Radunz Marcela, Wade Tracey D
School of Psychology, Flinders University, Adelaide, South Australia, Australia.
Blackbird Initiative, Flinders Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia.
Early Interv Psychiatry. 2023 Oct;17(10):1012-1020. doi: 10.1111/eip.13394. Epub 2023 Jan 17.
Early intervention in eating disorders (EDs) is hampered by a lack of validated measures of barriers to treatment seeking. The present study examined the factor structure of the Perceived Barriers to Psychological Treatment scale (PBPT) and a combination of PBPT and Barriers to Seeking Help for ED items (BATSH-ED) with respect to treatment-seeking for an ED.
Participants were 456 female university students aged 17-25 reporting a wide range of disordered eating severity. Confirmatory factor analyses were conducted with the whole sample followed by correlational and regression analyses with a high-risk sample to assess validity of the selected questionnaire items.
Four models were tested. First, we replicated the original PBPT 8-factor structure in our sample with comparable fit indices. Second, the addition of six ED items comprising a Denial and Ambivalence subscale improved model fit. Third and fourth, when only significant subscales predicting treatment seeking were retained, with removal of items with weak loadings, a 15-item six-factor solution provided a best fit. A range of psychosocial measures had relationships in the expected directions with the questionnaire subscales. In addition to disordered eating, the denial subscale was uniquely associated with treatment seeking.
While the present study contributes to refining the assessment of barriers to help-seeking, future studies should consider co-design with lived experience to further improve the model fit of the questionnaire and improve predictiveness of help-seeking.
寻求治疗的障碍缺乏经过验证的测量方法，这阻碍了对饮食失调（EDs）的早期干预。本研究考察了“心理治疗感知障碍量表”（PBPT）以及PBPT与“饮食失调求助障碍项目”（BATSH-ED）的组合在饮食失调寻求治疗方面的因素结构。
参与者为456名年龄在17至25岁之间的女大学生，她们报告了广泛的饮食失调严重程度。对整个样本进行验证性因素分析，随后对高危样本进行相关性和回归分析，以评估所选问卷项目的有效性。
测试了四个模型。首先，我们在样本中复制了原始PBPT的八因素结构，拟合指数相当。其次，增加六个构成否认与矛盾子量表的饮食失调项目提高了模型拟合度。第三和第四，当仅保留预测寻求治疗的显著子量表，并去除载荷较弱的项目时，一个包含15个项目的六因素解决方案拟合最佳。一系列社会心理测量指标与问卷子量表的关系符合预期方向。除了饮食失调外，否认子量表与寻求治疗存在独特关联。
虽然本研究有助于完善对求助障碍的评估，但未来研究应考虑与实际经历者共同设计，以进一步提高问卷的模型拟合度并改善求助预测性。
