PDF(Pubmed)
Abstract：
Bulimia nervosa (BN) and other specific feeding or eating disorders with subthreshold BN symptoms (OSFED-BN) are characterized by recurrent binge eating episodes accompanied by compensatory behaviors, including excessive exercise. We aimed to examine the role of compensatory exercise on several clinical disorder-related variables and the treatment outcomes. The sample included 478 patients diagnosed with either BN or OSFED-BN admitted for a 16-week eating disorder-specific treatment program. A battery of questionnaires was administered to evaluate eating and general psychopathology, and personality traits. Other clinical disorder-related data, including levels of compensatory exercise, were assessed through a semi-structured clinical interview. Between-group comparisons of compensatory exercise levels were analyzed, as a predictive model of risk of poor treatment outcomes. Path analysis was conducted using structural equation models to estimate the direct and indirect effects between the main variables. Higher levels of self-reported compensatory exercise were associated with greater eating psychopathology, general psychopathology, and more dysfunctional personality traits and were a predictor of poor treatment outcomes. Additionally, these levels achieved a mediating role in several paths contributing to a higher likelihood of a poor outcome. Further research is required to determine how psychotherapeutic approaches can be optimized to adequately include adaptive exercise for these patients.
摘要：
神经性贪食症（BN）和其他具有阈值下BN症状的特定进食或进食障碍（OSFED-BN）的特征是反复暴食发作并伴有代偿行为，包括过度锻炼。我们旨在研究代偿性运动对几种临床疾病相关变量和治疗结果的作用。样本包括478名诊断为BN或OSFED-BN的患者，他们接受了为期16周的进食障碍特异性治疗计划。进行了一系列问卷调查，以评估饮食和一般精神病理学，和人格特质。其他临床疾病相关数据，包括补偿性锻炼的水平，通过半结构化临床访谈进行评估。对代偿运动水平的组间比较进行了分析，作为不良治疗结果风险的预测模型。使用结构方程模型进行路径分析，以估计主要变量之间的直接和间接影响。自我报告的补偿性运动水平较高与饮食心理病理学有关，一般精神病理学，和更多功能失调的人格特质，是不良治疗结果的预测指标。此外,这些水平在几条路径中发挥了中介作用，导致结果不佳的可能性更高。需要进一步的研究来确定如何优化心理治疗方法，以充分包括这些患者的适应性锻炼。
