The Role of Negative Affect in the Cognitive-Behavioral Model of Avoidant/Restrictive Food Intake Disorder: An Integrated Analysis of Neural Circuitry, Hormones, and Momentary Negative Emotions

负面情绪在回避/限制性食物摄入障碍认知行为模型中的作用：神经回路、激素和瞬间负面情绪的综合分析

• 批准号: 10549777
• 负责人: Kendra R Becker
• 金额: $ 19.95万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10549777
• 关键词: Address; Adult; Affect; Age; Amygdaloid structure; Anorexia Nervosa; Anterior; Anti-Anxiety Agents; Anxiety; Anxiety Disorders; Area; Behavior; Behavioral Model; Biological; Brain; Brain region; Chronic; Circulation; Clinical; Cognitive; Competence; Cues; DSM-V; Data; Data Analyses; Data Collection; Development; Eating; Eating Behavior; Eating Disorders; Ecological momentary assessment; Emotional; Emotions; Endocrine; Exhibits; Fasting; Female; Food; Food Aversion; Formulation; Frequencies; Fright; Functional Magnetic Resonance Imaging; Funding; Gender; Goals; Growth; Hippocampus; Hormonal; Hormones; Hydrocortisone; Hyperactivity; Individual; Insula of Reil; K-Series Research Career Programs; Maintenance; Malnutrition; Maps; Medial; Medical; Mental Depression; Mental Health; Mentors; Methodology; Methods; Moods; Morbidity - disease rate; Negative Reinforcements; Neuroanatomy; Neurobiology; Neurocognitive; Neuroendocrinology; Neurohormones; Nutritional status; Oxytocin; Pathology; Patient Self-Report; Pattern; Peripheral; Prefrontal Cortex; Prevalence; Psychopathology; Public Health; Reporting; Reproducibility; Research; Research Design; Rewards; Role; Scientist; Sensory; Shapes; Signal Transduction; Standardization; Stimulus; Stress; Symptoms; Testing; Time; Training; Treatment Cost; Variant; Weight; Youth; anxiety symptoms; avoidant restrictive food intake disorder; biological adaptation to stress; blood oxygen level dependent; career development; cingulate cortex; cognitive testing; depressive symptoms; design; emotion dysregulation; emotion regulation; emotional functioning; emotional reaction; feeding; food avoidance; food restriction; innovation; interdisciplinary approach; interest; male; medical complication; multidisciplinary; negative affect; neural circuit; patient oriented research; physical conditioning; programs; psychiatric comorbidity; psychosocial; receptor; response; restrictive eating; trait

PROJECT SUMMARY/ABSTRACT Avoidant/restrictive food intake disorder (ARFID) is identified as a restrictive eating disorder in DSM-5 and is associated with substantial medical morbidity, psychiatric comorbidity, and high treatment costs. Maintenance mechanisms for ARFID are unknown. However, the cognitive behavioral model of ARFID suggests that negative reinforcement, via reductions in negative affect, may be key in understanding these highly persistent and medically compromising behaviors. This 5-year K23-Patient-Oriented Research Career Development award application addresses this hypothesis using an innovative, multi-disciplinary approach to examine differences in neural circuitry and hormone functioning in adults with ARFID compared to healthy controls (HC) and to explore the relationships between real-time emotions and behaviors with brain responsivity and endocrine signaling to food stimuli. Specifically, this proposal leverages ongoing data collection from a funded R01 (MH108595) investigating the neurobiology of ARFID in youth and extends these methods by focusing on adults and including one week of ecological momentary assessment (EMA). Activation in the amygdala, hippocampus, anterior insula, anterior cingulate cortex, and medial prefrontal cortex (brain regions in the limbic and paralimbic circuits governing emotional processing) as well as cortisol and oxytocin levels around a standardized meal (hormones associated with mood and anxiety) will be compared between adults with ARIFD and HC. EMA ratings of negative emotions and eating behaviors will be used to test whether negative affect is reduced following common problematic eating behaviors (i.e., food refusal) in ARFID. As a final aim, this study will explore if activity in limbic/paralimbic circuitry and aberrant cortisol and oxytocin correlate with negative affect levels as well as reports of avoidant/restrictive eating during the one-week EMA period. This project represents the first exploration of ARFID in adults, the first examination of emotional functioning in ARFID, and a rigorous first test of the cognitive-behavioral model of ARFID. The training plan corresponding to this project will support Dr. Kendra R. Becker in becoming an independent clinical scientist with a program of research examining neurobiological underpinnings of affect and reward maintenance mechanisms in feeding/eating disorders to better understand illness trajectory and inform personalized formulations of pathology. Each aim of the study corresponds to a specific training goal, which will map onto four main areas of competency for Dr. Becker: (1) reproducible fMRI methodology, (2) study design and analysis/interpretation of endocrine data, (3), EMA methodology including advanced longitudinal data analysis integrating neurobiological variables, and (4) career development. Training goals will be implemented under the guidance of Dr. Jennifer J. Thomas (primary mentor), Drs. Elizabeth A. Lawson and Laura M. Holsen (co-mentors), Drs. Stephen A. Wonderlich and Ross D. Crosby (collaborators), and Drs. Kamryn T. Eddy and Madhusmita Misra (other significant contributors).

