Grogan Katie, MacGarry Diarmuid, Bramham Jessica, Scriven Mary, Maher Caroline, Fitzgerald Amanda
School of Psychology, University College Dublin, Dublin, Ireland.
Elm Mount Unit, St. Vincent's University Hospital, Dublin, Ireland.
J Eat Disord. 2020 Jul 22;8:36. doi: 10.1186/s40337-020-00311-6. eCollection 2020.
Although previous reviews suggest a strong association between abuse and eating disorders, less is known about non-abuse adverse life experiences, such as parental mental illness or family discord, which occur frequently for this population. The aim of the current study was to identify family-related non-abuse adverse life experiences occurring for adults with eating disorders, and to establish whether they occur for people with anorexia nervosa, bulimia nervosa or binge-eating disorder more than the general population and other psychiatric populations.
A systematic review of studies focusing on family-related non-abuse adverse life experiences and eating disorders was conducted in accordance with PRISMA guidelines. The search string was applied to four electronic databases including Psycinfo, PubMed/Medline, CINAHL Plus and EMBASE.
Of the 26 studies selected for inclusion, six types of family-related non-abuse adverse life experiences were identified: adverse parenting style; family disharmony; loss of a family member, relative or close person; familial mental health issues; family comments about eating, or shape, weight and appearance; and family disruptions. Findings provided tentative evidence for eating disorder specific (i.e. parental demands and criticism) and non-specific (i.e. familial loss and family disruptions) non-abuse adversities, with findings also suggesting that those with bulimia nervosa and binge-eating disorder were more impacted by loss, family separations and negative parent-child interactions compared to those with anorexia nervosa.
This review provides a clear synthesis of previous findings relating to family-related non-abuse adverse life experiences and eating disorders in adults. Implications for trauma-informed care in clinical practice were discussed (e.g. considering the impact of past life events, understanding the function of ED behaviours, reducing the risk of potential re-traumatisation).
尽管先前的综述表明虐待与饮食失调之间存在紧密联系，但对于非虐待性不良生活经历，如父母精神疾病或家庭不和，人们了解较少，而这些情况在这一人群中经常发生。本研究的目的是确定患有饮食失调症的成年人所经历的与家庭相关的非虐待性不良生活经历，并确定这些经历在神经性厌食症、神经性贪食症或暴饮暴食症患者中是否比普通人群和其他精神疾病患者更常见。
根据PRISMA指南，对关注与家庭相关的非虐待性不良生活经历和饮食失调的研究进行了系统综述。检索词应用于四个电子数据库，包括Psycinfo、PubMed/Medline、CINAHL Plus和EMBASE。
在入选的26项研究中，确定了六种与家庭相关的非虐待性不良生活经历：不良养育方式；家庭不和；家庭成员、亲属或亲密之人的离世；家族心理健康问题；家庭对饮食、体型、体重和外貌的评论；以及家庭破裂。研究结果为饮食失调特异性（即父母的要求和批评）和非特异性（即家族性丧失和家庭破裂）的非虐待性逆境提供了初步证据，研究结果还表明，与神经性厌食症患者相比，神经性贪食症和暴饮暴食症患者受丧失、家庭分离和负面亲子互动的影响更大。
本综述清晰地综合了先前关于成年人与家庭相关的非虐待性不良生活经历和饮食失调的研究结果。讨论了其对临床实践中创伤知情护理的启示（例如考虑过去生活事件的影响、理解饮食失调行为的功能、降低潜在再次创伤的风险）。
