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 PDF全文下载地址:
点我下载PDF 