Real Time Assessment of Physiologic Stress, Mood, and Eating Behavior in Adolescents

饮食失控是一种危害健康的行为，通常发生在青春期。 鉴于其与体重过度增加、代谢参数恶化、 部分或全部综合征暴食症，并增加抑郁症状，暴食可能有 对整个生命周期的身心健康产生负面影响。虽然负面情绪 被认为是成年人暴食的预测因素，儿童可能很难识别和报告他们的饮食习惯。 负面情绪预测儿童暴食的假设得到了不同的支持。 由于这些原因，痛苦的生理指标可能是一个可行的替代预测暴食症， 青年心率（HR）和心率变异性（HRV）反映了自主神经系统的活动，它们是 被认为是痛苦的标志特别是，高HR和低HRV反映了痛苦和抑郁的组合。 自我调节能力下降，以应对困境。我们之前进行了一个生态瞬间 在17名青少年中进行的EMA评估研究中，在进食事件之前检查HR和HRV， 我们发现高心率和低心率变异性都与高水平的进食有关。广大 本研究的目的是进行一项随访EMA研究的生理应激指标和饮食， 样本量较大（n = 40），每位参与者持续时间较长（7天）。我们的具体目标是调查 生理指标（HR、HRV）与进食（目标1）之间的相关性，以研究相关性 生理指标（HR，HRV）与自我报告的压力和消极情绪（目标2）之间的关系，并检查 HR和HRV的轨迹导致高和低心率事件（探索性目的）。40超重/ 将招募肥胖青少年并完成基线筛选访视， 时间，最后一次访问。在为期1周的EMA期间，青少年将佩戴带有生物传感器的胸带 在清醒的时候，他们会使用智能手机定期自我报告压力、情绪和饮食情况。 一天中的间隔时间。青少年将在智能手机上输入信息，以回应研究人员- 启动“哔哔声”和之前和之后吃。为了评价生理指标之间的关系， 和自我报告结构，与时间对应的连续心电图记录的片段， 将提取来自智能电话的加盖的自我报告数据。与之前的研究一致，30分钟 片段将根据视频质量水平进行评估，5分钟片段将根据 压力和消极情绪。与将暴食作为一种应对行为的概念化相一致，我们 假设HR与血压水平之间存在正相关关系，而HR与血压水平之间存在负相关关系 心率变异性和心率变异性之间的关系。我们还预计，人力资源和压力之间将存在正相关， 负性情绪，以及HRV与压力和负性情绪之间的负相关。学习生理学 进食障碍的预测因子将告知其病因并促进新干预措施的发展。

Loss of control (LOC) eating is a health risk behavior that often originates and progresses during adolescence. Given its prospective associations with excess weight gain, worsening metabolic parameters, development of partial- or full-syndrome binge eating disorder, and increases in depressive symptoms, LOC eating may have negative physical and mental health consequences across the life span. Although negative emotions are considered a predictor of LOC eating in adults, children may have difficulty identifying and reporting their emotions and there is mixed support for the hypothesis that negative emotions predict LOC eating in children. For these reasons, physiologic indices of distress may be a feasible alternative predictor of LOC eating in youth. Heart rate (HR) and heart rate variability (HRV) reflect autonomic nervous system activity and they are considered markers of distress. In particular, high HR and low HRV reflect a combination of distress and reduced capacity to self-regulate in response to distress. We previously conducted an ecological momentary assessment (EMA) study in 17 adolescents in which HR and HRV were examined prior to eating episodes, and we found that higher HR and lower HRV were each associated with higher level of LOC eating. The broad aim of the current study is to conduct a follow-up EMA study of physiologic stress indices and LOC eating in a larger sample (n = 40) with a longer duration (7 days) per participant. Our specific aims are to investigate associations between physiologic indices (HR, HRV) and LOC eating (Aim 1), to investigate associations between physiologic indices (HR, HRV) and self-reported stress and negative mood (Aim 2), and to examine the trajectories of HR and HRV leading up to high- and low-LOC episodes (Exploratory Aim). Forty overweight/ obese adolescents with LOC eating will be recruited to complete a baseline screening visit, a 1-week EMA period, and a final visit. During the 1-week EMA period, adolescents will wear a chest strap with a biosensor during waking hours and they will use a smartphone to self-report stress, mood, and LOC eating at periodic intervals throughout the day. Adolescents will enter information on the smartphone in response to researcher- initiated “beeps” and before and after eating. In order to evaluate relationships between physiologic indices and self-report constructs, segments of the continuous electrocardiogram recording that correspond with time- stamped self-report data from the smartphone will be extracted. Consistent with prior studies, 30-minute segments will be evaluated in relation to level of LOC, and 5-minute segments will be evaluated in relation to stress and negative mood. Consistent with conceptualization of LOC eating as a coping behavior, we hypothesize that there will be a positive relationship between HR and level of LOC, and an inverse relationship between HRV and LOC. We also expect that there will be a positive association between HR and stress and negative mood, and an inverse association between HRV and stress and negative mood. Studying physiologic predictors of LOC eating will inform its etiology and facilitate development of novel interventions.