Perturbações do comportamento alimentar e ferimentos autoinfligidos: Avaliação dos fatores de risco e implementação de uma intervenção baseada na internet

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Putative risk factors for non-suicidal self-injury in eating disorders

Publication . Vieira, Ana Isabel; Machado, Bárbara C.; Machado, Paulo P. P.; Brandão, Isabel; Roma-Torres, António; Gonçalves, Sónia

Evidence suggests a common association between eating disorders (EDs) and non-suicidal self-injury (NSSI). The present study aimed to investigate the potential risk factors for NSSI among ED patients. We assessed 245 ED patients with the Oxford Risk Factor Interview for ED. The results showed that 33% of ED patients reported NSSI in their lifetime. NSSI appeared to occur more frequently among binge eating/purging type ED patients than among patients with other ED and to be related to a more severe eating pathology. A younger age at the onset of eating problems, more negative self-evaluation, suicide attempts, substance abuse, parents’ low weight, family tension at mealtime, parental alcohol problems, childhood abuse, peer aggression, and negative antecedent life events were more common among patients with co-occurring EDs and NSSI than among patients without NSSI. The results may inform the risk assessment and treatment of NSSI in EDs in the early detection period.

2017Journal article

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Eating disorders and non-suicidal self-injury: Structural equation modelling of a conceptual model

Publication . Vieira, Ana Isabel; Machado, Bárbara C.; Moreira, Célia S.; Machado, Paulo P.P.; Brandão, Isabel; Roma‐Torres, António; Gonçalves, Sónia

Evidence suggests several risk factors for both eating disorders (ED) and nonsuicidal self‐injury (NSSI), but the relationships between these factors are not well understood. Considering our previous work and a conceptual model, this cross‐sectional study aimed to assess the relationships among distal and proximal factors for the presence of NSSI in ED. We assessed 245 ED patients with the Oxford Risk Factor Interview for ED. Structural equation modelling revealed that both distal and proximal factors were related to the presence of NSSI in ED, disclosing a mediating role of the proximal factors. Stressful life events mediated the relationship between childhood sexual abuse, peer aggres-sion, and both ED and NSSI. Childhood physical abuse was related to ED and NSSI via substance use, negative self‐evaluation, and suicide attempts. Find- ings provided support for the conceptual model and highlight the possible mechanisms by which psychoso cial factors may lead to ED and NSSI.

2018Journal article

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Psychometric properties of the Portuguese version of the invalidating childhood environment scale

Publication . Vieira, Ana Isabel; Gonçalves, Mónica; Machado, Bárbara César; Rodrigues, Tânia; Machado, Paulo P. P.; Brandão, Isabel; Timóteo, Sertório; Nunes, Patrícia; Gonçalves, Sónia

Purpose The current study aimed to examine the psychometric properties of the Portuguese version of the invalidating childhood environment scale (ICES) in a non-clinical and clinical sample of eating disorder (ED) patients. This study also investigated the between-sample differences regarding invalidating parental behaviors and family styles and explored the associations between invalidating childhood environments and eating pathology. Methods A sample of 410 high school and college students and 101 patients with a diagnosis of ED completed self-report measures. Principal component analyses and confirmatory factor analyses were conducted to examine the factor structure of the ICES. The internal consistency and the between-sample differences and associations between invalidating childhood environments and eating pathology were also tested. Results Principal component analyses and confirmatory factor analyses indicated a two-factor solution for each parent. The ICES demonstrated high internal consistency and was able to differentiate between non-clinical and clinical samples. The perception of parental invalidation was higher in ED patients, and the clinical sample presented higher scores in the chaotic and perfect family styles and lower scores in the validating family style, in comparison with the non-clinical sample. Both maternal invalidation and invalidating styles were significantly associated with a higher ED symptomatology. Conclusions The Portuguese version of the ICES revealed adequate psychometric properties. Considering the relationship between invalidation in family and eating pathology, the ICES may be useful in clinical practice, especially among ED patients. Level of Evidence Level V, cross-sectional descriptive study.

2020Journal article

Open access