摘要：

目的·研究神經(jīng)性厭食（anorexia nervosa，AN）患者人格特質(zhì)，比較不同亞型AN患者的人格特質(zhì)差異。方法·選擇2013年7月—2018年7月期間于上海交通大學(xué)醫(yī)學(xué)院附屬精神衛(wèi)生中心臨床心身病房及心理咨詢門(mén)診治療的164例AN患者以及124例健康對(duì)照（healthy control，HC）作為研究對(duì)象。依據(jù)《精神疾病診斷與統(tǒng)計(jì)手冊(cè)（第5版）》，將AN分為限制型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。采用進(jìn)食障礙檢查自評(píng)問(wèn)卷（Eating Disorder Examination-questionnaire，EDE-Q 6.0）評(píng)估AN患者病理心理癥狀的嚴(yán)重程度，采用Frost多維完美主義心理量表（Multidimensional Perfectionism Psychological Scale，F(xiàn)MPS）、Barratt沖動(dòng)性量表（Barratt Impulsiveness Scale 11th Version，BIS-11）及自尊量表（Self-esteem Scale，SES）評(píng)估患者完美主義、沖動(dòng)性、自尊水平方面的人格特質(zhì)。運(yùn)用獨(dú)立樣本t檢驗(yàn)、方差分析比較AN-R與AN-BP組及AN與HC組間各量表評(píng)分差異，并分析人格特質(zhì)與AN臨床癥狀的相關(guān)性。結(jié)果·AN組的FMPS量表總分顯著高于HC組（P=0.044），SES量表總分顯著低于HC組（P=0.000）。AN-BP組的FMPS量表總分、非適應(yīng)性維度得分、擔(dān)心錯(cuò)誤得分、行動(dòng)遲疑得分、父母批評(píng)得分以及BIS-11量表總分、注意力沖動(dòng)性得分、運(yùn)動(dòng)沖動(dòng)性得分、無(wú)計(jì)劃沖動(dòng)性得分均顯著高于AN-R組（均P<0.05），其條理性（即適應(yīng)性維度）得分和SES量表總分顯著低于AN-R組（均P<0.05）。AN的疾病癥狀嚴(yán)重程度（EDE-Q 6.0量表總分及各分量表得分）與完美主義（FMPS量表總分）及沖動(dòng)性（BIS-11量表總分）呈顯著正相關(guān)（P=0.000），與自尊水平（SES總分）呈顯著負(fù)相關(guān)（P=0.000）。結(jié)論·AN患者具有完美主義、低自尊的人格特質(zhì)。AN-BP患者存在更明顯的完美主義、高沖動(dòng)性、低自尊的特點(diǎn)，而AN-R患者則表現(xiàn)出低沖動(dòng)性的特點(diǎn)。

關(guān)鍵詞: 神經(jīng)性厭食, 人格特質(zhì), 完美主義, 沖動(dòng)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

中圖分類號(hào): 

R749.92

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