Examination of the Attention Bias Model of Loss of Control Eating in Adolescents

描述（由申请方提供）：进食失控（Loss of control，简称EEE），即无法控制所摄入食物的类型或数量的主观体验，是患有亚阈值和完全综合征进食障碍的青少年的标志性特征。患有厌食症的青少年不断报告社会压力和对食物的奖励特性的敏感性增加。需要澄清社会压力和食物奖励敏感性触发和加剧暴食的机制，以开发新的有针对性的干预措施。为了了解精神病理学的原因，国家精神卫生战略计划研究所提出，研究的一个关键重点应该包括阐明神经回路扰动如何导致行为障碍和核心心理过程。Ruth L. Kirschstein National Research Service Award（NRSA）是一项为期两年的研究和培训计划，专注于调节青少年饮食中对社会威胁和美味食物线索的注意力偏差的神经回路。脑磁图（Magnetoencephalography，MEG）是一种具有良好的时间和空间分辨率的神经成像技术，它可以分离两种有序的注意偏向机制：1）由情绪显著性线索引起的早期无意识注意捕获; 2）随后对那些引起越来越强烈的不舒服的情感状态的显著刺激的持续注意部署。在75名青少年女孩（n=50）和没有（n=25）暴食，拟议的项目将使用MEG在社会威胁和可口的食物线索注意力偏差点探针范式在一个随机交叉设计在2个独立的日子检查神经回路活动。每次MEG后，将在经过充分验证的实验室测试餐中评估LOC样饮食行为。这些MEG测试餐将评估假设，在回应威胁，（与中性）面孔和可口的食物（相对于中性非食物）图像，增加的报告和观察到的焦虑严重程度将与：1）在无意识注意力捕获期间，“自下而上”注意力回路中的相对激活更大;以及2）在持续的注意力部署期间，“自上而下”注意力回路中的相对激活变钝。在亚组的女孩与暴食症（n=50），神经回路反应的普遍性在注意力偏差范式现实世界的心理过程将使用生态瞬时评估。这项研究的结果将证实一种新的注意力机制的重要性，这种机制至少部分解释了情绪失调和暴食之间的关系。研究结果还将提供重要的新信息，说明在实验室中观察到的大脑-行为关系是否具有生态学意义。拟议的NRSA将提供独特的多学科培训，开展这一多模式研究所需的概念和技术研究技能。神经影像学，实验室测试膳食和生态瞬时评估的创新整合将阐明大脑，行为和环境如何相互作用，以促进青少年饮食失调的发展和维持。

DESCRIPTION (provided by applicant): Loss of control (LOC) eating, the subjective experience of being unable to control the type or quantity of food consumed, is a hallmark feature of adolescents with sub-threshold and full syndrome eating disorders. Youth with LOC consistently report heightened social stress and sensitivity to the rewarding properties of food. Clarifying the mechanisms by which social stress and food reward sensitivity trigger and exacerbate LOC eating is required to develop novel targeted interventions. To understand the causes of psychopathology, the National Institute of Mental Health Strategic Plan proposes that a critical focus of study should involve elucidating how neural circuitry perturbations contribute to behavioral disturbances and core psychological processes. The proposed Ruth L. Kirschstein National Research Service Award (NRSA) is a two-year program of research and training focused on the neural circuitry mediating attention biases to social threat and palatable food cues in adolescent LOC eating. Magnetoencephalography (MEG), a neuroimaging technology with both excellent temporal and good spatial resolution, allows for the dissociation of two sequenced attention bias mechanisms: 1) Early unconscious attention capture provoked by emotionally salient cues; and 2) Later continued attention deployment towards those salient stimuli that gives rise to increasingly intense uncomfortable affective states. Among 75 adolescent girls with (n=50) and without (n=25) LOC eating, the proposed project will examine neural circuit activity using MEG during social threat and palatable food cue attention bias dot probe paradigms in a randomized crossover design on 2 separate days. Following each MEG session, LOC-like eating behavior will be assessed at a well-validated laboratory test meal. These MEG- test meal sessions will evaluate hypotheses that, in response to threatening (vs. neutral) faces and palatable food (vs. neutral non-food) images, increased reported and observed LOC severity will be associated with: 1) greater relative activation in "bottom-up" attention circuitry during the unconscious attention capture period; and 2) blunted relative activation in "top-down" attention circuitry during the continued attention deployment period. In the subset of girls with LOC eating (n=50), the generalizability of neural circuitry responses during the attention bias paradigms to real-world psychological processes will be evaluated using ecological momentary assessment. Findings from the proposed study would confirm the importance of a novel attentional mechanism that at least partly explains the relationship between affect dysregulation and LOC eating. Results will also provide important new information about whether brain-behavior relationships observed in the laboratory are ecologically valid. The proposed NRSA will provide unique multidisciplinary training in conceptual and technical research skills needed to carry out this multi-modal study. The innovative integration of neuroimaging, laboratory test meals, and ecological momentary assessment will elucidate how the brain, behavior, and environment interact to contribute to the development and maintenance of disordered eating in adolescents.