Eating Disorder Symptoms and Proneness in Gay Men, Lesbian Women, and Transgender and Non-conforming Adults: Comparative Levels and a Proposed Mediational Model
Eating Disorder Symptoms and Proneness in Gay Men, Lesbian Women, and Transgender and Non-conforming Adults: Comparative Levels and a Proposed Mediational Model
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DOI：
10.3389/fpsyg.2018.02692
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发表时间：
2019-01-08
影响因子：
3.8
通讯作者：
Hirsch, Jameson K.
中科院分区：
文献类型：
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作者：
Bell, Kathryn;Rieger, Elizabeth;Hirsch, Jameson K.
在这项研究中，我们试图比较男同性恋者、女同性恋者、变性人和异性恋者(TGNC)之间的进食障碍态度和行为，以及进食障碍的倾向性(“ED倾向”)。另一个目的是识别和比较风险和保护因素，并检验基于进食障碍人际理论(IPT-ED)的中介模型，在该模型中，人际因素与ED倾向性之间的关联将通过与自我和负面情绪有关的心理结构来中介。数据来自一项更大规模的全国性研究，研究对象是性少数群体和不同性别人群的健康风险和保护因素。样本包括97名男同性恋者，82名女同性恋者和138名TGNC成年人。受试者完成了国家大学生健康评估、饮食障碍初级护理筛查、患者健康问卷抑郁量表、广泛性焦虑障碍7量表、自我同情量表-简表、多维度健康状况问卷中的负性社会交往子量表、人际需求问卷和知觉污名量表。两组间ED倾向有显著差异，女同性恋者(66.7%)明显高于男同性恋者(47.6%)。在基于体重的自我价值感方面，不同群体之间也存在显著差异，男同性恋者的比例最低(63%)，女同性恋者的比例最高(82%)，对饮食方式的不满意比例最高，TGNC成年人的比例最高(69.8%)，男同性恋者的比例最低(47.7%)。不适当补偿行为的比例较低，组间无显著差异。Logistic回归分析显示，男同性恋者的抑郁、知觉到的耻辱和自我同情、女同性恋者的抑郁和TGNC成人的自我同情是ED倾向的预测变量。中介分析表明，受挫的归属感(即未被满足的归属感)和感觉到的耻辱与ED倾向有间接关联，这种联系是通过男同性恋者的自我同情和抑郁(仅限于感觉到的耻辱)、女同性恋者的抑郁和TGNC成年人的自我同情来中介的。因此，进食障碍的人际关系理论扩展到了性别少数和性别不同的人群；然而，结果表明，理论模型和干预计划正在扩大，以包括耻辱和自我同情的作用。
In this study we sought to compare eating disorder attitudes and behaviors, and proneness to an eating disorder ("ED proneness"), between gay men, lesbian women, and transgender and non-conforming (TGNC) adults. A further aim was to identify and compare risk and protective factors, and examine a mediational model based on the interpersonal theory of eating disorders (IPT-ED), whereby the association between interpersonal factors and ED proneness would be mediated by psychological constructs pertaining to the self and negative affect. Data was obtained from a larger national study of health risk and protective factors among sexual minority and gender diverse populations. The sample included 97 gay men, 82 lesbian women, and 138 TGNC adults. Participants completed the National College Health Assessment, Eating Disorders Screen for Primary Care, Patient Health Questionnaire Depression scale, Generalized Anxiety Disorder 7 scale, Self-Compassion Scale-Short Form, Negative Social Exchange subscale of the Multidimensional Health Profile, Interpersonal Needs Questionnaire, and Perceived Stigma Scale. There was a significant difference between groups in ED proneness, with lesbian women (66.7%) having a significantly higher percentage than gay men (47.6%). There was also a significant difference between groups in weight-based self-worth, with the lowest percentage in gay men (63%) and the highest percentage in lesbian women (82%), as well as dissatisfaction with eating patterns, with the highest percentage in TGNC adults (69.8%) and the lowest percentage in gay men (47.7%). There was a low percentage of inappropriate compensatory behaviors, with no significant difference between groups. Logistic regression analyses showed that the predictor variables of ED proneness were depression, perceived stigma, and self-compassion in gay men; depression in lesbian women; and self-compassion in the TGNC adults. Mediation analyses showed that thwarted belongingness (i.e., an unmet to belong) and perceived stigma had an indirect association with ED proneness that was mediated by self-compassion and depression (for perceived stigma alone) in gay men, depression in lesbian women, and self-compassion in TGNC adults. The interpersonal theory of eating disorders therefore extends to sexual minority and gender diverse populations; however, the results suggest a broadening of theoretical models and intervention programs to include the role of stigma and self-compassion.