Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia.
School of Health, University of Sunshine Coast, Sippy Downs, QLD, Australia.
Eat Weight Disord. 2024 Aug 29;29(1):54. doi: 10.1007/s40519-024-01682-4.
PURPOSE: Understanding how early adaptive schemas, cognitive flexibility, and emotional regulation influence eating disorder (ED) symptoms, and whether this differs across diagnostic subtypes is critical to optimising treatment. The current study investigated the relationship between these variables and ED symptomology in individuals self-reporting an ED diagnosis and healthy controls. METHODS: A dataset of 1576 online survey responses yielded subsamples for anorexia nervosa (n = 155), bulimia nervosa (n = 55), binge eating disorder (n = 33), other specified feeding or eating disorder (n = 93), and healthy participants (n = 505). The hierarchical linear regression analysis included Eating Disorder Examination Questionnaire 6.0 Global Score as the dependent variable; Young Positive Schema Questionnaire, Emotional Regulation Questionnaire, and Cognitive Flexibility Inventory subscale scores as the independent variables; and demographic measures as the covariates. RESULTS: The number of significant predictors varied considerably by ED sub-group. Amongst the anorexia nervosa, bulimia nervosa, and healthy subsamples, the adaptive schema Self-Compassion and Realistic Expectations was associated with lower ED symptom severity. In comparison, age and body mass index were the strongest predictors for binge eating disorder, whilst the Expressive Suppression (a subscale of the Emotional Regulation Questionnaire) was the strongest predictor for other specified feeding or eating disorders. CONCLUSION: Early adaptive schemas, cognitive flexibility, and emotional regulation vary across ED subtype, suggesting the need for tailored treatment that disrupts the self-reinforcing cycle of ED psychopathology. Future research investigating how early adaptive schemas may predict or be associated with treatment response across diagnostic subtypes is needed. LEVEL OF EVIDENCE: Level IV, evidence obtained from multiple time-series with or without the intervention, such as case studies.
目的:了解早期适应模式、认知灵活性和情绪调节如何影响饮食失调(ED)症状,以及这种影响在不同诊断亚型中是否存在差异,对于优化治疗至关重要。本研究调查了在自我报告 ED 诊断的个体和健康对照组中,这些变量与 ED 症状学之间的关系。
方法:一项包含 1576 份在线调查回复的数据集产生了神经性厌食症亚组(n=155)、神经性贪食症亚组(n=55)、暴食障碍亚组(n=33)、其他特定进食或饮食障碍亚组(n=93)和健康对照组(n=505)。分层线性回归分析包括饮食障碍检查问卷 6.0 全球评分作为因变量;Young 积极模式问卷、情绪调节问卷和认知灵活性量表子量表评分作为自变量;以及人口统计学指标作为协变量。
结果:ED 亚组之间显著预测因子的数量差异很大。在神经性厌食症、神经性贪食症和健康亚组中,适应性模式自我同情和现实期望与较低的 ED 症状严重程度相关。相比之下,年龄和体重指数是暴食障碍最强的预测因子,而表达抑制(情绪调节问卷的一个子量表)是其他特定进食或饮食障碍的最强预测因子。
结论:早期适应模式、认知灵活性和情绪调节在 ED 亚型中存在差异,表明需要针对特定疾病的治疗,以打破 ED 病理心理学的自我强化循环。未来需要研究早期适应模式如何预测或与不同诊断亚型的治疗反应相关。
证据水平:IV 级,从多个时间序列获得的证据,有或没有干预,如病例研究。
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