Division of Psychological Medicine and Psychiatry, Section of Eating Disorders, King's College London, Institute of Psychiatry, UK.
Br J Clin Psychol. 2011 Sep;50(3):310-25. doi: 10.1348/014466510X519215. Epub 2011 Mar 8.
OBJECTIVES. Difficulties in processing emotional states are implicated in the aetiology and maintenance of diverse health conditions, including anorexia nervosa (AN) and chronic fatigue syndrome (CFS). This study sought to explore distress tolerance, self-silencing, and beliefs regarding the experience and expression of emotions in individuals diagnosed with AN and CFS. These conditions were chosen for this study because their clinical presentation is characterized by physical symptoms, yet cognitive behavioural models suggest that emotional processing difficulties contribute to the aetiology and maintenance of both. DESIGN. A between-subjects cross-sectional design was employed. METHODS. Forty people with AN, 45 with CFS, and 48 healthy controls (HCs) completed the Distress Tolerance Scale (DTS), Silencing the Self Scale (STSS), Beliefs about Emotions Scale (BES), and measures of clinical symptomatology. RESULTS. Initial group comparisons found that both AN and CFS participants scored higher than HCs on a subscale measuring difficulties in distress tolerance. AN and CFS participants were also more likely to judge themselves by external standards, endorse statements reflecting a tendency to put the needs of others before themselves, and present an outwardly socially compliant image of themselves whilst feeling hostile within. Relative to HCs, AN participants reported more maladaptive beliefs regarding the experience of having negative thoughts and feelings and revealing these emotions to others, with CFS participants showing a non-significant trend in the same direction. After controlling for differences in age, anxiety, and depression the only significant difference to remain was that observed for the STSS care as self-sacrifice subscale. More maladaptive beliefs about the experience and expression of emotions were associated with greater degree of eating disorder symptomatology in the AN group. CONCLUSIONS. Differences in emotional processing are present in AN and CFS compared to HCs, with some disorder-specific variation, and may be associated with greater clinical symptomatology. These findings support current explanatory models of both AN and CFS, and suggest that emotional processing should be addressed in the assessment and treatment of individuals with these illnesses.
情绪处理困难与多种健康状况的病因和维持有关，包括神经性厌食症（AN）和慢性疲劳综合征（CFS）。本研究旨在探讨诊断为 AN 和 CFS 的个体的痛苦耐受力、自我沉默和对情绪体验和表达的信念。选择这些病症进行本研究是因为它们的临床表现以身体症状为特征，但认知行为模型表明，情绪处理困难有助于这两种病症的病因和维持。
采用了受试者间的横断面设计。
40 名 AN 患者、45 名 CFS 患者和 48 名健康对照者（HCs）完成了痛苦耐受力量表（DTS）、自我沉默量表（STSS）、情绪信念量表（BES）以及临床症状测量。
初步的组间比较发现，AN 和 CFS 患者在衡量痛苦耐受力困难的子量表上的得分均高于 HCs。AN 和 CFS 患者也更倾向于以外在标准评判自己，认同将他人的需求置于自己之前的倾向的陈述，并表现出表面上的社交顺从形象，而内心却充满敌意。与 HCs 相比，AN 患者报告了更多关于体验负面想法和感受以及向他人表达这些情绪的适应不良信念，而 CFS 患者则表现出朝着同一方向的非显著趋势。在控制年龄、焦虑和抑郁的差异后，唯一保持显著差异的是 STSS 关心即自我牺牲子量表。对情绪体验和表达的信念越不适应，AN 组的饮食障碍症状程度越大。
与 HCs 相比，AN 和 CFS 患者在情绪处理方面存在差异，且存在一些特定于障碍的变化，这些差异可能与更大的临床症状有关。这些发现支持了 AN 和 CFS 的现有解释模型，并表明在评估和治疗这些疾病的个体时应考虑情绪处理。
