Binge Eating: Clinical Patterns & Biological Correlates

本研究的长期目标是探索通过摄入食物量来定义神经性贪食症暴食发作的效用，并揭示导致贪食症症状发生或维持的因素。 另一个目标是提高对类似于神经性贪食症清除亚型的替代症状群的识别，只不过感知到的暴食事件并不涉及客观上大量的食物。 最近的研究表明，大量年轻女性患有这种替代症状群（主观性神经性贪食症-SBN），这表明 SBN 是一个重大的公共卫生问题。 本研究的一个具体目的是检验这一假设，即与患有 DSM-IV 神经性贪食症的女性一样，患有 SBN 的女性也表现出临床上显着的痛苦和损伤水平。 第二个目的是证明 SBN 与 DSM-IV 神经性贪食症不同，因此不应与该综合征合并在一个诊断类别中。 该研究提议扩展初步数据，表明患有神经性贪食症的女性比患有 SBN 的女性冲动程度更高。 此外，这项研究提出了一项新的检查，即与患有 SBN 的女性相比，患有神经性贪食症的女性在休息餐后是否表现出较低的饱腹感和胆囊素 (CCK) 释放水平较低。 该研究将包括 30 名患有 DSM-IV 神经性贪食症清除亚型的女性、30 名患有 SBNm 的女性和 30 名非饮食失调对照女性。受试者将完成心理评估，包括结构化临床访谈和针对抑郁、焦虑、冲动以及社交和职业功能的标准化问卷评估。 受试者还将参与餐后饱腹感和 CCK 释放的评估。 这项研究将测试一种神经性贪食症模型，其中饱足感信号不足无法减少进食冲动，再加上冲动控制不良，增加了经历客观大量暴食事件的可能性（根据所消耗的食物量），并揭示了神经性贪食症中客观大量暴食事件的病因或维持因素。 此外，这项研究有可能确定一种新的饮食失调亚型，值得研究、治疗和纳入疾病分类方案。

The long term objectives of this study are to explore the utility of defining binge-eating episodes in bulimia nervosa by the amount of food consumed and to reveal factors that contribute to the development or maintenance of bulimic symptoms. An additional objective is to improve the recognition of an alternative symptom cluster that resembles bulimia nervosa-purging subtype, except that perceived binge episodes do not involve objectively large amounts of food. Recent research indicates that a substantial number of young women suffer from this alternative symptom cluster (subjective bulimia nervosa-SBN) suggesting that SBN represents a significant public health concern. One specific aim of this study is to test the hypothesis that, like women with DSM-IV bulimia nervosa, women with SBN demonstrate clinically significant levels of distress and impairment. A second aim is to demonstrate that SBN is distinct from DSM-IV bulimia nervosa and thus should not be combined with this syndrome within one diagnostic category. The study proposes to extend preliminary data suggesting that women with bulimia nervosa have higher levels of impulsiveness compared to women with SBN. In addition, this study proposes a novel examination of whether, compared to women with SBN, women with bulimia nervosa demonstrate lower levels of satiety and blunted cholecystokin (CCK) release following a rest meal. The study will include 30 women with DSM-IV bulimia nervosa-purging subtype, 30 women with SBNm and 30 non-eating disordered control females. Subjects will complete psychological assessments including structured clinical interviews and standardized questionnaire assessments of depression, anxiety, impulsiveness, and social and occupational functioning. Subjects will also participate in assessments of post-prandial satiety and CCK release. This study will test a model of bulimia nervosa in which deficient satiety signals fail to decrease the impulse to eat which, combined with poor impulse control, increases the liability to experience objectively large binge-eating episodes by the amount of food consumed and reveal etiologic or maintaining factors for objectively large bing episodes in bulimia nervosa. Further, this study has the potential to identify a new subtype of eating disorder that is worthy of study, treatment, and inclusion in nosological schemes.