Eating disorder fear networks: Identification of central eating disorder fears
Eating disorder fear networks: Identification of central eating disorder fears
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DOI：
10.1002/eat.23382
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发表时间：
2020-09-12
影响因子：
5.5
通讯作者：
Williams, Brenna M.
中科院分区：
文献类型：
--
作者：
Levinson, Cheri A.;Williams, Brenna M.
目的进食相关的恐惧和焦虑是进食障碍的标志性症状。然而，目前还不清楚哪些恐惧是最重要的（例如，食物、体重增加），这具有实际意义，鉴于对进食相关恐惧的治疗需要基于特定的恐惧驱动艾德病理学进行修改。例如，应该根据维持病理的特定恐惧来优化暴露治疗。目前的研究（N = 1,622结合临床艾德和本科生样本）开始回答关于艾德恐惧的确切性质以及它们如何与其他艾德症状一起运作的问题。方法采用网络分析法建立艾德恐惧和症状的两个模型。第一个模型仅由艾德恐惧组成（例如，恐惧食物，恐惧体重增加），以确定哪种恐惧是最核心的。第二个模型由艾德恐惧和艾德症状组成，以检测艾德恐惧如何与艾德症状一起工作。结果我们发现恐惧因体重增加而不喜欢自己的身体感觉，不喜欢在社交场合进食，对食物感到紧张，恐惧因体重增加而被评判，以及食物焦虑是最核心的艾德恐惧。我们还确定了艾德恐惧和症状之间的几个桥梁症状。最后，我们发现，最核心的艾德恐惧预测过度运动在两个月的后续行动。讨论这些数据支持后果（即，与体重增加恐惧和内感受性恐惧相关的判断）是最核心的艾德恐惧。这些数据对未来针对ED相关恐惧的精确干预措施的发展具有影响。
Objective Eating-related fear and anxiety are hallmark symptoms of eating disorders (EDs). However, it is still unclear which fears are most important (e.g., food, weight gain), which has practical implications, given treatments for eating-related fear necessitate modifications based on the specific fear driving ED pathology. For example, exposure treatments should be optimized based on specific fears that maintain pathology. The current study (N= 1,622 combined clinical ED and undergraduate sample) begins to answer questions on the precise nature of ED fears and how they operate with other ED symptoms. Method We used network analysis to create two models of ED fears and symptoms. The first model consisted of ED fears only (e.g., fears of food, fears of weight gain) to identify which fear is most central. The second model consisted of ED fears and ED symptoms to detect how ED fears operate with ED symptoms. Results We foundfear of disliking how one's body feels due to weight gain, disliking eating in social situations, feeling tense around food, fear of judgment due to weight gain,andfood anxietywere the most central ED fears. We also identified several bridge symptoms between ED fears and symptoms. Finally, we found that the most central ED fears predicted excessive exercise at two-month follow-up. Discussion These data support the idea that consequences (i.e., judgment) associated with fears of weight gain and interoceptive fears are the most central ED fears. These data have implications for the future development of precision interventions targeted to address ED-related fear.