Alexithymia and binge eating in obese outpatients who are starting a weight-loss program: A structural equation analysis
Alexithymia and binge eating in obese outpatients who are starting a weight-loss program: A structural equation analysis
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DOI：
10.1002/erv.2696
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发表时间：
2019-07-02
影响因子：
5.3
通讯作者：
Porcelli, Piero
中科院分区：
文献类型：
--
作者：
Conti, Chiara;Di Francesco, Giulia;Porcelli, Piero
目的探讨肥胖暴食患者是否具有较高的述情障碍特征，以及心理特征(述情障碍、抑郁、焦虑)与BE的不同关系。方法对361例肥胖BE患者进行述情障碍、心理困扰和BE测评。用多伦多述情障碍量表(TAS-20)评定述情障碍，BE量表(BES)评定BE，医院焦虑抑郁量表(HADS)评定抑郁和焦虑症状。结果BE患者TAS-20总分显著高于非BE患者(P<；.001)。结构方程分析表明，述情障碍的情感识别困难(DIF)和情感描述困难(DDF)成分受不同途径的影响。DIF是直接影响饮食改变的主要因素(p=0.20*)，最重要的是通过心理痛苦的中介作用(p=0.19**)，而DDF仅在较小程度上通过心理痛苦影响BE(p=0.09**)。情感知觉中的述情障碍可能在BE的发生和维持中起重要作用，尤其是当患者出现焦虑和抑郁症状时。参与肥胖管理的临床医生应该通过计划有效的以病人为中心的干预措施来解决述情障碍和情绪困扰的组合问题。
Objective To investigate whether obese patients with binge eating (BE) have higher alexithymic features; to explore the different relationships between psychological features (alexithymia, depression, and anxiety) and BE. Method Three hundred sixty one obese BE-patients were evaluated for alexithymia, psychological distress, and BE. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20); BE was assessed with the BE Scale (BES), and depression and anxiety symptoms were evaluated with the Hospital Anxiety and Depression Scale (HADS). Results Patients with BE reported significantly higher TAS-20 total scores than those without BE (p < .001). The SEM analysis showed that the difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF) components of alexithymia affected BE along different pathways. DIF was found as a major factor influencing altered eating both directly (p = .20*) and above all through the mediation of psychological distress (p = .19***), whereas DDF affected BE only through psychological distress at a lesser extent (p = .09**). Discussion Alexithymic difficulties in affective awareness may play an important role in the onset and maintenance of BE, especially when patients experienced anxiety and depression symptoms. Clinicians involved in the management of obesity should address the combination of alexithymic traits and emotional distress by planning effective client-focused interventions.