Evaluating the effect of brief interventions on effort to restrict dietary intake

评估短期干预措施对限制饮食摄入的影响

• 批准号: 8526988
• 负责人: Ann Frances Haynos
• 金额: $ 2.9万
• 依托单位: UNIVERSITY OF NEVADA RENO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-06-07 至 2015-06-06
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8526988
• 关键词: Address; Adolescent; Adult; Affect; Alcohol or Other Drugs use; Anorexia Nervosa; Anxiety; Attention; Automobile Driving; Behavioral; Calories; Cardiac; Cessation of life; Chronic; Chronic Disease; Clinical Treatment; Cognitive; Computers; Consumption; Development; Diagnosis; Diet; Dietary intake; Disease; Eating; Eating Behavior; Eating Disorders; Electrolytes; Emotions; Energy Intake; Fasting; Financial compensation; Guidelines; Health; Healthcare Systems; Identification (Psychology); Individual; Inpatients; Intake; Intervention; Investigation; Knowledge; Laboratories; Literature; Measures; Mediating; Medical; Mental Depression; Methodology; Methods; Modeling; Morbidity - disease rate; Nutrient; Outcome; Overweight; Patient Self-Report; Process; Public Health; Randomized; Randomized Controlled Trials; Relapse; Reliance; Research Design; Sampling; Self-control as a personality trait; Societies; Stress; Testing; Theoretical model; Time; Weight; Weight maintenance regimen; Work; active control; active method; behavior measurement; brief intervention; cost; cost effective; dietary restriction; disorder later incidence prevention; driving behavior; effective therapy; emotion regulation; experience; innovation; intervention effect; mortality; nutrition; psychologic; public health relevance; screening; skills; suicidal risk; therapy development

DESCRIPTION (provided by applicant): Dietary restriction (DR), or inadequate caloric and nutrient consumption, is a shockingly common practice associated with serious medical and psychological consequences. DR predicts development of both overweight and eating disorders. At its extreme, DR can develop into anorexia nervosa (AN), a serious and chronic disorder associated with considerable morbidity and lifetime mortality up to 20%. Despite the negative effects of DR, the psychological processes driving this behavior have received little attention and remain poorly understood. While certain psychological processes (e.g., excessive self-control; emotion dysregulation) have been hypothesized to be involved in DR, the models proposing the importance of these processes have not been adequately tested. As a result, treatments of DR are inadequate. No efficacious treatments have been identified for adults with AN and, DR interferes with treatment for other eating disorders, and the guidelines for addressing DR in treatment of other related disorders (e.g., depression) are unspecified. Research design issues hinder progress in understanding and treating DR. Traditionally, randomized, controlled trials (RCTs) have been used to investigate treatment for DR, yet this is often an impractical first step for investigating treatment targets. Further, self-report measures f eating behavior, which are unreliable, have been over-utilized. The current study proposes to address these problems by examining the effects of 2 brief interventions targeting different psychological processes (self-control, emotion dysregulation) hypothesized to affect DR, compared to an active control, on a behavioral measure of the amount of effort restrictive eaters exert to reduce caloric intake at a test meal. Individuals identified as engaging in frequent DR will be told they will be expected to consume a self-selected quantity of a high-calorie milkshake and participate in an intervention that may help them tolerate this experience. Subjects will then be randomized to receive 1 of 3 brief computer- guided interventions: 1) cognitive restructuring (targeting self-control), 2) emotion regulation skills (targeting emotion dysregulation), or 3) nutrition information (control). Following the intervention, subjects will be given the option to work (by pressing the space bar on a computer task) to either: 1) decrease the number of calories they will be expected to consume, or 2) increase monetary compensation. The primary dependent variable will be number of button presses (i.e., effort) subjects employ toward reducing intake. This study is innovative due to utilization of: 1) Brief interventions targeting psychological processes, as opposed to RCTs, representing a time- and cost- effective means of evaluating promising psychological targets for DR; 2) A behavioral measure of a DR-related outcome, as opposed to self-report methods, presenting a more methodological precision. Results of this study will provide information regarding the psychological processes involved in DR, informing treatment development for DR. This has potential to make a substantial impact, as currently no efficacious treatments exist for DR, despite its commonality and potential for severe outcomes.

描述（由申请人提供）：饮食限制（DR）或热量和营养消耗不足，是与严重的医学和心理后果相关的令人震惊的常见实践。 DR预测超重和饮食失调的发展。在极端情况下，DR可以发展为神经性厌食症（AN），这是一种严重而慢性的疾病，与相当多的发病率和终生死亡率相关，高达20％。尽管DR产生了负面影响，但推动这种行为的心理过程几乎没有引起关注，并且对理解不多。尽管已经认为某些心理过程（例如，过度自我控制；情绪失调）参与了DR，但提出这些过程重要性的模型尚未得到充分的测试。结果，博士的治疗不足。尚未确定针对患有AN和DR的成年人对其他饮食失调的治疗的有效治疗方法，并且未指定针对其他相关疾病（例如抑郁症）治疗DR的准则。研究设计问题阻碍了理解和治疗DR的进步。传统上，随机，对照试验（RCT）已用于研究DR的治疗，但这通常是研究治疗靶标的不切实际的第一步。此外，自我报告衡量不可靠的饮食行为已被过度利用。当前的研究提议通过检查针对不同心理过程的2种简短干预措施的影响（自我控制，情绪失调），假设会影响DR，而与主动控制相比，对DR的影响，对努力限制性食客的行为度量，以减少测试食物中减少钙的摄入量。被确定为频繁DR的个人将被告知他们将期望他们消耗自我选择的高热量奶昔数量，并参加可能有助于他们容忍这种经历的干预措施。然后，受试者将被随机接收3个简短的计算机引导干预措施中的1个：1）认知重组（靶向自我控制），2）情绪调节技能（靶向情绪失调）或3）营养信息（控制）。干预后，将为受试者提供工作（通过按计算机任务上的太空栏）的选项：1）减少预期消耗的卡路里数量，或者2）增加货币补偿。主要的因变量将是按钮按钮的数量（即，努力）对减少摄入的使用。这项研究具有创新性，这是由于：1）针对心理过程的简短干预措施，而不是RCT，代表了评估DR的有希望的心理目标的时间和成本效益手段； 2）与自我报告方法相反，与自我报告方法相反的行为度量是一种更精确的精确度。这项研究的结果将提供有关DR涉及的心理过程的信息，为DR的治疗开发提供了信息。这有可能产生重大影响，因为目前对DR的治疗尚无效果，尽管它的共同点且可能产生严重结果。