Jimerson D C, Wolfe B E, Franko D L, Covino N A, Sifneos P E
Department of Psychiatry, Beth Israel Hospital, Boston, Massachusetts.
Psychosom Med. 1994 Mar-Apr;56(2):90-3. doi: 10.1097/00006842-199403000-00002.
Previous reports indicate that some patients with eating disorders have alexithymic characteristics, including affect deficit states and paucity of imagination. This study evaluated whether nonhospitalized patients with bulimia nervosa had elevated ratings of alexithymia in comparison to age-matched controls, and whether severity of bulimic symptoms was correlated with elevations in alexithymia ratings. Because alexithymia may be secondary to concurrent depression, this study was limited to patients with bulimia nervosa who were free of major depression. The authors compared alexithymia ratings for nonhospitalized normal weight women meeting DSM-III-R criteria for bulimia nervosa (N = 20) to healthy female volunteers (N = 20), utilizing the Toronto Alexithymia Scale (TAS) as the primary assessment instrument. Subjects also completed standardized rating scales for bulimic symptoms, depression, and anxiety. Alexithymia rating scale scores were significantly higher for patients with bulimia nervosa than for controls. In comparison to controls, patients had significant elevations on TAS factors reflecting affect deficit states, but normal scores for factors reflecting imagination and abstract thinking. Frequency of binge eating or purging behaviors was not correlated with alexithymia ratings. These data indicate that some patients with bulimia nervosa have alexithymic characteristics. Affect dysregulation was more prominent than limitation in fantasy or metaphorical thought. Additional studies are needed to assess whether presence of alexithymic characteristics may be predictive of response to treatment in patients with bulimia nervosa.
先前的报告表明，一些饮食失调患者具有述情障碍的特征，包括情感缺陷状态和想象力匮乏。本研究评估了与年龄匹配的对照组相比，非住院神经性贪食症患者的述情障碍评分是否升高，以及贪食症状的严重程度是否与述情障碍评分升高相关。由于述情障碍可能继发于并发的抑郁症，本研究仅限于无重度抑郁症的神经性贪食症患者。作者使用多伦多述情障碍量表（TAS）作为主要评估工具，比较了符合DSM-III-R神经性贪食症标准的非住院正常体重女性（N = 20）与健康女性志愿者（N = 20）的述情障碍评分。受试者还完成了贪食症状、抑郁和焦虑的标准化评分量表。神经性贪食症患者的述情障碍评分量表得分显著高于对照组。与对照组相比，患者在反映情感缺陷状态的TAS因子上有显著升高，但在反映想象力和抽象思维的因子上得分正常。暴饮暴食或清除行为的频率与述情障碍评分无关。这些数据表明，一些神经性贪食症患者具有述情障碍的特征。情感失调比幻想或隐喻思维的局限更为突出。需要进一步的研究来评估述情障碍特征的存在是否可以预测神经性贪食症患者对治疗的反应。
