Bell Kathryn, Rieger Elizabeth, Hirsch Jameson K
Research School of Psychology, Australian National University, Canberra, ACT, Australia.
Department of Psychology, East Tennessee State University, Johnson City, TN, United States.
Front Psychol. 2019 Jan 8;9:2692. doi: 10.3389/fpsyg.2018.02692. eCollection 2018.
In this study we sought to compare eating disorder attitudes and behaviors, and proneness to an eating disorder ("ED proneness"), between gay men, lesbian women, and transgender and non-conforming (TGNC) adults. A further aim was to identify and compare risk and protective factors, and examine a mediational model based on the interpersonal theory of eating disorders (IPT-ED), whereby the association between interpersonal factors and ED proneness would be mediated by psychological constructs pertaining to the self and negative affect. Data was obtained from a larger national study of health risk and protective factors among sexual minority and gender diverse populations. The sample included 97 gay men, 82 lesbian women, and 138 TGNC adults. Participants completed the National College Health Assessment, Eating Disorders Screen for Primary Care, Patient Health Questionnaire Depression scale, Generalized Anxiety Disorder 7 scale, Self-Compassion Scale-Short Form, Negative Social Exchange subscale of the Multidimensional Health Profile, Interpersonal Needs Questionnaire, and Perceived Stigma Scale. There was a significant difference between groups in ED proneness, with lesbian women (66.7%) having a significantly higher percentage than gay men (47.6%). There was also a significant difference between groups in weight-based self-worth, with the lowest percentage in gay men (63%) and the highest percentage in lesbian women (82%), as well as dissatisfaction with eating patterns, with the highest percentage in TGNC adults (69.8%) and the lowest percentage in gay men (47.7%). There was a low percentage of inappropriate compensatory behaviors, with no significant difference between groups. Logistic regression analyses showed that the predictor variables of ED proneness were depression, perceived stigma, and self-compassion in gay men; depression in lesbian women; and self-compassion in the TGNC adults. Mediation analyses showed that thwarted belongingness (i.e., an unmet to belong) and perceived stigma had an indirect association with ED proneness that was mediated by self-compassion and depression (for perceived stigma alone) in gay men, depression in lesbian women, and self-compassion in TGNC adults. The interpersonal theory of eating disorders therefore extends to sexual minority and gender diverse populations; however, the results suggest a broadening of theoretical models and intervention programs to include the role of stigma and self-compassion.
在本研究中，我们试图比较男同性恋者、女同性恋者以及跨性别和非顺性别（TGNC）成年人之间的饮食失调态度与行为，以及饮食失调倾向（“ED倾向”）。另一个目标是识别并比较风险因素和保护因素，并基于饮食失调人际理论（IPT-ED）检验一个中介模型，即人际因素与ED倾向之间的关联将由与自我和消极情绪相关的心理结构来介导。数据来自一项关于性少数群体和性别多样化人群健康风险与保护因素的更大规模的全国性研究。样本包括97名男同性恋者、82名女同性恋者和138名TGNC成年人。参与者完成了《全国大学生健康评估》《初级保健饮食失调筛查》《患者健康问卷抑郁量表》《广泛性焦虑障碍7项量表》《自我同情量表简版》《多维健康状况量表的负面社会交换子量表》《人际需求问卷》和《感知污名量表》。在ED倾向方面，各群体之间存在显著差异，女同性恋者（66.7%）的比例显著高于男同性恋者（47.6%）。在基于体重的自我价值方面，各群体之间也存在显著差异，男同性恋者的比例最低（63%），女同性恋者的比例最高（82%）；在对饮食模式的不满方面，TGNC成年人的比例最高（69.8%），男同性恋者的比例最低（47.7%）。不适当的代偿行为比例较低，各群体之间无显著差异。逻辑回归分析表明，男同性恋者中ED倾向的预测变量是抑郁、感知污名和自我同情；女同性恋者中是抑郁；TGNC成年人中是自我同情。中介分析表明，受阻归属感（即归属需求未得到满足）和感知污名与ED倾向存在间接关联，在男同性恋者中，这种关联由自我同情和抑郁（仅针对感知污名）介导，在女同性恋者中由抑郁介导，在TGNC成年人中由自我同情介导。因此，饮食失调人际理论适用于性少数群体和性别多样化人群；然而，结果表明理论模型和干预项目需要扩展，以纳入污名和自我同情的作用。
