On Pathogenetic Diagnosis and Treatment Based on Conditioned Emotional Response and Self Body Image in Eating Disorders

我们推测，体像条件性情绪反应可能参与神经性厌食症的发病机制。对14例神经性厌食症（DSM-III）患者和18名年龄、性别相匹配的健康女性进行了体像估计和事件相关电位（ERP）检测.受试者估计自身身体的真实的和理想的形状以及模仿女性身体的可乐瓶的真实的形状。患者倾向于高估真实的体型而低估理想体型。此外，与健康组相比，患者组高估了可乐瓶的形状.以进食行为相关词语作为警告刺激（S1）时，患者ERPs的负慢电位（CNV）幅值增加。与健康组相比，当患者对这些词产生不愉快情绪时，无论其内容如何，患者都表现出更大的S1相关P300和晚期CNV成分。当S1的词为体型“胖”和父母“妈妈”时，患者组的ERP与不愉快反应组相似.高估自身体型的患者CNV较高估自身体型的健康组增加，而低估自身体型的患者CNV与健康组无显著性差异。这些结果支持了我们的假设，即过高估计自己体型的抑郁症患者可能对体型有显著的条件性情绪反应。

We hypothesized that emotional response conditioned on body image might involve in pathogenesis of anorexia nervosa. The body image estimation and the event-related potentials (ERPs) were obtained from 14 patients with anorexia nervosa (DSM-III) and 18 sex- and age-matched healthy young women.1. The subject estimated real and ideal shapes of self body as well as real shape of a coke bottle imitative of a female body. The patients tended to overestimate the real body shape and to underestimate the ideal body shape. In addition, the patient group overestimated the coke bottle shape as compared with the healthy group.2. Negative slow potential (CNV) of the ERPs increased in amplitude for the patients when the words concerned with eating behaviors were used as a warning stimulus (S1). The patients showed larger components of the S1-related P300 and the late CNV when they responded with unpleasant emotion to these words irrespective of their contents than the healthy group did. The patient group showed the ERPs similar to those with the unpleasant response when the words of S1 were the body shape "fatty" and the parent "mother" .3. The CNV of the patients with overestimation of self body shape increased in amplitude as compared with the healthy group with the overestimation, but there was no significant difference between the patient and healthy groups with the underestimation. These results support our hypothesis that the anorexic patients who overestimate their own body shape may have remarkable conditioned emotional responses to body shape.