项目摘要/摘要 回避/限制性食物摄入障碍（ARFID）被确定为DSM-5中的限制性饮食失调症，IS 与大量的医疗发病率，精神病合并症和高治疗成本相关。维护 ARFID的机制尚不清楚。但是，ARFID的认知行为模型表明 通过减少负面影响，负面强化可能是理解这些高度持久性的关键 和医学妥协的行为。这项为期5年的K23患者研究职业发展 奖励申请使用创新的，多学科的方法来解决这一假设 与健康对照组相比，成年人的神经回路和激素功能的差异（HC） 并探索实时情绪与大脑反应性和行为之间的关系 内分泌发信号向食物刺激。具体而言，该提案利用了资助的持续数据收集 R01（MH108595）研究青年中Arfid的神经生物学，并通过关注这些方法来扩展这些方法 成人，包括一周的生态瞬时评估（EMA）。在杏仁核中激活， 海马，前岛，前扣带回皮层和内侧前额叶皮层（边缘的大脑区域 和旁皮电路管理情感处理）以及围绕一个左侧的皮质醇和催产素水平 将比较ARIFD的成年人之间的标准餐（与情绪和焦虑有关的激素） 和HC。 EMA负面情绪和饮食行为的评级将用于测试负面影响是否为 在ARFID中，常见的有问题的饮食行为（即食物拒绝）减少了。作为最终目标，这项研究 将探索边缘/旁皮电路中的活性以及异常皮质醇和催产素的活性与阴性 在一周的EMA期间影响水平以及回避/限制性进食的报告。这个项目 代表了成人Arfid的第一次探索，对Arfid中情绪功能的首次检查以及 对Arfid的认知行为模型的严格首次测试。与该项目相对应的培训计划 将支持Kendra R. Becker博士成为一名研究计划的独立临床科学家 检查喂养/进食中情感和奖励维持机制的神经生物学基础 可以更好地理解疾病轨迹并为个性化病理表述提供疾病。每个目标 该研究对应于一个特定的培训目标，该目标将映射到Dr. Dr.的四个主要能力领域。 贝克尔：（1）可重复的fMRI方法论，（2）内分泌数据的研究设计和分析/解释，（3）， EMA方法论包括整合神经生物学变量的高级纵向数据分析和（4） 职业发展。培训目标将在詹妮弗·J·托马斯（Jennifer J. Thomas）博士的指导下实施（主要 导师），博士。伊丽莎白·劳森（Elizabeth A. Lawson）和劳拉·霍尔森（Laura M.斯蒂芬·A·奇德利希（Stephen A. Wonderlich）和罗斯（Ross） D. Crosby（合作者）和Drs。 Kamryn T. Eddy和Madhusmita Misra（其他重要的贡献者）。