青少年神经性厌食症患者的改变动机、应对方式和自尊：神经性厌食症改变阶段问卷（ANSOCQ）的效度研究
Motivation to change, coping, and self-esteem in adolescent anorexia nervosa: a validation study of the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ).
作者信息
Pauli Dagmar, Aebi Marcel, Winkler Metzke Christa, Steinhausen Hans-Christoph
机构信息
Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, Neumünsterallee 3, 8032 Zurich, Switzerland.
Child and Youth Forensic Psychiatry, Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland.
出版信息
J Eat Disord. 2017 Apr 17;5:11. doi: 10.1186/s40337-016-0125-z. eCollection 2017.
BACKGROUND
Understanding motivation to change is a key issue in both the assessment and the treatment of eating disorders. Therefore, sound instruments assessing this construct are of great help to clinicians. Accordingly, the present study analysed the psychometric properties of the Anorexia Nervosa Stages of Change Questionnaire (ANSOCQ), including its relation to coping style and self-esteem.
METHODS
= 92 adolescents referred to an eating disorders outpatient clinic meeting criteria for anorexia nervosa gave written informed consent to participate in this study and completed the ANSOCQ, the Eating Disorder Inventory, the Eating Attitudes Test, the Body Image Questionnaire, two questionnaires measuring Self-Related Cognitions and the Coping Across Situations Questionnaire. After a treatment period of nine months, clinical anorexia nervosa diagnosis and the body mass index were re-assessed. In addition to exploratory factor analysis, correlational analysis was used to test for the convergent validity of the ANSOCQ and logistic regression analysis was used to test its predictive validity.
RESULTS
The ANSOCQ had good psychometric properties. Factor analysis yielded two meaningful factors labelled as 'weight gain and control' and 'attitudes and feelings'. Internal consistencies of the two factors amounted to Cronbach's alpha = .87 and .76, respectively. Significant correlations with other scales measuring eating disorder psychopathology were indicative of meaningful construct validity. Higher motivation to change was related to higher self-esteem and a more active coping style. Higher (positive) ANSOCQ total scores predicted remission of anorexia nervosa after nine months of treatment. A higher score on 'attitudes and feelings' was a protective factor against drop-out from intervention.
CONCLUSIONS
The ANSOCQ is a clinically useful instrument for measuring motivation to change in adolescents with AN. Two factorial dimensions explain most of the variation. Self-esteem and coping style are relevant additional constructs for the understanding of the motivation to change in anorexia nervosa.
TRIAL REGISTRATION
NCT02828956. Retrospectively registered July 2016.
背景
了解改变动机是饮食失调评估和治疗中的关键问题。因此，能够评估这一概念的可靠工具对临床医生有很大帮助。相应地，本研究分析了神经性厌食症改变阶段问卷（ANSOCQ）的心理测量特性，包括其与应对方式和自尊的关系。
方法
92名符合神经性厌食症标准并被转介到饮食失调门诊的青少年书面知情同意参与本研究，并完成了ANSOCQ、饮食失调量表、饮食态度测试、身体意象问卷、两份测量自我相关认知的问卷以及情境应对问卷。经过九个月的治疗期后，重新评估临床神经性厌食症诊断和体重指数。除探索性因素分析外，还使用相关分析来检验ANSOCQ的收敛效度，并使用逻辑回归分析来检验其预测效度。
结果
ANSOCQ具有良好的心理测量特性。因素分析产生了两个有意义的因素，分别标记为“体重增加与控制”和“态度与情感”。这两个因素的内部一致性分别为克朗巴哈系数α = 0.87和0.76。与其他测量饮食失调心理病理学的量表的显著相关性表明具有有意义的结构效度。更高的改变动机与更高的自尊和更积极的应对方式相关。更高（正向）的ANSOCQ总分预测了九个月治疗后神经性厌食症的缓解。“态度与情感”得分较高是防止退出干预的保护因素。
结论
ANSOCQ是一种临床上有用的工具，用于测量青少年神经性厌食症患者的改变动机。两个因子维度解释了大部分变异。自尊和应对方式是理解神经性厌食症改变动机的相关附加概念。
试验注册
NCT02828956。2016年7月追溯注册。
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