母亲和家庭因素与儿童进食障碍：风险和保护关系。
Maternal and family factors and child eating pathology: risk and protective relationships.
机构信息
Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, Australia ; School of Psychology, The University of Western Australia, Crawley, WA, Australia.
Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth, WA, Australia.
出版信息
J Eat Disord. 2014 Apr 29;2:11. doi: 10.1186/2050-2974-2-11. eCollection 2014.
BACKGROUND
Previous studies have found associations between maternal and family factors and child eating disorder symptoms. However, it is not clear whether family factors predict eating disorder symptoms specifically, or relate to more general child psychopathology, of which eating disorder symptoms may be one component. This study aimed to identify maternal and family factors that may predict increases or decreases in child eating disorder symptoms over time, accounting for children's body mass index z-scores and levels of general psychological distress.
METHODS
Participants were 221 mother-child dyads from the Childhood Growth and Development Study, a prospective cohort study in Western Australia. Participants were assessed at baseline, 1-year follow-up and 2-year follow-up using interview and self-report measures. Children had a mean age of 10 years at baseline and 46% were male. Linear mixed models and generalised estimating equations were used to identify predictors of children's eating disorder symptoms, with outcome variables including a global index of eating disorder psychopathology, levels of dietary restraint, levels of emotional eating, and the presence of loss of control ('binge') eating.
RESULTS
Children of mothers with a current or past eating disorder reported significantly higher levels of global eating disorder symptoms and emotional eating than other children, and mothers with a current or past eating disorder reported significantly more concern about their children's weight than other mothers. Maternal concern about child weight, rather than maternal eating disorder symptoms, was significant in predicting child eating disorder symptoms over time. Family exposure to stress and low maternal education were additional risk factors for eating disorder symptoms, whilst child-reported family satisfaction was a protective factor.
CONCLUSIONS
After adjusting for relevant confounding variables, maternal concern about child weight, children's level of family satisfaction, family exposure to stress, and maternal education are unique predictors of child eating disorder symptoms.
背景
先前的研究发现，母亲和家庭因素与儿童饮食失调症状之间存在关联。然而，目前尚不清楚家庭因素是否专门预测饮食失调症状，或者是否与更普遍的儿童心理病理学有关，而饮食失调症状可能是其中的一个组成部分。本研究旨在确定可能预测儿童饮食失调症状随时间增加或减少的母亲和家庭因素，同时考虑到儿童的体重指数 z 分数和一般心理困扰水平。
方法
参与者为来自西澳大利亚儿童生长发育研究的 221 对母婴二人组，这是一项前瞻性队列研究。参与者在基线、1 年随访和 2 年随访时使用访谈和自我报告措施进行评估。儿童的平均年龄为基线时 10 岁，其中 46%为男性。线性混合模型和广义估计方程用于确定儿童饮食失调症状的预测因素，包括饮食失调心理病理学的总体指数、饮食抑制水平、情绪性进食水平以及失控性（“暴食”）进食的存在。
结果
患有当前或既往饮食障碍的母亲的孩子报告的整体饮食失调症状和情绪性进食水平明显高于其他孩子，而患有当前或既往饮食障碍的母亲比其他母亲更关注孩子的体重。母亲对孩子体重的关注，而不是母亲的饮食失调症状，是预测儿童饮食失调症状随时间变化的重要因素。家庭面临的压力和母亲教育程度低是饮食失调症状的其他危险因素，而儿童报告的家庭满意度是一个保护因素。
结论
在调整了相关混杂变量后，母亲对孩子体重的关注、孩子对家庭的满意度、家庭面临的压力以及母亲的教育程度是儿童饮食失调症状的独特预测因素。
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