1/2-Preventing Eating Disorders and Reducing Comorbidity

1/2-预防饮食失调和减少合并症

基本信息

批准号：
7835757
负责人：
CRAIG BARR TAYLOR
金额：
$ 56.18万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-05-07 至 2012-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7835757
关键词：
Acquired Immunodeficiency Syndrome Address Affect Age Alcohol abuse Alcohol consumption Alcohols Anxiety Anxiety Disorders Behavior Behavior Therapy Binge Eating Body mass index Clinical Clinical Research Clinical Services Comorbidity Coping Skills Data Depressive disorder Diet Disease Eating Eating Disorders Emotions Exposure to Family history of Fatty acid glycerol esters Future Goals High Risk Woman Incidence Internet Intervention Intervention Studies Lead Link Maintenance Mediator of activation protein Medical Mental Depression Mental Health Mental disorders Methods Moods NIH Program Announcements Onset of illness Participant Pharmaceutical Preparations Population Prevention program Preventive Preventive Intervention Program Development Psychopathology Public Health Published Comment Randomized Recording of previous events Recruitment Activity Regulation Reporting Research Risk Risk Factors Sample Size Screening procedure Sensitivity and Specificity Shapes Siblings Site Students Subgroup Substance Use Disorder Substance abuse problem Symptoms Translating Translational Research Universities Vomiting Weight Woman Work alcohol use disorder base college coping cost depressive symptoms dietary restriction disorder risk emotion regulation follow-up high risk improved intervention effect laxative abuse population based prevent programs psychologic public health relevance purge skills teacher therapy design treatment as usual treatment effect university student

项目摘要

DESCRIPTION (provided by applicant): The long-range objective of the proposed research is to refine, evaluate, and disseminate an Internet-based intervention to prevent eating disorders (EDs) and comorbidities in college-age women. EDs are highly prevalent among college women and can lead to serious psychological and medical consequences. In previous work, we have shown that an Internet-based intervention can reduce onset of EDs in select subgroups but, given its focus solely on weight/shape concerns (WCS), the intervention had little impact on comorbidities common to this population. We have also identified three risk factors which, when combined with the presence of WCS, indicate very high risk for an ED: a history of depression and/or exposure to critical comments about weight/eating from teachers/coaches/siblings and/or low-level compensatory behaviors (e.g., vomiting and purging). The rate of onset of EDs in women presenting with these risk factors is greater than 30% over 2 years, compared to less than 4% in participants presenting with WCS only. We propose to enhance our previous Internet-based intervention to address these risk factors, and to sustain the effects of the intervention, by including affect improvement and regulation modules, and by adding a maintenance component, respectively. Our primary hypothesis is that, compared to a usual care group, participants in the intervention will have a significantly lower incidence of EDs at two-year follow-up. We expect to lower the incidence from an anticipated rate of 30% to 15%. We also hypothesize that the intervention will significantly reduce WCS, unhealthy weight regulation behaviors (e.g., vomiting, laxative abuse), and dietary restriction while improving mood, coping skills, and emotion regulation. We expect reductions in the combined incidence of depressive, anxiety, and substance use disorders. Moderators and mediators of potential treatment effects will be examined as well. In order to further illustrate our ability to disseminate a low-cost program to universities, we plan to implement and examine the sensitivity and specificity of an Internet-based screen to identify women at risk for EDs and to provide our original prevention program to women with high WCS only. To achieve these aims, 200 college-age women with both high WCS and at least one of the very high risk factors will be randomized to the intervention or a usual care group and followed for at least two years. 250 women with high WCS only and 100 women with low WCS will be recruited for the purpose of screening and dissemination aims. The enhanced intervention, which will be provided for 12 weeks, followed by four maintenance sessions provided over the subsequent eight months, translates findings from basic clinical studies into a disseminable intervention. If effective, the enhanced intervention provides an easy and inexpensive method to reduce EDs and ED comorbidity in college-age women PUBLIC HEALTH RELEVANCE: Eating disorders are common and disabling problems among college-age women. Research has identified a group of college age women at particularly high risk for eating disorders and co-morbid conditions. The purpose of this study is to determine if an internet-based intervention can reduce the onset of eating disorders among this highest risk population and also reduce co-morbidity. If so, this finding, combined with our previous research would have a major public health impact on reducing eating disorder rates.

描述（由申请人提供）：拟议研究的远程目标是完善，评估和传播基于互联网的干预措施，以防止饮食失调（ED）和大学时代女性的合并症。 ED在大学妇女中非常普遍，可能导致严重的心理和医学后果。在以前的工作中，我们已经表明，基于Internet的干预措施可以减少某些亚组中的ED发作，但是鉴于其仅关注体重/形状问题（WCS），该干预对该人群常见的合并症几乎没有影响。我们还确定了三个危险因素，当与WC的存在结合使用时，表明ED的风险很高：抑郁症和/或暴露于有关体重/饮食的批判性评论的历史/教师/教练/兄弟姐妹和/或低级补偿行为（例如，呕吐和清除）。在2年内，出现这些危险因素的女性ED发作率大于30％，而仅出现WC的参与者不到4％。我们建议通过包括影响改进和监管模块，分别添加维护组件来加强我们以前的基于Internet的干预措施，以解决这些风险因素，并维持干预措施的影响。我们的主要假设是，与通常的护理组相比，干预措施的参与者将在两年随访时的ED发病率明显降低。我们预计，预期的30％降至15％。我们还假设，干预措施将显着降低WC，不健康的体重调节行为（例如呕吐，泻药滥用）和饮食限制，同时提高情绪，应对技巧和情绪调节。我们预计抑郁，焦虑和药物使用障碍的综合发生率降低。还将检查潜在治疗效果的主持人和介体。为了进一步说明我们将低成本计划传播给大学的能力，我们计划实施和检查基于Internet的屏幕的敏感性和特异性，以识别有EDS风险的女性，并向仅WCS高的女性提供我们的原始预防计划。为了实现这些目标，有200名具有高WC和至少一个非常高的风险因素的大学时代女性将被随机分为干预措施或通常的护理小组，并至少遵循两年。为了筛查和传播目的，将招募250名只有高WC和100名WC较低女性的妇女。增强的干预措施将提供12周，然后在随后的八个月内提供四次维护课程，将基本临床研究的发现转化为可融合的干预措施。如果有效，增强的干预措施提供了一种简单且廉价的方法，可以减少大学时代女性的ED和ED合并症公共卫生相关性：饮食失调是普遍的，并且在大学时代妇女中存在残疾问题。研究已经确定了一群大学时代的女性，饮食失调和合并症的风险特别高。这项研究的目的是确定基于Internet的干预措施是否可以减少这种最高风险人群中饮食失调的发作，并降低合并症。如果是这样，这一发现与我们先前的研究相结合，将对降低饮食失调率产生重大的公共卫生影响。