神经性厌食患者人格特质的相关性研究

doi:10.3969/j.issn.1674-8115.2021.12.015

上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (12): 1650-1655.doi: 10.3969/j.issn.1674-8115.2021.12.015

• 论著 · 临床研究 • 上一篇

神经性厌食患者人格特质的相关性研究

陈涵¹(), 张靖²(), 李小平¹, 韩慧琴¹, 吴梦婷¹, 陈妍¹, 亢清¹, 徐文艳³(), 陈珏¹()

^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.上海市黄浦区精神卫生中心精神科，上海 200003
^3.复旦大学社会发展与公共政策学院，上海 200433

收稿日期:2021-06-11 出版日期:2021-12-28 发布日期:2022-01-28
通讯作者: 徐文艳,陈珏 E-mail:chenhan_920@163.com;xuwenyan@fudan.edu.cn;chenjue2088@163.com
作者简介:陈涵（1979—），男，副主任医师，学士；电子信箱：chenhan_920@163.com
陈涵（1979—），男，副主任医师，学士；电子信箱：chenhan_920@163.com
基金资助:
国家自然科学基金(81771461);上海市徐汇区卫生健康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);上海市精神心理疾病临床医学研究中心(19MC1911100)

Correlation study on personality traits of patients with anorexia nervosa

Han CHEN¹(), Jing ZHANG²(), Xiao-ping LI¹, Hui-qin HAN¹, Meng-ting WU¹, Yan CHEN¹, Qing KANG¹, Wen-yan XU³(), Jue CHEN¹()

^1.Department of Clinical Psychology, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
^2.Department of Psychiatry, Shanghai Huangpu Mental Health Center, Shanghai 200003, China
^3.School of Social Development and Public Policy, Fudan University, Shanghai 200433, China

Received:2021-06-11 Online:2021-12-28 Published:2022-01-28
Contact: Wen-yan XU,Jue CHEN E-mail:chenhan_920@163.com;xuwenyan@fudan.edu.cn;chenjue2088@163.com
Supported by:
National Natural Science Foundation of China(81771461);Important Disease Joint Research Project of Xuhui District Health Commission of Shanghai(XHLHGG201808);Shanghai Health System Important Weak Discipline Construction Plan(2019ZB0201);Shanghai Clinical Research Center for Mental Health(19MC1911100)

摘要/Abstract

摘要：

目的·研究神经性厌食（anorexia nervosa，AN）患者人格特质，比较不同亚型AN患者的人格特质差异。方法·选择2013年7月—2018年7月期间于上海交通大学医学院附属精神卫生中心临床心身病房及心理咨询门诊治疗的164例AN患者以及124例健康对照（healthy control，HC）作为研究对象。依据《精神疾病诊断与统计手册（第5版）》，将AN分为限制型AN（restricting type AN，AN-R）、暴食清除型AN（binge/purging type AN，AN-BP）和非典型AN，其中AN-R患者76例，AN-BP患者81例，非典型AN患者7例。采用进食障碍检查自评问卷（Eating Disorder Examination-questionnaire，EDE-Q 6.0）评估AN患者病理心理症状的严重程度，采用Frost多维完美主义心理量表（Multidimensional Perfectionism Psychological Scale，FMPS）、Barratt冲动性量表（Barratt Impulsiveness Scale 11th Version，BIS-11）及自尊量表（Self-esteem Scale，SES）评估患者完美主义、冲动性、自尊水平方面的人格特质。运用独立样本t检验、方差分析比较AN-R与AN-BP组及AN与HC组间各量表评分差异，并分析人格特质与AN临床症状的相关性。结果·AN组的FMPS量表总分显著高于HC组（P=0.044），SES量表总分显著低于HC组（P=0.000）。AN-BP组的FMPS量表总分、非适应性维度得分、担心错误得分、行动迟疑得分、父母批评得分以及BIS-11量表总分、注意力冲动性得分、运动冲动性得分、无计划冲动性得分均显著高于AN-R组（均P<0.05），其条理性（即适应性维度）得分和SES量表总分显著低于AN-R组（均P<0.05）。AN的疾病症状严重程度（EDE-Q 6.0量表总分及各分量表得分）与完美主义（FMPS量表总分）及冲动性（BIS-11量表总分）呈显著正相关（P=0.000），与自尊水平（SES总分）呈显著负相关（P=0.000）。结论·AN患者具有完美主义、低自尊的人格特质。AN-BP患者存在更明显的完美主义、高冲动性、低自尊的特点，而AN-R患者则表现出低冲动性的特点。

关键词: 神经性厌食, 人格特质, 完美主义, 冲动性, 自尊

Abstract:

Objectives·To investigate the personality traits of patients with anorexia nervosa (AN), and compare the differences of personality traits among different subtypes of AN.

