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

进食失控(LOC)是一种健康危险行为，通常起源于青春期并在青春期进展。 鉴于其与超重增加、代谢参数恶化的预期关联， 部分或全部综合征暴饮暴食障碍，以及抑郁症状的增加，LOC进食可能有 在一生中对身心健康造成负面影响。尽管负面情绪是 被认为是成人摄入低脂食物的预测因子，儿童可能难以识别和报告他们的 对于负面情绪预测儿童摄入低碳水化合物这一假设，人们的支持褒贬不一。 出于这些原因，痛苦的生理指标可能是一种可行的替代预测LOC进食的指标。 青春年华。心率(HR)和心率变异性(HRV)反映自主神经系统的活动，它们是 被认为是痛苦的标志。特别是，高心率和低心率变异性反映了痛苦和 降低了应对困境的自我调节能力。我们之前进行了一次生态瞬间 对17名青少年进行的评估(EMA)研究，其中HR和HRV在进食前进行了检查， 我们发现，较高的心率和较低的心率变异性分别与较高的低脂饮食水平相关。《博大》 本研究的目的是对老年人的生理应激指数和低脂饮食进行EMA随访研究。 样本较大(n=40)，每个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(心率、心率变异性)和低脂饮食(目标1)之间的关联，以调查关联 生理指标(心率、心率变异性)与自我报告的压力和消极情绪(目标2)之间的关系，并检验 心率和心率变异性导致高LOC和低LOC发作的轨迹(探索性目标)。四十个超重/ 有低密度脂饮食的肥胖青少年将被招募来完成基线筛查访问，为期1周的EMA 期间，以及最后一次访问。在为期一周的EMA期间，青少年将佩戴带有生物传感器的胸带 在醒着的时候，他们会使用智能手机来自我报告压力、情绪和定期进食 一天中的间隔时间。青少年会在智能手机上输入信息，以回应研究人员-- 在进食前和进食后发出“哔声”。为了评估生理指标之间的关系 和自我报告结构，与时间相对应的连续心电记录的片段- 将从智能手机中提取盖章的自我报告数据。与之前的研究一致，30分钟 片断将根据LOC水平进行评估，5分钟片断将根据以下内容进行评估 压力和消极情绪。与将低脂饮食作为一种应对行为的概念一致，我们 假设HR与LOC水平呈正相关，而与LOC水平呈负相关 HRV和LOC之间的差异。我们还预计，人力资源和压力之间将存在正相关关系， 负性情绪，心率变异性与压力和负性情绪呈负相关。学习生理学 LOC摄入的预测指标将为其病因提供信息，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.