Paterson Gillian, Power Kevin, Collin Paula, Greirson David, Yellowlees Alex, Park Katy
NHS Tayside Eating Disorders Service, Tayside, Scotland, UK.
Eur Eat Disord Rev. 2011 Mar-Apr;19(2):112-20. doi: 10.1002/erv.1021.
Poor problem-solving and low self-esteem are frequently cited as significant factors in the development and maintenance of anorexia nervosa. The current study examines the multi-dimensional elements of these measures and postulates a model whereby self-esteem mediates the relationship between social problems-solving and anorexic pathology and considers the implications of this pathway.
Fifty-five inpatients with a diagnosis of anorexia nervosa and 50 non-clinical controls completed three standardised multi-dimensional questionnaires pertaining to social problem-solving, self-esteem and eating pathology.
Significant differences were yielded between clinical and non-clinical samples on all measures. Within the clinical group, elements of social problem-solving most significant to anorexic pathology were positive problem orientation, negative problem orientation and avoidance. Components of self-esteem most significant to anorexic pathology were eating, weight and shape concern but not eating restraint. The mediational model was upheld with social problem-solving impacting on anorexic pathology through the existence of low self-esteem.
Problem orientation, that is, the cognitive processes of social problem-solving appear to be more significant than problem-solving methods in individuals with anorexia nervosa. Negative perceptions of eating, weight and shape appear to impact on low self-esteem but level of restriction does not. Finally, results indicate that self-esteem is a significant factor in the development and execution of positive or negative social problem-solving in individuals with anorexia nervosa by mediating the relationship between those two variables.
解决问题能力差和自尊心低常被认为是神经性厌食症发生和维持的重要因素。本研究考察了这些指标的多维度因素,并提出了一个模型,即自尊在社交问题解决能力与厌食症病理之间起中介作用,并探讨了这一路径的意义。
55名诊断为神经性厌食症的住院患者和50名非临床对照者完成了三份关于社交问题解决能力、自尊和饮食病理的标准化多维度问卷。
临床样本和非临床样本在所有指标上均存在显著差异。在临床组中,对厌食症病理最具重要性的社交问题解决能力因素为积极问题取向、消极问题取向和回避。对厌食症病理最具重要性的自尊组成部分为对饮食、体重和体型的关注,而非饮食限制。中介模型得到支持,即社交问题解决能力通过低自尊对厌食症病理产生影响。
问题取向,即社交问题解决的认知过程,在神经性厌食症患者中似乎比解决问题的方法更为重要。对饮食、体重和体型的负面认知似乎会影响低自尊,但限制程度则不然。最后,结果表明,自尊通过调节这两个变量之间的关系,在神经性厌食症患者积极或消极社交问题解决的发展和执行中是一个重要因素。