Breland Jessica Y, Donalson Rosemary, Dinh Julie V, Maguen Shira
a Center for Innovation to Implementation , VA Palo Alto Health Care System , Menlo Park , California , USA.
b Department of Psychiatry and Behavioral Sciences , Stanford University , Stanford , California , USA.
Women Health. 2018 Feb;58(2):160-174. doi: 10.1080/03630242.2017.1282398. Epub 2017 Feb 8.
Quantitative studies have demonstrated a positive association between trauma exposure and disordered eating. However, reasons for this relationship are unclear. We used qualitative methods to understand why some individuals exposed to trauma report disordered eating. We conducted five focus groups and two dyadic interviews between spring 2013 and fall 2014 with women at a Veterans Health Administration medical center (N = 20). Most participants were recruited from outpatient mental health clinics. Participants completed demographic and psychological questionnaires. Using thematic analysis of transcripts, we identified trauma and disordered eating-related themes. Most participants were women of color (55%), and many reported psychological symptoms (65%). The mean age was 48 years (SD = 15). Thematic analysis resulted in three themes. First, trauma can be associated with disordered eating, often in relation to negative affect and maladaptive thoughts. Second, disordered eating can provide short-term, but not long-term, relief from trauma-related negative affect. Third, disordered eating can provide a mechanism to avoid unwanted attention from potential and past perpetrators of trauma. Trauma-related disordered eating, particularly in relation to sexual trauma, may have a distinct profile. Querying patients about causes of disordered eating when women report trauma histories may help clinicians ensure patients receive appropriate treatment.
定量研究表明,创伤暴露与饮食失调之间存在正相关关系。然而,这种关系的原因尚不清楚。我们采用定性方法来了解为什么一些遭受创伤的个体报告有饮食失调问题。在2013年春季至2014年秋季期间,我们在一家退伍军人健康管理局医疗中心对女性进行了五次焦点小组讨论和两次二元访谈(N = 20)。大多数参与者是从门诊心理健康诊所招募的。参与者完成了人口统计学和心理问卷。通过对访谈记录进行主题分析,我们确定了与创伤和饮食失调相关的主题。大多数参与者是有色人种女性(55%),许多人报告有心理症状(65%)。平均年龄为48岁(标准差 = 15)。主题分析得出了三个主题。第一,创伤可能与饮食失调有关,通常与负面影响和适应不良的想法有关。第二,饮食失调可以提供短期但非长期的缓解创伤相关负面影响的作用。第三,饮食失调可以提供一种机制,以避免来自创伤潜在和过去肇事者的不必要关注。与创伤相关的饮食失调,特别是与性创伤相关的饮食失调,可能有独特的特征。当女性报告有创伤史时,询问患者饮食失调的原因可能有助于临床医生确保患者得到适当的治疗。