Mang Thai Qua Gương: Các Yếu Tố Liên Quan Đến Thái Độ Ăn Uống Rối Loạn Trong Một Mẫu Phụ Nữ Mang Thai Ở Liban

BMC Psychiatry - Tập 23 Số 1
Sarah Gerges1, Sahar Obeïd2, Souheil Hallit1
1School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
2Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon

Tóm tắt

Tóm tắt Giới thiệu

Mặc dù có nguy cơ của rối loạn ăn uống trong thai kỳ đối với cả mẹ và thai nhi, nhưng nghiên cứu về chủ đề này vẫn còn ít ỏi ở các nước đang phát triển, đặc biệt là ở Liban. Mục tiêu của nghiên cứu của chúng tôi là tìm hiểu những yếu tố dự đoán thái độ ăn uống rối loạn trong thai kỳ ở một mẫu phụ nữ mang thai của Liban, đồng thời đánh giá tác động trung gian tiềm năng của sự không hài lòng về cơ thể giữa các yếu tố tâm lý xã hội và thái độ ăn uống rối loạn trong thai kỳ.

Phương pháp

Chúng tôi thiết kế một nghiên cứu cắt ngang, dựa trên các biện pháp tự khai báo. Phụ nữ mang thai từ 18 tuổi trở lên đã được tuyển chọn từ tất cả các tỉnh của Liban thông qua một cuộc khảo sát trực tuyến (N = 433).

Kết quả

Các kết quả cho thấy rằng các vấn đề cụ thể trong thai kỳ cao hơn (Beta = 0.19), ảnh hưởng của truyền thông và người nổi tiếng mang thai (Beta = 0.22), và sự không hài lòng về cơ thể (Beta = 0.17) có mối liên hệ đáng kể với thái độ ăn uống rối loạn tăng cao trong thai kỳ; trong khi đó, sự hỗ trợ xã hội được cảm nhận cao hơn (Beta = -0.03), tình trạng kinh tế xã hội thấp hơn (Beta = -0.84), và tình trạng mang thai nhiều lần (Beta = -0.96) có mối liên hệ đáng kể với thái độ ăn uống rối loạn thấp hơn trong thai kỳ. Sự không hài lòng về cơ thể đã trung gian hoá mối liên hệ giữa các vấn đề cụ thể trong thai kỳ và thái độ ăn uống rối loạn, và giữa những lo ngại về ngoại hình xã hội và thái độ ăn uống rối loạn.

Kết luận

Nghiên cứu của chúng tôi nêu bật rằng việc chăm sóc thai sản, đặc biệt là ở Liban, không nên chỉ giới hạn trong việc theo dõi sinh học mà còn cần tìm cách xác định các rối loạn ăn uống có thể xảy ra và các mối đe dọa đến sức khỏe tâm thần. Các nghiên cứu tiếp theo với thiết kế theo chiều dọc nên tiếp tục xác định các yếu tố liên quan đến rối loạn ăn uống trong thai kỳ trong bối cảnh lâm sàng, nhằm củng cố các chương trình sàng lọc và xây dựng các chiến lược điều trị nhằm mục tiêu.

Từ khóa


Tài liệu tham khảo

Kelly RH, Zatzick DF, Anders TF. The detection and treatment of psychiatric disorders and substance use among pregnant women cared for in obstetrics. Am J Psychiatry. 2001;158(2):213–9. https://doi.org/10.1176/appi.ajp.158.2.213.

Micali N, Treasure J, Simonoff E. Eating disorders symptoms in pregnancy: a longitudinal study of women with recent and past eating disorders and obesity. J Psychosom Res. 2007;63(3):297–303. https://doi.org/10.1016/j.jpsychores.2007.05.003.

Easter A, Bye A, Taborelli E, et al. Recognising the symptoms: how common are eating disorders in pregnancy? Eur Eat Disord Rev. 2013;21(4):340–4. https://doi.org/10.1002/erv.2229.

