Sommerfeldt Bente, Skårderud Finn, Kvalem Ingela Lundin, Gulliksen Kjersti S, Holte Arne
Institute of Eating Disorders, Oslo, Norway.
Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.
Front Psychol. 2022 Sep 28;13:986217. doi: 10.3389/fpsyg.2022.986217. eCollection 2022.
Being pregnant is a vulnerable period for women with a history of eating disorders. A central issue in eating disorders is searching control of one's body and food preferences. Pregnancy implies being increasingly out of control of this. Treatment and targeted prevention start with the patient's experience. Little is known about how women with a history of eating disorder experience being pregnant.
We interviewed 24 women with a history of eating disorder at the time of pregnancy, recruited from five public pregnancy controls at local family health centers in Norway. Interviews were analyzed by means of ideal type analysis, with a particular focus on how the participants experienced pregnancy and perceived triggers in possible experiences of relapse or worsening during pregnancy. All participants completed the Eating Disorder Examination Questionnaire (EDE-Q) and were diagnosed (DSM-5) by using the Eating Disorder Examination (EDE).
On becoming pregnant, 23 of the 24 participants experienced worsening or relapse of their disorder. This occurred both at first time and after several pregnancies, and either interviewed early or late in pregnancy. Ideal type analyses indicated seven different personal features associated with worsening or relapse: the "chaotic" "rigid" "perfect" "worried" "shameful" "motherhood fearing" and "the mother with lost identity" Perceived triggers of worsening or relapse were: "loss of control" "unpredictability" "competition" "change of appearance" "shame and nausea" and "loss of identity."
Pregnancy is a vulnerable period for women with a history of eating disorders. A great variation in personal psychological dynamics seems to interact with perceived triggers in worsening or relapse of eating disorder. Our findings have important implications in understanding mechanisms of relapse in pregnancy, preventing relapse and help tailoring adequate intervention.
对于有饮食失调病史的女性来说，怀孕是一个脆弱时期。饮食失调的一个核心问题是寻求对自己身体和食物偏好的控制。而怀孕意味着越来越难以控制这些。治疗和针对性预防应从患者的经历入手。对于有饮食失调病史的女性如何体验怀孕，我们知之甚少。
我们采访了24名怀孕时患有饮食失调病史的女性，她们是从挪威当地家庭健康中心的五个公共孕期诊所招募的。通过理想类型分析对访谈进行分析，特别关注参与者如何体验怀孕以及在怀孕过程中可能出现的复发或病情恶化经历中察觉到的触发因素。所有参与者都完成了饮食失调检查问卷（EDE-Q），并通过饮食失调检查（EDE）依据《精神疾病诊断与统计手册》第五版（DSM-5）进行诊断。
在怀孕时，24名参与者中有23名经历了病情恶化或复发。这种情况在首次怀孕以及多次怀孕后均有发生，且无论是在怀孕早期还是晚期接受访谈时都出现了。理想类型分析表明有七种不同的个人特征与病情恶化或复发相关：“混乱型”“刻板型”“完美型”“焦虑型”“羞耻型”“恐惧母亲身份型”和“身份丧失的母亲型”。察觉到的病情恶化或复发的触发因素有：“失去控制”“不可预测性”“竞争”“外貌变化”“羞耻和恶心”以及“身份丧失”。
怀孕对于有饮食失调病史的女性来说是一个脆弱时期。个人心理动态的巨大差异似乎与饮食失调病情恶化或复发时察觉到的触发因素相互作用。我们的研究结果对于理解孕期复发机制、预防复发以及帮助制定适当的干预措施具有重要意义。
