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基于互联网的饮食失调针对性预防中结果的调节因素和中介因素

Moderators and mediators of outcome in Internet-based indicated prevention for eating disorders.

作者信息

Völker Ulrike, Jacobi Corinna, Trockel Mickey T, Taylor C Barr

机构信息

Technische Universität Dresden, Institut für Klinische Psychologie und Psychotherapie, Chemnitzer Straße 46, 01187 Dresden, Germany.

Technische Universität Dresden, Institut für Klinische Psychologie und Psychotherapie, Chemnitzer Straße 46, 01187 Dresden, Germany.

出版信息

Behav Res Ther. 2014 Dec;63:114-21. doi: 10.1016/j.brat.2014.09.008. Epub 2014 Sep 28.

Abstract

The objective of this study was to investigate moderators and mediators of the effect of an indicated prevention program for eating disorders (ED) on reduction of dysfunctional attitudes and specific ED symptoms. 126 women (M age = 22.3; range 18-33) reporting subthreshold ED symptoms were randomized to the Student Bodies™+ (SB+) intervention or an assessment-only control condition. Assessments took place at pre-intervention, mid-intervention (mediators), post-intervention, and 6-month follow-up. Mixed effects modeling including all available data from all time points were used for the data analysis. Intervention effects on the reduction of binge rate were weaker for participants with higher baseline BMI and for participants with a lower baseline purge rate. Intervention effects on reduction of eating disorder pathology were weaker for participants with higher baseline purge rate and with initial restrictive eating. No moderators of the intervention effect on restrictive eating were identified. An increase in knowledge mediated the beneficial effect of SB+ on binge rate. The results suggest that different moderators should be considered for the reduction of symptoms and change in attitudes of disturbed eating and that SB+ at least partially operates through psychoeducation.

摘要

本研究的目的是调查针对饮食失调(ED)的一种指导性预防项目对减少功能失调态度和特定ED症状的调节因素和中介因素。126名报告有阈下ED症状的女性(年龄中位数 = 22.3岁;范围18 - 33岁)被随机分配到“学生健康”升级版(SB +)干预组或仅进行评估的对照组。在干预前、干预中期(中介因素)、干预后以及6个月随访时进行评估。数据分析采用混合效应模型,纳入所有时间点的所有可用数据。对于基线BMI较高的参与者和基线清除率较低的参与者,干预对降低暴饮暴食率的效果较弱。对于基线清除率较高和最初有节食行为的参与者,干预对减少饮食失调病理症状的效果较弱。未发现干预对节食行为影响的调节因素。知识的增加介导了SB +对暴饮暴食率的有益影响。结果表明,在减少紊乱饮食的症状和态度改变方面应考虑不同的调节因素,且SB +至少部分通过心理教育发挥作用。

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