Examination and expansion of the entire modified dual pathway model of disordered eating among individuals with type 1 diabetes.

IF 2.1 3区心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL

Journal of Pediatric Psychology Pub Date : 2025-09-03 DOI:10.1093/jpepsy/jsaf070

Tamar Propper-Lewinsohn, Shlomit Shalitin, Michal Gillon-Keren, Alon Liberman, Roni Elran-Barak

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引用次数: 0

Abstract

Objective: Disordered eating behaviors (DEB) are more common among adolescents with type 1 diabetes (T1D) relative to the general population, potentially influenced by disease-specific risk factors. This study aims to examine associations among proposed risk factors in the modified dual pathway model and to identify literature-supported adaptations to improve the model's fit for adolescents with T1D.

Methods: The study included 215 adolescents and young adults with T1D (age 13-21 years; 51.2% female). Data were collected from medical charts, diabetes device data, and self-report questionnaires assessing diabetes-specific dietary regimen, dietary restraint, body dissatisfaction, hunger disruption, diabetes-specific negative affect, and DEB. Multiple group path modeling tested the hypotheses.

Results: The original modified dual pathway model showed poor fit. However, adding a well supported, theory-based path and omitting nonsignificant paths improved model fit. Dietary restraint and diabetes-specific negative affect were significantly associated with DEB. Significant indirect paths to DEB emerged from a diabetes-specific dietary regimen via dietary restraint, and from body dissatisfaction via both dietary restraint and diabetes-specific negative affect.

Conclusions: This study supports the associations proposed in the modified dual pathway model and highlights the potential for targeted interventions addressing disease-specific risk factors for DEB, including diabetes-specific dietary regimen, dietary restraint, accelerated weight gain since T1D diagnosis, body dissatisfaction, and diabetes-specific negative affect in adolescents with T1D. These findings underscore the need for strategies that focus on the unique psychological and physiological challenges faced by this population. Longitudinal studies are needed to test the temporal ordering of constructs and identify mechanistic pathways for intervention.

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1型糖尿病患者饮食失调的整个修正双途径模型的检验和扩展

目的：与一般人群相比，青少年1型糖尿病（T1D）患者饮食失调行为（DEB）更为常见，可能受到疾病特异性危险因素的影响。本研究旨在研究改进的双途径模型中提出的风险因素之间的关联，并确定文献支持的适应性，以提高模型对青少年T1D的适用性。方法：研究纳入215例T1D青少年和青壮年患者（13-21岁，51.2%为女性）。数据收集自医疗图表、糖尿病设备数据和评估糖尿病特定饮食方案、饮食限制、身体不满、饥饿中断、糖尿病特定负面影响和DEB的自我报告问卷。多组路径模型验证了假设。结果：原修正双通路模型拟合效果不佳。然而，增加一个良好的支持，基于理论的路径和省略不重要的路径改善了模型拟合。饮食限制和糖尿病特异性负面影响与DEB显著相关。重要的间接途径是通过饮食限制的糖尿病特定饮食方案，以及通过饮食限制和糖尿病特定负面影响的身体不满。结论：本研究支持修改后的双途径模型中提出的关联，并强调了针对DEB疾病特异性风险因素的靶向干预的潜力，包括糖尿病特异性饮食方案、饮食限制、T1D诊断后体重加速增加、身体不满和糖尿病特异性负面影响。这些发现强调了关注这一人群所面临的独特心理和生理挑战的策略的必要性。需要纵向研究来测试构念的时间顺序，并确定干预的机制途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric Psychology PSYCHOLOGY, DEVELOPMENTAL-

CiteScore

6.00

自引率

11.10%

发文量

期刊介绍： The Journal of Pediatric Psychology is the official journal of the Society of Pediatric Psychology, Division 54 of the American Psychological Association. The Journal of Pediatric Psychology publishes articles related to theory, research, and professional practice in pediatric psychology. Pediatric psychology is an integrated field of science and practice in which the principles of psychology are applied within the context of pediatric health. The field aims to promote the health and development of children, adolescents, and their families through use of evidence-based methods.