Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada.
Department of Psychology, Michigan State University, East Lansing, Michigan.
Int J Eat Disord. 2020 Mar;53(3):391-403. doi: 10.1002/eat.23204. Epub 2019 Nov 24.
Reports of disordered eating are increasing in mainland China; however, little is known regarding Chinese psychotherapists' conceptualizations of disordered eating symptomatology. This study explores Chinese psychotherapists' conceptualizations of binge eating (BE)/vomiting symptoms and treatment considerations.
In-depth, semi-structured interviews were conducted with mainland Chinese psychotherapists (N = 41) in Mandarin. Participants were given a hypothetical case and provided their conceptualization of the patient's BE/vomiting etiology and treatment recommendations. Etiological conceptualizations were coded using directed content analysis, and treatment recommendations were grouped by intervention strategy.
Participants described psychosocial risk factors for BE/vomiting including intrapersonal characteristics and the childhood family environment, but rarely discussed genetic and neurobiological factors. Few participants reported that they would prioritize the BE/vomiting symptoms in treatment and their specific treatment recommendations varied widely.
Most research on BE/vomiting behaviors in the literature is based on Western samples with little attention to mainland Chinese populations. Participants in this study provided conceptualizations of risk factors and treatment recommendations that could generally find evidence in the existing Western literature, even if some theories are no longer supported by updated Western research and the participants focused primarily on psychosocial risks as opposed to genetic/neurobiological factors. It will be important for future research to ascertain mainland Chinese therapists' understanding of these additional types of risk. These findings also suggest a disconnect between clinical findings on neurobiological risks and Chinese therapists' knowledge and/or perceived clinical utility of these risks. Implications for treatment and research dissemination to diverse global communities are discussed.
中国大陆地区饮食失调的报告正在增加；然而，对于中国心理治疗师对饮食失调症状的概念化，我们知之甚少。本研究探讨了中国心理治疗师对暴食（BE）/呕吐症状的概念化及其治疗考虑因素。
用普通话对中国大陆的心理治疗师（N=41）进行了深入的半结构化访谈。研究人员向参与者提供了一个假设案例，并要求他们对患者的 BE/呕吐病因和治疗建议进行概念化。使用有针对性的内容分析对病因概念化进行编码，并按干预策略对治疗建议进行分组。
参与者描述了 BE/呕吐的心理社会风险因素，包括个体特征和童年家庭环境，但很少讨论遗传和神经生物学因素。很少有参与者表示他们会优先考虑治疗中的 BE/呕吐症状，他们的具体治疗建议差异很大。
文献中关于 BE/呕吐行为的大多数研究都是基于西方样本，很少关注中国大陆人群。本研究的参与者提供了风险因素和治疗建议的概念化，这些概念化在现有的西方文献中通常可以找到证据，即使一些理论不再得到更新的西方研究的支持，并且参与者主要关注心理社会风险，而不是遗传/神经生物学因素。未来的研究确定中国大陆治疗师对这些额外类型的风险的理解将是很重要的。这些发现还表明，临床发现的神经生物学风险与中国治疗师对这些风险的知识和/或感知临床实用性之间存在脱节。讨论了对不同全球社区的治疗和研究传播的影响。
