Effects of an attentional bias modification training on eating behavior in binge eating disorder

暴饮暴食的客观发作是暴饮暴食症（BED）的中心症状。进食障碍的认知模型表明，典型的障碍刺激，如高热量的食物激活选择性记忆，解释和注意力的过程，假设大大有助于维持病理性进食行为。相应地，与没有BED的超重女性相比，患有BED的女性显示出对食物刺激的注意力增加（Schag等人，2013; Schmitz，Naumann，Trentowska，& Svaldi，2014; Svaldi，Tuschen-Caffier，Peyk，& Blechert，2010）.然而，到目前为止，还不清楚（a）这些机制是否是可修改的，（B）所描述的注意过程的修改是否减少了被诊断为BED的患者的暴饮暴食发作的频率。为此，基于先前的研究（Schmitz等人，2014; Svaldi等人，2010）目前的项目计划在两个实验中使用眼动追踪和EEG评估在有和没有床的超重个体中观看食物图片时对典型和中性刺激的注意力处理。实验范例将在注意力偏差修正训练之前和之后进行（AMT; Amir & Conley，2014），该训练基于点探测任务。在这个任务中，要求个体通过尽可能快和准确的按键来对命令性刺激（探针;通常是一个点）的外观侧（右，左）进行分类。在AMT中，强制性刺激经常超过比例（约70%的试验）取代中性刺激。因此，培训的目的是减少疾病的典型偏见。因此，参与者被认为是隐性学习，以转移他们的注意力从障碍典型的刺激。目前，AMT在蒂宾根和弗赖堡的中心进行试点。AMT控制条件（AMT-C）将与AMT条件并行进行，不同之处在于，在具有进食相关刺激的试验中，在AMT-C条件下，探针将同样频繁地出现在食物和中性刺激的一侧。在该项目中，每个中心将招募50名诊断为BED（DSM-5）的患者和25名超重对照参与者。在这两个中心，只有BED参与者将接受AMT。中心结果测量是（a）注意力分配的变化（如通过实验范例评估的），（B）在假味觉测试中摄入的卡路里，和（c）通过专家访谈（EDE;前、后、3个月随访）评估的进食相关病理学。

Objective episodes of binge eating are the central symptom of binge eating disorder (BED). Cognitive models of eating disorders suggest that disorder-typical stimuli such as high caloric food activate selective memory, interpretation and attentional processes, assumed to substantially contribute to the maintenance of pathological eating behavior. In accordance, women with BED compared to overweight women without BED display an increased attention towards food stimuli (Schag et al., 2013; Schmitz, Naumann, Trentowska, & Svaldi, 2014; Svaldi, Tuschen-Caffier, Peyk, & Blechert, 2010). To date it is unclear, though, (a) whether these mechanisms are modifiable, and (b) whether a modification of the described attentional processes reduces the frequency of binge eating episodes in patients diagnosed with BED. To this end, based on previous studies (Schmitz et al., 2014; Svaldi et al., 2010) the present project plans to assess the attentional processing of disorder-typical and neutral stimuli when looking at food pictures in two experiments using eye tracking and EEG in overweight individuals with and without BED. The experimental paradigms will be administered prior to and after an attentional bias modification training (AMT; Amir & Conley, 2014), which is based on a dot probe task. In this task, individuals are required to classify the side of appearance (right, left) of an imperative stimulus (the probe; usually a dot) by key press as fast and as accurately as possible. In the AMT, the imperative stimulus over-proportionally often (about 70% of all trials) replaces the neutral stimulus. As such, the training aims at a reduction of the disorder typical bias. Participants are thereby thought to implicitly learn to divert their attention away from disorder typical stimuli. Currently the AMT is piloted at the centers of Tübingen and Freiburg. The AMT control condition (AMT-C) will be carried out comparably to the AMT condition, with the difference that in the AMT-C condition in trials with eating related stimuli the probe will appear equally often at the side of the food and neutral stimulus.In the project 50 patients with a diagnosis of BED (DSM-5) and 25 overweight control participants will be recruited at each center. In both centers, only BED participants will receive the AMT. Central outcome measures are (a) changes in the attention allocation (as assessed by the experimental paradigms), (b) eaten calories in a bogus taste test, and (c) eating-related pathology as assessed by an expert interview (EDE; pre, post, 3 months follow-up).