The central role of disgust in disorders of food avoidance
The central role of disgust in disorders of food avoidance
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DOI：
10.1002/eat.23047
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发表时间：
2019-05-01
影响因子：
5.5
通讯作者：
Zucker, Nancy L.
中科院分区：
文献类型：
--
作者：
Harris, Adrianne A.;Romer, Adrienne L.;Zucker, Nancy L.
极端食物回避的个体，如回避性限制性食物摄入障碍（ARFID），因营养种类或/和数量不足而导致身心健康受损。确定导致食物回避的机制对于制定有效的干预措施至关重要。焦虑在食物回避的理论模型中占突出地位;然而，有有限的证据表明，反复暴露于食物会增加ARFID患者的接近行为。研究厌恶，以及厌恶和焦虑之间的关系，可能会提供新的见解，因为厌恶在功能上与避免病原体污染（可能通过摄入发生）有关，并且在很大程度上抵抗灭绝。这项探索性的横断面研究包括来自1,644名成年人的数据，他们完成了在线问卷调查。参与者的反应被用来衡量ARFID分类，挑食，感觉灵敏度，厌恶和焦虑。结构方程模型测试了潜在的厌恶和焦虑因素的测量模型，通过自我报告的厌恶和焦虑反应的频率来测量。中介模型被用来探索因果排序。结果潜在厌恶因子与挑食严重程度（B约为0.4）和ARFID分级（B约为0.6）的相关性大于潜在焦虑因子（B约为0.1）。厌恶部分介导了焦虑和挑食之间的关联，完全介导了焦虑和ARFID之间的关联。测试反向因果顺序的模型表现出较差的拟合。研究结果表明，焦虑可能与食物回避有关，部分原因是厌恶感增加。结论厌恶可能在食物回避中起重要作用。这些发现可能会为新的治疗方法提供信息。
Background Individuals with extreme food avoidance such as Avoidant Restrictive Food Intake Disorder (ARFID) experience impairing physical and mental health consequences from nutrition of insufficient variety or/and quantity. Identifying mechanisms contributing to food avoidance is essential to develop effective interventions. Anxiety figures prominently in theoretical models of food avoidance; however, there is limited evidence that repeated exposures to foods increases approach behavior in ARFID. Studying disgust, and relationships between disgust and anxiety, may offer novel insights, as disgust is functionally associated with avoidance of contamination from pathogens (as may occur via ingestion) and is largely resistant to extinction. Method This exploratory, cross-sectional study included data from 1,644 adults who completed an online questionnaire. Participant responses were used to measure ARFID classification, picky eating, sensory sensitivity, disgust, and anxiety. Structural equation modeling tested a measurement model of latent disgust and anxiety factors as measured by self-reported frequency of disgust and anxiety reactions. Mediational models were used to explore causal ordering. Results A latent disgust factor was more strongly related to severity of picky eating (B approximate to 0.4) and ARFID classification (B approximate to 0.6) than the latent anxiety factor (B approximate to 0.1). Disgust partially mediated the association between anxiety and picky eating and fully mediated the association between anxiety and ARFID. Models testing the reverse causal ordering demonstrated poorer fit. Findings suggest anxiety may be associated with food avoidance in part due to increased disgust. Conclusions Disgust may play a prominent role in food avoidance. Findings may inform novel approaches to treatment.