Pine Abigail E, Shank Lisa M, Burke Natasha L, Higgins Neyland M K, Schvey Natasha A, Quattlebaum Mary, Leu William, Wilfley Denise E, Stephens Mark, Jorgensen Sarah, Olsen Cara H, Sbrocco Tracy, Yanovski Jack A, Klein David A, Quinlan Jeffrey, Tanofsky-Kraff Marian
Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Pine, Shank, Higgins Neyland, Schvey, Quattlebaum, Leu, Olsen, Sbrocco, Klein, Quinlan, Tanofsky-Kraff); Department of Medicine, Military Outcomes Cardiovascular Research, Uniformed Services University of the Health Sciences, Bethesda (Shank, Higgins Neyland, Tanofsky-Kraff); Department of Psychology, Fordham University, New York (Burke); Section on Growth and Obesity, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, (Schvey, Yanovski); Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, (Wilfley); Department of Family and Community Medicine, Pennsylvania State University, State College (Stephens); Fort Belvoir Community Hospital, Fort Belvoir, Virginia (Jorgensen, Klein).
Am J Psychother. 2020 Jun 1;73(2):43-49. doi: 10.1176/appi.psychotherapy.20190034. Epub 2020 Feb 13.
Adolescent military dependents may be at higher risk for psychosocial stressors and disordered eating compared with civilian youths, but the mechanisms underlying these risks are unclear. Interpersonal theory proposes that difficult relationships lead to negative affect, thereby promoting emotional eating, which has been linked to and predictive of disordered eating. The interpersonal model may have particular relevance for understanding disordered eating among adolescent military dependents, given the unique stressors related to their parents' careers. This study aimed to examine the premise of the interpersonal model (that negative emotions mediate the association between multiple aspects of social functioning and emotional eating) among a cohort of adolescent military dependents.
Military dependents (N=136; 56% female, mean±SD age=14±2 years, body mass index adjusted for age and sex [BMI]=2.0±0.4) at risk for adult obesity and binge eating disorder, as indicated by reported loss-of-control eating and/or anxiety symptoms, were assessed prior to participation in a study of excess weight-gain prevention. Bootstrapped mediation analyses were conducted to examine depressive symptoms as a potential mediator of the relationship between social functioning and emotional eating. Analyses were adjusted for age, sex, race-ethnicity, BMI and presence of reported loss-of-control eating and anxiety.
Depressive symptoms were a significant mediator of the relationship between multiple domains of social functioning, including loneliness, social adjustment related to family and friends, attachment to father and peers, and emotional eating (p<0.05).
The interpersonal model may contribute to our understanding of excess weight gain and binge eating disorder among adolescent military dependents. Prospective data are needed to determine the utility of interpersonal theory in predicting treatment response and outcomes among this population.
与普通青少年相比，青少年军属可能面临更高的心理社会压力源和饮食失调风险，但这些风险背后的机制尚不清楚。人际理论认为，困难的人际关系会导致负面影响，从而促进情绪化进食，而情绪化进食与饮食失调有关且可预测饮食失调。鉴于与父母职业相关的独特压力源，人际模型可能对于理解青少年军属的饮食失调特别相关。本研究旨在检验人际模型的前提（即负面情绪介导社会功能多个方面与情绪化进食之间的关联）在一组青少年军属中的情况。
根据报告的失控进食和/或焦虑症状表明有成人肥胖和暴饮暴食障碍风险的军属（N = 136；56%为女性，平均±标准差年龄 = 14±2岁，根据年龄和性别调整的体重指数[BMI] = 2.0±0.4），在参与一项预防体重过度增加的研究之前进行了评估。进行了自抽样中介分析，以检验抑郁症状作为社会功能与情绪化进食之间关系的潜在中介。分析针对年龄、性别、种族、BMI以及报告的失控进食和焦虑的存在情况进行了调整。
抑郁症状是社会功能多个领域之间关系的重要中介，这些领域包括孤独感、与家人和朋友相关的社会适应、对父亲和同伴的依恋以及情绪化进食（p<0.05）。
人际模型可能有助于我们理解青少年军属的体重过度增加和暴饮暴食障碍。需要前瞻性数据来确定人际理论在预测该人群治疗反应和结果方面的效用。
