Behavioral Phenotypes of Reward and Inhibition in Parent-Child Weight Loss

摘要 大约三分之一的儿童和三分之二的成年人超重或肥胖。到 迄今为止，最成功的儿童减肥治疗是以家庭为基础的儿童肥胖治疗（FBT）， 它将营养和体育活动教育与行为治疗策略和家长 旨在塑造孩子和父母健康行为的管理技术。但并不是所有 孩子和父母的反应和大多数恢复大部分或全部的体重回来。面临的挑战之一 家庭试图控制他们的体重是目前的食物环境，这是充满了高热量， 享乐，低成本的食物，使它非常容易吃超出营养需求。很有可能 减肥计划失败，因为目前的治疗不足以针对基本的认知机制， 与个体如何与当前的食物环境相互作用有关。暴饮暴食，或吃过 营养需求，理论上是两种基本认知机制之间相互作用的结果; 食物的生理和心理奖励以及抑制暴饮暴食冲动的能力。我们有 开发了一些针对特定食物的认知评估，这些评估针对的是 超重和肥胖。对于这个项目，我们建议增加奖励和抑制的评估， 包括参与两个R 01 260对父母/子女之间的自我报告和基于任务的测量 项目评估6个月的FBT计划。将在基线、6、12和24个月时进行评估 时间点。本研究的主要目的是：1）确定行为和心理表型， 儿童和父母基线时的奖励和抑制，2）评估这些表型是否预测 在6个月、12个月和24个月的时间点，儿童和父母的体重减轻。我们还将比较行为 父母和孩子之间的奖励和抑制的心理表型，我们将1）评估 孩子和父母的奖励和抑制表型之间的相互作用是否可以预测体重变化， 6、12和24个月的时间点，2）评估父母教养方式是否与儿童行为和 奖励和抑制的心理表型，以及3）探索行为和心理 在儿童和父母中基线时鉴定的表型随时间变化，以及这些变化是否是 与儿童和父母的体重减轻有关。该项目将收集关键的，独特的数据， 和抑制方面的认知，在儿童和家长参与FBT计划。这些数据将 允许识别超重和肥胖儿童的特定认知表型， 父母，并最终开发有针对性的治疗方法，可以更有效地与特定群体的 孩子和父母。

ABSTRACT Approximately one out of every three children and two out of every three adults have overweight or obesity. To date, the most successful treatment for child weight loss is family-based treatment for childhood obesity (FBT), which combines nutrition and physical activity education with behavior therapy strategies and parent management techniques targeted to shape healthy behaviors in both the child and parent. Unfortunately, not all children and parents respond and the majority regain most or all of their weight back. One of the challenges for families attempting to manage their weight is the current food environment, which is replete with high calorie, hedonic, low cost foods which make it incredibly easy to eat beyond nutritional needs. It is very possible that weight loss programs fail because current treatments inadequately target basic cognitive mechanisms that are inherently involved in how individuals interact with the current food environment. Overeating, or eating past nutritional needs, is theorized to be a result of the interaction between two basic cognitive mechanisms; physiological and psychological reward from food and the ability to inhibit impulses to overeat. We have developed a number of food-specific cognitive assessments which target specific vulnerabilities in people who have overweight and obesity. For this project, we propose to add assessments of reward and inhibition that include both self-report and task-based measurements among 260 parent/child pairs participating in two R01 projects evaluating 6-month FBT programs. Assessments will be conducted at baseline, 6-, 12- and 24-month timepoints. The primary aims of this study are 1) to determine behavioral and psychological phenotypes of reward and inhibition at baseline in children and parents and 2) to evaluate whether these phenotypes predict weight loss in both children and parents at 6-, 12- and 24-month timepoints. We will also compare behavioral and psychological phenotypes of reward and inhibition between parents and children, and we will 1) evaluate whether the interaction between child and parent phenotypes of reward and inhibition predict weight change at 6, 12- and 24-month timepoints, 2) evaluate whether parenting style interacts with child behavioral and psychological phenotypes of reward and inhibition, and 3) explore whether the behavioral and psychological phenotypes identified at baseline in children and parents change over time and whether these changes are associated with weight loss in children and parents. This project will collect crucial, unique data on both reward and inhibition aspects of cognition, in both children and parents participating in an FBT program. These data will allow the identification of specific cognitive phenotypes in children with overweight and obesity and their parents, and ultimately to develop targeted treatments that could be more effective with specific groups of children and parents.