Department of Psychological Sciences, Swinburne University, Hawthorn, Victoria, Australia.
Centre for Mental Health, Swinburne University, Hawthorn, Victoria, Australia.
Int J Eat Disord. 2020 Jun;53(6):873-882. doi: 10.1002/eat.23264. Epub 2020 Mar 21.
The impact of disordered eating extends beyond women with a diagnosed eating disorder. Scarce research to date has investigated disordered eating in a general perinatal population, including the complex interplay between psychosocial factors, mental health symptoms, and disordered eating at numerous pregnancy periods. Specifically, maternal attitudes and relationship satisfaction are psychosocial factors that have been identified as a gap in the literature.
Pregnant women completed an online questionnaire between 18 and 24 weeks gestation (T1, n = 258) and again between 30 and 32 weeks gestation (T2, n = 159). Structural equation modeling was used to test an interrelated model of psychosocial factors-attitudes to pregnancy, attitudes to motherhood, and relationship satisfaction-and disordered eating, mediated by either depressive or anxiety symptoms. Invariance testing examined whether model weights differed between primiparous and multiparous women at each time point.
While at T1 and T2, there were significant direct associations between psychosocial factors and disordered eating, only at T2 were the associations between psychosocial factors and disordered eating mediated by depressive and anxiety symptoms. Furthermore, at T2, multiparous women were at greater risk of an association between maladaptive attitudes to pregnancy and motherhood, depressive symptoms, and disordered eating.
The present study highlights the need to investigate the relationships between psychosocial factors and disordered eating, while accounting for the unique antenatal needs of women during different pregnancy periods and across differing parity. The mediating effect of depressive and anxiety symptoms have implications for future research and clinical care.
饮食失调的影响不仅局限于被诊断为饮食失调的女性。迄今为止，关于一般围产期人群的饮食失调的研究很少，包括心理社会因素、心理健康症状以及在多个妊娠期间的饮食失调之间的复杂相互作用。具体而言，母亲的态度和关系满意度是心理社会因素，这是文献中的一个空白。
孕妇在 18 至 24 周妊娠（T1，n=258）和 30 至 32 周妊娠（T2，n=159）期间完成在线问卷。结构方程模型用于测试心理社会因素-对怀孕的态度、对母亲的态度和关系满意度-与饮食失调之间相互关联的模型，由抑郁或焦虑症状介导。不变性检验检查了在每个时间点，模型权重是否因初产妇和多产妇而不同。
虽然在 T1 和 T2 时，心理社会因素与饮食失调之间存在显著的直接关联，但仅在 T2 时，心理社会因素与饮食失调之间的关联才通过抑郁和焦虑症状介导。此外，在 T2 时，多产妇更容易出现妊娠和母亲的不良态度、抑郁症状和饮食失调之间的关联。
本研究强调了需要调查心理社会因素与饮食失调之间的关系，同时考虑到不同妊娠期间和不同产次的女性的独特产前需求。抑郁和焦虑症状的中介作用对未来的研究和临床护理具有意义。