Methods·A total of 164 patients with AN treated in the Clinical Psychosomatic Ward and Psychological Counseling Clinic of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine from July 2013 to July 2018 were selected and 124 healthy controls (HC) were recruited. According to Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), AN was divided into restricting type AN (AN-R), binge-purging type AN (AN-BP) and atypical AN. In AN group, 76 cases were AN-R, 81 cases were AN-BP, and 7 cases were atypical AN. The severity of pathological psychological symptoms of AN patients was evaluated by Eating Disorder Examination-questionnaire (EDE-Q 6.0), and the personality traits of perfectionism, impulsivity and self-esteem of AN patients were evaluated by Frost Multidimensional Perfectionism Psychological Scale (FMPS), Barratt Impulsiveness Scale 11th Version (BIS-11) and Self-esteem Scale (SES). Independent sample t test and variance analysis were used to compare the differences between AN-R group and AN-BP group and differences between the AN group and HC group, and correlation analysis was used to analyze the correlation between personality traits and AN clinical symptom.

Results·The total FMPS score of the AN group was significantly higher than that of the HC group (P=0.044), and the total score of SES was significantly lower than that of the HC group (P=0.000). The total score of FMPS, non-adaptive dimension score, BIS-11 total score, attentional impulse score, motor impulse score, and unplanned impulse score in the AN-BP group were significantly higher than those in the AN-R group (all P<0.05). Compared with the AN-R group, AN-BP group had significantly lower organization (adaptive dimension) score and SES total score (all P<0.05). The severity of clinical symptoms of AN (EDE-Q 6.0 total score and subscale scores) was positively correlated with perfectionism (FMPS total score) and impulsivity (BIS-11 total score), and negatively correlated with self-esteem (SES total score) (all P=0.000).

Conclusion·Patients with AN have perfectionism and low self-esteem. The patients with AN-BP have more perfectionism, high impulsivity and low self-esteem, while the patients with AN-R show low impulsivity.

Key words: anorexia nervosa (AN), personality trait, perfectionism, impulsivity, self-esteem

中图分类号:

R749.92

陈涵, 张靖, 李小平, 韩慧琴, 吴梦婷, 陈妍, 亢清, 徐文艳, 陈珏. 神经性厌食患者人格特质的相关性研究[J]. 上海交通大学学报(医学版), 2021, 41(12): 1650-1655.

Han CHEN, Jing ZHANG, Xiao-ping LI, Hui-qin HAN, Meng-ting WU, Yan CHEN, Qing KANG, Wen-yan XU, Jue CHEN. Correlation study on personality traits of patients with anorexia nervosa[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(12): 1650-1655.

