Fitzsimmons-Craft Ellen E, Eichen Dawn M, Kass Andrea E, Trockel Mickey, Crosby Ross D, Taylor C Barr, Wilfley Denise E
Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 S. Euclid Ave., St. Louis, MO, 63110, USA.
Department of Pediatrics, University of California, 8950 Villa La Jolla Dr., Suite C-203, San Diego, CA, 92037, USA.
Eat Weight Disord. 2019 Dec;24(6):1189-1198. doi: 10.1007/s40519-017-0469-7. Epub 2017 Dec 28.
Understanding how known eating disorder (ED) risk factors change in relating to one another over time may inform efficient intervention targets. We examined short-term (i.e., 1 month) reciprocal longitudinal relations between weight/shape concern and comorbid symptoms (i.e., depressed mood, anxiety) and behaviors (i.e., binge drinking) over the course of 24 months using cross-lagged panel models.
Participants were 185 women aged 18-25 years at very high risk for ED onset, randomized to an online ED preventive intervention or waitlist control. We also tested whether relations differed based on intervention receipt.
Weight/shape concern in 1 month significantly predicted depressed mood the following month; depressed mood in 1 month also predicted weight/shape concern the following month, but the effect size was smaller. Likewise, weight/shape concern in 1 month significantly predicted anxiety the following month, but the reverse was not true. Results showed no temporal relations between weight/shape concern and binge drinking in either direction. Relations between weight/shape concern, and comorbid symptoms and behaviors did not differ based on intervention receipt.
Results support focusing intervention on reducing weight/shape concern over reducing comorbid constructs for efficient short-term change.
Level I, evidence obtained from a properly designed randomized controlled trial.
了解已知的饮食失调（ED）风险因素如何随时间相互关联变化，可能为有效的干预目标提供信息。我们使用交叉滞后面板模型，在24个月的过程中研究了体重/体型关注与共病症状（即情绪低落、焦虑）和行为（即暴饮）之间的短期（即1个月）相互纵向关系。
参与者为185名18 - 25岁处于ED发病极高风险的女性，她们被随机分配到在线ED预防干预组或等待名单对照组。我们还测试了这些关系是否因接受干预而有所不同。
1个月时的体重/体型关注显著预测了下一个月的情绪低落；1个月时的情绪低落也预测了下一个月的体重/体型关注，但效应量较小。同样，1个月时的体重/体型关注显著预测了下一个月的焦虑，但反之则不然。结果表明，体重/体型关注与暴饮在两个方向上均无时间关系。体重/体型关注与共病症状及行为之间的关系不因接受干预而有所不同。
结果支持将干预重点放在减轻体重/体型关注上，而非减轻共病症状，以实现有效的短期改变。
I级，从适当设计的随机对照试验中获得的证据。
