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。     

手机成瘾影响因素述评

有心理学家预测手机成瘾在接下来的五年内将成为最大的问题之一,近些年国内外学者渐而对手机成瘾的关注和研究也日益增多。在研究手机成瘾的影响因素方面,国内外研究多从人口统计学变量、人格、自尊、孤独、控制感等方面进行探讨,本文述评了国内外对手机成瘾的影响因素的研究成果,在此基础上,指出了现有研究存在的问题,展望了将来的研究方向。     

移情的心理机制及其影响因素概述

移情是心理学的重要研究领域之一.文章从发展心理学有关移情的研究人手,对移情的定义、所涉及的心理机制和影响因素进行了梳理.并概述了发展心理学在该领域研究的主要研究成果和最新的研究动态.     

生命意义感获取的心理机制及其影响因素

生命意义感体验对个体身心健康有重要的影响,其相关研究也已开始受到心理学各个领域的广泛关注。生命意义感获得与维持的理论研究主要是包括意义感层次模型、意义感构建模型及意义感维持与流动模型。大五人格、心理模拟、积极/消极情绪和亲社会行为是影响个体生命意义感体验的主要因素。未来研究要进一步探讨生命意义感产生的影响因素,完善相关的理论模型,并要从时间序列的角度探讨意义感的产生过程,并对生命意义感获得及维持的跨文化差异进行探讨。     

愤怒反刍:内涵、影响因素及其神经机制

愤怒反刍是指重复回忆愤怒事件及其起因、结果的认知情绪过程.愤怒反刍的认知过程会保持或强化愤怒情绪,降低个体的抑制控制能力,提高个体的攻击性,影响身心健康.愤怒反刍不仅会受到人口统计学变量的影响,还会受到个体的身体因素、心理因素以及社会因素的影响.未来可以从特质愤怒反刍与状态愤怒反刍的异同,愤怒反刍影响因素的探讨,愤怒反...     

住院放化疗肺癌患者生活质量影响因素分析

生活质量研究是近年来肿瘤治疗研究的热点之一。应用生存质量核心问卷（QLQ—C30）及卡氏功能量表,于治疗前、中、后进行问卷式调查,探讨60例经病理证实接受放、化疗的肺癌患者生活质量的影响因素,预测患者预后和远期生存状态,为住院放化疗肺癌的治疗方法提供一个较好的参考标准,对放化疗肺癌的治疗水平和改善生活质量起到了一定的推动作用。     

同性恋者的心理健康状况及其影响因素

半个世纪以来,国外对同性恋者的心理健康进行了大量的实证研究,而我国心理学领域对此的研究几乎是空白。本为通过对国内外相关文献的整理和分析,论证了同性恋作为一种性取向虽然不是一种心理疾病,但同性恋者却面临着社会污名、内化的恐同观念、偏见、歧视、侵害、暴力、家庭压力,以及对自己性取向的暴露与隐藏等一系列影响心理健康的消极因素,这些因素导致了同性恋者面临着比较严重的情绪障碍、物质依赖、自杀等心理健康问题。     

创业精神的影响因素及其绩效评价

创业精神分为个体创业精神和企业创业精神。个性特质、认知模式、教育培训和创业经验影响个体创业精神,企业战略、组织结构、企业环境和组织支持影响企业创业精神。该文最后讨论了创业精神的绩效评价问题,指出准确的绩效测量是创业研究的关键。     

判断校准及其影响因素

文章从决策过程的角度, 提出了判断校准的系统模型。结合以往的相关研究, 分析了专长、任务结构、反馈和决策支持等因素与判断校准之间的关系, 同时, 还对这些因素之间的相互关系、判断策略的作用等进行了深入探讨     

青少年早期职业不确定性及其影响因素

本文首先总结了国外有关青少年早期职业不确定性的研究进展,包括职业不确定性的认知和情感成分、早期职业不确定性与有效求职行为之间的联系;其次,进一步分析了影响青少年早期职业不确定性的各种主要因素,如个性差异、职业兴趣、人口学变量、早期工作经验和家庭环境;最后,对未来有关早期职业不确定性的研究方向提出展望。     

Body-related film clip triggers desire to binge in women with binge eating disorder

Previous research suggests that excessive influence of shape or weight concern on self-evaluation is strongly associated with psychological functioning in women with binge eating disorder (BED). However, little is known so far about its direct influence on binge episodes. In an experimental study, 27 women with BED (DSM-IV) and 25 overweight healthy controls watched a body-related film clip. Ratings of the desire to binge and mood were assessed prior to and at the end of the film clip. Additionally, measures of heart rate, finger pulse and electrodermal activity were obtained. Main results revealed a significant increase in the desire to binge, sadness and anxiety, as well as a significant increase in non-specific skin conductance fluctuation on the body-related clip in the group of BED only. The results underline the importance of shape and weight concerns in BED.     