Bye A, Nath S, Ryan EG, et al. Prevalence and clinical characterisation of pregnant women with eating disorders. Eur Eat Disord Rev. 2020;28(2):141–55. https://doi.org/10.1002/erv.2719.

Mathieu J. What is pregorexia? J Am Diet Assoc. 2009;109(6):976–9. https://doi.org/10.1016/j.jada.2009.04.021.

Tuncer E, Gumus AB, Keser A. The importance of pregorexia awareness. Clin Exp Health Sci. 2020;10(3):186–90. https://doi.org/10.33808/clinexphealthsci.673306.

Mandera A, Pawlikowska A, Szuster EM, Całkosiński A, Kostrzewska P, Majewski M. The pregorexia - anorexia during the pregnancy. Journal of Education. 2019;9(5):137–44. https://doi.org/10.5281/zenodo.2718477.

Saleem T, Saleem S, Shoib S, Shah J, Ali SA. A rare phenomenon of pregorexia in Pakistani women: need to understand the related behaviors. J Eat Disord. 2022;10(1):1–11.

Weeden J, Sabini J. Physical attractiveness and health in western societies. Psychol Bull. 2005;131(5):635–53. https://doi.org/10.1037/0033-2909.131.5.635.

Grabe S, Ward LM, Hyde JS. The role of the media in body image concerns among women. Psychol Bull. 2008;134(3):460–76. https://doi.org/10.1037/0033-2909.134.3.460.

Brown Z, Tiggemann M. Celebrity influence on body image and eating disorders: a review. J Health Psychol. 2021:1359105320988312. https://doi.org/10.1177/1359105320988312.

Bainbridge J. Pregorexia: body image over baby? Br J Midwifery. 2008;16(9):608.

Bjelica A, Cetkovic N, Trninic-Pjevic A, Mladenovic-Segedi L. The phenomenon of pregnancy - a psychological view. Ginekol Pol. 2018;89(2):102–6. https://doi.org/10.5603/GP.a2018.0017.

Lemberg R, Phillips J. The impact of pregnancy on anorexia nervosa and bulimia. Int J Eat Disord. 1989;8(3):285–95. https://doi.org/10.1002/1098-108X(198905)8:33.0.CO;2-P.

Blais MA, Becker AE, Burwell RA, et al. Pregnancy: outcome and impact on symptomatology in a cohort of eating-disordered women. Int J Eat Disord. 2000;27(2):140–9. https://doi.org/10.1002/(SICI)1098-108X(200003)27:23.0.CO;2-E.

Bulik CM, von Holle A, Hamer R, et al. Patterns of remission, continuation and incidence of broadly defined eating disorders during early pregnancy in the Norwegian mother and child cohort study (MoBa). Psychol Med. 2007;37(8):1109–18. https://doi.org/10.1017/S0033291707000724.

Luigi Rocco P, Orbitello B, Perini L, Pera V, Ciano RP, Balestrieri M. Effects of pregnancy on eating attitudes and disorders: a prospective study. J Psychosom Res. 2005;59(3):175–9. https://doi.org/10.1016/j.jpsychores.2005.03.002.

Crow SJ, Agras WS, Crosby R, Halmi K, Mitchell JE. Eating disorder symptoms in pregnancy: a prospective study. Int J Eat Disord. 2008;41(3):277–9. https://doi.org/10.1002/eat.20496.

Hoffman ER, Zerwas SC, Bulik CM. Reproductive issues in anorexia nervosa. Expert Rev Obstet Gynecol. 2011;6(4):403–14. https://doi.org/10.1586/eog.11.31.

Davies K, Wardle J. Body image and dieting in pregnancy. J Psychosom Res. 1994;38(8):787–99. https://doi.org/10.1016/0022-3999(94)90067-1.

