Randomized trial of a dissonance-based transdiagnostic group treatment for eating disorders: An evaluation of target engagement.
Randomized trial of a dissonance-based transdiagnostic group treatment for eating disorders: An evaluation of target engagement.
复制标题
DOI：
10.1037/ccp0000430
复制
发表时间：
2019-09
影响因子：
5.9
通讯作者：
E. Stice;S. Yokum;P. Rohde;H. Shaw;J. Gau;Sarah Johnson;Aviva N. Johns
中科院分区：
文献类型：
--
作者：
E. Stice;S. Yokum;P. Rohde;H. Shaw;J. Gau;Sarah Johnson;Aviva N. Johns
目的测试基于不和谐的transdiagnosis饮食失调治疗是否降低了对瘦美理想和高热量暴食的评价，干预目标，以及相对于等待名单控制的饮食病理学。方法将患有精神疾病诊断和统计手册-5种进食障碍的女性（N = 100）随机分配至8周组实施的身体项目治疗（BPT），该治疗经过重新设计以鼓励快速症状减轻或等待控制条件，完成功能性MRI范式评估对瘦模型和暴饮暴食的神经反应，问卷调查和前测和后测的诊断访谈。结果与对照组相比，BPT参与者表现出更大的反应性降低涉及奖励评价的区域（腹内侧前额叶皮层、背外侧前额叶皮层、尾状核）以瘦为典范，但不暴饮暴食，追求瘦的理想（d = 0.72）、暴饮暴食的可口性评级（d = 0.78）以及干预目标平均体重模型的吸引力评级的更大增加（d = 0.44）。与对照组相比，BPT参与者的身体不满意度（d = .83）、负面情绪（d = .76）和进食障碍症状（d = .59）也显著降低，并且对暴饮暴食和补偿行为的戒断率略高（39%对21%）。结论：结果提供了新的证据表明，BPT影响了假设的干预目标，并减少了追求苗条理想的次要变量，包括身体不满，负面影响和饮食失调症状。症状的减少比过去的试验要小，这表明在要求参与者减少用于追求这种理想的无序饮食行为之前，降低对瘦理想的评价可能是最佳的。（PsycINFO数据库记录（c）2019阿帕，保留所有权利）。
OBJECTIVE Test whether a dissonance-based transdiagnostic eating disorder treatment reduces valuation of the thin beauty ideal and high-calorie binge foods, the intervention targets, and eating pathology relative to waitlist controls. METHOD Women with Diagnostic and Statistical Manual of Mental Disorders-5 eating disorders (N = 100) were randomized to an 8-week group-implemented Body Project Treatment (BPT) redesigned to encourage rapid symptom reduction or a waitlist control condition, completing functional MRI paradigms assessing neural response to thin models and binge foods, questionnaires, and diagnostic interviews at pretest and posttest. RESULTS Compared to controls, BPT participants showed greater reductions in responsivity of regions involved in reward valuation (ventromedial prefrontal cortex, dorsolateral prefrontal cortex, caudate) to thin models but not binge foods, pursuit of the thin ideal (d = .72), palatability ratings of binge foods (d = .78), and greater increases in attractiveness ratings of average-weight models (d = .44), the intervention targets. BPT participants also showed significantly greater reductions in body dissatisfaction (d = .83), negative affect (d = .76), and eating disorder symptoms (d = .59), and marginally greater abstinence from binge eating and compensatory behaviors (39% vs. 21%) than controls. CONCLUSIONS Results provide novel evidence that BPT affected the hypothesized intervention targets and reduced variables that are putatively secondary to pursuit of the thin ideal, including body dissatisfaction, negative affect, and eating disorder symptoms. Symptom reductions were smaller than in past trials, suggesting that it may be optimal to reduce valuation of the thin ideal before asking participants to reduce disordered eating behaviors that are used to pursue this ideal. (PsycINFO Database Record (c) 2019 APA, all rights reserved).