Fear, gastrointestinal distress, and interoception: Physiological and psychological mechanisms in eating disorders

恐惧、胃肠道不适和内感受：饮食失调的生理和心理机制

• 批准号: 10358991
• 负责人: Katherine Jean Forney
• 金额: $ 45.07万
• 依托单位: OHIO UNIVERSITY ATHENS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10358991
• 关键词: Academic Research Enhancement Awards; Address; Adherence; Affect; American; Award; Behavior; Brain; Cessation of life; Cholecystokinin; Crossover Design; Disease remission; Distress; Eating; Eating Behavior; Eating Disorders; Ensure; Evidence based treatment; Fasting; Fatty acid glycerol esters; Food; France; Fright; Galvanic Skin Response; Homeostasis; Individual; Interoception; Intervention; Link; Maintenance; Mediating; Mediation; Mediator of activation protein; Mental disorders; Modeling; Nausea; Ohio; Participant; Patients; Peptide YY; Peptides; Perception; Physiological; Psychophysiology; Reporting; Research; Research Personnel; Symptoms; Testing; Training; Treatment outcome; Weight; Weight Gain; Woman; Yogurt; base; causal model; clinical practice; cost; design; eating pathology; experience; food consumption; gastrointestinal; improved; insight; next generation; novel; psychoeducation; psychologic; response; restrictive eating; success; university student

7. Project Summary/Abstract Eating disorders are prevalent, costly, and deadly psychiatric illnesses. Current empirically-supported interventions fail to achieve symptom remission in the majority of patients. Gastrointestinal (GI) distress (e.g., nausea, stomachache) is one barrier that contributes to poor adherence to the meal-related interventions that comprise evidence-based treatments. The proposed R15 Academic Research Enhancement Award seeks to test a causal model of GI distress in eating disorder maintenance. In this model, fear of food, eating, and weight gain are hypothesized to cause GI distress through two direct mechanisms (i.e., by increasing cholecystokinin and peptide YY gut peptide responses and by increasing perceived fullness due to biased interoception) as well as through an indirect mechanism of fear-related increases in fullness via enhanced gut peptide response. Specific Aim 1 will test fear as a contributor to GI distress using a within-subject test meal paradigm wherein participants consume foods that they are told contains high or low fat content, but which are actually identical. Specific Aim 2 will test the proposed direct and indirect mechanisms of GI distress. In addition, a serial multiple mediation model will be conducted to explore fear as a cause of enhanced gut peptide response and in turn, increases in fullness, GI distress, and urges to restrict food intake. To address these aims, 152 women with eating disorders in the normal weight range who report postprandial GI distress will participate in a test meal paradigm. Using a within-subjects crossover design, on two separate mornings, participants will eat yogurt described as “high fat” and “low fat.” Although the “high fat” meal is designed to activate fear of food, eating, and weight gain relative to the “low fat” meal, in actuality the meals will not differ and will each contain 67% fat. Efficacy of this manipulation will be assessed using subjective ratings of fear and skin conductance. In addition, gut peptide levels and subjective ratings of GI distress, fullness, and urges to restrict food intake will be assessed before, during, and after the test meal. This study fills a fundamental gap by being the first to experimentally test an integration of fear, enhanced gut peptide response, and biased interoception in an eating disorder maintenance model. This study will make a significant contribution by examining fear as a cause of GI distress. This will provide specific insight into how to adapt empirically- supported interventions (i.e., exposure) for eating disorder patients who experience GI distress. Identifying enhanced gut peptide response as the cause of fullness and GI distress will facilitate tailoring psychoeducation and interoceptive exposures for eating disorder patients based upon symptoms. This study will shift current clinical practice by identifying fear, gut peptide response, and fullness as potential symptom-based treatment targets, with the potential to improve treatment outcomes by tailoring interventions to the symptom experience of individual eating disorder patients. Consistent with the aims of the R15, this study will enhance the research experiences of Ohio University students.

7.项目摘要/摘要 饮食失调是一种普遍的、代价高昂的致命精神疾病。当前的经验支持 干预措施未能在大多数患者中实现症状缓解。胃肠道(GI)不适(例如， 恶心、胃痛)是导致对与饮食相关的干预措施依从性差的一个障碍 包括循证治疗。拟议的R15学术研究促进奖旨在 在进食障碍的维持中测试胃肠道痛苦的因果模型。在这个模型中，对食物、吃的恐惧，以及 体重增加可能通过两种直接机制引起胃肠道不适(即通过增加 缩胆囊素和多肽YY肠多肽的反应以及由于偏向而增加的饱足感 内感)，以及通过增强肠道的与恐惧相关的饱腹感增加的间接机制 多肽反应。具体目标1将使用受试者内的测试用餐来测试恐惧是导致胃肠道痛苦的因素 参与者摄入的食物被告知含有高或低脂肪含量，但这些食物 实际上一模一样。具体目标2将测试拟议的胃肠道痛苦的直接和间接机制。在……里面 此外，还将进行一系列多重调解模式，以探索恐惧作为增强肠道功能的原因 多肽反应，进而增加饱腹感、胃肠道不适和限制食物摄入的冲动。致信地址 这些目标是，152名患有正常体重范围内饮食失调的女性报告餐后胃肠道不适 将参与一项试餐范例。使用受试者内部交叉设计，在两个不同的早晨， 参与者将吃到被描述为“高脂肪”和“低脂肪”的酸奶。尽管这顿“高脂肪”大餐的目的是 激活对食物、进食和体重增加的恐惧，相对于“低脂”餐，在现实中，这些餐不会有什么不同 每一种都会含有67%的脂肪。这种操控的效果将使用恐惧的主观评级进行评估 和皮肤传导性。此外，肠肽水平和胃肠道不适、饱满和冲动的主观评分 限制食物摄入量将在试餐前、期间和之后进行评估。这项研究填补了一个基本的 GAP通过第一个实验测试恐惧、增强的肠肽反应和偏见的整合 进食障碍维持模型中的内感。这项研究将做出重大贡献，通过 研究恐惧是胃肠道痛苦的原因之一。这将为如何从经验上适应提供具体的见解- 支持对经历胃肠道痛苦的进食障碍患者进行干预(即暴露)。识别 作为饱腹感和胃肠道不适的原因，增强的肠肽反应将有助于进行量身定制的心理教育 以及基于症状的进食障碍患者的相互感觉暴露。这项研究将改变趋势 确定恐惧、肠肽反应和饱腹感作为潜在的基于症状的治疗的临床实践 目标，有可能通过根据症状经验量身定做干预措施来改善治疗结果 个别进食障碍患者。与R15的目标一致，这项研究将加强研究 俄亥俄大学学生的经历。