Kong Seongsook, Bernstein Kunsook
School of Nursing, College of Medicine, Soonchunhyang University, 36-1 Sangyong-dong, Chonan 330-090, South Korea.
J Clin Nurs. 2009 Jul;18(13):1897-907. doi: 10.1111/j.1365-2702.2008.02740.x.
The aims of this study were to determine whether specific forms of childhood trauma predict eating psychopathologies and to investigate the mediating effects of the psychological symptoms of depression and obsessive-compulsion between childhood trauma and eating psychopathologies in patients with eating disorders.
The highest probability of poor treatment outcomes in patients with eating disorders has been observed in those who experienced childhood trauma. Therefore, researchers are now examining whether childhood trauma should be considered a risk factor for eating psychopathology, but childhood traumatic experiences as predictors of eating psychopathology and their mediating variables has not been investigated sufficiently with this clinical population.
Survey.
The subjects were 73 Korean patients with eating disorders. The Childhood Trauma Questionnaire, Eating Disorder Inventory-2, Beck Depression Inventory and Maudsley Obsessional-Compulsive Inventory were used to assess self-reported childhood trauma in five domains (emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect), eating psychopathology, depression and obsessive-compulsion. Stepwise multiple regression analyses were used to explore whether these childhood traumatic experiences predict eating psychopathology and mediation analyses were conducted according to Baron and Kenny's guidelines.
Emotional abuse, physical neglect and sexual abuse were found to be significant predictors of eating psychopathology. We also found that depression fully mediated the association between some forms of childhood trauma and eating psychopathology, while obsessive-compulsion did not mediate this association.
Future interventions for patients with eating disorders should focus on assessing the possibility of childhood trauma, especially in those patients with poor treatment outcomes. In addition, whether or not traumatised individuals exhibit depression is a more important predictor of eating psychopathology than the traumatic experience itself.
Early intervention for childhood trauma and depression might contribute to preventing eating disorders in traumatised individuals.
本研究旨在确定特定形式的童年创伤是否能预测饮食心理病理学,并调查抑郁症和强迫症的心理症状在饮食失调患者的童年创伤与饮食心理病理学之间的中介作用。
在经历过童年创伤的饮食失调患者中,观察到治疗效果不佳的可能性最高。因此,研究人员目前正在研究童年创伤是否应被视为饮食心理病理学的一个风险因素,但童年创伤经历作为饮食心理病理学的预测因素及其中介变量,在这一临床人群中尚未得到充分研究。
调查。
研究对象为73名韩国饮食失调患者。使用童年创伤问卷、饮食失调量表-2、贝克抑郁量表和莫兹利强迫症量表来评估自我报告的五个领域的童年创伤(情感虐待、身体虐待、性虐待、情感忽视和身体忽视)、饮食心理病理学、抑郁和强迫症。采用逐步多元回归分析来探讨这些童年创伤经历是否能预测饮食心理病理学,并根据巴伦和肯尼的指导方针进行中介分析。
发现情感虐待、身体忽视和性虐待是饮食心理病理学的重要预测因素。我们还发现,抑郁完全中介了某些形式的童年创伤与饮食心理病理学之间的关联,而强迫症并未中介这种关联。
未来对饮食失调患者的干预应侧重于评估童年创伤的可能性,尤其是在那些治疗效果不佳的患者中。此外,受过创伤的个体是否表现出抑郁,比创伤经历本身更能预测饮食心理病理学。
对童年创伤和抑郁的早期干预可能有助于预防受过创伤个体的饮食失调。