Effects of body-related checking behavior in lab and field: Comparison studies in bulimia nervosa, body dysmorphic disorder, and illness anxiety disorder

身体相关检查行为（body -related checking behavior， CB）是神经性贪食症（BN）、身体畸形障碍（BDD）和疾病焦虑症（IAD）等精神障碍的症状和潜在维持因素。在各种认知-行为模型中，认知认知障碍被认为主要发生在消极情绪激活状态下，并在短期内减少消极情绪激活，这反过来又加强了认知认知障碍。到目前为止，经验证据很少，现有的几项研究得出了相互矛盾的结果。对于IAD，目前的证据初步表明负面情绪会立即减少，而对于BN和BDD，在大多数研究中发现负面情绪会增加。相互矛盾的发现可能是由于不同的疾病特异性功能，以及不同的设置、测量点和因变量。因此，考虑到这些潜在的混杂变量，本项目旨在比较上述疾病在CB的情感、认知和生理后果方面的影响。此外，每个临床组都包括一个健康对照组，以检查（疾病特异性）CB的致病意义。为了最大限度地提高外部效度，在该领域的观察性研究（研究1）中，将检查自然发生的CB在CB发作之前，期间和之后的多个点对情绪和认知的影响。与此相反，本实验室的实验研究（研究2）旨在最大限度地提高内部效度，研究实验诱导和标准化的负性情绪诱发后的cb事件的情绪和认知过程。自我报告的补充是对心率及其变异性以及皮肤电导等生理参数的评估。虽然前两项研究关注的是单个cb发作的直接影响，但该领域的实验研究（研究3）考察了连续数天cb频率增加对情绪、认知以及特定障碍和一般精神病理学的影响。因此，拟议的项目允许首次阐明可能的经诊断有效的以及疾病特异性的CB强化机制。这些结果具有临床相关性，因为了解可能功能失调的CB将为开发跨诊断和疾病特异性干预措施以减少CB提供信息。

Body-related checking behavior (CB) is a symptom and potentially maintaining factor of different mental disorders such as bulimia nervosa (BN), body dysmorphic disorder (BDD), and illness anxiety disorder (IAD). In various cognitive-behavioral models of the disorders, CB is supposed to occur predominantly in states of negative emotional activation and to decrease it in the short term, which, in turn, reinforces CB. So far, empirical evidence is scarce and the few existing studies yielded conflicting findings. While for IAD, current evidence tentatively suggests an immediate reduction of negative emotions, for BN and BDD, in most studies an increase in negative emotions was found. The conflicting findings might be due to different disorder-specific functionality of CB as well as to varying settings, measurement points, and dependent variables. Therefore, the present project aims to compare the aforementioned disorders with regard to the emotional, cognitive, and physiological consequences of CB, taking into account these potentially confounding variables. Additionally, for each clinical group a healthy control group is included in order to examine (disorder-specific) pathogenic significance of CB. In order to maximize external validity, in the observational study in the field (study 1), naturally occurring CB will be examined regarding its effects on emotions and cognitions before, during and at multiple points after the CB-episodes. In contrast, the experimental study in the lab (study 2) aims to maximize internal validity and investigates the course of emotions and cognitions during an experimentally induced and standardized CB-episode after negative mood induction. Self-report is supplemented by the assessment of physiological parameters such as heart rate and its variability as well as skin conductance. While these first two studies focus on the immediate effects of a single CB-episode, the experimental study in the field (study 3) examines the impact of a multiple-day increase of CB-frequency on emotions, cognitions as well as disorder-specific and general psychopathology. Therefore, the proposed project allows for the first time to shed light on possible transdiagnostically effective as well as disorder-specific reinforcement mechanisms of CB. These results are clinically relevant as an understanding of probably dysfunctional CB would inform the development of transdiagnostic as well as disorder-specific interventions to reduce CB.