The Impact of Affect Regulatory Mechanisms and Binge Eating on Drug Recovery

描述(由申请人提供)：越来越多的证据支持药物依赖和暴饮暴食之间强烈和多方面的联系。流行病学调查证实了暴饮暴食和物质使用障碍之间的高共患率；动物模型显示，类似成瘾的行为在各种物质(包括食品)中普遍存在；神经生物学研究揭示了食品和非法药物的共同奖励途径。为了更好地定义这种关联的性质，当前的提案每天都会进行审查 治疗人群中最常见的滥用药物，即阿片类药物与暴饮暴食行为之间的行为联系。具体地说，我将调查从成瘾中恢复的个人对阿片类药物的戒断如何与情感驱动的狂欢饮食有关，以及这些失调的饮食模式如何纵向上与阿片类药物失效和复发的风险有关。我的研究目的是：1)建立一个理想的评估系统，量化阿片成瘾康复者的日常卡路里和营养摄入量以及暴饮暴食行为；2)测试阿片成瘾康复者和人口统计学匹配的对照组之间的负面情绪和暴饮暴食之间的关系是否不同；3)确定加剧情感驱动的暴饮暴食的特定时间因素(例如压力)和个人特定因素(例如个性)，作为成瘾状态的缓和；以及4)测试各种应对策略，特别是咖啡因驱动的暴饮暴食的做法，对阿片成瘾康复者复发的纵向风险的影响。为了实现这些目标，我将研究来自两个吸毒成瘾治疗机构的至少N=106名参与者，以及来自治疗中心附近社区样本的N=35名人口统计学上相似的健康对照。参与者将在连续14天内每天对电子信号做出三次回应，回答有关药物使用和渴望、负面影响以及一天中发生的饮食行为的问题。戒毒者还将在24个月内每两周接受一次评估，以确定持续的复发风险、药物使用和其他健康后果。通过将我提出的研究计划与接受正规培训和指导的计划相结合，该计划由具有药物使用情感模式、药物成瘾治疗、狂欢等专业知识的教职员工提供。 除了饮食和成瘾的神经生物学，拟议的职业发展奖补充了我在量化方法方面的背景，提供了我需要的培训，以发展一条独立和富有成效的研究路线，致力于理解成瘾和暴饮暴食行为的共存，特别是与影响调节失调的关系。我提议的研究和培训将导致提交一份R01提案，该提案将提供向独立研究职业的过渡，并帮助临床医生和客户了解暴饮暴食如何影响个人在阿片使用障碍治疗中的康复努力。

DESCRIPTION (provided by applicant): Accumulating evidence increasingly supports a strong and multifaceted association between drug dependence and binge eating. Epidemiological investigations confirm high comorbidity between binge eating and substance use disorders; animal models reveal that addiction-like behaviors generalize across substances (including food); and neurobiological studies reveal common reward pathways for both food and illicit drugs. To better define the nature of this association, the current proposal examines daily behavioral associations between the most commonly abused drug among treatment populations, namely opiates, and binge eating behaviors. Specifically, I will investigate how abstinence from opiates among individuals recovering from addiction is associated with affect-driven binge eating, and how these dysregulated eating patterns are longitudinally associated with risk for opiate lapse and relapse. My research aims are to: 1) establish an ideal assessment system for quantifying daily caloric and nutritional intake and binge eating behavior in individuals recovering from opiate addiction; 2) test whether the relationship between negative affect and binge eating differs for individuals recovering from opiate addiction and demographically-matched controls; 3) identify time- specific (e.g., stress) and person-specific (e.g., personality) factors that exacerbate affect-driven binge eating as moderated by addiction status; and 4) test the effects of various coping strategies, and particularly the practice of affet-driven binge eating, on the longitudinal risk for relapse among those in recovery from opiate addiction. To accomplish these aims, I will study a minimum of N = 106 participants from two treatment facilities for drug addiction and N = 35 demographically comparable healthy controls from a community sample in the geographic vicinity of the treatment centers. Participants will respond to electronic signals three times daily over fourteen consecutive days by answering questions about drug use and cravings, negative affect, and eating behaviors occurring during the day. Individuals recovering from addiction will also be assessed every two weeks over 24 months to determine ongoing risk for relapse, substance use and other health outcomes. By integrating my proposed research plan with a plan to receive formal training and mentorship from faculty with expertise in affective models of drug use, the treatment of drug addiction, binge eating, and the neurobiology of addiction, the proposed Career Development Award complements my background in quantitative methodology by providing training I need to develop an independent and productive line of research dedicated to understanding the co-occurrence of addictive and binge eating behaviors, particularly in relationship to affect dysregulation. The research and training that I propose will lead to the submission of an R01 proposal that will provide a transition to an independent research career and serve to inform clinicians and clients about the ways in which binge eating influences recovery efforts for individuals in treatment for opiate use disorder.