Self-Perception and Social Rewards in Atypical Anorexia Nervosa

非典型神经性厌食症的自我认知和社会奖励

• 批准号: 10468305
• 负责人: Carrie Justine McAdams
• 金额: $ 24.43万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10468305
• 关键词: Acute; Adult; Animal Model; Anorexia Nervosa; Behavior; Behavioral; Body Image; Body Size; Body Weight; Body Weight Changes; Body Weight decreased; Body mass index; Brain; Bulimia; Characteristics; Chronic; Clinical; Clinical Treatment; Cognition Disorders; Cognitive; Corpus striatum structure; DSM-V; Data; Diagnosis; Dimensions; Disease; Eating; Eating Behavior; Eating Disorders; Evidence based treatment; Food; Functional Magnetic Resonance Imaging; Functional disorder; Image; Impaired cognition; Impairment; Individual; Knowledge; Lead; Link; Magnetic Resonance Imaging; Malnutrition; Measures; Mediating; Modeling; Neurobiology; Neurophysiology - biologic function; Neuropsychology; Obesity; Oranges; Overweight; Pathologic; Pathway interactions; Patients; Perception; Persons; Pilot Projects; Process; Psychopathology; Recovery; Research; Rewards; Self Perception; Self-Examination; Severities; Shapes; Social Perception; Stimulus; Sum; Symptoms; System; Testing; Underweight; Weight; Weight Perception; Woman; Work; clinical care; cohort; experience; food restriction; healthy weight; imaging study; meetings; neural circuit; neurobehavioral; neuroeconomics; neuromechanism; novel; prevent; psychological distress; psychosocial; relating to nervous system; response; restrictive eating; severe mental illness; social; virtual; weight restoration

PROJECT SUMMARY Eating disorders (ED) are serious mental illnesses with few evidence-based treatments and little mechanistic understanding of the neural circuit impairments that underlie both illness and recovery. This project contributes to developing a more dimensional understanding of EDs, by comparing the neural circuits involved in both self- perception and social reward in a previously unstudied clinical cohort, atypical anorexia nervosa (AAN) to a psychiatrically-healthy cohort that has lost similar amounts of body weight (WLC). Typical anorexia nervosa (AN), for the purpose of research and clinical care, is defined by a malnourished body state (BMI < 18.5) with persistent behaviors that interfere with weight restoration, and often includes preoccupations with body image. Atypical anorexia nervosa (AAN) was defined in DSM-5 as meeting all criteria for AN without being underweight; these patients have typically experienced substantial weight loss due to severe restrictive eating behaviors as well as disruptions of their psychosocial functioning due to the severity of their ED cognitions. Clinically, AAN is associated with similar to higher levels of psychological distress and distortions about both eating and body- image as typical AN. This exploratory pilot project will evaluate whether similar neurobehavioral problems in self- perception and social reward are observed in the brain in AAN, extending an existing R01 that is currently examining these circuits in both AN and bulimia nervosa (BN). In addition, the psychiatrically-healthy weight loss cohort (WLC) will have experienced significant weight loss (10-20% of highest body weight) but will not endorse pathological ED cognitive preoccupations; this cohort, in comparison to AAN, allows separation of the impact of weight loss on brain function from the neuropsychological processes that mediate body preoccupations. In sum, this exploratory pilot study evaluates neurobiological circuitry in an understudied diagnosis, AAN, and provides the necessary data to fill current gaps in our knowledge about the effects of weight and ED cognitions on neural function as well as clinical symptoms in EDs. These data are a step towards a more mechanistic understanding of the pathophysiology in EDs.

项目概要 饮食失调 (ED) 是一种严重的精神疾病，几乎没有循证治疗方法，而且机制也很少 了解疾病和康复背后的神经回路损伤。该项目贡献 通过比较两种自体行为所涉及的神经回路，对 ED 形成更维度的理解。 在之前未研究的临床队列中，非典型神经性厌食症（AAN）对感知和社会奖励的影响 精神健康的队列，体重减轻量相似 (WLC)。典型的神经性厌食症（AN）， 出于研究和临床护理的目的，定义为持续营养不良的身体状态（BMI < 18.5） 干扰体重恢复的行为，通常包括对身体形象的关注。非典型 DSM-5 中将神经性厌食症 (AAN) 定义为满足 AN 的所有标准且体重不不足；这些 由于严重的限制性饮食行为以及饮食习惯，患者通常会经历显着的体重减轻 由于 ED 认知的严重性，他们的心理社会功能受到干扰。临床上，AAN 与类似的较高水平的心理困扰以及饮食和身体扭曲有关 图像为典型的 AN。这个探索性试点项目将评估自我认知中是否存在类似的神经行为问题。 在 AAN 的大脑中观察到感知和社会奖励，扩展了目前正在研究的现有 R01 检查 AN 和神经性贪食症 (BN) 中的这些回路。此外，精神健康的减肥 队列 (WLC) 将经历显着的体重减轻（最高体重的 10-20%），但不会认可 病理性 ED 认知关注；与 AAN 相比，该队列可以分离以下因素的影响： 介导身体关注的神经心理过程导致大脑功能减重。总而言之， 这项探索性试点研究评估了一项正在研究的诊断 AAN 中的神经生物学回路，并提供了 填补我们目前关于体重和 ED 认知对神经的影响的知识空白所需的数据 ED 中的功能以及临床症状。这些数据是朝着更加机械化的理解迈出的一步 ED 的病理生理学。