Night-time eating in men and women with binge eating disorder

This study examined the frequency of night-time eating (NE) and its correlates in men and women with binge eating disorder (BED). Two-hundred and seven consecutively evaluated adults (45 men and 162 women) with BED were assessed with semi-structured interviews and a battery of behavioral and psychological measures. Overall, 28% (N = 58) of the participants reported NE. A significantly higher proportion of men (42%) than women (24%) reported NE. Overall, participants who reported NE had a significantly higher body mass index, but otherwise differed little from those who did not report NE. Men and women without NE differed little on behavioral and psychological measures, whereas women with NE had significantly higher levels of eating-, weight-, and shape-concerns than men with NE.     

Diagnostic efficiency of DSM-IV criteria for obsessive compulsive personality disorder in patients with binge eating disorder

This study examined the diagnostic efficiency of the DSM-IV criteria for obsessive compulsive personality disorder (OCPD) in patients with binge eating disorder (BED). Two hundred and eleven consecutive adult patients with axis I diagnoses of BED were reliably assessed with semi-structured diagnostic interviews. Conditional probabilities-sensitivity, specificity, positive predictive power (PPP), and negative predictive power (NPP)-were calculated for each of the eight criteria for OCPD, using the 'best-estimate' OCPD diagnosis as the standard. The diagnostic efficiencies of the OCPD criteria were variable, with three criteria failing to have predictive value (PPP<0.50). The best inclusion criterion (highest PPP) was 'Perfectionism,' which was also the overall most predictive criterion. The findings suggest ordering of the DSM-IV criteria for OCPD based on performance and call into question the utility of some criteria.     

Reliability of the Eating Disorder Examination-Questionnaire in patients with binge eating disorder

This study examined the test-retest reliability of the Eating Disorder Examination-Questionnaire (EDE-Q) in patients with binge eating disorder (BED). Short-term (mean days = 4.8; SD = 3.6) test-retest reliability of the EDE was examined in a sample of 86 patients with BED. Test-retest reliability was excellent for objective bulimic episodes (correlation = .84), but poor to unacceptable for subjective bulimic episodes and objective overeating episodes (correlations = .51 and .39, respectively). Test-retest reliabilities were good for the EDE-Q scales (correlations = .66 to .77), albeit somewhat variable for the individual EDE-Q items (.54 to .78). These findings support the reliability of the EDE-Q for patients with BED. The EDE-Q has utility for assessing the number of binge eating episodes (objective bulimic episodes) and associated features of eating disorders in patients with BED. The results for subjective bulimic episodes are consistent with previous studies in suggesting that these eating behaviors may not be reliable indicators of eating disorders for patients with BED.     

Eating patterns and breakfast consumption in obese patients with binge eating disorder

This study examined eating patterns and breakfast consumption, and their relationships to weight and binge eating, in obese individuals with binge eating disorder (BED). One-hundred seventy-three consecutively evaluated men (n=46) and women (n=127) with BED were administered semi-structured interviews and self-report measures to assess the frequency of meals and snacks eaten, as well as binge eating and eating disorder features. Overall, those who consumed more frequent meals, particularly breakfast, and snacks, weighed less. Breakfast, which was eaten on a daily basis by less than half of participants (n=74; 43%), was the least frequently eaten meal of the day. Participants (n=56; 32%) who ate three meals per day weighed significantly less, and had significantly fewer binges, than participants (n=117; 68%) who did not regularly eat three meals per day. Thus, eating more frequently, having breakfast and consuming three meals every day, have potentially important clinical applications for the treatment of BED given that the effectiveness of specific interventions within treatments for BED are unknown, and that weight loss outcome for BED has been poor.     

