神经性厌食症与神经性贪食症女性患者父母教养方式的比较研究

Parenting styles of female patients with anorexia nervosa and bulimia nervosa:a comparative study

目的探究神经性厌食症(anorexia nervosa,AN)和神经性贪食症(bulimia nervosa,BN)女性患者父母教养方式的特征,为进食障碍的临床治疗提供参考。方法回顾性纳入2019年11月-2020年5月四川大学华西医院心理卫生中心的AN和BN患者,并将来自四川大学的女性师生作为正常对照。收集3组受试者的一般情况,并采用父母教养方式评价量表对3组受试者的父母教养方式和行为进行评估。结果最终AN组纳入受试者30例,BN组纳入受试者44例,健康对照组纳入受试者33例。AN组和BN组病程差异无统计学意义(P>0.05)。3组受试者的年龄、居住地、文化程度、父母离异、父母文化程度及父母职业差异均无统计学意义(P>0.05)。AN组的体质量指数低于BN组和健康对照组(P<0.05)。父母教养方式评价量表得分结果显示,父亲得分方面,3组受试者过分干涉维度得分差异无统计学意义(P>0.05),AN组偏爱维度得分[(14.60±4.45)vs.(10.18±5.98)vs.(10.36±5.90)分]高于BN组和健康对照组,BN组情感温暖与理解维度得分[(50.55±11.81)vs.(55.33±9.12)vs.(57.03±6.13)分]低于AN组和健康对照组,健康对照组拒绝与否认维度[(7.91±3.65)vs.(10.10±3.85)vs.(10.16±3.83)分]和过度保护维度得分[(11.76±2.82)vs.(14.10±3.16)vs.(13.25±2.97)分]低于AN组和BN组(P<0.05);母亲得分方面,AN组偏爱维度得分[(14.40±4.64)vs.(10.59±5.92)vs.(10.94±5.34)分]高于BN组和健康对照组,健康对照组情感温暖与理解维度得分[(58.06±7.05)vs.(51.40±11.79)vs.(52.91±11.57)分]高于AN组和BN组(P<0.05)。结论女性进食障碍患者父母教养方式与健康对照者相比体现出更多拒绝与否认等消极情感,女性BN患者的父母教养方式与女性AN患者相比表现出更多的负性情绪,提示父母的教养方式以及态度和行为可能是女性AN和BN的影响因素。

Objective To explore the characteristics of parenting styles of female patients with anorexia nervosa(AN)and bulimia nervosa(BN),to and provide a reference for the clinical treatment of eating disorders.Methods Patients with AN and BN between November 2019 and May 2020 in the Centre for Mental Health,West China Hospital,Sichuan University were retrospectively included.Female teachers and students from Sichuan University were used as normal controls.The general conditions of the subjects in the three groups were collected,and the parenting styles and behaviors of the subjects in the three groups were evaluated using Egna Minnen av Barndoms Uppfostran(Parenting Style Evaluation Scale).Results Finally,30 subjects were included in the AN group,44 subjects were included in the BN group,and 33 subjects were included in the healthy control group.There was no significant difference in the course of disease between the AN group and the BN group(P>0.05).There were no significant differences in age,place of residence,education level,parental divorce,parental education level and parental occupation among the three groups(P>0.05).The body mass index of the AN group was lower than that of the BN group and the healthy control group(P<0.05).The parenting style evaluation scale scores showed that in terms of father scores,there was no significant difference in the excessive interference dimension scores among the three groups(P>0.05).The score of preference dimension in AN group(14.60±4.45 vs.10.18±5.98 vs.10.36±5.90)was higher than that in BN group and healthy control group,the score of emotional warmth and understanding dimension in BN group(50.55±11.81 vs.55.33±9.12 vs.57.03±6.13)was lower than that in the AN group and the healthy control group,and the scores of rejection and denial dimension(7.91±3.65 vs.10.10±3.85 vs.10.16±3.83)and overprotection dimension(11.76±2.82 vs.14.10±3.16 vs.13.25±2.97)in healthy control group were lower than those of AN group and BN group(P<0.05).In terms of mother scores,the scores of preference dimension(14.40±4.64 vs.10.59±5.92 vs.10.94±5.34)in AN group was higher than that in the BN group and the healthy control group,and the scores of emotional warmth and understanding dimension(58.06±7.05 vs.51.40±11.79 vs.52.91±11.57)in healthy control group was higher than that in AN group and BN group(P<0.05).Conclusion Compared with healthy controls,the parenting styles of female patients with eating disorders show more negative emotions such as rejection and denial.The parenting styles of female BN patients show more negative emotions than female AN patients.These all suggest that the parenting style,attitude and behavior may be the influencing factors of female AN and BN.