图/表 4

参考文献 28

1	Hudson JI, Hiripi E, Pope HG, et al. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication[J]. Biol Psychiatry, 2007, 61(3): 348-358.
2	Rymarczyk K. The role of personality traits, sociocultural factors, and body dissatisfaction in anorexia readiness syndrome in women[J]. J Eat Disord, 2021, 9(1): 51.
3	范轶欧, 段一凡, 郝利楠, 等. 我国7城市中学生进食障碍的流行状况[J]. 中国健康教育, 2009, 25(9): 657-659.
4	侯安娴. 北京市初中生进食障碍倾向与体质状况及其关系的研究[D]. 北京: 北京体育大学, 2016.
5	陈珏. 进食障碍[M]. 北京: 人民卫生出版社, 2013: 96-98.
6	Hewitt PL, Flett GL. Perfectionism in the self and social contexts: conceptualization, assessment, and association with psychopathology[J]. J Pers Soc Psychol, 1991, 60(3): 456-470.
7	Cassin SE, von Ranson KM. Personality and eating disorders: a decade in review[J]. Clin Psychol Rev, 2005, 25(7): 895-916.
8	黄佳滨, 陈珏, 岳玲, 等. 神经性厌食症患者的抑制功能与完美主义特质[J]. 临床精神医学杂志, 2017, 27(4): 217-220.
9	古练, 陈珏, 黄悦, 等. 进食障碍检查自评问卷6.0中文版在女性进食障碍患者中应用的效度和信度[J]. 中国心理卫生杂志, 2017, 31(5): 350-355.
10	訾非, 周旭. 中文frost多维度完美主义问卷的信效度检验[J]. 中国临床心理学杂志, 2006, 14(6): 560-563.
11	周亮, 肖水源, 何晓燕, 等. BIS-11中文版的信度与效度检验[J]. 中国临床心理学杂志, 2006, 14(4): 343-344, 342.
12	田录梅. Rosenberg(1965)自尊量表中文版的美中不足[J]. 心理学探新, 2006, 26(2): 88-91.
13	Muzi L, Tieghi L, Rugo MA, et al. Personality as a predictor of symptomatic change in a residential treatment setting for anorexia nervosa and bulimia nervosa[J]. Eat Weight Disord, 2021, 26(4): 1195-1209.
14	Walderhaug E, Herman AI, Magnusson A, et al. The short (S) allele of the serotonin transporter polymorphism and acute tryptophan depletion both increase impulsivity in men[J]. Neurosci Lett, 2010, 473(3): 208-211.
15	Cassin SE, von Ranson KM. Personality and eating disorders: a decade in review[J]. Clin Psychol Rev, 2005, 25(7): 895-916.
16	Shafran R, Cooper Z, Fairburn CG. Clinical perfectionism: a cognitive-behavioural analysis[J]. Behav Res Ther, 2002, 40(7): 773-791.
17	Steward T, Mestre-Bach G, Vintró-Alcaraz C, et al. Delay discounting of reward and impulsivity in eating disorders: from anorexia nervosa to binge eating disorder[J]. Eur Eat Disord Rev, 2017, 25(6): 601-606.
18	Joiner TE, Heatherton TF, Rudd MD, et al. Perfectionism, perceived weight status, and bulimic symptoms: two studies testing a diathesis-stress model[J]. J Abnorm Psychol, 1997, 106(1): 145-153.
19	Nishimura H, Komaki G, Ando T, et al. Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa[J]. Biopsychosoc Med, 2008, 2: 5.
20	Cyders MA, Smith GT, Spillane NS, et al. Integration of impulsivity and positive mood to predict risky behavior: development and validation of a measure of positive urgency[J]. Psychol Assess, 2007, 19(1): 107-118.
21	Fischer S, Smith GT, Cyders MA. Another look at impulsivity: a meta-analytic review comparing specific dispositions to rash action in their relationship to bulimic symptoms[J]. Clin Psychol Rev, 2008, 28(8): 1413-1425.
22	Zalar B, Weber U, Sernec K. Aggression and impulsivity with impulsive behaviours in patients with purgative anorexia and bulimia nervosa[J]. Psychiatr Danub, 2011, 23(1): 27-33.
23	Le Grange D, Crosby RD, Engel SG, et al. DSM-Ⅳ-defined anorexia nervosa versus subthreshold anorexia nervosa (EDNOS-AN)[J]. Eur Eat Disord Rev, 2013, 21(1): 1-7.
24	Claes L, Nederkoorn C, Vandereycken W, et al. Impulsiveness and lack of inhibitory control in eating disorders[J]. Eat Behav, 2006, 7(3): 196-203.
25	Watson D, Suls J, Haig J. Global self-esteem in relation to structural models of personality and affectivity[J]. J Pers Soc Psychol, 2002, 83(1): 185-197.
26	Wilksch S, Wade TD. Differences between women with anorexia nervosa and restrained eaters on shape and weight concerns, self-esteem, and depression[J]. Int J Eat Disord, 2004, 35(4): 571-578.
27	Hoare P, Cosgrove L. Eating habits, body-esteem and self-esteem in Scottish children and adolescents[J]. J Psychosom Res, 1998, 45(5): 425-431.
28	Puttevils L, Vanderhasselt MA, Vervaet M. Investigating transdiagnostic factors in eating disorders: does self-esteem moderate the relationship between perfectionism and eating disorder symptoms? [J]. Eur Eat Disord Rev, 2019, 27(4): 381-390.

