Using prospection to improve obesity treatment

利用前景改善肥胖治疗

• 批准号: 8838338
• 负责人: Leonard H Epstein
• 金额: $ 48.02万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-01-01 至 2019-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8838338
• 关键词: 12 year old; Address; Adult; Basic Science; Behavior; Behavior Therapy; Behavioral; Body Weight Changes; Body Weight decreased; Brain region; Child; Clinical; Clinical Research; Clinical Trials; Clinical effectiveness; Cues; Decision Making; Dose; Eating; Effectiveness; Energy Intake; Episodic memory; Event; Evidence based treatment; Family; Future; Goals; Grant; Health; Imagery; Individual; Intervention; Laboratories; Laboratory Study; Length; Measures; Non obese; Obesity; Outcome; Overweight; Parents; Participant; Pattern; Process; Randomized; Relative (related person); Research; Rewards; Risk-Taking; Sampling; Series; Specificity; Testing; Thinking; Training; Translating; Weight; base; behavioral/social science; clinical efficacy; design; discounting; evidence base; executive function; experience; field study; improved; innovation; intervention effect; novel strategies; obesity in children; obesity treatment; public health relevance; response; simulation

 DESCRIPTION (provided by applicant): The inability to delay gratification is cross-sectionally and prospectively related to obesity, and the desire for immediate gratification is fundamental to the inability to delay gratification. People tend to devalue larger future rewards relative to smaller immediate rewards, with greater discounting of the future as the temporal distance between the immediate and delayed rewards increases. This pattern of temporal discounting is known as delay discounting (DD). A novel approach to reducing the bias towards immediate gratification is episodic future thinking (EFT), which can change the context of decision making by engaging the episodic memory to prospectively experience or simulate future events. Cueing individuals to think about future events during inter- temporal decision-making reduces DD. The overarching goal of this grant is to translate basic research on EFT into clinical interventions to treat pediatric obesity. We originally submitted this under grant mechanism PA-11- 063, "Translating Basic Behavioral and Social Science Discoveries into Interventions to Improve Health-Related Behaviors" as this provides for the opportunity to integrate basic and field studies to refine interventions that can be tested in a pilot clinical trial. We have demonstrated that EFT is associated with a reduction in DD in three samples of adults and one sample of children, that EFT has similar effects on DD in overweight/obese and non-overweight participants, and that EFT is associated with a reduction in energy intake in an ad lib eating task in adults and children. We have shown EFT effects in relation to a present thinking control task, as well as non-future and recent or past thinking control tasks. There has been no clinical research using EFT to modify DD in the treatment of obesity, but since EFT has been shown to decrease DD and energy intake in adults and children, it may be especially suited for a family-based treatment (FBT) of pediatric obesity. To translate EFT to a clinical intervention for pediatric obesity, we propose a series of laboratory, field and clinical studies for overweight/obese 8-12 year-old children and their parents. Specific Aims 1a-1b will assess the specificity of imagery, and process versus goal imagery on DD, energy intake and multiple measures of decision making. Specific Aim 2 is designed to determine the best dose of EFT (4, 8 or 12 weeks of training) to influence DD and energy intake, using the optimal EFT approach based on results of studies addressing Specific Aims 1a-b. Specific Aim 3 will use the optimal treatment package based on previous studies to assess the effects of adding EFT to evidence-based behavioral obesity treatment to evaluate the added benefits of EFT training. Developing effective ways to reduce discounting the future and improve delay of gratification may have important benefits in the treatment of pediatric obesity.

 描述（由适用提供）：无法延迟满足感在横截面和前瞻性上相关，而立即满足的愿望对于无法延迟满足满足感至关重要。人们倾向于相对于较小的即时奖励而贬值更大的未来奖励，随着即时和延迟奖励之间的临时距离增加，未来的折扣更大。这种临时折扣的模式称为延迟折现（DD）。一种新颖的方法来减少对即时满足的偏见是情节的未来思维（EFT），它可以通过使情节记忆参与前瞻性体验或模拟未来事件来改变决策的背景。提示个人思考时间间决策期间的未来事件减少了DD。该赠款的总体目标是将EFT的基础研究转化为临床干预措施 治疗小儿肥胖。我们最初是根据PA-11-063提出的，“将基本的行为和社会科学发现转化为干预措施，以改善与健康相关的行为”，因为这为将基本和现场研究提供了机会，以完善可以在飞行员临床试验中测试的干预措施。我们已经证明，EFT与三个成人样本和一个儿童样本中的DD减少有关，EFT对超重/肥胖和非重量级参与者的DD具有相似的影响，并且EFT与AD LIB饮食任务中能量摄入的减少有关 在成人和儿童中。我们已经显示了与当前的思维控制任务以及非未来以及最近或过去的思维控制任务有关的EFT效应。没有使用EFT来修改DD在治疗肥胖症方面的临床研究，但是由于已证明EFT可以减少成人和儿童的DD和能量摄入，因此可能特别适合于儿科肥胖的基于家庭的治疗（FBT）。为了将EFT转化为小儿肥胖症的临床干预措施，我们建议对超重/肥胖的8-12岁儿童及其父母进行一系列实验室，现场和临床研究。具体目的1a-1b将评估图像的特异性，以及在DD，能量摄入量和多种决策量度上的过程与目标图像。特定目标2旨在根据针对特定目标1A-B的研究结果，使用最佳的EFT方法来确定EFT（4、8或12周的训练）（4、8或12周）以影响DD和能量摄入。具体目标3将根据先前的研究使用最佳治疗程序包来评估将EFT添加到基于证据的行为客观性处理中的影响，以评估EFT培训的附加益处。开发有效的方法来减少未来的折现并改善满足延迟可能在治疗小儿客观性方面具有重要的好处。