摄食障碍与家庭系统的关系研究

发布时间：2018-03-12 13:28

本文选题：摄食障碍　切入点：家庭关系　出处：《中国地质大学》2013年硕士论文　论文类型：学位论文

【摘要】：摄食障碍在临床上表现为严重异常的进食行为紊乱和控制体重的行为,身心健康和社会功能明显受损,严重甚至危及生命。近些年伴随患病人数的增长,以及大众传媒对一些极端案例的报道,这一疾病愈发引起我国民众的重视和担忧。摄食障碍的病因十分复杂,原生家庭关系是其发生、发展、维持和康复过程中一个重要的社会心理因素。西方已有许多理论解读了摄食障碍与家庭之间的关系,众多实证研究也发现患者的原生家庭环境有其独特的特征。众多学者对二者的关系相继开展了经典临床研究、量化研究以及后现代视角下的研究。近些年的研究呈现出多方法、多水平的特点。我国有关摄食障碍的家庭研究非常短缺,开展这方面研究对于探明这一疾病的病理学,改善家庭在疾病发展和治疗中的角色有重要的价值。本研究以质性研究扎根理论为方法论指导,收集摄食障碍患者家庭经历叙事,探索我国摄食障碍患者原生家庭系统的关系特征,以及家庭经历的主题,寻找这些因素彼此之间的影响。具体而言,本研究一共选取了23名摄食障碍患者,对她们进行开放式深度访谈,鼓励受访者生动而丰富地讲述其家庭生活经历,将访谈录音转录成逐字稿,使用质性研究分析软件对访谈内容进行自下而上的三级编码,总结了摄食障碍患者家庭叙事中凸显出来的主题和特征,探寻家庭环境因素与疾病之间的联系和相互作用。本研究主要结果如下。父女关系：交流差(18位受访者提及)；相处少(16)；情感疏离(16)。母女关系：交流差(16)；关系过度紧密(12),且她们均报告了父母婚姻关系存在较为明显的问题；冲突矛盾多(10)。父母婚姻关系：冲突矛盾多(17)。早年与父母长期分离(11)。父母存在成瘾行为和物质依赖倾向(13)。18位受访者提及首次出现摄食问题的具体时间(大部分发生在大一或高中)。关系变化：父女关系出现好转(15),其中大部分好转发生在“得病后”、“现在”；母女关系出现好转(12),大部分好转是发生在“得病后”、“最近一段时间”：父母婚姻关系出现好转(6)，，而且绝大部分发生在“最近一两年”、“目前”。结合已有理论和过往研究,对结果进行了分析与讨论,得到如下结论：摄食障碍患者早年父女关系疏离,父亲的情感缺席使得女儿陷于“父亲饥饿”,这使得女儿对父性的认可变得异常渴望；在青春期女儿开始认同社会文化赋予的“美”的标准,试图通过广义的性的表达来拉近父女关系,但是由于父亲对自身俄狄浦斯创伤再度激活的恐惧,父女关系更加疏离；内心的空洞和羞耻使得这些女儿的身体意象愈加扭曲。父亲的缺场和父母婚姻失败使得母女纠缠变得更加严重,而母女关系过度紧密进一步阻碍了女儿从家庭中分离和个体化；患者父母之间存在大量矛盾无法得到直接处理,并将自身的创伤投射给了女儿,女儿成为家庭的替罪羊，而维系家庭平衡也成为疾病的二级获益；家庭系统问题“迫使”女儿成为患者。父母的物质依赖和成瘾行为使患者习得了类似的应对方式；在患者的经历中,饮食行为往往伴随强烈的家庭情感经验,伴随着关系的建立和丧失。由此，这些遭受父亲饥饿、母女纠缠、凝聚家庭创伤的女性,在面对内心或环境的挫折与应激时，选择外在的食物来给予自己抚慰,或者通过同避食物来避免长大和分离、避免家庭分崩离析。
[Abstract]:Eating disorders in the clinical manifestations of severe abnormal eating behavior disorders and weight control behavior, mental health and social function was significantly impaired, serious or even life-threatening. In recent years, with the prevalence of growth, and the mass media to some extreme cases, the disease has attracted our people's attention and concern. The etiology of feeding the disorder is very complex, the original family relationship is its occurrence, development, and maintain an important social and psychological factors in the rehabilitation process.
There are many western theory to explain the relationship between eating disorders and family, many empirical studies have found that the original family environment with its unique characteristics. Many scholars on the relationship between the two carried out clinical research from the perspective of modern classic research, quantitative research and research in recent years. After showing a multi method, multi features at the level of a shortage of research on family eating disorders in our country, to carry out research in this area for pathological proven this disease, improve the family in the development and treatment of diseases in the role of significant value.
Based on qualitative research grounded theory, this study collects family experience narratives of patients with eating disorders, explores the relationship characteristics of family system in Chinese patients with eating disorders, and explores themes of family experience to find out the effects of these factors.
Specifically, this study selected a total of 23 patients with eating disorders, they were open interviews, to encourage respondents to vivid about their family life experience, the interviews transcribed verbatim text, use qualitative analysis software from the interview content three encoding, summarizes the theme and features out of eating disorders in patients with family narrative, explore between family environment factors and diseases of the connection and interaction.
The main results of this study are as follows: the relationship between father and daughter. (18 of respondents mentioned the exchange difference); with less (16); emotional alienation (16). The relationship between mother and daughter: AC difference (16); over close relationship (12), and they are reported more obvious problems of parents' marital relationship; conflict (multi 10). Many conflicts: the marital relationship of parents (17). Early and long-term separation of parents (11). There is addiction and substance dependence tendency of parents (13).18 respondents mentioned for the first time the specific time feeding problems (mostly in a large or high school). The relationship between father and daughter have improved changes: (15), most of them improved in "sick", "now"; the mother daughter relationship has improved (12), most improvement occurred in the "sick", "a long time": the marital relationship of parents have improved (6), and most recently in " Two years "," now ".
Combined with the existing theories and past studies, the results are analyzed and discussed, and the following conclusions are obtained.
Feeding disorders in patients with early paternity alienation, father's emotional absence makes her daughter in a "father hunger", which makes her become abnormal desire for father's approval; in her adolescent daughter began to identify social culture give the "beauty" standard, tries to generalized expression the close relationship between father and daughter, but because of their father Oedipus trauma RE activated the fear, the father daughter relationship is more alienation; the heart of the hole and the more shame these daughters body image distortions.
Father's absence and failure makes parents marriage becomes more serious and the entanglement of mother and daughter, mother and daughter relationship too close further hindered the daughter separated from family and individual; there are a lot of contradiction between parents can not be directly addressed, and its projection trauma to his daughter, daughter to become a family and family balance is the scapegoat a disease of grade two benefit; family system "forcing" daughter to be patient.
Parental substance dependence and addiction behavior of the patients acquire similar coping styles; in patients with experience, eating behavior is often accompanied by strong family emotional experience, accompanied by the establishment and loss of relationship. Thus, the father and daughter suffered from hunger, entanglement, family trauma of women, in the face of frustration and stress or inner environment when the external food to give yourself comfort, or by avoiding the same food to avoid growth and separation, avoid families fall apart.

【学位授予单位】：中国地质大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R395

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