Item	AN group （n=164）	AN-R group （n=76）	AN-BP group （n=81）	HC group （n=124）	P value
Item	AN group （n=164）	AN-R group （n=76）	AN-BP group （n=81）	HC group （n=124）	AN group vs HC group	AN-R group vs AN-BP group
Age/year	18.18±4.45	16.40±3.22	19.94±4.89	19.07±3.13	0.064	0.000
Education/year	11.47±3.37	10.16±3.12	12.74±3.19	12.09±2.79	0.103	0.000
Height/m	1.62±0.05	1.62±0.55	1.62±0.05	1.62±0.16	0.844	0.972
Body mass/kg	40.26±6.60	37.99±6.86	42.73±5.46	52.83±7.35	0.000	0.000
BMI/（kg·m^-2）	15.27±2.22	14.40±2.26	16.22±1.78	19.76±2.41	0.000	0.000
EDE-Q 6.0/score	2.17±1.53	1.53±1.24	2.84±1.48	1.19±1.04	0.000	0.000
Restraint/score	1.83±1.70	1.34±1.46	2.37±1.78	0.81±1.03	0.000	0.000
Eating concern/score	2.19±1.72	1.29±1.30	3.15±1.59	0.72±0.96	0.000	0.000
Weight concern/score	2.14±1.69	1.59±1.31	2.80±1.78	1.41±1.29	0.000	0.000
Shape concern/score	2.52±1.69	1.96±1.49	3.18±1.64	1.80±1.45	0.000	0.000

Item	AN group （n=164）	AN-R group （n=76）	AN-BP group （n=81）	HC group （n=124）	P value
Item	AN group （n=164）	AN-R group （n=76）	AN-BP group （n=81）	HC group （n=124）	AN group vs HC group	AN-R group vs AN-BP group
Age/year	18.18±4.45	16.40±3.22	19.94±4.89	19.07±3.13	0.064	0.000
Education/year	11.47±3.37	10.16±3.12	12.74±3.19	12.09±2.79	0.103	0.000
Height/m	1.62±0.05	1.62±0.55	1.62±0.05	1.62±0.16	0.844	0.972
Body mass/kg	40.26±6.60	37.99±6.86	42.73±5.46	52.83±7.35	0.000	0.000
BMI/（kg·m^-2）	15.27±2.22	14.40±2.26	16.22±1.78	19.76±2.41	0.000	0.000
EDE-Q 6.0/score	2.17±1.53	1.53±1.24	2.84±1.48	1.19±1.04	0.000	0.000
Restraint/score	1.83±1.70	1.34±1.46	2.37±1.78	0.81±1.03	0.000	0.000
Eating concern/score	2.19±1.72	1.29±1.30	3.15±1.59	0.72±0.96	0.000	0.000
Weight concern/score	2.14±1.69	1.59±1.31	2.80±1.78	1.41±1.29	0.000	0.000
Shape concern/score	2.52±1.69	1.96±1.49	3.18±1.64	1.80±1.45	0.000	0.000

Item	AN group （n=164）	HC group （n=124）	P value
FMPS/score	107.22±24.13	101.84±16.89	0.044
Maladaptive dimension/score	84.58±23.23	80.03±15.76	0.072
Concern over mistakes/score	25.36±9.18	22.46±6.61	0.004
Doubts about actions/score	12.52±4.00	12.20±3.02	0.474
Personal standards/score	22.42±6.08	21.62±4.28	0.226
Parental expectations/score	13.29±4.57	13.82±3.87	0.321
Parental criticism/score	10.63±3.81	9.92±3.10	0.109
Adaptive dimension （organization）/score	22.35±4.76	21.81±3.93	0.337
BIS-11/score	54.73±9.47	56.27±7.82	0.165
Attentional impulsiveness/score	13.13±3.94	13.36±2.38	0.557
Motor impulsiveness/score	17.63±3.70	19.01±3.26	0.002
Nonplanning impulsiveness/score	23.80±4.64	23.85±4.30	0.934
SES/score	27.05±6.44	29.28±4.25	0.002

