Psihološka prilagodba i sociokulturni stavovi u adolescentica s anoreksijom nervozom [Psychological maladjustment and sociocultural attitudes towards appearance in adolescents with anorexia nervosa]

Batista, Maja (2019) Psihološka prilagodba i sociokulturni stavovi u adolescentica s anoreksijom nervozom [Psychological maladjustment and sociocultural attitudes towards appearance in adolescents with anorexia nervosa]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

Anorexia nervosa is severe psychiatric disorder with the high mortality rate and represents a significant psychiatric, pediatric and public-scientific problem. The treatment is long-lasting, followed by a series of complications, and a deathly outcome. Although most commonly occurs in adolescence, there is an increasing incidence of this disease in the pre-puberty age. This research comprehensively approaches anorexia nervosa as an entity whose development and maintenance are influenced by biological, psychological and socio-cultural factors. The study included 122 subjects, 62 subjects with restrictive type anorexia and 60 subjects in the control group. Adolescent with AN-R were divided into two groups, younger (<14 years) and older (> 14 years). The following questionnaires were used in the survey: General and Health Data Questionnaire, Inventory of Eating disoreders-3 (EDI-3), Difficulties in Emotion Regulation Scale (DERS), Basic Empathy Scale (BES), Socio-cultural attitudes towards physical appearance-3 (SATAQ-3). The aim of the study included the risk factors for eating disorder, and the comparison of the results between patients with anorexia nervosa and control group in terms of general psychological maladaptation, empathy, attachment style, and sociocultural attitudes towards physical appearance. The difference between younger and older adolescents with AN-R on these variables was investigated, as well as the correlation between psychological and socio-cultural factors with a risk for developing eating disorder. Finally, the aim was to examine the predictors of risk for developing eating disorders. Research findings confirm that there is a statistically significant difference between patients with anorexia nervosa and healthy group due to psychological and socio-cultural factors. Girls with AN-R have lower self-esteem, greater personal alienation, social insecurity, social alienation, interoceptive difficulties, perfectionism and asceticism, body dissatisfaction, drive for thinness, emotional regulation difficulties, and higher prevalence of insecure and avoiding attachment style. Additionally, girls with AN-R have greater thin internalization and social pressures to be slim. In older adolescents with AN-R there are more those with interoceptive difficulties and with emotional regulation difficulties, compared to young adolescent with AN-R. Insecure attachment style, emotional regulation, and psychological maladjustment are significant predictors of risk for developing eating disorders in girls with AN-R. In the final model, only psychological maladjustemnt has proved to be a significant predictor and shows a 50.4% variation of risk for eating disorders development. Insecure and avoiding attachment, social attitudes towards physical appearance and psychological maladjustment have been shown as significant predictors of the risk of developing eating disorders in the control group. In the final model, significant predicor was psychological maladjustemnt and social attitudes toeards physical appearance, with more than 64,7% of the eating disorder risk comosite variance explained.

Abstract in Croatian

Anoreksija nervoza spada u teške psihijatrijske poremećaje s visokom stopom mortaliteta te predstavlja značajan psihijatrijski, pedijatrijski, ali i javno-znanstveni problem. Liječenje je dugotrajno, praćeno nizom komplikacija, pa i smrtnim ishodom. Iako se najčešće javlja u doba adolescencije, sve je veća pojavnost ove bolesti u ranijoj, predpubertetskoj dobi. Ovo istraživanje na sveobuhvatan način prilazi anoreksiji nervozi kao entitetu na čiji nastanak, razvoj i održavanje utječu biološki, psihološki i sociokulturalni čimbenici. U opisanom istraživanju sudjelovalo je 122 ispitanica, 62 ispitanice s anoreksijom nervozom restriktivnog tipa i 60 ispitanica u kontrolnoj skupini. Adolescentice a anoreksijom nervozom podijeljene su u dvije skupine, na mlađe (<14 godina) i starije (>14 godina). U istraživanju su korišteni sljedeći upitnici: Upitnik općih i zdravstvenih podataka, Upitnik za procjenu simptomatologije poremećaja hranjenja-3 (engl. „Eating Disorder Inventory-3“; EDI-3), Upitnik teškoća u emocionalnoj regulaciji (engl. „Difficulties in Emotion Regulation Scale“; DERS), Upitnik iskustva u bliskim vezama – revidirana verzija (engl. „Experience in Close Relationship-Revised“; ECR-R), Upitnik o empatiji (engl. „Basic Empathy Scale“; BES), te Upitnik sociokulturalnih stavova o tjelesnom izgledu-3 (engl. „Sociocultural Attitudes Towards Appearance Questionnaire -3“; SATAQ-3). Cilj istraživanja odnosi se na definiranje rizičnih čimbenika poremećaja hranjenja, te usporedbu rezultata između adolescentica s anoreksijom nervozom i kontrolne skupine obzirom na psihološku prilagodbu, emocionalnu regulaciju, empatiju, stil privrženosti, te sociokulturalne stavove o tjelesnom izgledu. Istraživala se i razlika između mlađih i starijih adolescenata s AN-R po navedenim varijablama, kao i povezanost psiholoških i sociokulturalnih čimbenika s rizikom za razvoj poremećaja hranjenja i dijagnozom anoreksije nervoze. Konačno, cilj je bio ispitati prediktore rizika za razvoj poremećaja hranjenja. Rezultati istraživanja potvrđuju kako postoji statistički značajna razlika između osoba s anoreksijom nervozom i kontrolne skupine obzirom na psihološke i sociokulturološke čimbenike. Djevojke s AN-R imaju niže samopoštovanje, te veće osobno otuđenje, socijalnu nesigurnost, socijalno otuđenje, interoceptivne teškoće, perfekcionizam i asketizam, nezadovoljstvo tijelom, želju za mršavosti, teškoće u emocionalnoj regulaciji, te nesigurni i izbjegavajući stil privrženosti. Uz navedeno, djevojke s AN-R imaju veću internalizaciju ideala mršavosti i osjećaju jače socijalni pritiske o mršavosti. U starijih adolescentica s AN-R ima više onih s teškoćama u interocepciji i emocionalnoj regulaciji, u odnosu na mlađe adolescentice s AN-R. Nesigurni stil privrženosti, teškoće u emocionalnoj regulaciji, te teškoće u psihološkoj prilagodbi su značajni prediktori rizika za razvoj poremećaja hranjenja u djevojaka s AN-R. U konačnom modelu jedino se psihološka neprilagodba pokazala značajnim prediktorom AN, te objašnjava 50,4% varijance rizika za razvoj poremećaja hranjenja. Nesigurni i izbjegavajući stil privrženosti, socijalni stavovi o tjelesnom izgledu i psihološka neprilagodba su se pokazali značajnim prediktorima rizika za razvoj poremećaja hranjenja u kontrolnoj skupini. U konačnom modelu u kontrolnoj skupini značajnim prediktorima potvrdili su se psihološka neprilagodba i socijalni stavovi o tjelesnom izgledu, te objašnjavaju sveukupno 64,7% varijance rizika za razvoj poremećaja hranjenja.

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