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[述情障碍与快感缺乏之间的关系:一项针对饮食失调患者和对照受试者的研究]

[Relations between alexithymia and anhedonia: a study in eating disordered and control subjects].

作者信息

Deborde A S, Berthoz S, Godart N, Perdereau F, Corcos M, Jeammet P

机构信息

Service de Psychiatrie, Institut Mutualiste Montsouris, 75014 Paris.

出版信息

Encephale. 2006 Jan-Feb;32(1 Pt 1):83-91. doi: 10.1016/s0013-7006(06)76140-1.

Abstract

INTRODUCTION

Alexithymia and anhedonia both refer to a deficit in emotion regulation. Although these 2 concepts have been conceptualized to be closely linked, very few studies aimed at examining carefully their interrelations.

OBJECTIVES

Therefore, the purpose of the present study was to investigate the relationships between scores on alexithymia and anhedonia self-reports, and to assess whether the results were influenced by the presence of an emotional disorder.

LITERATURE FINDINGS

The 20-item Toronto Alexithymia Scale is the self-report most frequently used to assess alexithymia. Nevertheless, the results of recent studies comparing the psychometric properties of the TAS-20 and another alexithymia self-report - the Bermond-Vorst Alexithymia Questionnaire (BVAQ) - have recommended the BVAQ over the TAS-20.

DESIGN

Thus, both questionnaires were included in the present study. In addition, since depression and anxiety may influence the correlations between alexithymia and anhedonia scores, we also measured depression and anxiety and these scores were used to control for their potential confounding effect in the analyses. Two groups of participants were included in this study: 46 eating disordered female patients (ED) and 198 female control subjects. All the participants filled up the Bermond-Vorst Alexithymia Questionnaire-form B (BVAQ-B), the 20-item Toronto Alexithymia Scale (TAS-20), the Chapman and Chapman Social Anhedonia Scale (SAS) and Physical Anhedonia Scale (PAS), the 13-item Beck Depression Inventory (BDI) and the Spielberger State and Trait Anxiety Inventory (STAI-Y). The analyses consisted, first, in establishing the matrix of correlations between these self-reports total scores, using Pearson's coefficients of correlation. Then, TAS-20, BVAQ-B, SAS and PAS scores were correlated, adjusting for BDI and STAI scores, using partial correlation analyses. Mean scores comparisons according to the group of participants, and to the presence/absence of alexithymia, as well as to the presence/absence of anhedonia were performed using ANCOVAs or Mann-Whitney tests.

RESULTS

As predicted, BDI and STAI scores were found significantly and positively correlated with alexithymia and anhedonia scores in both participant groups. After controlling for depression and anxiety scores, TAS-20 and PAS scores remained significantly correlated, but not TAS-20 and SAS scores. BVAQ-B scores remained significantly correlated with PAS and SAS scores in the control group, but only with the PAS scores in the ED group. ED patients had higher alexithymia and anhedonia scores than the controls. In total, among the alexithymic individuals, 8.9% were social anhedonics, and 31.1% had a physical anhedonia. Conversely, among the participants with a physical anhedonia, two third were alexithymics. The same proportion of participants with a social anhedonia was alexithymic (66.7%).

CONCLUSION

The results of the present study are informed about the relationships between alexithymia and anhedonia. They also stress the need to rely on several alexithymia measurements, and they further demonstrate the necessity to compare the associations between different affect regulation dimensions in normal and psychopathological disorders.

摘要

引言

述情障碍和快感缺乏均指情绪调节方面的缺陷。尽管这两个概念在概念上被认为紧密相关,但很少有研究旨在仔细考察它们之间的相互关系。

目的

因此,本研究的目的是调查述情障碍得分与快感缺乏自我报告之间的关系,并评估结果是否受情绪障碍的影响。

文献发现

20项多伦多述情障碍量表是最常用于评估述情障碍的自我报告。然而,最近比较TAS-20与另一种述情障碍自我报告——伯蒙德-沃斯特述情障碍问卷(BVAQ)——心理测量特性的研究结果推荐使用BVAQ而非TAS-20。

设计

因此,本研究纳入了这两种问卷。此外,由于抑郁和焦虑可能影响述情障碍与快感缺乏得分之间的相关性,我们还测量了抑郁和焦虑,这些得分用于在分析中控制其潜在的混杂效应。本研究纳入了两组参与者:46名患有饮食失调的女性患者(ED)和198名女性对照者。所有参与者均填写了伯蒙德-沃斯特述情障碍问卷B表(BVAQ-B)、20项多伦多述情障碍量表(TAS-20)、查普曼和查普曼社交快感缺乏量表(SAS)和身体快感缺乏量表(PAS)、13项贝克抑郁量表(BDI)以及斯皮尔伯格状态-特质焦虑量表(STAI-Y)。分析首先使用皮尔逊相关系数建立这些自我报告总分之间的相关矩阵。然后,使用偏相关分析,在调整BDI和STAI得分的情况下,对TAS-20、BVAQ-B、SAS和PAS得分进行相关分析。根据参与者组、述情障碍的有无以及快感缺乏的有无进行平均得分比较,使用协方差分析或曼-惠特尼检验。

结果

如预期的那样,在两个参与者组中均发现BDI和STAI得分与述情障碍和快感缺乏得分显著正相关。在控制抑郁和焦虑得分后,TAS-20与PAS得分仍显著相关,但TAS-20与SAS得分不相关。在对照组中,BVAQ-B得分与PAS和SAS得分仍显著相关,但在ED组中仅与PAS得分相关。ED患者的述情障碍和快感缺乏得分高于对照组。总体而言,在有述情障碍的个体中,8.9%有社交快感缺乏,31.1%有身体快感缺乏。相反,在有身体快感缺乏的参与者中,三分之二有述情障碍。有社交快感缺乏的参与者中述情障碍者的比例相同(66.7%)。

结论

本研究结果说明了述情障碍与快感缺乏之间的关系。它们还强调了依赖多种述情障碍测量方法的必要性,并且进一步证明了比较正常和精神病理障碍中不同情绪调节维度之间关联的必要性。

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