Weight History, Brain Activation to Food Cues and Eating Disorder Psychopathology

体重史、食物线索的大脑激活和饮食失调精神病理学

基本信息

批准号：
9076365
负责人：
Anna Rose Childress
金额：
$ 22.88万
依托单位：
DREXEL UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-04-04 至 2019-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9076365
关键词：
Accounting Address Adverse effects Affect Ambulatory Care Area Base of the Brain Behavior Behavioral Binge Eating Body Weight Body Weight Changes Body Weight decreased Brain Brain region Characteristics Clinical Cognitive Therapy Cues Development Diagnosis Diagnostic and Statistical Manual of Mental Disorders Dimensions Disease Disease model Dopamine Eating Eating Disorders Energy Intake Energy Metabolism Etiology Food Frequencies Functional Magnetic Resonance Imaging Future Goals Health Individual Intake Lead Leptin Maintenance Measures Mediating Medical Mental Health Modeling Nature Negative Valence Outcome Overweight Patients Pattern Population Prevalence Psychopathology Recommendation Recording of previous events Research Research Domain Criteria Resistance Rewards Source System Testing Translating Underweight Weight Weight Gain Weights and Measures brain metabolism clinically significant disorder subtype energy balance follow-up improved interest neuroimaging novel physical conditioning prospective purge response standardize measure

项目摘要

DESCRIPTION (provided by applicant): Eating disorders (EDs) affect approximately 5% of the population and have a variety of adverse effects on mental and physical health. The treatment of disordered eating has progressed in recent years but further progress will depend in part on improving the field's understanding of eating disorder psychopathology. The cognitive-behavioral therapy (CBT) model of EDs has garnered substantial support but this framework does not sufficiently address two domains that appear to have a major impact on disordered eating. We call the first domain Weight History, which consists of premorbid body mass, the discrepancy between highest ever and current body weight (weight suppression, WS) and current BMI (which is often at very low, unhealthy levels). We have shown that WS and BMI (and their interaction) are robust predictors of many ED characteristics and that these relationships are not sufficiently accounted for by the CBT model. The second domain involves brain reward and inhibitory responses to palatable food cues. Evidence indicates that a continuum exists, with the poles anchored by the opposing responses to food cues of restricting anorexic patients and overweight binge eaters (with the former showing reward hypo-activation and inhibitory hyper-activation and the latter showing the reverse). Yet little known about how these abnormal patterns contribute to ED psychopathology. Because the variables comprising both domains are continuous in nature, and because the current application will study ED individuals regardless of DSM diagnosis, the proposed research is consistent with RDoC recommendations. We test the hypotheses that the two domains will be cross-sectionally related to eating disorder psychopathology, will predict future weight gain, ED symptomatology and course and that brain activation in reward and inhibitory regions of interest will mediate the predictive effects of Weight History variables on weight change and ED outcomes. These hypotheses will be tested among 96 ED individuals receiving treatment in any level of outpatient care. At baseline they will be assessed using standardized measures of Weight History and ED psychopathology and will undergo structural and functional MRI using a paradigm aimed at measuring their reward and inhibitory activation to food pictures in regions of interest. The measures of weight and ED symptomatology will be repeated at 3 and 6-month follow-ups. The proposed research has substantial potential to identify new sources of ED psychopathology that can be translated into novel treatments for these treatment-resistant disorders.

描述（由申请人提供）：饮食失调 (ED) 影响大约 5% 的人口，并对精神和身体健康产生多种不利影响。近年来，饮食失调的治疗取得了进展，但进一步的进展将部分取决于该领域对饮食失调精神病理学的理解。 ED 的认知行为疗法 (CBT) 模型已获得大量支持，但该框架并未充分解决似乎对饮食失调产生重大影响的两个领域。我们将第一个领域称为“体重历史”，其中包括病前体重、最高体重与当前体重之间的差异（体重抑制，WS）以及当前 BMI（通常处于非常低的不健康水平）。我们已经证明，WS 和 BMI（及其相互作用）是许多 ED 特征的稳健预测因子，并且 CBT 模型没有充分解释这些关系。第二个领域涉及大脑对美味食物线索的奖励和抑制反应。有证据表明，存在一个连续体，极点由限制性厌食症患者和超重暴食者对食物线索的相反反应所固定（前者表现出奖励性低激活和抑制性过度激活，后者则表现出相反的情况）。然而，人们对这些异常模式如何导致 ED 精神病理学却知之甚少。由于包含两个域的变量本质上是连续的，并且由于当前的应用程序将研究 ED 个体，而不管 DSM 诊断如何，因此拟议的研究与 RDoC 建议一致。我们测试了以下假设：这两个领域将与饮食失调精神病理学横断面相关，将预测未来的体重增加、ED 症状和病程，并且奖励和抑制感兴趣区域的大脑激活将介导体重历史变量对饮食失调的预测作用。体重变化和 ED 结果。这些假设将在 96 名接受任何级别门诊治疗的 ED 患者中进行测试。在基线时，他们将使用体重史和 ED 精神病理学的标准化测量进行评估，并将使用旨在测量他们对感兴趣区域的食物图片的奖励和抑制激活的范式进行结构和功能 MRI。体重和 ED 症状的测量将在 3 个月和 6 个月的随访中重复进行。拟议的研究具有巨大的潜力，可以确定 ED 精神病理学的新来源，这些来源可以转化为治疗这些难治性疾病的新疗法。