Impulsive and compulsive self-injurious behavior in bulimia nervosa: Prevalence and psychological correlates
Impulsive and compulsive self-injurious behavior in bulimia nervosa: Prevalence and psychological correlates
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DOI：
10.1097/00005053-199803000-00004
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发表时间：
1998-03-01
影响因子：
1.9
通讯作者：
Santonastaso, P
中科院分区：
文献类型：
--
作者：
Favaro, A;Santonastaso, P
已经观察到自我伤害行为和神经性暴食症之间的特定联系。在情感谱系障碍中，一些作者提出了冲动和强迫自伤行为之间的区别。本研究的目的之一是研究不同类型的自我伤害行为，包括排泄行为，如何被归类为神经性暴食症。将研究不同类型的自残对临床的影响。研究对象为125名符合DSM-IV诊断标准的神经性贪食症患者。受试者通过半结构访谈和自我报告问卷(饮食障碍问卷和霍普金斯症状检查表)进行评估。在我们的样本中，强迫性和冲动性自伤行为之间的区别似乎通过主成分分析得到了证实。强迫维度上的自我诱发呕吐和冲动维度上的泻药滥用。为了研究这两种行为对临床的影响，将暴食症患者按他们在这两个维度上的位置进行了划分。冲动的自我伤害行为的存在与性虐待史和症状检查表上的较高分数有关。冲动和强迫行为的出现都与更严重的抑郁有关，而没有强迫行为的冲动特征的出现似乎与更长的病程和更高的辍学率有关。强迫性和冲动性的自我伤害行为都与更大程度上缺乏内感意识有关。
A specific Link between self-injurious behavior and bulimia nervosa has been observed. Ln affective spectrum disorders, some authors propose a distinction between impulsive and compulsive self-injurious behavior. One of the aims of the present study is to examine how different kinds of self-injurious behavior, including purging behavior, may be classified in bulimia nervosa. The clinical impact of the different types of self-injury will be studied. The subjects of the study were 125 consecutive patients with bulimia nervosa, diagnosed by DSM-IV criteria. Subjects were evaluated by means of a semistructured interview and self-report questionnaires (Eating Disorders Inventory and Hopkins Symptom Checklist). In our sample, the distinction between compulsive and impulsive self-injurious behavior appeared to be confirmed by a principal component analysis. Self-induced vomiting loaded on the compulsive dimension and laxative abuse on the impulsive dimension. To study the clinical impact of the two kinds of behavior, bulimic subjects were divided according to their position in the two dimensions. The presence of impulsive self-injurious behavior is associated with a history of sexual abuse and with higher scores on the Symptom Checklist. The presence of both impulsive and compulsive behavior is associated with greater depression, whereas the presence of impulsive features in the absence of compulsive ones seems to be Linked to a longer duration of illness and to a higher dropout rate. Both compulsive and impulsive self-injurious behaviors are associated with a greater lack of interoceptive awareness.