Item	AN group （n=164）	HC group （n=124）	P value
FMPS/score	107.22±24.13	101.84±16.89	0.044
Maladaptive dimension/score	84.58±23.23	80.03±15.76	0.072
Concern over mistakes/score	25.36±9.18	22.46±6.61	0.004
Doubts about actions/score	12.52±4.00	12.20±3.02	0.474
Personal standards/score	22.42±6.08	21.62±4.28	0.226
Parental expectations/score	13.29±4.57	13.82±3.87	0.321
Parental criticism/score	10.63±3.81	9.92±3.10	0.109
Adaptive dimension （organization）/score	22.35±4.76	21.81±3.93	0.337
BIS-11/score	54.73±9.47	56.27±7.82	0.165
Attentional impulsiveness/score	13.13±3.94	13.36±2.38	0.557
Motor impulsiveness/score	17.63±3.70	19.01±3.26	0.002
Nonplanning impulsiveness/score	23.80±4.64	23.85±4.30	0.934
SES/score	27.05±6.44	29.28±4.25	0.002

Item	AN-R group （n=76）	AN-BP group （n=81）	HC group （n=124）	F value	P value	P value
Item	AN-R group （n=76）	AN-BP group （n=81）	HC group （n=124）	F value	P value	AN-R group vs AN-BP group	AN-R group vs HC group	AN-BP group vs HC group
FMPS/score	103.19±22.36	113.46±23.76	101.84±16.89	6.685	0.002	0.000	0.668	0.006
Maladaptive dimension/score	79.84±21.69	91.91±22.00	80.03±15.76	8.526	0.000	0.001	0.951	0.000
Concern over mistakes/score	23.03±8.93	28.56±8.30	22.46±6.61	13.176	0.000	0.000	0.631	0.000
Doubts about actions/score	11.58±3.67	13.87±3.83	12.20±3.02	7.639	0.001	0.000	0.233	0.002
Personal standards/score	22.32±5.51	23.10±6.20	21.62±4.28	1.680	0.189	-	-	-
Parental expectations/score	12.94±4.42	13.88±4.68	13.82±3.87	1.100	0.335	-	-	-
Parental criticism/score	9.67±3.62	11.85±3.69	9.92±3.10	8.086	0.000	0.000	0.633	0.000
Adaptive dimension （organization）/score	23.33±3.92	21.70±5.22	21.81±3.93	3.194	0.043	0.033	0.022	0.872
BIS-11/score	49.91±8.02	59.57±8.45	56.27±7.82	24.928	0.000	0.000	0.000	0.008
Attentional impulsiveness/score	11.61±2.80	14.64±4.36	13.36±2.38	16.055	0.000	0.000	0.000	0.007
Motor impulsiveness/score	16.33±3.36	18.97±3.52	19.01±3.26	15.541	0.000	0.000	0.000	0.943
Nonplanning impulsiveness/score	21.87±4.33	25.65±4.21	23.85±4.30	13.265	0.000	0.000	0.003	0.006
SES/score	29.12±6.03	24.78±5.93	29.28±4.25	15.375	0.000	0.000	0.845	0.000

神经性厌食患者人格特质的相关性研究

Correlation study on personality traits of patients with anorexia nervosa

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Metrics

EDE-Q 6.0 score	FMPS score		BIS-11 score		SES score
EDE-Q 6.0 score	r value	P value	r value	P value	r value	P value
Total score	0.417	0.000	0.448	0.000	-0.501	0.000
Restraint score	0.332	0.000	0.305	0.000	-0.369	0.000
Eating concern score	0.386	0.000	0.446	0.000	-0.491	0.000
Weight concern score	0.368	0.000	0.438	0.000	-0.458	0.000
Shape concern score	0.406	0.000	0.426	0.000	-0.478	0.000

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[5]	苏杭，李质彬，杜江，江海峰，陈志康，孙海明，赵敏. 5年随访研究海洛因复吸的预测因子——气质、冲动性和COMT基因多态性的性别差异[J]. 上海交通大学学报（医学版）, 2015, 35(10): 1452-.
[6]	古练，陈珏，肖泽萍. 进食障碍患者治疗动机的评估和干预[J]. 上海交通大学学报（医学版）, 2015, 35(10): 1560-.
[7]	杨秀木，申正付，齐玉龙，等. 人格特质、人际信任与医学生主观幸福感的关系分析[J]. 上海交通大学学报（医学版）, 2015, 35(1): 102-.