Schmidt U, Tiller J, Treasure J
Institute of Psychiatry, London.
Psychol Med. 1993 Aug;23(3):663-72. doi: 10.1017/s0033291700025447.
The aim of this study was to determine whether the childhood experiences of patients with anorexia nervosa and bulimia nervosa differ and affect the course of the illness. A semistructured interview developed by Harris et al. (1986) was used to assess the childhood family environment of 64 patients with restricting anorexia nervosa (RAN), 23 patients with bulimic anorexia nervosa (BAN), 37 bulimic patients with a history of anorexia nervosa (BN/HistAN) and 79 patients with normal weight bulimia nervosa (BN). There were no significant differences between groups in terms of parental mental disorder, low parental control or childhood sexual abuse. BN patients had had significantly more family arrangements and had experienced more parental indifference, excessive parental control, physical abuse, and violence against other family members than RAN patients with the BAN and BN/HistAN group being intermediate. There was a trend for BN-patients to have had more intra-familial discord than the other groups. Different aspects of adversity tended to cluster in the same patients and 65% of the bulimic group had experienced two or more types of childhood adversity. These results suggest that childhood experiences contribute to the form of eating disorder which later develops.
本研究的目的是确定神经性厌食症和神经性贪食症患者的童年经历是否存在差异以及是否会影响疾病进程。采用哈里斯等人（1986年）编制的半结构式访谈，对64例限制型神经性厌食症（RAN）患者、23例贪食型神经性厌食症（BAN）患者、37例有神经性厌食症病史的贪食症患者（BN/HistAN）以及79例体重正常的神经性贪食症患者（BN）的童年家庭环境进行评估。在父母精神障碍、父母低控制或童年性虐待方面，各组之间无显著差异。与RAN患者相比，BN患者有更多的家庭安排，经历了更多的父母冷漠、过度的父母控制、身体虐待以及针对其他家庭成员的暴力行为，BAN和BN/HistAN组则介于两者之间。BN患者比其他组有更多家庭内部不和的趋势。不同方面的逆境往往集中在同一患者身上，65%的贪食症组患者经历过两种或更多类型的童年逆境。这些结果表明，童年经历会导致后来发展出的饮食失调形式。
