Section of Eating Disorders, King`s College London, Institute of Psychiatry, Psychological Medicine, 103 Denmark Hill, London SE5 8AF, United Kingdom.
Curr Neuropharmacol. 2018;16(8):1122-1130. doi: 10.2174/1570159X16666180118100028.
Social difficulties in eating disorders can manifest as predisposing traits and premorbid difficulties, and/or as consequences of the illness.
The aim of this paper is to briefly review the evidence of social problems in people with eating disorders and to consider the literature on treatments that target these features.
A narrative review of the literature was conducted.
People with eating disorders often manifest traits, such as shyness, increased tendency to submissiveness and social comparison, and problems with peer relationships before illness onset. Further social difficulties occur as the illness develops, including impaired social cognition and increased threat sensitivity. All relationships with family, peers and therapists are compromised by these effects. Thus, social difficulties are both risk and maintaining factors of eating disorders and are suitable targets for interventions. Several forms of generic treatments (e.g. interpersonal psychotherapy, cognitive analytic therapy, focal psychodynamic therapy) have an interpersonal focus and show some efficacy. Guided self-management based on the cognitive interpersonal model of the illness directed to both individuals and support persons has been found to improve outcomes for all parties. Adjunctive treatments that focus on specific social difficulties, such as cognitive remediation and emotion skills training and cognitive bias modification have been shown to have a promising role.
More work is needed to establish whether these approaches can improve on the rather disappointing outcomes that are attained by currently used treatments for eating disorders.
饮食失调症患者的社交困难可能表现为易患特质和发病前的困难，以及/或疾病的后果。
本文旨在简要回顾饮食失调症患者社交问题的证据，并探讨针对这些特征的治疗方法的文献。
对文献进行了叙述性回顾。
饮食失调症患者在疾病发作前常常表现出一些特质，如害羞、增加的顺从倾向和社会比较，以及同伴关系问题。随着疾病的发展，还会出现更多的社交困难，包括社交认知受损和威胁敏感性增加。所有与家人、同伴和治疗师的关系都受到这些影响的影响。因此，社交困难既是饮食失调症的风险因素，也是维持因素，是干预的合适目标。几种通用治疗方法（如人际心理治疗、认知分析治疗、焦点心理动力学治疗）都具有人际焦点，并显示出一定的疗效。基于对疾病的认知人际模式，针对个体和支持人员的指导性自我管理已被发现可以改善所有各方的结果。针对特定社交困难的附加治疗，如认知矫正、情绪技能训练和认知偏差修正，已显示出有希望的作用。
需要进一步研究这些方法是否可以改善目前用于治疗饮食失调症的方法所取得的相当令人失望的结果。
