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As perturbações da alimentação e da ingestão: fatores de risco e a sua interação com as características clínicas e psicológicas numa amostra de estudantes universitários
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Abstract(s)
Segundo a nosologia da psiquiatria americana no Manual DSM-5, as Perturbações da Alimentação e da Ingestão (PAI) são, nos dias de hoje, consideradas uma das disfunções psicológicas mais prejudiciais à saúde humana considerando o sofrimento prolongado que provocam, bem como, as elevadas taxas de mortalidade apresentadas (Mitchell & Crow, 2006). Possuem uma etiologia multifatorial, constituída por predisposições genéticas, socioculturais, biológicas e psicológicas que contribuem para o seu aparecimento e desenvolvimento (Morgan & Negrão, 2022). Ademais, segundo o DSM-5, tanto a Anorexia Nervosa (AN) como a Bulimia Nervosa (BN) têm início tipicamente na adolescência e/ou início da vida adulta (American Psychological Association, 2013), o que nos confirma que as PAI são uma problemática importante a ter em conta quando se fala nestes períodos do desenvolvimento, No que concerne ao início da sua manifestação clínica, os estudantes universitários são a população mais afetada dado à influência de fatores externos como o stress, bem como, o facto de se situarem na faixa etária privilegiada para o surgimento da maioria das perturbações mentais (Fitzsimmons-Craft, Balantekin, Eichen, Graham, Monterubio, Sadeh-Sharvit, Goel, Flatt, Saffran, Karam, Firebaugh, Trockel, Taylor & Wilfley, 2019).
Entre os fatores predisponentes, relativamente aos quadros das PAI, destacam-se a história familiar de sintomatologias do mesmo tipo, padrões de interação no núcleo familiar e social, contexto e ideais socioculturais. Na esfera da personalidade, traços como baixa auto-estima aliada a uma distorção da imagem corporal, traços perfecionistas e ascéticos, impulsividade e instabilidade afetiva que, se manifesta em pensamentos/emoções desadaptativas. Além disso, a restrição alimentar e o uso de substâncias e métodos compensatórios revelam a sua importância como acontecimentos antecedentes à instalação de uma PAI (Morgan et al., 2022).
Após uma abordagem abrangente dos traços psicológicos das PAI, torna-se necessário investigar uma perspetiva diferencial entre os diversos quadros destas perturbações e respetivas manifestações. Neste sentido, uma melhor compreensão das diferentes manifestações destas perturbações e um melhor desenvolvimento de intervenções no campo mencionado demonstra ser uma questão fundamental para a saúde pública (Galmiche, Déchelotte, Lambert & Tavolacci, 2019; Cororve, Fingeret, Warren, Cepeda-Benito & Gleaves, 2006).
O presente estudo tem como objetivo principal contribuir para a caracterização dos fatores de risco (FR) associados ao desenvolvimento de uma PAI, abrangendo as respetivas características clínicas e psicológicas destes quadros sintomatológicos. Desta forma, conta com uma amostra de 38 participantes, ingressados no ensino superior, em que 55,3% são do género feminino e 44,7% do género masculino, com uma média de idades de 19,21 (DP= 0,811).
Os resultados indicam que os FR individuais foram mais prevalentes na amostra estudada, enquanto que, os FR socioculturais foram os menos relevantes. Ainda, constatou-se que, os FR Autoestima e o FR Apoio Social revelam uma correlação negativa face a possibilidade de estarmos perante uma PAI, sugerindo assim, uma possível função protetora. Por fim, foi possível averiguar que todos os FR associados ao desenvolvimento de uma PAI, se encontram relacionados com pelo menos 2 características clínicas e psicológicas descritas, em indivíduos com os quadros psicopatológicos estudados, à exceção do FR Autoestima. Esta informação sugere que, este FR poderá apresentar um contributo associado a uma função protetora face à instalação das condições abordadas.
