情绪智力在身体自尊与进食障碍倾向间的调节作用

采取整群抽样对1043名中学生进行问卷调查,主要探讨身体自尊、情绪智力与青少年进食障碍倾向之间的关系,检验情绪智力的调节作用。结果表明：（1）BMI、性别、年级和年龄均是青少年进食障碍倾向的预测因素。（2）青少年身体自尊负向预测其进食障碍倾向。（3）青少年情绪智力在身体自尊和进食障碍倾向之间起调节作用,具体来说,无论情绪智力高低,青少年身体自尊均显著预测其进食障碍倾向,然而,相对于高情绪智力被试,低情绪智力被试的身体自尊对其进食障碍倾向的预测力更大。     

暴食症的诊断、治疗及其疗效

暴食症已成为目前世界上广泛流行的三大进食障碍之一,我国患者亦不在少数并有增加之势,但对暴食症的研究与治疗尚属起步阶段。文章回顾了暴食症的表征及其诊断技术,简要介绍了常见的三种治疗方法（即行为疗法、认知疗法及伴随症状改善法）,并讨论了影响暴食症疗效的诸个体因素。暴食症的诊断主要是根据美国精神疾病诊断与统计手册第四版（DSM-IV）、进食障碍检测评估表（EDE）（治疗者用）和患者用进食障碍检测问卷（EDE-Q）（患者用）,并结合过往病史和伴随症状。三类治疗方法在理论与操作层面各有倚重,均可收到一定治疗效果。但各疗法的效果与预后会因患者而异甚或迥乎相异,这是因为暴食症疗效还受到患者自身人格、社会和认知诸因素的影响,治疗者应根据特定患者选择适合该患者的疗法。     

大学生进食障碍症状的潜在剖面分析及其与抑郁的关系

为了解大学生进食障碍症状的类别特征及其与抑郁和性别的关系,使用进食障碍检查自评问卷6.0和9项患者健康问卷对575名大学生施测,采用带预测变量（抑郁）和分类结果变量（性别）的潜在剖面法进行数据分析。结果表明：大学生进食障碍症状可划分为体形关注组（62.4%）、体像顾虑组（28.0%）和进食障碍风险组（9.6%）;抑郁得分越高,个体被归为体像顾虑组或进食障碍风险组的可能性越大;女性属于体像顾虑组和进食障碍风险组的可能性比男性高。     

进食障碍发病机制的研究进展与思考

进食障碍是一组典型而严重的心身疾病。随着现代医学模式的转变,生物-心理-社会因素对进食障碍的影响日益受到关注。本文拟从生物学、心理学、社会学因素方面,综述近年来国内外对进食障碍发病机制的最新研究,并结合哲学相关理论对进食障碍发病机制的研究进行探讨分析。     

进食障碍发病机制的研究进展与思考

进食障碍是一组典型而严重的心身疾病.随着现代医学模式的转变,生物-心理-社会因素对进食障碍的影响日益受到关注.本文拟从生物学、心理学、社会学因素方面,综述近年来国内外对进食障碍发病机制的最新研究,并结合哲学相关理论对进食障碍发病机制的研究进行探讨分析.     

西方家庭影响进食障碍的研究述评

家庭是进食障碍发展过程中一个重要的影响因素。已有众多西方学者采用各种方法对进食障碍和家庭之间的关系进行了研究。从时间发展脉络来看, Minuchin等学者首先对此进行了经典临床研究; 随后有众多量化研究出现, 对此可以依据不同的测量水平、研究变量和被试视角进行梳理; 近些年, 有学者采用质化研究方法重新对此进行探讨。进食障碍家庭研究的发展趋势表现出：重视本土化研究、对家庭做多水平的探讨、兼顾家庭结构和家庭变化过程。     

神经性厌食症的家庭治疗--西方关于神经性厌食症心理治疗的新进展

弗洛伊德关于家庭和心理性别发展的论述给神经性厌食症的理解、分析与治疗带来了新的关注焦点,在其之后的学者将他的思想进一步继承和发展,创造出了以家庭为关注对象的且在当代得到广泛应用的系统家庭疗法,并将该疗法应用到了神经性厌食症的诊断与治疗中,取得了开创性的成果.     

