报告了广泛的童年期受虐经历,这些经历在性别或肥胖状况上并无差异。不同形式的虐待与超重、节食或暴饮暴食的发病无关,也与当前体重指数或饮食失调特征的变异性无关(身体忽视与饮食限制之间的一种关联除外)。情感虐待的报告与男性和女性更高的身体不满、抑郁和更低的自尊相关,性虐待与男性更高的身体不满相关。

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