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成年初期的饮食失调:一项系统性综述

Eating Disorders During Emerging Adulthood: A Systematic Scoping Review.

作者信息

Potterton Rachel, Richards Katie, Allen Karina, Schmidt Ulrike

机构信息

Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

The Eating Disorders Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom.

出版信息

Front Psychol. 2020 Jan 31;10:3062. doi: 10.3389/fpsyg.2019.03062. eCollection 2019.

Abstract

Eating disorders (EDs) during the transition to adulthood can derail social, psychological, and vocational development. Effective treatment is of paramount importance, yet young adults' treatment needs are typically less well met than those of adolescents. In recent years, there has been a considerable shift in how developmental psychologists understand the transition to adulthood, with this life-phase reconceptualized as "emerging adulthood" (EA) (~18-25 years). Engagement with burgeoning developmental research is likely key to providing more effective care for young people experiencing EDs. To review ED research which has utilized the concept of EA, and to assess the usefulness of this concept for ED research and practice. A systematic scoping review was conducted in accordance with the Joanna Briggs Institute guidelines for scoping reviews. Three databases (Psychinfo, PubMed, Embase) were searched for papers which explicitly focused on EDs during EA. No restrictions as to publication type, language, study design, or participants were applied. Included studies were assessed for developmental "informedness," and findings were qualitatively synthesized. Thirty-six studies ( = 25,475) were included in the review. Most studies used quantitative methodologies, were cross-sectional in design and focused on identifying psychological and social factors which contribute to etiology of EDs. Many studies ( = 22) used well-defined samples of emerging adults (EAs); few studies ( = 8) included developmental measures relevant to EAs. Findings indicate that whilst factors implicated in EDs in adolescence and adulthood are relevant to EAs, EA-specific factors (e.g., identity exploration) may also contribute. Conventional ED services and treatments present difficulties for EAs, whilst those adapted to EAs' needs are feasible, acceptable, and more effective than treatment-as-usual. Directions for future research and clinical implications are discussed. Existing research indicates that the EA concept is relevant for understanding EDs during the transition to adulthood, and ED services should implement adaptations which exploit the opportunities and overcome the challenges of this developmental stage. EA is currently an underused concept in ED research, and future engagement with the developmental literature by both researchers and clinicians may be key to understanding and treating EDs during transition to adulthood.

摘要

向成年期过渡过程中的饮食失调(EDs)会扰乱社会、心理和职业发展。有效的治疗至关重要,但与青少年相比,年轻人的治疗需求通常更难以得到满足。近年来,发展心理学家对向成年期过渡的理解发生了相当大的转变,这一生命阶段被重新定义为“新兴成年期”(EA)(约18 - 25岁)。参与新兴的发展研究可能是为患有饮食失调症的年轻人提供更有效护理的关键。 回顾利用新兴成年期概念的饮食失调研究,并评估该概念对饮食失调研究和实践的有用性。 根据乔安娜·布里格斯研究所的范围审查指南进行了系统的范围审查。在三个数据库(Psychinfo、PubMed、Embase)中搜索明确关注新兴成年期饮食失调的论文。对出版类型、语言、研究设计或参与者没有限制。对纳入的研究进行发展“信息性”评估,并对结果进行定性综合。 该综述纳入了36项研究(n = 25475)。大多数研究采用定量方法,设计为横断面研究,重点是确定导致饮食失调病因的心理和社会因素。许多研究(n = 22)使用了定义明确的新兴成年人样本;很少有研究(n = 8)纳入了与新兴成年人相关的发展测量。结果表明,虽然青春期和成年期饮食失调所涉及的因素与新兴成年人相关,但特定于新兴成年期的因素(如身份探索)也可能起作用。传统的饮食失调服务和治疗对新兴成年人来说存在困难,而那些适应新兴成年人需求的服务和治疗是可行的、可接受的,并且比常规治疗更有效。讨论了未来研究的方向和临床意义。 现有研究表明,新兴成年期概念与理解向成年期过渡过程中的饮食失调相关,饮食失调服务应进行调整,以利用这一发展阶段的机会并克服挑战。新兴成年期目前在饮食失调研究中是一个未得到充分利用的概念,研究人员和临床医生未来参与发展文献研究可能是理解和治疗向成年期过渡过程中饮食失调的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/784e/7005676/baa59272538e/fpsyg-10-03062-g0001.jpg

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