从强迫运动到进食障碍症状:依恋的中介效应

目的:考察在校大学生依恋关系在强迫运动与进食障碍症状之间的中介效应。方法:研究一和研究二采用问卷调查法分别对466名男大学生和334名女大学生的依恋焦虑、依恋回避水平、强迫运动和进食障碍临床症状进行考察,通过分层回归检验依恋焦虑和依恋回避在强迫运动与进食障碍症状间的中介效应,并用Bootstrap法对中介效应进行验证。结果:在男女大学生中强迫运动可显著预测进食障碍症状; 在男生当中,依恋的两个维度依恋焦虑和依恋回避在强迫运动与进食障碍间的部分中介作用显著; 在女生当中,仅依恋焦虑起到部分中介作用。结论:强迫运动是进食障碍症状的重要风险因子,可通过依恋关系的中介作用影响进食障碍症状,依恋关系对强迫运动与进食障碍症状之间关系的中介效应具有性别差异。     

走出厌食的困境

神经性厌食症常常发于青春期，一般发展比较缓慢，可以持续到成年。患者年龄一般为10—30岁，高峰期则是13一18岁。近年来，由于社会思潮的影响，女性以身体苗条为美，许多女性为追求苗条而节食，最终导致厌食。体重显著减轻是它的重要特征之一。一般认为害     

体型知觉的准确性及其认知机制

体型知觉的准确性既和一般人群的心理健康水平有关, 又对进食障碍的理解、预防和治疗具有重要意义。首先, 进食障碍患者可能高估自己的身体, 其体型知觉准确度可能受其BMI和症状的影响, 并与患者预后相关。其次, 通过和对他人体型估计的结果进行对比发现, 对自己的体型的高估可能受到对自己身体态度因素的影响。第三, 一般人群对自己的体型估计的结果往往不一致, 这可能是体型知觉的不同量化方式所致。最后, 体型知觉准确性的相关认知机制主要有收缩偏差、视觉适应和序列依赖效应。     

Cognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment

This paper is concerned with the psychopathological processes that account for the persistence of severe eating disorders. Two separate but interrelated lines of argument are developed. One is that the leading evidence-based theory of the maintenance of eating disorders, the cognitive behavioural theory of bulimia nervosa, should be extended in its focus to embrace four additional maintaining mechanisms. Specifically, we propose that in certain patients one or more of four additional maintaining processes interact with the core eating disorder maintaining mechanisms and that when this occurs it is an obstacle to change. The additional maintaining processes concern the influence of clinical perfectionism, core low self-esteem, mood intolerance and interpersonal difficulties. The second line of argument is that in the case of eating disorders shared, but distinctive, clinical features tend to be maintained by similar psychopathological processes. Accordingly, we suggest that common mechanisms are involved in the persistence of bulimia nervosa, anorexia nervosa and the atypical eating disorders. Together, these two lines of argument lead us to propose a new transdiagnostic theory of the maintenance of the full range of eating disorders, a theory which embraces a broader range of maintaining mechanisms than the current theory concerning bulimia nervosa. In the final sections of the paper we describe a transdiagnostic treatment derived from the new theory, and we consider in principle the broader relevance of transdiagnostic theories of maintenance.     

Molecular Genetic Studies of Eating Disorders: Current Status and Future Directions

ABSTRACT— We review association studies that have examined the genetic basis of eating disorders. Overall, findings suggest that serotonin, brain-derived neurotrophic factor, and estrogen genes may be important for the development of the disorders. These neuronal systems influence behavioral and personality characteristics (e.g., anxiety, food intake) that are disrupted in eating disorders. Future studies would benefit from larger sample sizes and inclusion of behavioral and personality covariates in analyses. Consideration of the mechanisms of genetic effects and interactions between genes and environment is also needed to extend conceptualizations of the genetic basis of these disorders.     

