Relationships, Emotion, and Eating: Dynamic Systems Investigation of Weight Gain

描述(申请人提供)：尽管进行了广泛的研究和干预，但超重的美国人的比例仍在继续攀升，使很大一部分人口面临慢性病的风险。这一失败的原因之一可能是，传统研究不太适合处理导致一个人超重的因素的动态复杂性。本研究接受了这一挑战，并采用动态系统方法测试了一个模型，该模型预测了关系动态、情绪和自主生理对新组建家庭的饮食、活动和短期体重增加的综合影响。在婚姻的最初几年，夫妻双方建立了共同的饮食和活动习惯，这些习惯随后将传递给他们的孩子。要阻止肥胖的流行，需要研究夫妇如何发展共同的肥胖相关行为。这些机制可以接受行为干预，但开发此类干预的一个关键挑战是我们缺乏对这些因素如何相互作用的理解。我们模型的基本前提是，围绕饮食和活动的夫妻层面的行为和情感模式提供了维持饮食和活动习惯的近端力量，并伴随着对体重的影响。我们专注于两种模式，对吸烟和酒精成瘾的研究表明，这两种模式对于维持不健康的行为很重要。第一种是系统症状匹配(SSF)，指的是一种不健康的行为，如暴饮暴食，通过增加积极的情绪或夫妻关系来帮助保持关系的幸福感(Rohrbaugh，Shoham，Butler，Hasler，&Berman，2009；Shoham，Butler，Rohrbaugh，&Trost，2007)。第二种模式，需求-退出(DW)，当一个伙伴要求改变另一个伙伴的健康行为时，导致被唠叨的伙伴退出互动并抵制改变(Eldridge，Sevier，Jones，Atkins，&Christensen，2007)。我们认为，新婚夫妇中SSF或DW的存在将预示6个月后体重增加和健康习惯恶化。为了检验我们的假设，我们招募了100对在同居第一年内的异性伴侣。在研究开始时，所有参与者都将处于健康体重范围的上端。因此，他们将面临超重的风险。基线时的SSF和DW的多方法评估将用于预测6个月后饮食/活动习惯和体重的变化。这个项目有潜力 通过整合传统上独立的科学和临床社区，并阐明解决肥胖问题的动态系统方法，从而产生广泛的影响。因此，它可以为不同背景的研究人员和临床医生提供理论依据。此外，这项研究的结果将为关于整合家庭系统、情绪调节和生物反馈方法以理解和治疗肥胖症的最佳、有针对性的方法的研究和实践提供信息。 与公共健康相关：肥胖是美国面临的主要健康挑战之一。这项拟议的研究测试了一种假设，即新组建的家庭中的情感和生理机制会产生以饮食和活动为重点的关系层面的组织形式，而这反过来又会导致体重增加。如果这是真的，这可能与公共卫生有很大的相关性，因为它意味着需要制定超越个人的干预措施，而这在当前的实践中很少做到。预防和治疗需要侧重于破坏家庭一级系统的稳定，并促使人们转向新的稳定但更健康的人际行为模式。拟议的研究将提供与这一关键但研究不足的问题有关的初步证据。

DESCRIPTION (provided by applicant): Despite extensive research and intervention efforts the percentage of overweight Americans has continued to climb, putting a large segment of the population at risk for chronic disease. One reason for this failure may be that traditional research is not well suited for tackling the dynamic complexity of factors that result in a person becoming overweight. The present study takes up this challenge and adopts a dynamic systems approach to test a model that predicts the combined effects of relationship dynamics, emotions, and autonomic physiology on eating, activity, and short term weight gain in newly formed families. During the early years of marriage couples establish shared eating and activity habits that will subsequently be passed on to their children. Interrupting the obesity epidemic requires research focused on how couples develop shared obesity relevant behaviors. These mechanisms are amenable to behavioral intervention, but a key challenge for developing such interventions is our lack of understanding about how these factors interact. The basic premise of our model is that couple-level behavioral and emotional patterns focused around eating and activity provides proximal forces perpetuating eating and activity habits, with accompanying effects on body weight. We focus on two patterns that research on smoking and alcohol addiction suggests are important for maintaining unhealthy behaviors. The first, System-Symptom Fit (SSF), refers to an unhealthy behavior, such as excessive eating, helping to preserve relationship well-being by increasing positive emotion or couple closeness (Rohrbaugh, Shoham, Butler, Hasler, & Berman, 2009; Shoham, Butler, Rohrbaugh, & Trost, 2007). The second pattern, Demand-Withdraw (DW), occurs when one partner demands change in the other partner's health behaviors, which causes the "nagged" partner to withdraw from the interaction and to resist change (Eldridge, Sevier, Jones, Atkins, & Christensen, 2007). We propose that the presence of SSF or DW in newly formed couples will predict increases in weight and deteriorating health habits 6 months later. To test our hypotheses we will recruit 100 heterosexual couples who are within the first year of cohabiting. All participants will be in the upper-end of the healthy weight range at the beginning of the study. As such, they will be at risk of becoming overweight. Multi-method assessments of SSF and DW at baseline will be used to predict changes in eating/activity habits and weight 6 months later. This project has the potential for broad impact due to integrating across traditionally separate scientific and clinical communities, and by articulating a dynamic systems approach to the problem of obesity. As such, it could provide a theoretical basis for researchers and clinicians from diverse backgrounds. In addition, results from the study would inform research and practice regarding optimal, targeted ways to integrate family systems, emotion regulation, and biofeedback approaches to understanding and treating obesity. PUBLIC HEALTH RELEVANCE: Obesity is one of the primary health challenges facing America. The proposed research tests the hypothesis that emotional and physiological mechanisms in newly formed families give rise to relationship-level organizational forms focused around eating and activity that in turn contribute to weight gain. If true, this could have great relevance to public-health because it implies that interventions need to be developed that look beyond the individual, something that is rarely done in current practice. Prevention and treatment will need to focus on destabilizing family-level systems and provoking movement towards new stable, but healthier, interpersonal behavioral patterns. The proposed research will provide preliminary evidence relevant to this critical but under-studied issue.