Central Symptoms Predict Posttreatment Outcomes and Clinical Impairment in Anorexia Nervosa: A Network Analysis
Central Symptoms Predict Posttreatment Outcomes and Clinical Impairment in Anorexia Nervosa: A Network Analysis
复制标题
DOI：
10.1177/2167702619865958
复制
发表时间：
2019-10-11
影响因子：
4.8
通讯作者：
Schmidt, Ulrike
中科院分区：
文献类型：
--
作者：
Elliott, Haley;Jones, Payton J.;Schmidt, Ulrike
网络分析可以用来识别中枢症状的饮食失调，如神经性厌食症（AN），但这种方法的有效性受到质疑。使用网络分析，在本研究中，我们确定成人AN的中枢症状，确定AN和焦虑/抑郁之间的关键桥梁症状，并检查基线时的中枢症状是否是治疗结果的重要预测因素。我们使用纵向数据（N = 142）对AN和共病的抑郁和焦虑进行了网络分析，这些数据包括基线、随机化后6个月、12个月和24个月的随访测量值。我们确定了中心症状和桥症状，并测试了基线计算的中心性值是否与症状的纵向预后效用相关。感觉肥胖和害怕体重增加是AN最主要的症状之一。孤独感是连接抑郁和AN的最高桥梁中心性。基线症状集中性与预后效用密切相关（r（2）= .52，.55）。症状中心性与预后效用密切相关，这一发现支持了网络理论的有效性，即中心症状可能对临床损伤和恢复产生特别强烈的影响。这些分析产生了关于AN和相关合并症的病因和维持的有用假设，并可能为未来的治疗开发提供信息。
Network analysis can be used to identify central symptoms of eating disorders such as anorexia nervosa (AN), but the validity of this approach has been questioned. Using network analysis, in the present study we identify central symptoms of adult AN, identify key bridge symptoms between AN and anxiety/depression, and examine whether central symptoms at baseline are important predictors of treatment outcomes. We conducted network analyses for AN and comorbid depression and anxiety using longitudinal data (N = 142) with measurements at baseline, and at 6-month, 12-month, and 24-month postrandomization follow-ups. We identified central symptoms and bridge symptoms and tested whether centrality values calculated at baseline were related to the prognostic utility of symptoms longitudinally. Feeling fat and fear of weight gain were among the most central symptoms of AN. Feelings of worthlessness had the highest bridge centrality connecting depression to AN. Symptom centrality at baseline was strongly related to prognostic utility (r(2) = .52, .55). The finding that symptom centrality was strongly related to prognostic utility supports the validity of network theory in that central symptoms may have a particularly strong influence on clinical impairment and recovery. These analyses generate useful hypotheses about the etiology and maintenance of AN and related comorbidities and may inform future treatment development.