Thought-shape fusion in anorexia nervosa: an experimental investigation

Cognitive biases and cognitive distortions have been implicated as important factors in the development and maintenance of many disorders. The concept of thought-shape fusion (TSF) in eating disorders was developed by Shafran, Teachman, Kerry, and Rachman (British Journal of Clinical Psychology 38 (1999) 167) as a variant of thought-action fusion, described by Shafran, Thordarson and Rachman (Journal of Anxiety Disorders 10 (1996) 379). TSF occurs when thinking about eating certain types of food increases a person's estimate of their shape and/or weight, elicits a perception of moral wrongdoing, and/or makes the person feel fat. Shafran et al. (1999) examined both the psychometric and experimental properties of TSF in an undergraduate sample. This paper reports an extension of this work to a clinical group (N=20) of patients with anorexia nervosa. After completing a set of relevant questionnaires, participants were asked to think about a food which they considered extremely fattening. They were then asked to write out the sentence, "I am eating--.", inserting the name of the fattening food in the blank. After being asked to rate their anxiety, guilt, feelings about their weight, morality, etc., participants were given the opportunity to neutralize their statement in any way they chose. The majority of the participants neutralized in ways consistent with the findings of Shafran et al. (1999). The results are discussed in terms of cognitive-behavioural formulations of eating disorders, and of the influence of cognitive biases and cognitive distortions on the processing of information relevant to food, weight and shape in anorexia nervosa.     

Emotion regulation difficulties in anorexia nervosa: Relationship to self-perceived sensory sensitivity

Changes in sensation (e.g., prickly skin) are crucial constituents of emotional experience, and the intensity of perceived changes has been linked to emotional intensity and dysregulation. The current study examined the relationship between sensory sensitivity and emotion regulation among adults with anorexia nervosa (AN), a disorder characterised by disturbance in the experience of the body. Twenty-one individuals with AN, 20 individuals with AN who were weight–restored, and 23 typical controls completed self-report measures of sensory sensitivity and emotion regulation. AN participants reported heightened sensory sensitivity and greater difficulty regulating emotions relative to controls. Self-perceived sensory sensitivity was associated with greater emotion dysregulation. Weight-restored AN participants reported greater ability to regulate emotions than their currently underweight counterparts, despite heightened sensitivity. Findings suggest that hypersensitivity may be a persisting feature in AN, and that weight restoration may involve improved ability to cope with sensation.     

Developing a model of the treatment for eating disorder: Using neuroscience research to examine the how rather than the what of change

Treatments for eating disorders, in particular for people with anorexia nervosa, have often been adaptations of therapies designed for other conditions. Indeed, there is a move advocating the use of a transdiagnostic treatment approach in which general module based treatments are mixed together as needed rather than using a specific anorexia nervosa targeted strategy. The outcome of treatment is relatively poor, especially for those who for some reason do not have the benefit of an expert form of early intervention for anorexia nervosa. Technological advances in the neurosciences and genetics have radically altered how eating disorders and in particular anorexia nervosa have been conceptualised. In this paper we describe evidence that suggests that key aspects of the social information processing network both the cognitive and affective elements may be anomalous in people with anorexia nervosa. This has implications for models of treatment which can be tailored more directly to these causal and or maintaining factors. We describe the Maudsley method of working with adults with anorexia nervosa which has integrated these elements. This treatment approach includes working with the individual to develop a more flexible and holistic cognitive style with greater emotional intelligence. This is supplemented with work with the families to interrupt interactions that either accommodate to or aggravate the symptoms. Thus we are now in the position to understand and work to change how people with anorexia nervosa think and behave rather than focusing on what people think and say they do. Our prediction is that treatments that focus more directly on aetiology such as the intrapersonal and interpersonal maintaining factors will improve outcome.     

The Role of Cognitive Deficits in the Development of Eating Disorders

Eating disorders (ED), including anorexia and bulimia nervosa, are chronic illnesses with periods of symptom exacerbation and remission. Because symptoms are usually present from 6 to 24 months before a diagnosis is made, aetiological agents are believed to be active well before symptoms appear. It is proposed that neuropsychological deficits in various cognitive domains preexist and underlie the aetiology of ED. This paper provides a comprehensive review of the literature relevant to neuropsychological deficits in ED patients and explores the relationship between cognitive deficits, psychosocial development, and the development of ED. Although the role of neuropsychological deficits in the evolution of ED requires further research, the proposed association has significant implications for clinical practice.     

