Characterizing Acute Exercise Response in Restrictive Eating Disorders

项目总结 进食障碍(EDs)是所有精神疾病中最致命的。然而，一线治疗对 EDS仅对大约40%的青少年患者有效。治疗效果的一个障碍是持久性 动力运动(Dex；以强迫的方式锻炼以控制体重和/或调节情绪)，这是一个标志 在许多被诊断为限制性ED的青少年中报告了症状(59%-73%)。在其他负面因素中 后遗症，地塞米松与自杀行为、治疗结果较差、并存增加有关 精神变态和复发风险。此外，虽然多项与饮食相关的任务已经得到验证，但 区分患有ED的个体和健康人群，目前还没有经过充分验证的任务 直接评估ED人群对运动的敏感性和反应性。因为德克斯是一个鲜为人知的人 在ED维持中起关键作用的症状，调查其生物行为基础至关重要 重要性。现有的研究指出，锻炼的奖励和威胁功能可能会推动和 使Dex在患有EDS的人中永久存在。对运动奖赏和威胁函数的评价 使用EDS将提高对此ED功能的机械理解；最终，提高对Dex的理解 将通知治疗目标。拟议的项目将招募青少年和年轻成年女性(16-22岁)， 来自两个地点的67名和33名急救人员参加了急性运动的综合评估 回应。目前的项目将1)表征在实验室中接触到的生物行为反应的变异性 在有和没有ED的人中进行中等强度的锻炼；2)创建和改进任务，以捕获 在运动中参与与奖励和威胁相关的系统；以及3)测试急性运动的假设 在患有ED的个体中反应更明显，急性运动反应与ED有关 症状严重程度、地塞米松和自由生活活动。详细解释急性运动对个人的影响 将EDS置于受控环境将对EDS的实证研究产生重大影响，特别是对(I) 改进对Dex风险和功能的评估(Ii)阐明Dex风险的可测试模型和(Iii)建议目标 进行德克斯干预。在这个项目中验证的方法将提高对Dex的理解，Dex是一种治疗- 抗ED功能。这些方法也将为更大规模的临床研究奠定基础，以澄清 Dex在ED治疗中的最佳靶点。

PROJECT SUMMARY Eating disorders (EDs) are among the deadliest of all psychiatric disorders. However, first-line treatments for EDs are effective for only roughly 40% of adolescent patients. One barrier to treatment efficacy is the persistence of driven exercise (DEx; exercising in a compulsive manner to control weight and/or regulate emotion), a hallmark symptom reported among many adolescents diagnosed with restrictive EDs (59-73%). Among other negative sequelae, DEx is associated with suicidal behavior, poorer treatment outcome, increased comorbid psychopathology, and risk for relapse. Further, while multiple eating-related tasks have been validated that discriminate between individuals with EDs and healthy populations, there are currently no well-validated tasks that directly assess sensitivity and responsivity to exercise in ED populations. As DEx is a poorly understood symptom that plays a key role in ED maintenance, investigating its biobehavioral underpinnings is of critical importance. Existing research points towards both reward and threat functions of exercise, which may drive and perpetuate DEx among those with EDs. Evaluation of both reward and threat functions of exercise among those with EDs will improve mechanistic understanding of this ED feature; ultimately, improved understanding of DEx will inform treatment targets. The proposed project will recruit adolescent and young adult females (16-22y) with (n = 67) and without (n = 33) EDs from two sites to participate in a comprehensive evaluation of acute exercise response. The current project will 1) characterize variability in biobehavioral response to in-lab exposure to moderate-intensity exercise among those with and without EDs; 2) create and refine tasks that capture engagement of reward- and threat-related systems during exercise; and 3) test hypotheses that acute exercise response is more pronounced among individuals with EDs and that acute exercise response relates to ED symptom severity, DEx, and free-living activity. Detailed explication of acute exercise effects among individuals with EDs in a controlled setting will have significant impact on the empirical study of EDs, specifically to (i) improve assessment of DEx risk and function (ii) elucidate a testable model of DEx risk and (iii) suggest targets for DEx intervention. The methods validated in this project will improve understanding of DEx, a treatment- resistant ED feature. These methods will also lay the groundwork for larger-scale, clinical research which clarifies optimal targets for DEx in ED treatment.