神经性厌食患者应激负性感受和体象关注的关系:抑郁症状的中介作用  

Relationship between stress-related negative feelings and shape concern of the patients with anorexia nervosa:mediating effect of depressive symptoms

作　　者：郭垒 胡嫣然 亢清[1] 王钰萍 王振[1] 陈涵[1] 陈珏[1] GUO Lei;HU Yan-ran;KANG Qing;WANG Yu-ping;WANG Zhen;CHEN Han;CHEN Jue(Department of Clinical Psychology,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Department of Psychiatry and Mental Health,Medical School of Ningbo University,Ningbo 315211,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心临床心理科,上海200030 [2]宁波大学医学院精神病与精神卫生学系,宁波315211

出　　处：《上海交通大学学报（医学版）》2020年第6期798-803,共6页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81771461);上海市徐汇区卫生和计划生育委员会重要疾病联合攻关项目(XHLHGG201808);上海市卫生健康系统重要薄弱学科建设计划(2019ZB0201)。

摘　　要：目的·探讨神经性厌食(anorexia nervosa,AN)患者中,应激相关的负性感受、抑郁症状和体象关注三者之间的相互作用,以及抑郁症状在负性感受和体象关注之间的中介作用。方法·选取110例符合《精神障碍诊断与统计手册(第5版)》[Diagnosis and Statistical Manual of Mental Disorders(Fifth Edition),DSM-5]的AN患者,使用应激感受量表(Perceived Stress Scale,PSS)评估患者的应激负性感受,采用贝克抑郁量表(Beck Depression Inventory,BDI)评估患者的抑郁症状,采用进食障碍检查自评问卷6.0(Eating Disorder Examination Questionnaire 6.0,EDE-Q 6.0)评估患者的体象关注。采用Pearson相关分析检验变量间的关系,采用Bootstrap法检验抑郁症状在应激负性感受和体象关注间的中介作用。结果·AN患者的负性感受与抑郁症状和体象关注均呈正相关(r=0.537,r=0.729,均P=0.000),抑郁症状与体象关注呈正相关(r=0.614,P=0.000)。中介效应分析结果显示,抑郁症状在负性感受与体象关注间的中介效应大小为0.332(95%CI 0.156~0.535),效应占比61.673%。结论·AN患者的抑郁症状可能在负性感受与体象关注间起中介作用,且中介效应大于直接效应。Objective·To investigate the interaction among stress-related negative feelings,depressive symptoms and shape concern of the patients with anorexia nervosa(AN),and the mediating effect of depressive symptoms between negative feelings and shape concern.Methods·A total of 110 AN patients who met the diagnostic criteria of the Diagnosis and Statistical Manual of Mental Disorders(Fifth Edition)(DSM-5)were recruited and their stress-related negative feelings were measured with Perceived Stress Scale(PSS),depressive symptoms were measured with Beck Depression Inventory(BDI),and shape concern was measured with Eating Disorder Examination Questionnaire 6.0(EDE-Q 6.0).Pearson’s correlation test was used to examine the relation between the variables,and the Bootstrap method was used to test the mediating effect of depressive symptoms between negative feelings and shape concern.Results·Negative feelings of the AN patients were positively correlated with depressive symptoms and shape concern(r=0.537,r=0.729,both P=0.000),and depressive symptoms were positively correlated with shape concern(r=0.614,P=0.000).The mediating effect analysis showed that the mediating role of depressive symptoms between negative feelings and shape concern was 0.332(95%CI 0.156-0.535),with the mediating effect ratio of 61.673%.Conclusion·The depressive symptoms of the AN patients may play a mediating effect between negative feelings and shape concern,and the mediating effect is greater than the direct effect.

关 键 词：神经性厌食 抑郁症状 体象关注 中介作用 

分 类 号：R749.7[医药卫生—神经病学与精神病学]