Using prospection to improve obesity treatment

 描述（由申请人提供）：无法延迟满足与肥胖具有横截面和前瞻性相关性，对立即满足的渴望是无法延迟满足的基础。相对于较小的即时奖励，人们倾向于贬低较大的未来奖励，随着即时奖励和延迟奖励之间的时间距离增加，未来的折扣更大。这种时间折扣模式称为延迟折扣（DD）。情景未来思维（episodic future thinking，EFT）是一种减少即时满足偏差的新方法，它可以通过情景记忆来前瞻性地体验或模拟未来事件，从而改变决策的背景。提示个体在跨期决策过程中思考未来事件可以减少DD。该基金的总体目标是将EFT的基础研究转化为临床干预措施， 治疗小儿肥胖症我们最初是在PA-11- 063“将基本行为和社会科学发现转化为改善健康相关行为的干预措施”的资助机制下提交的，因为这为整合基础和实地研究提供了机会，以改进可以在试点临床试验中测试的干预措施。我们已经证明，在三个成人样本和一个儿童样本中，EFT与DD减少相关，EFT对超重/肥胖和非超重参与者的DD具有相似的影响，并且EFT与随意进食任务中能量摄入的减少相关 在成人和儿童。我们已经表明，EFT的影响，在一个现在的思维控制任务，以及非未来和最近或过去的思维控制任务。目前还没有使用EFT来改变肥胖治疗中的DD的临床研究，但由于EFT已被证明可以减少成人和儿童的DD和能量摄入，因此它可能特别适合于儿童肥胖的家庭治疗（FBT）。为了将EFT转化为儿童肥胖的临床干预措施，我们提出了一系列针对超重/肥胖8-12岁儿童及其父母的实验室、现场和临床研究。具体目标1a-1b将评估图像的特异性，以及DD，能量摄入和决策的多个措施的过程与目标图像。具体目标2旨在确定EFT的最佳剂量（4、8或12周的训练），以影响DD和能量摄入，使用基于具体目标1a-b研究结果的最佳EFT方法。具体目标3将使用基于先前研究的最佳治疗方案来评估将EFT添加到循证行为肥胖治疗中的效果，以评估EFT训练的额外益处。开发有效的方法来减少对未来的折扣和改善延迟满足可能对儿童肥胖症的治疗有重要的好处。

 DESCRIPTION (provided by applicant): The inability to delay gratification is cross-sectionally and prospectively related to obesity, and the desire for immediate gratification is fundamental to the inability to delay gratification. People tend to devalue larger future rewards relative to smaller immediate rewards, with greater discounting of the future as the temporal distance between the immediate and delayed rewards increases. This pattern of temporal discounting is known as delay discounting (DD). A novel approach to reducing the bias towards immediate gratification is episodic future thinking (EFT), which can change the context of decision making by engaging the episodic memory to prospectively experience or simulate future events. Cueing individuals to think about future events during inter- temporal decision-making reduces DD. The overarching goal of this grant is to translate basic research on EFT into clinical interventions to treat pediatric obesity. We originally submitted this under grant mechanism PA-11- 063, "Translating Basic Behavioral and Social Science Discoveries into Interventions to Improve Health-Related Behaviors" as this provides for the opportunity to integrate basic and field studies to refine interventions that can be tested in a pilot clinical trial. We have demonstrated that EFT is associated with a reduction in DD in three samples of adults and one sample of children, that EFT has similar effects on DD in overweight/obese and non-overweight participants, and that EFT is associated with a reduction in energy intake in an ad lib eating task in adults and children. We have shown EFT effects in relation to a present thinking control task, as well as non-future and recent or past thinking control tasks. There has been no clinical research using EFT to modify DD in the treatment of obesity, but since EFT has been shown to decrease DD and energy intake in adults and children, it may be especially suited for a family-based treatment (FBT) of pediatric obesity. To translate EFT to a clinical intervention for pediatric obesity, we propose a series of laboratory, field and clinical studies for overweight/obese 8-12 year-old children and their parents. Specific Aims 1a-1b will assess the specificity of imagery, and process versus goal imagery on DD, energy intake and multiple measures of decision making. Specific Aim 2 is designed to determine the best dose of EFT (4, 8 or 12 weeks of training) to influence DD and energy intake, using the optimal EFT approach based on results of studies addressing Specific Aims 1a-b. Specific Aim 3 will use the optimal treatment package based on previous studies to assess the effects of adding EFT to evidence-based behavioral obesity treatment to evaluate the added benefits of EFT training. Developing effective ways to reduce discounting the future and improve delay of gratification may have important benefits in the treatment of pediatric obesity.