Radix Anne Kathrin, Rinck Mike, Becker Eni Sabine, Legenbauer Tanja
LWL University Hospital Hamm for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany.
Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, Netherlands.
Front Psychol. 2019 Jan 8;9:2661. doi: 10.3389/fpsyg.2018.02661. eCollection 2018.
Body checking (BC) and avoidance (BA) form the behavioral component of body image disturbance. High levels of BC/BA have often been documented to hold a positive and potentially reinforcing relationship with eating pathology. While some researchers hypothesize, that patients engage in BC/BA to prevent or reduce levels of anxiety, little is known about the mediating factors. Considering the great comorbidity between eating disorders (ED) and in particular social anxieties, the present study investigated whether socially relevant types of anxiety mediate the relationship between eating pathology and BC/BA. 83 participants reporting an eating disorder and 323 healthy participants (14-25 years) took part in an online survey. Eating pathology was measured with the Eating Disorder Examination Questionnaire and Body Checking and Avoidance Questionnaire. Trait and social anxiety were assessed by means of the State Trait Anxiety Inventory (STAI-T), the Fear of Negative Evaluation (FNE) and the Social Appearance and Anxiety Scale (SAAS). Separate mediation analyses were carried out with eating pathology as independent variable, BC/BA as dependent variable and STAI, FNE, and SAAS as mediating variables. Anxieties correlated highly positive with eating pathology in both groups. SAAS mediated the relationship between ED pathology and BC/BA in participants with ED and mediated the relationship between ED pathology and BA in healthy participants. FNE mediated the relationship between eating pathology and BA for participants with eating pathology. SAAS mediated the relationship between eating pathology and BC/BA. Being afraid of bodily evaluations may represent a particular relevant fear that triggers safety behaviors.
身体检查（BC）和回避（BA）构成了身体意象障碍的行为成分。高水平的BC/BA常常被证明与饮食病理学存在积极且可能具有强化作用的关系。虽然一些研究人员推测，患者进行BC/BA是为了预防或减轻焦虑水平，但对于其中的中介因素却知之甚少。考虑到饮食失调（ED）尤其是社交焦虑之间的高度共病性，本研究调查了与社交相关的焦虑类型是否介导了饮食病理学与BC/BA之间的关系。83名报告患有饮食失调的参与者和323名健康参与者（14至25岁）参与了一项在线调查。饮食病理学通过饮食失调检查问卷以及身体检查和回避问卷进行测量。特质焦虑和社交焦虑通过状态特质焦虑量表（STAI-T）、消极评价恐惧（FNE）以及社交外表与焦虑量表（SAAS）进行评估。以饮食病理学为自变量、BC/BA为因变量以及STAI、FNE和SAAS为中介变量进行了单独的中介分析。在两组中，焦虑与饮食病理学均呈高度正相关。SAAS在患有饮食失调的参与者中介导了ED病理学与BC/BA之间的关系，在健康参与者中介导了ED病理学与BA之间的关系。FNE在患有饮食病理学的参与者中介导了饮食病理学与BA之间的关系。SAAS介导了饮食病理学与BC/BA之间的关系。害怕身体评估可能代表一种特别相关的恐惧，它会引发安全行为。
