Department of Psychiatry and Behavioral Sciences, Duke University Medical Center,NC 27710, USA.
Behav Res Ther. 2013 Jun;51(6):256-65. doi: 10.1016/j.brat.2013.01.010. Epub 2013 Feb 27.
The nature of disturbance in body experience in anorexia nervosa (AN) remains poorly operationalized despite its prognostic significance. We examined the relationship of subjective reports of sensitivity to and behavioral avoidance of sensory experience (e.g., to touch, motion) to body image disturbance and temperament in adult women currently diagnosed with AN (n = 20), women with a prior history of AN who were weight restored (n = 15), and healthy controls with no eating disorder history (n = 24). Levels of sensitivity to sensation and attempts to avoid sensory experience were significantly higher in both clinical groups relative to healthy controls. Sensory sensitivity was associated with body image disturbance (r(56) = .51, p < .0001), indicating that body image disturbance increased with increased global sensitivity to sensation. Sensory sensitivity was also negatively and significantly correlated with lowest BMI (r(2) = -.32, p < .001), but not current BMI (r(2) = .03, p = .18), and to the temperament feature of harm avoidance in both clinical groups. We discuss how intervention strategies that address sensitization and habituation to somatic experience via conditioning exercises may provide a new manner in which to address body image disturbance in AN.
尽管在预后方面具有重要意义,但神经性厌食症(AN)患者躯体体验障碍的性质仍未得到很好的操作化定义。我们研究了目前被诊断为 AN 的成年女性(n=20)、体重恢复的 AN 既往史女性(n=15)和无饮食障碍史的健康对照组(n=24)中,对感觉的主观敏感性报告和对感觉体验的行为回避(例如,触摸、运动)与躯体意象障碍和气质之间的关系。与健康对照组相比,两个临床组的感觉敏感性和回避感觉体验的尝试水平显著更高。感觉敏感性与躯体意象障碍呈正相关(r(56)=.51,p<0.0001),这表明躯体意象障碍随感觉的整体敏感性增加而增加。感觉敏感性与最低 BMI(r(2)=-.32,p<0.001)呈负相关,但与当前 BMI(r(2)=.03,p=0.18)无关,与两个临床组的回避特质呈负相关。我们讨论了如何通过条件反射练习来解决躯体体验的敏感化和习惯化,这可能为解决 AN 中的躯体意象障碍提供一种新的方法。