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理解创伤后应激障碍症状、暴食症状与肥胖相关生活质量之间的关系:体验回避的作用。

Understanding relationships between posttraumatic stress disorder symptoms, binge-eating symptoms, and obesity-related quality of life: the role of experiential avoidance.

机构信息

VA San Diego Healthcare System, San Diego, California, USA.

Department of Psychiatry, University of California, San Diego, California, USA.

出版信息

Eat Disord. 2021 May-Jun;29(3):260-275. doi: 10.1080/10640266.2020.1868062. Epub 2021 Jan 17.

Abstract

Obesity, binge-eating symptoms, and PTSD symptoms commonly co-occur. Avoidance, a key feature of PTSD and proposed mechanism of binge-eating, is one potential mechanism for explaining this clinical overlap. The purpose of the current study was to: 1) examine the associations between PTSD symptoms (PTSD Checklist-Civilian; PCL-C) and measures of bingeeating symptoms (Binge Eating Scale; BES) and obesity-related quality of life (Obesity Related Well-Being Questionnaire-97; ORWELL-97) in a sample of veterans with overweight or obesity ( = 89), and 2) determine whether experiential avoidance (The Acceptance and Action Questionnaire-II; AAQ-II) explains the relationship between PTSD symptoms and binge-eating symptoms, and PTSD symptoms and obesity-related quality of life, respectively. Scores on the PCL-C, BES, ORWELL-97, and AAQ-II were all significantly correlated. Linear regression analyses indicated that higher PCL-C scores were related to higher scores on the BES and ORWELL-97 after controlling for potentially confounding factors (BMI and race). Effect sizes were in the medium-large range. Further, AAQ-II mediated the relationship between PCL-C and ORWELL-97, but did not mediate the relationship between PCL-C and BES. These findings suggest that experiential avoidance should be considered in interventions addressing co-occurring PTSD, binge-eating, and poor obesity-related well-being. Longitudinal research is needed to better understand directionality of these relationships and changes over time.

摘要

肥胖、暴食症状和 PTSD 症状通常同时存在。回避是 PTSD 的一个关键特征,也是暴食的一个潜在机制,它是解释这种临床重叠的一种潜在机制。本研究的目的是:1)在超重或肥胖的退伍军人样本中,检查 PTSD 症状(平民 PTSD 检查表;PCL-C)与暴食症状(暴食量表;BES)和肥胖相关生活质量(肥胖相关幸福感问卷-97;ORWELL-97)之间的关联;2)确定经验回避(接受和行动问卷-II;AAQ-II)是否分别解释了 PTSD 症状与暴食症状、PTSD 症状与肥胖相关生活质量之间的关系。PCL-C、BES、ORWELL-97 和 AAQ-II 的得分均呈显著相关。线性回归分析表明,在控制潜在混杂因素(BMI 和种族)后,较高的 PCL-C 分数与 BES 和 ORWELL-97 的得分较高相关。效应大小处于中到大的范围。此外,AAQ-II 介导了 PCL-C 与 ORWELL-97 之间的关系,但不介导 PCL-C 与 BES 之间的关系。这些发现表明,在解决同时存在的 PTSD、暴食和肥胖相关幸福感差的干预措施中,应考虑经验回避。需要进行纵向研究,以更好地了解这些关系的方向性和随时间的变化。

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