According to the nosology of American psychiatry in the DSM-5 Manual, Eating Disorders (ED) are now considered to be one of the most damaging psychological disorders to human health, considering the prolonged suffering they cause, as well as, the high mortality rates (Mitchell & Crow, 2006). They assume a multifactorial aetiology, consisting of genetic, sociocultural, biological and psychological predispositions that contribute to their onset and development (Morgan & Negrão, 2022). Furthermore, according to the DSM-5, both Anorexia Nervosa (AN) and Bulimia Nervosa (BN) typically begin in adolescence and/or early adulthood (APA, 2013), which confirms that ED are an important problem to take into account when talking about these periods of development, With regard to the onset of their clinical manifestation, university students are the most affected population due to the influence of external factors such as stress, as well as the fact that they are in the favoured age group for the onset of most mental disorders (Fitzsimmons-Craft, Balantekin, Eichen, Graham, Monterubio, Sadeh-Sharvit, Goel, Flatt, Saffran, Karam, Firebaugh, Trockel, Taylor & Wilfley, 2019). Predisposing factors for ED include a family history of similar symptoms, patterns of interaction within the family and social nucleus, and socio-cultural context and ideals. In the sphere of personality, traits such as low self-esteem combined with a distorted body image, perfectionist and ascetic traits, impulsiveness and affective instability which manifests itself in maladaptive thoughts/emotions. In addition, food restriction and the use of substances and compensatory methods are understood to be precursor events to the development of an ED (Morgan et al., 2022). After a comprehensive approach to the psychological features of ED it becomes necessary to investigate a differential perspective between the various pictures of these disorders and their respective manifestations. In this sense, a better understanding of the different manifestations of these disorders and a better development of interventions in the aforementioned field proves to be a fundamental issue for public health (Galmiche, Déchelotte, Lambert & Tavolacci, 2019; Cororve, Fingeret, Warren, Cepeda-Benito & Gleaves, 2006). The main aim of this study is to help characterise the risk factors (RF) associated with the development of an ED, including the clinical and psychological characteristics of these psychopathology. The study included a sample of 38 participants who had entered higher education, 55.3% were females and 44.7% males, with an average age of 19.21 (SD= 0.811). The results indicated that individual RF were the most prevalent in the sample studied, while sociocultural RF were the least relevant. It was also found that self-esteem and social support were negatively correlated with the possibility of an ED diagnosis, thus suggesting a possible protective function. Finally, it was found that all the RF associated with the development of an IAP are related to at least 2 of the clinical and psychological characteristics described in individuals with the psychopathological conditions studied, with the exception of the Self-esteem RF. This information suggests that this RF may have a contribution associated with a protective function against the onset of the conditions discussed.
According to the nosology of American psychiatry in the DSM-5 Manual, Eating Disorders (ED) are now considered to be one of the most damaging psychological disorders to human health, considering the prolonged suffering they cause, as well as, the high mortality rates (Mitchell & Crow, 2006). They assume a multifactorial aetiology, consisting of genetic, sociocultural, biological and psychological predispositions that contribute to their onset and development (Morgan & Negrão, 2022). Furthermore, according to the DSM-5, both Anorexia Nervosa (AN) and Bulimia Nervosa (BN) typically begin in adolescence and/or early adulthood (APA, 2013), which confirms that ED are an important problem to take into account when talking about these periods of development, With regard to the onset of their clinical manifestation, university students are the most affected population due to the influence of external factors such as stress, as well as the fact that they are in the favoured age group for the onset of most mental disorders (Fitzsimmons-Craft, Balantekin, Eichen, Graham, Monterubio, Sadeh-Sharvit, Goel, Flatt, Saffran, Karam, Firebaugh, Trockel, Taylor & Wilfley, 2019). Predisposing factors for ED include a family history of similar symptoms, patterns of interaction within the family and social nucleus, and socio-cultural context and ideals. In the sphere of personality, traits such as low self-esteem combined with a distorted body image, perfectionist and ascetic traits, impulsiveness and affective instability which manifests itself in maladaptive thoughts/emotions. In addition, food restriction and the use of substances and compensatory methods are understood to be precursor events to the development of an ED (Morgan et al., 2022). After a comprehensive approach to the psychological features of ED it becomes necessary to investigate a differential perspective between the various pictures of these disorders and their respective manifestations. In this sense, a better understanding of the different manifestations of these disorders and a better development of interventions in the aforementioned field proves to be a fundamental issue for public health (Galmiche, Déchelotte, Lambert & Tavolacci, 2019; Cororve, Fingeret, Warren, Cepeda-Benito & Gleaves, 2006). The main aim of this study is to help characterise the risk factors (RF) associated with the development of an ED, including the clinical and psychological characteristics of these psychopathology. The study included a sample of 38 participants who had entered higher education, 55.3% were females and 44.7% males, with an average age of 19.21 (SD= 0.811). The results indicated that individual RF were the most prevalent in the sample studied, while sociocultural RF were the least relevant. It was also found that self-esteem and social support were negatively correlated with the possibility of an ED diagnosis, thus suggesting a possible protective function. Finally, it was found that all the RF associated with the development of an IAP are related to at least 2 of the clinical and psychological characteristics described in individuals with the psychopathological conditions studied, with the exception of the Self-esteem RF. This information suggests that this RF may have a contribution associated with a protective function against the onset of the conditions discussed.
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Keywords
Perturbações da alimentação e da ingestão Anorexia nervosa Bulimia nervosa Fatores de risco Características clínicas e psicológicas Estudantes universitários Eating disorders Risk factors Clinical and psychological characteristics University students