Strahler Jana, Wachten Hanna, Neuhofer Shanna, Zimmermann Peter
Department of Sport Psychology, Albert-Ludwigs-University Freiburg, Freiburg im Breisgau, Germany.
Department of Health Psychology and Applied Diagnostics, University of Wuppertal, Wuppertal, Germany.
Front Nutr. 2022 Mar 9;9:817047. doi: 10.3389/fnut.2022.817047. eCollection 2022.
Orthorexia nervosa, the pathological obsession with eating healthy, shares risks and significant comorbidity with other mental disorders. Based on a behavioral conceptualization of the overlap, emotion regulation, attachment style, and anxious-depressive-stress symptomatology are prominent but insufficiently researched endophenotypes for orthorexia nervosa. This study aimed at identifying ways in which difficulties in emotion regulation and attachment-related anxiety and avoidance become apparent in orthorexia nervosa and healthy orthorexia. Additionally, the moderating role of anxious, depressive, and stress symptoms was explored. A convenience sample of 399 adults (266 women) completed questionnaires to measure orthorexia nervosa and healthy orthorexia, difficulties in emotion regulation, partnership-related bond, and anxious-depressive-stress symptomatology. The healthy orthorexia subscale was negatively associated with lack of emotional awareness but no other subscale of difficulties in emotion regulation or attachment-related anxiety and avoidance. Orthorexia nervosa scores were positively linked to difficulties in emotion regulation as well as attachment-related anxiety and avoidance. Multiple linear regression indicated non-acceptance of emotional responses and impulse control difficulties to be the strongest predictors for orthorexia nervosa. Both subscales also mediated the effects of attachment style on orthorexia nervosa with anxious-depressive-stress symptomatology moderating some of these effects. Individuals with higher orthorexia nervosa tendencies showed difficulties in emotion regulation, a common feature also of affective and eating disorders. Improvement in understanding the psychological features of orthorexia nervosa can enable a better differentiation from other disorders, advances in the development of treatment approaches and treatment planning, and outlines directions for future research on mechanisms.
orthorexia nervosa，即对健康饮食的病态痴迷，与其他精神障碍存在共同风险和显著的共病情况。基于重叠部分的行为概念化，情绪调节、依恋风格以及焦虑 - 抑郁 - 应激症状是orthorexia nervosa突出但研究不足的内表型。本研究旨在确定情绪调节困难以及与依恋相关的焦虑和回避在orthorexia nervosa和健康的orthorexia中表现出来的方式。此外，还探讨了焦虑、抑郁和应激症状的调节作用。一个由399名成年人（266名女性）组成的便利样本完成了问卷调查，以测量orthorexia nervosa和健康的orthorexia、情绪调节困难、伴侣关系相关纽带以及焦虑 - 抑郁 - 应激症状。健康的orthorexia分量表与缺乏情绪意识呈负相关，但与情绪调节困难或与依恋相关的焦虑和回避的其他分量表无关。orthorexia nervosa得分与情绪调节困难以及与依恋相关的焦虑和回避呈正相关。多元线性回归表明，对情绪反应的不接受和冲动控制困难是orthorexia nervosa最强的预测因素。两个分量表还介导了依恋风格对orthorexia nervosa的影响，焦虑 - 抑郁 - 应激症状调节了其中一些影响。orthorexia nervosa倾向较高的个体表现出情绪调节困难，这也是情感障碍和饮食障碍的一个共同特征。更好地理解orthorexia nervosa的心理特征有助于更好地区分其他障碍，推动治疗方法和治疗计划的发展，并为未来机制研究指明方向。
