Temple University, Japan Campus.
Stanford University.
Behav Ther. 2024 Jul;55(4):712-723. doi: 10.1016/j.beth.2023.10.002. Epub 2023 Oct 31.
Because very few prospective studies have identified risk factors that predicted future onset of threshold/subthreshold anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD), we analyzed prospective data collected from a large cohort of adolescent girls followed over an 8-year period to advance knowledge about risk factor specificity. Adolescent girls recruited from middle schools in Texas (N = 492; M age = 13.02 [SD = 0.73], age range = 11-15) completed questionnaires assessing risk factors at baseline and diagnostic interviews assessing eating disorders annually over 8 years. Only low BMI predicted future AN onset. Pressure to be thin, thin-ideal internalization, body dissatisfaction, negative emotionality, low parent support, and modeling of eating pathology predicted future BN onset. Pressure to be thin, thin-ideal internalization, negative emotionality, low parent support, and modeling of eating pathology predicted future BED onset. Pressure to be thin, body dissatisfaction, dietary restraint, low parent support, modeling of eating pathology, and high BMI predicted future PD onset. Predictive effects were medium-to-large. Results support etiological theories of eating disorders that postulate the pursuit of the thin ideal, body dissatisfaction, negative affect, dietary restraint, and interpersonal issues increase risk for most eating disorders. The evidence that girls with low body weight are at risk for AN, whereas girls with high body weight are at risk for PD are novel. Although several risk factors predicted future onset of BN, BED, and PD, results suggest that risk factors for AN are qualitatively distinct and should be investigated further.
由于很少有前瞻性研究确定了可预测未来阈下/厌食症 (AN)、贪食症 (BN)、暴食障碍 (BED) 和清除障碍 (PD) 发病的风险因素，我们分析了一项从德克萨斯州中学招募的大量青春期女孩中收集的前瞻性数据，这些女孩在 8 年的时间里接受了随访，以增进对风险因素特异性的了解。这些女孩（N=492；M 年龄=13.02[SD=0.73]，年龄范围 11-15 岁）在基线时完成了评估风险因素的问卷，并在 8 年内每年进行一次评估饮食障碍的诊断访谈。只有低 BMI 预测未来 AN 的发病。对瘦的压力、瘦理想内化、身体不满、消极情绪、低父母支持以及饮食病理学的模仿预测未来 BN 的发病。对瘦的压力、瘦理想内化、消极情绪、低父母支持以及饮食病理学的模仿预测未来 BED 的发病。对瘦的压力、身体不满、饮食限制、低父母支持、饮食病理学的模仿以及高 BMI 预测未来 PD 的发病。预测效果为中到大。研究结果支持了饮食障碍的病因理论，该理论假设追求瘦理想、身体不满、消极情绪、饮食限制和人际关系问题会增加大多数饮食障碍的风险。女孩体重低易患 AN，而体重高易患 PD 的证据是新颖的。尽管有几个风险因素预测了未来 BN、BED 和 PD 的发病，但结果表明 AN 的风险因素在性质上是不同的，应该进一步研究。
