Jones Emily J, Egan Sarah J, Howell Joel A, Hoiles Kimberley J, Mazzucchelli Trevor G
School of Psychology, Curtin University, Perth, Australia.
School of Psychology, Curtin University, Perth, Australia.
Eat Behav. 2020 Dec;39:101445. doi: 10.1016/j.eatbeh.2020.101445. Epub 2020 Oct 20.
The validity of the transdiagnostic cognitive-behavioural model of eating disorders has been examined in adults, however there is limited examination in adolescents with eating disorders. The present study examined the direct and indirect relationships between eating disorder symptoms and the four maintaining processes: perfectionism, low core self-esteem, mood intolerance, and interpersonal difficulties.
Using a correlational cross-sectional design, adolescents with eating disorders (N = 270; anorexia nervosa [restricting; 35.9%]; anorexia nervosa [binge purge; 8.1%]; bulimia nervosa [9.3%]; atypical anorexia nervosa [27.4%]; bulimia nervosa [of low frequency and/or limited duration; 3%]; purging [1.1%]; and unspecified feeding or eating disorders [15.2%]) completed measures of perfectionism, self-esteem, mood intolerance, interpersonal difficulties, and eating disorder symptoms as part of the intake assessment to an eating disorders program.
Path analysis revealed that low self-esteem and mood intolerance were directly associated with eating disorder symptoms. Perfectionism was indirectly associated with eating disorder symptoms through self-esteem and mood intolerance.
The findings provide partial support for the transdiagnostic model of eating disorders in an adolescent clinical sample. In particular, core low self-esteem and mood intolerance were found to be pertinent in adolescents with eating disorders. A limitation of the current study was the use of cross-sectional data. Future research should examine the transdiagnostic model with the use of longitudinal data. Furthermore, future research is required to examine potential differences in the way the maintaining mechanisms operate between adolescents and adults with eating disorders and the implications for treatment.
饮食失调的跨诊断认知行为模型的有效性已在成年人中得到检验，但在患有饮食失调的青少年中进行的检验有限。本研究考察了饮食失调症状与四个维持过程之间的直接和间接关系：完美主义、核心自尊水平低、情绪不耐受和人际困难。
采用相关横断面设计，患有饮食失调的青少年（N = 270；神经性厌食症[限制型；35.9%]；神经性厌食症[暴食清除型；8.1%]；神经性贪食症[9.3%]；非典型神经性厌食症[27.4%]；神经性贪食症[低频率和/或有限持续时间；3%]；清除行为[1.1%]；以及未特定的喂养或饮食失调[15.2%]）完成了完美主义、自尊、情绪不耐受、人际困难和饮食失调症状的测量，作为饮食失调项目入院评估的一部分。
路径分析显示，低自尊和情绪不耐受与饮食失调症状直接相关。完美主义通过自尊和情绪不耐受与饮食失调症状间接相关。
研究结果为青少年临床样本中的饮食失调跨诊断模型提供了部分支持。特别是，发现核心低自尊和情绪不耐受在患有饮食失调的青少年中具有相关性。本研究的一个局限性是使用了横断面数据。未来的研究应该使用纵向数据来检验跨诊断模型。此外，未来的研究需要考察患有饮食失调的青少年和成年人在维持机制运作方式上的潜在差异及其对治疗的影响。
