Biobehavioral Prediction of Illness Trajectory in Bulimic Syndromes

暴食症候群疾病轨迹的生物行为预测

• 批准号: 9913584
• 负责人: Pamela K. Keel
• 金额: $ 39.55万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-08-05 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9913584
• 关键词: Accounting; Address; Age; Basic Science; Behavioral; Binge Eating; Binge eating disorder; Biological; Body Image; Body fat; Bulimia; Categories; Cessation of life; Chronic Disease; Clinical; Communities; Comprehension; DSM-V; Development; Diet; Dimensions; Disease; Distress; Eating; Eating Disorders; Evaluation; Food; Individual; Individual Differences; Intake; Intervention; Lead; Leptin; Maintenance; Measures; Mediating; Mediation; Mediator of activation protein; Modeling; Motivation; Outcome; Participant; Patient Self-Report; Physiological; Population; Positive Valence; Public Health; Research; Research Domain Criteria; Research Personnel; Rewards; Satiation; Series; Severities; Severity of illness; Syndrome; Testing; Text; Translating; Weight; Work; anorexia nervosa binge-purge subtype; base; behavioral pharmacology; biobehavior; brief intervention; disability; disorder control; effective therapy; follow-up; food consumption; glucagon-like peptide 1; improved; innovation; loss of control over eating; mortality risk; novel; productivity loss; prospective; prospective test; public health relevance; reinforcer; response; restraint; satisfaction; suicidal morbidity; willingness; young woman

Bulimic syndromes (BN-S) are characterized by large out-of-control binge episodes, span the three DSM-5 eating disorder categories of anorexia nervosa-binge purge subtype (ANbp), bulimia nervosa (BN), and binge eating disorder (BED), and vary considerably in illness severity and course. Our long-term objectives are to identify biobehavioral predictors of illness trajectory in BN-S so that treatments may be developed to address key factors influencing the severity and course of binge eating. The specific aims of this study are to test a model in which weight suppression (WS) leads to deficient circulating leptin, which contributes to blunted postprandial glucagon-like peptide 1 (GLP-1) response, which causes alterations in the RDoC core constructs of approach motivation and sustained responsiveness to reward, which then contribute to BN-S severity and maintenance. WS (the difference between an individual's highest weight and current weight) has emerged as one key predictor of severity and maintenance of BN-S, and investigators have posited a biobehavioral mechanism for this association. Yet, no study has evaluated how the biological consequences of WS may contribute to alterations in RDoC core constructs proposed to contribute to binge eating. Our model posits that the same set of physiological consequences of WS contribute to binge eating by 1) increasing drive/motivation to consume food (approach motivation), and 2) decreasing ability for food consumption to lead to a state of satiation/satisfaction (sustained responsiveness to reward). Approach motivation will be measured both behaviorally as breakpoint on progressive ratio tasks for food and non-food reinforcers and by self-report. Sustained responsiveness to reward (satiation) will be measured both behaviorally as food intake in an ad lib meal and by self-report. Participants (N=320) with BN-S and non-eating disorder controls, ranging in BMI from 16 to 35 kg/m2, will be assessed for WS, leptin, GLP-1 response to a fixed meal, approach motivation, ability to achieve satiation in an ad lib meal, self-report measures of core constructs, and binge eating at baseline, 6-, and 12-month follow-up, to produce the first study of biobehavioral predictors of illness trajectory in BN-S transdiagnostically. Examining the integration of approach motivation and satiation through the same set of physiological mechanisms represents a major innovation as it translates cutting-edge research in basic science to understand clinical phenomena in BN-S. If differences in illness trajectory across ANbp, BN, and BED are attributable to the underlying dimension of WS, this will fundamentally alter conceptualization of BN-S from three eating disorder categories to one eating disorder. If findings support biobehavioral distinctions across the BMI range, this would provide important information in what treatments would work in whom. Moreover, our focus on factors that are modifiable via behavioral and pharmacological interventions increases the public health significance of this work by facilitating novel treatment approaches to ameliorate distress, disability, and death in syndromes accounting for an important segment of those suffering from eating disorders.

暴食综合征（BN-S）的特点是大的失控狂欢发作，跨越三个DSM-5 进食障碍分类：神经性厌食症-暴食清除亚型（ANbp）、神经性贪食症（BN）和暴食 饮食失调（BED），在疾病的严重程度和过程中有很大的不同。我们的长远目标是 确定BN-S疾病轨迹的生物行为预测因子，以便开发治疗方法， 影响暴饮暴食严重程度和病程的关键因素。这项研究的具体目的是测试一个 模型中，体重抑制（WS）导致循环瘦素不足，这有助于钝化 餐后胰高血糖素样肽1（GLP-1）反应，导致RDoC核心结构的改变 接近动机和对奖励的持续反应，这有助于BN-S的严重性， 上维护WS（个人最高体重和当前体重之间的差异）已经出现， BN-S的严重程度和维持的一个关键预测因素，研究人员已经假设生物行为 这种联系的机制。然而，没有研究评估WS的生物学后果如何可能 有助于RDoC核心结构的改变，这些结构被认为有助于暴饮暴食。我们的模型假设， WS同样一组生理后果通过1）增加驱动/动机 消耗食物（接近动机），和2）减少食物消耗的能力，导致一种状态， 满足感/满意度（对奖励的持续反应）。方法动机将被测量， 行为作为食品和非食品添加剂的渐进比例任务的断点，并通过自我报告。 对奖励的持续反应（饱足感）将在行为上作为即兴食物摄入量进行测量 吃饭和自我报告。BN-S和非进食障碍对照的参与者（N=320），BMI范围为 16至35 kg/m2，将评估WS、瘦素、对固定膳食的GLP-1反应、接近动机、 在基线时，在随意进餐、核心结构的自我报告测量和暴饮暴食中达到饱足，6-， 和12个月的随访，以产生BN-S疾病轨迹的生物行为预测因子的第一项研究 transdiagnosis诊断。通过同一套方法来检验方法动机和满足感的整合 生理机制是一项重大创新，因为它将基础科学的前沿研究转化为 了解BN-S的临床现象。如果ANbp、BN和BED之间的疾病轨迹差异 归因于WS的基本维度，这将从根本上改变BN-S的概念化， 三种饮食失调症对应一种饮食失调症如果研究结果支持生物行为的差异， BMI范围，这将提供重要的信息，在什么样的治疗将在谁的工作。而且我们 关注通过行为和药物干预可以改变的因素， 这项工作的健康意义，促进新的治疗方法，以改善痛苦，残疾， 综合症死亡是饮食失调患者的重要组成部分。

项目成果

Eating disorders in children: is avoidant-restrictive food intake disorder a feeding disorder or an eating disorder and what are the implications for treatment?

• DOI: 10.12688/f1000research.13110.1
• 发表时间: 2018-01-01
• 期刊: F1000Research
• 作者: Kennedy, Grace A;Wick, Madeline R;Keel, Pamela K
• 通讯作者: Keel, Pamela K

Reliability and validity of a transdiagnostic measure of reward valuation effort.

• DOI: 10.1037/pas0001107
• 发表时间: 2022-05
• 期刊: PSYCHOLOGICAL ASSESSMENT
• 影响因子: 3.6
• 作者: Keel, Pamela K;Kennedy, Grace A;Rogers, Megan L;Joyner, Keanan J;Bodell, Lindsay P;Forney, K Jean;Duffy, Mary E
• 通讯作者: Duffy, Mary E