Pryor T, Wiederman M W, McGilley B
Eating Disorders Program, University of Kansas School of Medicine-Wichita 67214, USA.
Int J Eat Disord. 1996 Jul;20(1):13-8. doi: 10.1002/(SICI)1098-108X(199607)20:1<13::AID-EAT2>3.0.CO;2-7.
The results of the scant research on laxative abuse among women with eating disorders suggest that laxative abuse is a diagnostic indicator of greater psychopathology. We further investigated the relationship of history of laxative abuse to eating and related attitudes, impulsivity, and personality pathology.
Women assessed in an outpatient clinical setting and diagnosed with anorexia nervosa, binge-eating/purging type (n = 51) or bulimia nervosa, purging type (n = 280) completed measures of laxative abuse, eating and related attitudes, and personality psychopathology at intake.
More than one-half of both groups had abused laxatives at some point. History of laxative abuse was unrelated to eating disorder diagnostic category, current age or body weight, history of stealing, self-induced injury, having attempted suicide, interpersonal distrust, maturity fears, or compulsive or dependent personality features. Compared to nonabusers, laxative abusers demonstrated more perfectionism and avoidant personality features. Significant statistical interactions among variables revealed that bulimia nervosa patients who had abused laxatives exhibited the most pathological scores on scales measuring drive for thinness, body dissatisfaction, ineffectiveness, lack of interoceptive awareness, and passive-aggressive and borderline personality features. Anorexia nervosa patients who had abused laxatives had the highest scores on the histrionic scale.
Results are discussed with regard to past research and clinical implications. We propose that laxative abuse among eating disordered women may serve different functions depending on diagnosis and underlying personality dynamics.
对饮食失调女性泻药滥用的少量研究结果表明，泻药滥用是更严重精神病理学的诊断指标。我们进一步研究了泻药滥用史与饮食及相关态度、冲动性和人格病理学之间的关系。
在门诊临床环境中接受评估并被诊断为神经性厌食症、暴饮暴食/清除型（n = 51）或神经性贪食症、清除型（n = 280）的女性在入院时完成了泻药滥用、饮食及相关态度和人格精神病理学的测量。
两组中超过一半的人在某些时候曾滥用泻药。泻药滥用史与饮食失调诊断类别、当前年龄或体重、偷窃史、自我伤害、自杀未遂、人际不信任、成熟恐惧或强迫或依赖型人格特征无关。与未滥用者相比，泻药滥用者表现出更多的完美主义和回避型人格特征。变量之间的显著统计交互作用表明，滥用泻药的神经性贪食症患者在测量追求瘦身的驱动力、身体不满、无效感、缺乏本体感受意识以及被动攻击型和边缘型人格特征的量表上表现出最病态的分数。滥用泻药的神经性厌食症患者在表演型量表上得分最高。
根据过去的研究和临床意义对结果进行了讨论。我们提出，饮食失调女性中的泻药滥用可能根据诊断和潜在的人格动态发挥不同的作用。