Factorial structure and diagnostic efficiency of DSM-IV criteria for avoidant personality disorder in patients with binge eating disorder

This study examined the factorial structure and diagnostic efficiency of the DSM-IV criteria for avoidant personality disorder (AVPD). Two hundred and twenty-eight consecutive outpatients (181 females and 47 males) with a primary diagnosis of binge eating disorder were reliably assessed with diagnostic interviews. Internal consistency of AVPD criteria was good, as suggested by coefficient alpha of 0.87, the pattern of inter-item correlations (range 0.41 to 0.64), and the lack of changes in alpha if any criteria are deleted. Exploratory factor analysis revealed a one-factor solution (56% of variance) supporting the unidimensionality of the AVPD criteria. Diagnostic efficiency indices (conditional probabilities, total predictive power, and kappa coefficients) were calculated for each AVPD criterion, for the entire study group and separately by gender. Overall, the best inclusion criterion was 'fears being ridiculed,' which was also the best predictor overall. These psychometric findings did not differ by gender. The findings support certain important aspects of the AVPD diagnosis.     

Predictors and mediators of treatment outcome in patients with binge eating disorder

A randomized controlled trial (N=52) was conducted comparing cognitive-behavioral therapy with a waiting list control group to identify mediators and predictors of treatment outcome. Reduction of weight concerns mediated abstinence of binge eating at post-treatment. Abstinence was marginally mediated by changes in eating and shape concerns, depressive symptoms and global severity of general psychopathology. Neither treatment outcome nor status at 1-year follow-up could be predicted by severity of eating disorder, comorbid psychopathology or maladaptive core beliefs at baseline or at post-treatment. The only predictor for abstinence at both post-treatment and 1-year follow-up was the coping style palliative reacting: higher scores predicted less favorable outcomes. Lower expression of emotions at post-treatment predicted more reduction of eating disorder psychopathology at follow-up. No other patient characteristics allowing treatment-patient matching could be identified.     

Recurrent binge eating with and without the "undue influence of weight or shape on self-evaluation": implications for the diagnosis of binge eating disorder

Levels of eating disorder psychopathology, impairment in psycho-social functioning and use of health services were compared among probable cases of binge eating disorder (BED) with and without extreme weight or shape concerns ("undue influence of weight or shape on self-evaluation") recruited from a large community sample of women. Data for obese non-binge eaters (n=457), also recruited from the community sample, and for a clinical sample of eating disorder patients (n=128), recruited separately, were included for comparative purposes. BED cases who reported extreme weight or shape concerns (n=51, 46.4%) had significantly higher levels of eating disorder psychopathology and functional impairment than those who did not report such concerns (n=59), after controlling for between-group differences in age and body weight. In addition, BED cases who reported extreme weight or shape concerns were more likely to have sought treatment for an eating or weight problem than those who did not. Whereas levels of eating disorder psychopathology and functional impairment were markedly elevated among BED cases with extreme weight or shape concerns, BED cases who did not report extreme weight or shape concerns resembled obese non-binge eaters in most respects. The findings support the inclusion of an undue influence of weight or shape on self-evaluation as a diagnostic criterion for BED. In the absence of this influence, eating disorders that otherwise resemble BED do not appear to be "clinically significant".     

Emotional eating and cognitive conflicts as predictors of binge eating disorder in patients with obesity

Background/Objectives: Binge Eating Disorder (BED) is often associated with obesity. In order to identify the variables that allow to better detect the presence of BED, people with overnutrition were compared with and without BED in the presence of cognitive conflicts, eating symptoms and anxious-depressive symptoms. The inclusion of cognitive conflicts had been relevant in bulimia studies but had not been investigated with respect to BED. Method: Two groups with obesity were evaluated, one without BED (OB, n = 54) and the other with BED (OB-BED, n = 48), using a social-demographic questionnaire as well as a semi-structured interview to assess BED, questionnaires (DASS-21, EDE-Q, EEQ) and the Repertory Grid Technique. Results: Overall, the OB-BED group presented more conflicts and more symptoms. The model that best differentiated between the groups included emotional eating and level of cognitive conflicts, correctly classifying 91.4% of the sample. Conclusion: These results highlight the role played by cognitive conflicts and emotional eating as differentiating elements between OB and OB-BED, with a high level of predictive accuracy.