Larsson G, Andersson-Ellström A. Experiences of pregnancy-related body shape changes and of breast-feeding in women with a history of eating disorders. Eur Eat Disord Rev. 2003;11(2):116–24. https://doi.org/10.1002/erv.497.

Coker E, Abraham S. Body weight dissatisfaction before, during and after pregnancy: a comparison of women with and without eating disorders. Eat Weight Disord. 2015;20(1):71–9. https://doi.org/10.1007/s40519-014-0133-4.

Baskin R, Galligan R, Meyer D. Disordered eating from pregnancy to the postpartum period: the role of psychosocial and mental health factors. Appetite. 2021;156:10486210. https://doi.org/10.1016/j.appet.2020.104862.

Baskin R, Meyer D, Galligan R. Psychosocial factors, mental health symptoms, and disordered eating during pregnancy. Int J Eat Disord. 2020;53(6):873–82. https://doi.org/10.1002/eat.23264.

Baskin R, Meyer D, Galligan R. Predicting the change in perinatal disordered eating symptoms: an examination of psychosocial factors. Body Image. 2021;37:162–71. https://doi.org/10.1016/j.bodyim.2021.02.002.

Cohen R, Newton-John T, Slater A. The relationship between Facebook and Instagram appearance-focused activities and body image concerns in young women. Body Image. 2017;23:183–7. https://doi.org/10.1016/j.bodyim.2017.10.002.

Aparicio-Martinez P, Perea-Moreno A, Martinez-Jimenez MP, Redel-Macías MD, Pagliari C, Vaquero-Abellan M. Social media, thin-ideal, body dissatisfaction and disordered eating attitudes: an exploratory analysis. Int J Environ Res Public Health. 2019;16(21):4177. https://doi.org/10.3390/ijerph16214177.

Dye H. Does internalizing society and media messages cause body dissatisfaction, in turn causing disordered eating? J Evid Inf Soc Work. 2016;13(2):217–27. https://doi.org/10.1080/23761407.2015.1024572.

Watson B, Broadbent J, Skouteris H, Fuller-Tyszkiewicz M. A qualitative exploration of body image experiences of women progressing through pregnancy. Women Birth. 2016;29(1):72–9. https://doi.org/10.1016/j.wombi.2015.08.007.

Barker DJP. Fetal origins of coronary heart disease. BMJ. 1995;311(6998):171–7. https://doi.org/10.1136/bmj.311.6998.171.

Barker D, Hales C, Fall C, Osmond C, Phipps K, Clark P. Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth. Diabetologia. 1993;36(1):62–7. https://doi.org/10.1007/BF00399095.

Black RE, Victora CG, Walker SP, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet (British edition). 2013;382(9890):427–51. https://doi.org/10.1016/S0140-6736(13)60937-X.

Santos AMD, Benute GRG, Santos NOD, Nomura RMY, de Lucia MCS, Francisco RPV. Presence of eating disorders and its relationship to anxiety and depression in pregnant women. Midwifery. 2017;51:12–5. https://doi.org/10.1016/j.midw.2017.05.005.

Baskin R, Galligan R. Disordered eating and the perinatal period: a systematic review and best evidence synthesis of mental health and psychosocial correlates. Eur Eat Disord Rev. 2019;27(5):462–80. https://doi.org/10.1002/erv.2675.

Babicz-Zielińska E, Wądołowska L, Tomaszewski D. Eating disorders: problems of contemporary civilisation – a review. Pol J Food Nutr Sci. 2013;63(3):133–46. https://doi.org/10.2478/v10222-012-0078-0.

Santomauro DF, Melen S, Mitchison D, Vos T, Whiteford H, Ferrari AJ. The hidden burden of eating disorders: an extension of estimates from the Global Burden of Disease Study 2019. The Lancet Psychiatry. 2021;8(4):320–8.

Faul F, Erdfelder E, Buchner A, Lang A. Statistical power analyses using GPower 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149–60. https://doi.org/10.3758/BRM.41.4.1149.

Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: L. Erlbaum Associates; 1988.

Hallit S, Obeid S, Haddad C, et al. Construction of the Lebanese Anxiety Scale (LAS-10): a new scale to assess anxiety in adult patients. Int J Psychiatry Clin Pract. 2020;24(3):270–7. https://doi.org/10.1080/13651501.2020.1744662.

Sawaya H, Atoui M, Hamadeh A, Zeinoun P, Nahas Z. Adaptation and initial validation of the Patient Health Questionnaire – 9 (PHQ-9) and the Generalized Anxiety Disorder – 7 Questionnaire (GAD-7) in an Arabic speaking Lebanese psychiatric outpatient sample. Psychiatry Res. 2016;239:245–52. https://doi.org/10.1016/j.psychres.2016.03.030.

Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures. Spine (Philadelphia, Pa 1976). 2000;25(24):3186–91. https://doi.org/10.1097/00007632-200012150-00014.

Beaton D, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the cross-cultural adaptation of health status measures. N Y Am Acad Orthop Surg. 2002;12:1–9.

Gerges S, Obeid S, Hallit S. Associations between eating attitudes, mental health, and sexual dysfunction during pregnancy. J Sex Marital Ther. 2022:1–16. https://doi.org/10.1080/0092623X.2022.2149937.

Gerges S, Obeid S, Hallit S. Traversing mental health disorders during pregnancy: Lebanese women’s experiences of antepartum depression and anxiety. Ir J Med Sci. 2023. https://doi.org/10.1007/s11845-023-03371-0.

Melki IS, Beydoun HA, Khogali M, Tamim H, Yunis KA. Household crowding index: a correlate of socioeconomic status and inter-pregnancy spacing in an urban setting. J Epidemiol Community Health. 2004;58:476–80. https://doi.org/10.1136/jech.2003.012690.

Weary-Smith KA. Validation of the physical activity index (PAI) as a measure of total activity load and total kilocalorie expenditure during submaximal treadmill walking. 2007.

Gerges S, Obeid S, Hallit S. Initial psychometric properties of an Arabic version of the disordered eating attitudes in pregnancy scale (A-DEAPS) among Lebanese pregnant women. J Eat Disord. 2022;10(1):1–9. https://doi.org/10.1186/s40337-022-00710-x.

Bannatyne AJ. Disordered eating in pregnancy: the development and validation of a pregnancy-specific screening instrument. Bond University; 2018.

Kroenke K, Spitzer RL, Williams JBW. The PHQ-9. J Gen Intern Med. 2001;16(9):606–13. https://doi.org/10.1046/j.1525-1497.2001.016009606.x.

DiPietro JA, Christensen AL, Costigan KA. The pregnancy experience scale – brief version. J Psychosom Obstet Gynaecol. 2008;29(4):262–7. https://doi.org/10.1080/01674820802546220.

Garner DM. Eating disorder inventory-2. psychological assessment resources Odessa. 1991.

Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. J Pers Assess. 1988;52(1):30–41. https://doi.org/10.1207/s15327752jpa5201_2.

Merhi R, Kazarian SS. Validation of the Arabic translation of the Multidimensional Scale of Perceived Social Support (Arabic-MSPSS) in a Lebanese community sample. Arab Journal of Psychiatry. 2012;23(2):159–68.

Nunez D. “Hot Moms”: Sexual Objectification and Motherhood. Rollins Scholarship Online: Honors Program Theses. Paper 33;2016.

Netemeyer RG, Burton S, Lichtenstein DR. Trait aspects of vanity: measurement and relevance to consumer behavior. J Consum Res. 1995;21(4):612–26. https://doi.org/10.1086/209422.

Krisjanous J, Richard JE, Gazley A. The perfect little bump: does the media portrayal of pregnant celebrities influence prenatal attachment? Psychol Mark. 2014;31(9):758–73.

