目的:非自杀自我伤害(NSSI)行为和进食障碍(ED)症状的高并发性表明这些疾病具有共同的病因过程。我们评估了NSSI和ED症状的共同因素的新综合模型,影响失调的地方,冲动,自尊,身体不满介导了不安全依恋和适应不良模式与NSSI和ED症状之间的关系。该研究的另一个目的是评估该模型在临床进食障碍(ED)和社区样本中的行为是否相似。
方法:123名终生诊断为ED的女性和来自社区的531名女性完成了一项在线调查,其中包括评估感兴趣变量的措施。使用横截面单时间点分析。
结果:不变性测试表明该模型在结构上是非不变的(各组不同)。提出的综合模型很适合ED组,但对于社区样本,只有修订后的模型达到了可接受的拟合。附件和适应不良的模式,包括在模型的早期,与ED和社区组导致ED和NSSI症状的途径有关。在社区团体中,冲动,调解员,是NSSI和暴食症状的共同预测因子。两组中NSSI和ED症状没有其他中介变量。总的来说,所提出的模型解释了ED组相对于社区组而言,在瘦身(R2=.57vs.51)和NSSI(R2=.29vs.24)方面的差异略大,但在贪食症状方面的差异较小(R2=.33vs.39)。
结论:我们得出的结论是,当前模型仅为解释NSSI和ED症状之间的合并症提供了有限的支持。重要的是要考虑两者的共同点(例如,依恋和适应不良模式)和特定因素(例如,冲动性),以更好地了解导致NSSI和ED症状同时发生的途径。一个新的整合模型评估了情绪失调,冲动,自尊,身体不满是不安全依恋和对世界和自我的适应不良信念以及随后的饮食失调和自我伤害症状之间关系的中介。另一个目的是评估所提出的模型在临床进食障碍和社区样本之间是否存在差异。所有参与者均为女性,包括123名终生进食障碍患者和来自社区的531名个体。参与者在一个时间点完成了在线调查,其中包括评估感兴趣变量的措施。本研究的结果表明,所提出的模型是一个很好的匹配临床饮食失调样本,但对于社区样本,只有修订后的模型产生了可接受的统计拟合。对世界和自我的不安全依恋和不适应的信念,包括在模型的早期,与饮食失调和社区群体的饮食失调和自我伤害症状间接相关。冲动性,调解员,是自我伤害的唯一共同预测因子,和社区组的暴食症状。我们得出的结论是,当前模型仅提供了有限的支持来解释自残行为与饮食失调症状之间的合并症。
OBJECTIVE: The high co-occurrence of non-suicidal self-injury (NSSI) behaviours and eating disorder (ED) symptoms suggests these conditions share common aetiological processes. We assessed a new integrative model of shared factors for NSSI and ED symptoms, where affect dysregulation, impulsivity, self-esteem, and body dissatisfaction mediated the relationship between insecure attachment and maladaptive schemas and NSSI and ED symptoms. A further aim of the study was to assess whether the model behaved similarly across a clinical eating disorder (ED) and a community sample.
METHODS: 123 females with a lifetime ED diagnosis and 531 female individuals from the community completed an online survey, which included measures assessing the variables of interest. A cross-sectional single time point analysis was used.
RESULTS: Invariance testing indicated that the model was structurally non-invariant (different across groups). The proposed integrative model was a good fit for the ED group, but for the community sample only a revised model reached an acceptable fit. Both attachment and maladaptive schemas, included early in the model, were implicated in the pathways leading to ED and NSSI symptoms in the ED and community groups. In the community group, impulsivity, a mediator, was a shared predictor for NSSI and bulimic symptoms. No other mediating variables were shared by NSSI and ED symptoms in the two groups. Overall, the proposed model explained slightly more variance for the ED group relative to the community group in drive for thinness (R2 = .57 vs .51) and NSSI (R2 = .29 vs .24) but less variance in bulimic symptoms (R2 = .33 vs .39).
CONCLUSIONS: We conclude that the current model provides only limited support for explaining the comorbidity between NSSI and ED symptoms. It is vital to consider both common (e.g., attachment and maladaptive schemas) and specific factors (e.g., impulsivity) to better understand the pathways that lead to the co-occurrence of NSSI and ED symptoms. A new integrative model assessed whether emotion dysregulation, impulsivity, self-esteem, and body dissatisfaction were mediators in the relationship between insecure attachment and maladaptive beliefs about the world and the self and subsequent eating disorder and self-harm symptoms. A further aim was to assess whether the proposed model differed between a clinical eating disorder and a community sample. All participants were female and included 123 patients with a lifetime eating disorder and 531 individuals from the community. Participating individuals completed an online survey at one timepoint, which included measures assessing the variables of interest. The findings of the current study indicated that the proposed model was a good match for the clinical eating disorder sample, but for the community sample only a revised model yielded acceptable statistical fit. Both insecure attachment and maladaptive beliefs about the world and the self, included early in the model, were indirectly related to eating disorder and self-harm symptoms for both the eating disorder and the community groups. Impulsivity, a mediator, was the only shared predictor for self-harm, and bulimic symptoms in the community group. We conclude that the current model provides only limited support for explaining the comorbidity between self-harming behaviours and disordered eating symptoms.