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

• 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
• 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

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）影响了大约5％的人口，并对心理和身体健康产生多种不利影响。近年来，对饮食失调的治疗已经进展，但进一步的进步将取决于改善该领域对饮食失调心理病理学的理解。 EDS的认知行为疗法（CBT）模型已获得了大量支持，但是该框架没有足够解决似乎对无序饮食产生重大影响的两个领域。我们称为第一个域重量历史记录，该历史记录由病前体重组成，有史以来最高和当前体重（抑制重量，WS）和当前BMI（通常处于非常低，不健康的水平）之间的差异。我们已经表明，WS和BMI（及其相互作用）是许多ED特征的强大预测指标，并且CBT模型无法充分考虑这些关系。第二个领域涉及大脑奖励和对可口食品提示的抑制作用。证据表明，存在连续体，而两极的锚定是对限制厌食症患者和超重暴饮暴食者的相反反应（前者显示出奖励性低激活和抑制性过度激活，后者表现出相反）。然而，这些异常模式如何有助于ED心理病理学。由于包含两个领域的变量本质上都是连续的，并且由于当前的应用将研究个人，无论DSM诊断如何，因此拟议的研究与RDOC建议一致。我们检验了这两个领域将在饮食失调的心理病理学上与横截面相关的假设，将预测未来的体重增加，ED症状和过程，并且奖励和抑制感兴趣的抑制区域的大脑激活将介导体重历史变量对体重变化的预测影响和ED结果。这些假设将在96个在任何水平的门诊护理中接受治疗的人中进行检验。在基线时，将使用标准化的体重历史和ED心理病理学评估它们，并使用旨在衡量其奖励和抑制感兴趣的食物图片的范式进行结构和功能性MRI。体重和ED症状的度量将在3个月和6个月的随访中重复。拟议的研究具有确定ED心理病理学的新来源的巨大潜力，可以将其转化为这些耐药性疾病的新型治疗方法。