Hair JJ, Hult G, Ringle C, Sarstedt M. A primer on partial least squares structural equation modeling (PLS-SEM). SAGE publications; 2016.

Mishra P, Pandey C, Singh U, Gupta A, Sahu C, Keshri A. Descriptive statistics and normality tests for statistical data. Ann Card Anaesth. 2019;22(1):67–72. https://doi.org/10.4103/aca.ACA_157_18.

Vandekerckhove J, Matzke D, Wagenmakers E, et al. Model comparison and the principle of parsimony. In: Model comparison and the principle of parsimony. In: The Oxford handbook of computational and mathematical psychology. Oxford University Press; 2015:300–319.

Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008;3(1):1–8.

Johnston R, Jones K, Manley D. Confounding and collinearity in regression analysis: a cautionary tale and an alternative procedure, illustrated by studies of British voting behaviour. Qual Quant. 2018;52(4):1957–76. https://doi.org/10.1007/s11135-017-0584-6.

Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: Guilford Publications; 2017.

Culbert KM, Racine SE, Klump KL. Research review: what we have learned about the causes of eating disorders - a synthesis of sociocultural, psychological, and biological research. J Child Psychol Psychiatry. 2015;56(11):1141–64. https://doi.org/10.1111/jcpp.12441.

Sidani JE, Shensa A, Hoffman B, Hanmer J, Primack BA. The association between social media use and eating concerns among US young adults. J Acad Nutr Diet. 2016;116(9):1465–72. https://doi.org/10.1016/j.jand.2016.03.021.

Uchôa FNM, Uchôa NM, Daniele TMdC, et al. Influence of the mass media and body dissatisfaction on the risk in adolescents of developing eating disorders. Int J Environ Res Public Health. 2019;16(9):1508. https://doi.org/10.3390/ijerph16091508.

Obeyd M. Beyond the bump: The impact of pregnant and postpartum weight loss coverage in celebrity-based tabloid magazines - ProQuest. California State University, Fullerton; 2010. https://www.proquest.com/openview/99cf3786377fd1df05a203164996e47c/1?pq-origsite=gscholar&cbl=18750.

Mysko C, Amadeï M. Does this pregnancy make me look fat?: The essential guide to loving your body before and after baby. Health Communications, Inc.; 2009

Ward VB, Waller D. Eating disorders in pregnancy. BMJ. 2008;336(7635):93–6. https://doi.org/10.1136/bmj.39393.689595.BE.

Zeeni N, Abi Kharma J, Mattar L. Social media use impacts body image and eating behavior in pregnant women. Curr Psychol (New Brunswick, N.J.). 2021.  https://doi.org/10.1007/s12144-021-01848-8.

DiPietro JA, Millet S, Costigan KA, Gurewitsch E, Caulfield LE. Psychosocial influences on weight gain attitudes and behaviors during pregnancy. J Am Diet Assoc. 2003;103(10):1314–9. https://doi.org/10.1016/S0002-8223(03)01070-8.

Menatti AR, DeBoer LBH, Weeks JW, Heimberg RG. Social anxiety and associations with eating psychopathology: mediating effects of fears of evaluation. Body Image. 2015;14:20–8. https://doi.org/10.1016/j.bodyim.2015.02.003.

Saade S, Hallit S, Haddad C, et al. Factors associated with restrained eating and validation of the Arabic version of the restrained eating scale among an adult representative sample of the Lebanese population: a cross-sectional study. J Eat Disord. 2019;7(1):24. https://doi.org/10.1186/s40337-019-0254-2.

Bye A, Shawe J, Bick D, Easter A, Kash-Macdonald M, Micali N. Barriers to identifying eating disorders in pregnancy and in the postnatal period: a qualitative approach. BMC Pregnancy Childbirth. 2018;18(1):114. https://doi.org/10.1186/s12884-018-1745-x.