Makowski Anna Christin, Mnich Eva E, Angermeyer Matthias C, Löwe Bernd, von dem Knesebeck Olaf
Department of Medical Sociology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany.
Center for Public Mental Health, Untere Zeile 13, 3482 Gösing am Wagram, Austria.
Eat Behav. 2015 Jan;16:78-83. doi: 10.1016/j.eatbeh.2014.10.017. Epub 2014 Nov 4.
This study aims to examine the public's attitudes and predictors of social distance towards women afflicted by eating disorders (anorexia nervosa [AN] and bulimia nervosa [BN]) under specific consideration of the respondents' sex. Eating disorders are still often seen as a women's health issue, and those afflicted remain stigmatized in Western societies. The concept of social distance is a frequently used indicator in awareness campaigns. Sex-specific results could add important information to destigmatization programs.
Data originate from a German telephone survey which was conducted in 2011. Vignettes with signs and symptoms either suggestive of AN or BN were presented to the respondents randomly, who subsequently answered questions regarding beliefs about causes, contact to persons afflicted as well as desire for social distance. Stratified multiple linear regression analyses according to disorder under study were performed to examine associations between different predictors and desire for social distance.
There were significant sex differences in desire for social distance, causal attributions, and emotional reactions towards women with eating disorders. E.g., with respect to AN, women exhibited a significantly greater desire for social distance than men (p<.001), and more frequently believed that AN could be caused by sexual abuse during childhood. Regarding predictors of social distance, there was a significant positive association between age and desire for social distance equally among men and women. However, distinct sex differences came into effect concerning other predictors depending on the eating disorder under study. In BN, attribution of brain disease emerged as significant predictor of social distance among men. This is not true for women, where the attribution of weak will significantly predicted the desire for social distance.
Sex-dependent differences in attitudes and predictors of social distance towards females afflicted should be met with tailored measures in anti-stigma campaigns, addressing women and men on different levels.
本研究旨在考察公众对患有饮食失调症（神经性厌食症[AN]和神经性贪食症[BN]）女性的态度以及社交距离的预测因素，并特别考虑受访者的性别。饮食失调症在西方社会仍常被视为女性健康问题，且患者仍遭受污名化。社交距离的概念是提高公众意识运动中常用的指标。特定性别的结果可为消除污名化项目增添重要信息。
数据来源于2011年德国的一项电话调查。向受访者随机呈现提示AN或BN的症状和体征的 vignettes，随后他们回答有关病因信念、与患者接触情况以及社交距离意愿的问题。根据所研究的疾病进行分层多元线性回归分析，以检验不同预测因素与社交距离意愿之间的关联。
在对患有饮食失调症女性的社交距离意愿、因果归因及情绪反应方面存在显著的性别差异。例如，就AN而言，女性表现出比男性显著更强的社交距离意愿（p<.001），且更常认为AN可能由童年期性虐待导致。关于社交距离的预测因素，年龄与社交距离意愿在男性和女性中均存在显著正相关。然而，根据所研究的饮食失调症不同，在其他预测因素方面出现了明显的性别差异。在BN中，脑部疾病归因成为男性社交距离的显著预测因素。女性情况并非如此，女性中意志薄弱归因显著预测了社交距离意愿。
在反污名化运动中，应针对对患病女性态度及社交距离预测因素的性别差异采取量身定制的措施，在不同层面针对男性和女性开展工作。
