Ecological Momentary Assessment of Purging Disorder

净化紊乱的生态瞬时评估

• 批准号: 7714719
• 负责人: Alissa Haedt-Matt
• 金额: $ 3.02万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-01-01 至 2011-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7714719
• 关键词: Address; Affect; Affective; Anxiety Disorders; Behavior; Body Image; Bulimia; Cognitive; Data; Development; Disease model; Eating Disorders; Environment; Etiology; Evidence based treatment; Food; Goals; Impulsivity; Individual; Intervention; Laboratories; Life; Maintenance; Medical; Memory; Morbidity - disease rate; Palm-Top Computers; Participant; Patient Self-Report; Personal Digital Assistant; Personality; Play; Psychopathology; Public Health; Recruitment Activity; Recurrence; Research; Role; Shapes; Specific qualifier value; Stomach; Syndrome; Testing; Weight; Woman; base; design; effective intervention; effective therapy; improved; multilevel analysis; novel; psychologic; psychosocial; public health relevance; purge; purging behavior; purging disorder; response

DESCRIPTION (provided by applicant): Research indicates that Purging Disorder (PD), a newly specified eating disorder characterized by recurrent purging after normal or small amounts of food in normal weight individuals, is psychologically and biologically distinct from normality and Bulimia Nervosa. The broad, long-term goals of this research are to improve understanding of affective, cognitive, and somatic factors in the maintenance of PD so that effective treatments may be developed for this syndrome. Current explanatory models of disordered eating focus on antecedent factors that trigger a behavior and the psychological consequences that follow. Previous studies suggest that negative affect (NA), shape/weight concerns, stomach discomfort, and violation of dietary rules may play an important role in the propensity to purge among women with PD. However, research on PD has been limited to cross-sectional designs that cannot establish temporal sequences, retrospective self-reports that are subject to memory problems and cognitive biases, and laboratory-based studies that lack ecological validity. The proposed research addresses these limitations by using Ecological Momentary Assessment (EMA), a design that involves repeated assessments of current psychological states in participants' daily living environments. The specific aims of this study are to 1) identify proximal antecedents of purging, 2) identify consequences of purging, and 3) examine personality and comorbid psychopathology as moderators of associations between posited antecedents and purging behavior. Women with PD (N=35) will be recruited to carry palmtop computers and make multiple ratings per day for two weeks. Multilevel model analyses will be used to test study hypotheses that 1) increases in NA, shape/weight concerns, stomach discomfort, and violation of dietary rules predict purging behavior, 2) decreases in NA, shape/weight concerns, and stomach discomfort follow purging behavior, and 3) higher levels of impulsivity and current anxiety disorders enhance the association between posited antecedents and purging behavior. PUBLIC HEALTH RELEVANCE: The proposed study will be the first application of EMA to PD and thus represents highly novel research that will allow the examination of temporal associations between changes in affective, cognitive, and somatic factors and changes in purging behavior. These data are crucial to understand why women with PD purge after consuming normal or small amounts of food and may point to specific targets for the development of effective interventions. Currently, there are no evidence-based treatments for PD, a prevalent syndrome associated with significant psychosocial and medical morbidity. Thus, findings from the proposed study have the potential to significantly improve public health.

描述（由申请人提供）：研究表明，清除障碍（PD）是一种新指定的饮食失调症，其特征是在正常体重个体中正常或少量食物后复发，在心理和生物学上与正常性和神经性神经性疾病不同。这项研究的广泛，长期目标是提高对PD维持情感，认知和躯体因素的理解，以便可以为该综合症开发有效的治疗方法。当前的饮食无序饮食模型集中于引发行为和随后的心理后果的先决因素。先前的研究表明，负面影响（NA），形状/体重问题，胃部不适和侵犯饮食规则可能在PD女性清除倾向中起重要作用。但是，对PD的研究仅限于无法建立时间序列的横截面设计，受记忆问题和认知偏见的回顾性自我报告以及缺乏生态有效性的基于实验室的研究。拟议的研究通过使用生态瞬时评估（EMA）来解决这些局限性，该设计涉及对参与者日常生活环境中当前心理状态的重复评估。这项研究的具体目的是：1）确定清除的近端先例，2）确定净化的后果，3）检查人格和合并症的心理病理学，作为假定前因和清除行为之间关联的主持人。 PD（n = 35）的女性将被招募以携带掌上计算机，并每天进行多次评级，持续两周。多级模型分析将用于测试研究假设，即1）NA的增加，形状/体重的问题，胃部不适以及侵犯饮食规则的侵犯预测行为，2）NA的减少，形状/体重的关注以及胃部不适以及胃部不适后，伴随着净化行为以及3）冲动性和当前焦虑症的水平更高，可以增强抗抑制作用的临床和净化的行为。公共卫生相关性：拟议的研究将是EMA对PD的首次应用，因此代表了高度新颖的研究，该研究将允许检查情感，认知和躯体因素变化与清除行为的变化之间的时间关联。这些数据对于理解为什么在食用正常或少量食物后清除PD的女性至关重要，并且可能指向开发有效干预措施的特定目标。当前，尚无针对PD的循证治疗，这是一种与重大的社会心理和医疗发病率相关的普遍综合征。因此，拟议研究的发现有可能显着改善公共卫生。