Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
Amherst College, Amherst, Massachusetts, USA.
Int J Eat Disord. 2022 Jan;55(1):76-84. doi: 10.1002/eat.23630. Epub 2021 Oct 28.
Preoccupation (excessive and constant thoughts) about shape/weight and food/eating is thought to be prominent in individuals with eating disorders but has received much less research than overt behavioral features. This study examined the significance and distinctiveness of different foci of preoccupation in individuals categorized with different forms of eating disorders and in individuals with higher weight.
Participants (N = 1,363) completed a web-based survey with established measures of eating-disorder psychopathology and depression. The current study compared preoccupation among individuals with core features of bulimia nervosa (BN; n = 144), binge-eating disorder (BED; n = 576), anorexia nervosa (AN; n = 48), and higher body weight (body mass index [BMI] ≥ 25) without eating-disorder features (higher weight [HW]; n = 595). Associations of each type of preoccupation with other eating-disorder psychopathology and depression were examined both between and within study groups.
Preoccupation with shape/weight and with food/eating showed a graded pattern of statistically significant differences: AN and BN had higher preoccupation than BED, which was higher than HW. Within BN, BED, and AN study groups, correlation magnitudes of shape/weight and food/eating preoccupation with eating-disorder psychopathology and depression did not differ significantly. Within the HW group, shape/weight preoccupation was significantly more strongly correlated than food/eating preoccupation with overvaluation, body dissatisfaction, and depression.
The preoccupation cognitive style, as well as focus, appears associated with other facets of eating-disorder psychopathology and depression. If results are confirmed among individuals with formal diagnoses, clinicians addressing maladaptive cognitions in cognitive-behavioral therapy should consider the role of preoccupation. Future research should investigate whether preoccupation predicts or moderates eating disorder treatment outcomes.
过度且持续地关注体型/体重和食物/进食被认为是进食障碍个体的突出特征，但与明显的行为特征相比，对其的研究要少得多。本研究考察了不同形式的进食障碍个体和体重较高个体中不同关注焦点的重要性和独特性。
参与者（N=1363）完成了一项基于网络的调查，其中包括已确立的进食障碍心理病理学和抑郁测量。本研究比较了具有神经性贪食症（BN；n=144）、暴食障碍（BED；n=576）、神经性厌食症（AN；n=48）核心特征的个体以及无进食障碍特征但体重较高（BMI≥25）的个体（HW；n=595）之间的关注焦点。在研究组内和组间，分别检查了每种类型的关注焦点与其他进食障碍心理病理学和抑郁之间的关联。
对体型/体重和食物/进食的关注呈现出显著的梯度差异：AN 和 BN 的关注程度高于 BED，BED 又高于 HW。在 BN、BED 和 AN 研究组内，体型/体重和食物/进食关注与进食障碍心理病理学和抑郁的相关程度没有显著差异。在 HW 组内，体型/体重的关注程度与体像障碍、身体不满和抑郁的相关性明显强于食物/进食的关注程度。
关注的认知风格以及关注焦点似乎与进食障碍心理病理学和抑郁的其他方面有关。如果在有正式诊断的个体中得到证实，那么在认知行为疗法中解决适应不良认知的临床医生应该考虑关注的作用。未来的研究应该调查关注是否可以预测或调节进食障碍的治疗结果。
