Department of Psychology, University of Kansas, Lawrence, Kansas, USA.
Department of Psychology, University of Nevada Las Vegas, Las Vegas, Nevada, USA.
Int J Eat Disord. 2024 Jul;57(7):1542-1554. doi: 10.1002/eat.24194. Epub 2024 Mar 12.
The association between eating disorders (EDs) and harmful substance use (substance use that causes psychosocial impairment) is well recognized in the literature, and military veterans may be at heightened risk for both issues due to deployment-related stressors. However, little is known about which ED-related symptoms are associated with harmful substance use in veterans, and whether gender plays a differential role in this relationship. Our aims were to: (1) examine gender differences in ED-related symptoms; and (2) examine whether ED-related symptoms differentially predict harmful substance use in US veteran men and women who had recently separated from service.
This study was based on a nationally representative four-wave longitudinal sample of post-9/11 veterans (N = 835; 61.2% female). Longitudinal mixed modeling was used to test whether specific ED-related behaviors at baseline predicted harmful substance use at follow-ups.
We replicated gendered patterns of ED-related symptoms observed in civilian populations, wherein men had higher weight-and-body-related concerns (including excessive exercise and muscle building) and negative attitude toward obesity, and women had higher bulimic and restricting symptoms. For women, alcohol, drug, and marijuana problems were predicted by higher bulimic symptoms, whereas for men, these problems were predicted by higher restricting symptoms.
Gender played a differential role in the relationship between EDs and harmful substance use. Bulimic symptoms were the most robust predictor for harmful substance use among veteran women, whereas restricting was the most robust predictor for harmful substance use among veteran men.
The current study found that veteran women had higher bulimic symptoms (characterized by binge eating and purging) and restricting than veteran men. In women, bulimic symptoms predicted future harmful use of alcohol, marijuana, and other drugs. In contrast, veteran men had higher weight-and-body-related concerns (characterized by excessive exercise and muscle building) than veteran women. In men, restricting symptoms predicted future harmful use of alcohol, marijuana, and other drugs.
文献中已经充分认识到饮食障碍（ED）与有害物质使用（导致心理社会功能损害的物质使用）之间的关联，由于与部署相关的压力，退伍军人可能会同时面临这两个问题的风险增加。然而，对于哪些 ED 相关症状与退伍军人中的有害物质使用有关，以及性别在这种关系中是否起差异化作用，我们知之甚少。我们的目的是：（1）研究 ED 相关症状的性别差异；（2）研究 ED 相关症状是否会以不同的方式预测最近退伍的美国男性和女性退伍军人的有害物质使用。
这项研究基于一项具有全国代表性的、针对后 9/11 退伍军人的四波纵向样本（N=835；61.2%为女性）。纵向混合建模用于检验基线时特定的 ED 相关行为是否预测随访时的有害物质使用。
我们复制了在平民人群中观察到的与 ED 相关的症状的性别模式，其中男性的体重和身体相关问题（包括过度运动和肌肉锻炼）以及对肥胖的消极态度更高，而女性的贪食和限制症状更高。对于女性，酒精、药物和大麻问题与更高的贪食症状相关，而对于男性，这些问题与更高的限制症状相关。
性别在 ED 与有害物质使用之间的关系中起了差异化作用。贪食症状是退伍女性有害物质使用的最有力预测因素，而限制症状是退伍男性有害物质使用的最有力预测因素。
本研究发现，退伍女性比退伍男性的贪食症状（表现为暴食和催吐）和限制症状更高。在女性中，贪食症状预测未来对酒精、大麻和其他药物的有害使用。相比之下，退伍男性比退伍女性更关注体重和身体相关问题（表现为过度运动和肌肉锻炼）。在男性中，限制症状预测未来对酒精、大麻和其他药物的有害使用。
