Forsén Mantilla Emma, Norring Claes, Birgegård Andreas
Department of Clinical Neuroscience, Karolinska Institute, and Center for Psychiatry Research, Stockholm County Council, Norra Stationsgatan 69, SE-11364 Stockholm, Sweden.
J Eat Disord. 2019 May 3;7:15. doi: 10.1186/s40337-019-0247-1. eCollection 2019.
The interpersonal Structural Analysis of Social Behavior (SASB) model of self-image has repeatedly proven valuable in relation to eating disorder (ED) symptoms and in predicting ED outcome.
We studied the association between initial self-image according to the SASB and 12-month outcome, in five diagnostic groups of female ED patients. Based on previous findings, we expected autonomy related variables (self-control/autonomy) would strongly predict outcome in anorexia nervosa (AN) groups, whereas variables related to affiliation (self-attack/love) would moderately predict outcome in bulimia nervosa (BN).
Participants were adult female patients, of whom 457 had AN restrictive type, 228 AN binge/purge subtype, 861 BN, 505 other specified ED and 170 binge eating disorder. Data came from the Stepwise clinical database in Sweden. Outcomes were presence/absence of ED diagnosis and self-rated ED symptoms, and we controlled for baseline ED pathology, BMI, age and general psychiatric symptoms.
Regression analyses showed that although the pattern differed somewhat between diagnostic groups, high initial self-love and low self-attack/self-blame predicted a more positive 12-month outcome. In some groups (AN/R in particular), these variables remained important even when baseline pathology and age were included in the analyses.
Self-image aspects once again display substantial power in predicting outcome in EDs. In AN/R patients, self-love plays an almost as crucial a role as baseline ED pathology in relation to 12-month outcome.
社会行为人际结构分析（SASB）自我形象模型在饮食失调（ED）症状及预测ED预后方面已多次证明具有重要价值。
我们研究了女性ED患者五个诊断组中，基于SASB的初始自我形象与12个月预后之间的关联。基于先前的研究结果，我们预期自主性相关变量（自我控制/自主性）能强烈预测神经性厌食症（AN）组的预后，而与归属感相关的变量（自我攻击/爱）能中度预测神经性贪食症（BN）组的预后。
参与者为成年女性患者，其中457例为AN限制型，228例为AN暴食/清除亚型，861例为BN，505例为其他特定的ED，170例为暴食障碍。数据来自瑞典的逐步临床数据库。预后指标为是否存在ED诊断及自我报告的ED症状，我们控制了基线ED病理、BMI、年龄和一般精神症状。
回归分析表明，尽管不同诊断组的模式略有差异，但高初始自爱和低自我攻击/自责预示着更积极的12个月预后。在某些组（特别是AN/R组），即使在分析中纳入基线病理和年龄，这些变量仍然很重要。
自我形象方面再次显示出在预测ED预后方面的强大作用。在AN/R患者中，自爱与12个月预后的关系几乎与基线ED病理同样关键。
