Department of Psychological Medicine, King's College London, Institute of Psychiatry, London, United Kingdom.
Int J Eat Disord. 2013 Dec;46(8):867-74. doi: 10.1002/eat.22172. Epub 2013 Aug 14.
A cognitive interpersonal maintenance model of anorexia nervosa (AN) was first proposed in 2006 and updated in 2013 (Schmidt and Treasure, J Br J Clin Psychol, 45, 343-366, 2006; Treasure and Schmidt, J Eat Disorders, in press.). The aim of this study was to test the interpersonal component of this model in people with AN requiring intensive hospital treatment (inpatient/day patient).
On admission to hospital women with AN or eating disorder not otherwise specified (AN subtype; n = 152; P) and their primary carers (n = 152; C) completed questionnaires on eating symptoms (P), depression and anxiety (P, C), accommodation and enabling (C), and psychological control (C). Structural equation modeling was used to examine relationships among these components.
Carers' expressed emotion and level of psychological control were significantly related to carers' distress, which in turn, was related to patients' distress. This pathway significantly predicted eating symptoms in patients.
The cognitive interpersonal maintenance model of eating disorders (EDs) was confirmed in part and suggests that interventions targeting interpersonal maintaining factors such as carer distress might impact on patient outcomes.
厌食症（AN）的认知人际维持模型于 2006 年首次提出，并于 2013 年进行了更新（Schmidt 和 Treasure，J Br J Clin Psychol，45，343-366，2006；Treasure 和 Schmidt，J Eat Disorders，in press.）。本研究旨在检验该模型的人际成分在需要强化医院治疗的 AN 患者（住院/日间患者）中。
在入院时，患有 AN 或未特指的饮食障碍（AN 亚型；n = 152；P）及其主要照顾者（n = 152；C）完成了关于饮食症状（P）、抑郁和焦虑（P、C）、住宿和支持（C）以及心理控制（C）的问卷。结构方程模型用于检验这些成分之间的关系。
照顾者的表达情绪和心理控制水平与照顾者的困扰显著相关，而照顾者的困扰又与患者的困扰相关。这条途径显著预测了患者的饮食症状。
部分验证了进食障碍（EDs）的认知人际维持模型，表明针对照顾者困扰等人际维持因素的干预可能会影响患者的结局。