Feasibility,Acceptability, and Preliminary Target Engagement of a Healthy Physical Activity Promotion Intervention for Bulimia Nervosa: Development and Evaluation via Case Series Design

Bulimia nervosa (BN) is characterized by a pattern of binge eating and compensatory behaviors as well as an overemphasis on body weight and shape in self-evaluation. Although cognitive behavioral therapy (CBT) is efficacious, recent reviews suggest that only 30% of patients reach abstinence at posttreatment. One potential reason for these poor outcomes is that CBT fails to adequately reduce elevated negative affect (NA) and shape and weight concern, which have been shown to be correlated with poorer treatment outcomes in BN. Therefore, novel treatment components that focus on improving NA and shape and weight concern are needed in order to enhance outcomes. Promoting physical activity (PA) is a promising avenue through which to reduce NA and improve body image in healthy individuals, other clinical populations (e.g., individuals with depression or anxiety), and individuals with eating disorders. While prescribing PA for individuals with BN has been controversial (due to concerns that exercise maybe be used to compensate for binge episodes or become driven or compulsive), this approach may have many benefits, including promoting healthy lifetime exercise habits that reduce likelihood of relapse through the improvement of emotion regulation skills and weight regulation.Given the promise of PA for targeting key maintenance factors of BN, we developed a 12-session healthy PA promotion intervention for BN and tested initial feasibility, acceptability, and preliminary target engagement in an iterative case series design (n = 3). The treatment provided cognitive-behavioral skills designed to identify, practice, and achieve behavioral goals while asking patients to engage in up to 150 minutes of moderate-to-vigorous PA per week, which was preplanned during each session with the client’s therapist.Results suggested that the healthy PA promotion intervention was both feasible and acceptable to deliver. In addition, the intervention resulted in a clinically significant decrease in BN symptom frequency in each participant. Further, participants showed clinically significant decreases in NA and shape and weight concern.The current study demonstrates that healthy PA interventions can have beneficial effects on BN symptoms, NA, and shape and weight concern. However, due to the small sample size, conclusions must be treated with caution. Future research should investigate additional approaches for promoting healthy PA and include a larger sample in order to further test initial efficacy of this treatment approach.     

Body images of patients with anorexia nervosa, bulimia nervosa and female control subjects: a comparison with male ideals of female attractiveness

Body images of female patients with anorexia nervosa and bulimia nervosa were assessed against females without eating disorders and compared with male ideals of female attractiveness. A computer program was applied to examine body images of 62 patients with anorexia nervosa, 45 patients with bulimia nervosa, and 40 female and 39 male control subjects. Body size overestimation was most distinct in the two patient groups. Self-ideal discrepancy was highest in bulimia nervosa. Estimation of the society's ideal female body in all three female groups did not differ from men's perception of the most attractive female body. Congruence of ideals of female attractiveness in patients, female, and male control subjects and described differences between patients and female controls support the theory that body image disturbance is a problem of processing self-referential information regarding body image rather than a problem of processing body image related information per se.     

Bulimia nervosa in undergraduate women: Factors associated with internalization of the sociocultural standard of thinness

Diverse areas of research and theory are integrated in an attempt to better understand the specific risk factors for bulimia nervosa identified in the literature. It is suspected that the interplay of risk factors may be unique to different groups of individuals who develop bulimia. Further, it is proposed that specific determinants be studied individually to determine their particular influence in the etiology of bulimia. It is suggested that the investigation of specific risk factors for bulimia in certain groups will benefit researchers and clinicians in gaining a better conceptual understanding of the process involved in the development of the disorder. This article focuses on the determinants of a specific risk factor (i.e., internalization of the sociocultural standard of thinness) for bulimia in undergraduate women, a group identified as particularly vulnerable to this disorder. Research and theory are integrated to suggest that a combination of specific individual differences, family, and social factors make some undergraduate women more vulnerable to the influence of the sociocultural standard of thinness and bulimia. Suggestions for the inclusion of these psychosocial factors in future empirical investigations and treatment programs are also discussed.