Center for Anxiety and Related Disorders, Department of Psychology, Boston University, 648 Beacon St., Boston, MA 02215, USA.
Psychiatr Serv. 2012 Jan;63(1):73-8. doi: 10.1176/appi.ps.201100050.
The delivery of psychiatric services may be affected by clinicians' negative reactions to treatment-resistant or stigmatized patient groups. Some research has found that clinicians across professional disciplines react negatively to patients with eating disorders, but empirical data related to this topic have not been systematically reviewed. The authors sought to review all published empirical studies of clinician reactions to patients with eating disorders in order to characterize negative reactions to these patients and identify patient or clinical factors associated with negative reactions.
The authors conducted a comprehensive online search for all published studies of clinician reactions in regard to patients with eating disorders. The reference lists of articles found in the literature search were examined to identify additional studies.
Twenty studies, published between 1984 and 2010, were found. Clinician negative reactions in regard to patients with eating disorders typically reflected frustration, hopelessness, lack of competence, and worry. Inexperienced clinicians appeared to hold more negative attitudes toward patients with eating disorders than toward other patient groups, but experienced psychotherapists did not experience strong negative reactions to patients with eating disorders. Medical practitioners consistently reported strong feelings of lack of competence in treating eating disorders. Negative reactions to patients with eating disorders were associated with patients' lack of improvement and personality pathology and with clinicians' stigmatizing beliefs, inexperience, and gender.
Research about the impact of negative clinician attitudes toward patients with eating disorders on psychiatric service delivery, including multivariate analyses using larger samples, comparison groups, validated instruments, and experimental methods, is much needed.
精神科服务的提供可能会受到临床医生对治疗抵抗或受污名化患者群体的负面反应的影响。一些研究发现，跨专业学科的临床医生对饮食障碍患者会产生负面反应，但与该主题相关的经验数据尚未得到系统审查。作者试图对所有关于临床医生对饮食障碍患者反应的已发表经验研究进行综述，以描述对这些患者的负面反应，并确定与负面反应相关的患者或临床因素。
作者对关于饮食障碍患者的临床医生反应的所有已发表研究进行了全面的在线搜索。对文献检索中发现的文章的参考文献列表进行了检查，以确定其他研究。
共发现 20 项研究，发表于 1984 年至 2010 年之间。饮食障碍患者的临床医生负面反应通常反映出沮丧、绝望、缺乏能力和担忧。经验不足的临床医生似乎对饮食障碍患者持有比其他患者群体更负面的态度，但经验丰富的心理治疗师对饮食障碍患者没有强烈的负面反应。医疗从业者在治疗饮食障碍方面始终报告强烈缺乏能力的感觉。对饮食障碍患者的负面反应与患者缺乏改善和人格病理以及临床医生的污名化信念、经验不足和性别有关。
非常需要针对饮食障碍患者的临床医生负面态度对精神科服务提供的影响进行研究，包括使用更大样本、对照组、经过验证的工具和实验方法进行多变量分析。
