Emotion regulation variability and flexibility across the eating disorder spectrum

有进食障碍(ED)症状的人，包括那些患有神经性厌食症(AN)、神经性暴食症(BN)或暴饮暴食障碍(Bed)等完整综合征EDs的人，自我报告获得适应性情绪调节(ER)策略的机会有限。相反，他们经常使用ER策略(例如，沉思)，这些策略被认为只有短期影响，并与负面后果相关。然而，实验证据很少，现有的少数几项研究得出了喜忧参半的结果。然而，包括我们自己在内的一些发现提出了一个新的假设，即在执行更有效的ER策略本身可能不存在普遍的缺陷，而是有ED症状的个体可能在正确的时机灵活地根据背景选择正确的策略方面存在困难。较新的ER模型采用了一种更动态的方法，认为成功的ER可能与1.ER的可变性(例如，策略库的大小)有关，2.对语境变化的敏感性，以及3.ER的灵活性，即两者的协变。拟议的项目将在EDS患者(使用实验室评估的AN和BN/BED综合征)以及具有增加的ED症状的亚临床个人(使用在线平台的维度方法)中调查每一种概念。目的1研究内质网缺陷是否与内质网变异性降低有关。为此，我们应用生态瞬时评估(通过智能手机)来调查现实生活中应用的不同ER策略的数量。目的2利用已建立的ER策略选择范式，解决对环境因素的敏感性，这些因素最近被证明影响健康个体的ER策略选择。为了探讨不同的刺激特征(如高/低负强度或高/低热量食物)对策略选择的影响，实验室评估不仅包括策略选择，还包括情绪反应和内质网选择的客观指标，以及成功程度(瞳孔扩大和包括MVPA的功能磁共振成像)。在一个大的众包在线样本中，通过对相同任务的适应来评估感知努力和目标操纵对ER策略选择的影响。目标3结合了目标1和目标2的数据。分析将侧重于a)ER灵活性(ER变异性和上下文变化之间的协变)与ED症状或组之间是否存在关联，以及b)ER变异性和灵活性是否与应用策略的短期和长期成功相关。拟议项目的三个目标承诺更好地了解和更精细地描述ED以及有ED症状的个人的明显ER缺陷，从而可用于开发新的治疗方法和预防措施。

Individuals with eating disorder (ED) symptoms including those with full-syndrome EDs such as Anorexia nervosa (AN) Bulimia nervosa (BN) or Binge-eating disorder (BED) self-report limited access to adaptive emotion regulation (ER) strategies. Instead, they frequently employ ER strategies (e.g. rumination) that are considered to have only short-lasting effects and are associated with negative consequences. However, experimental evidence is scarce and the few existing studies have delivered mixed results. Nonetheless, some findings including our own give rise to the novel assumption that there might not be a general deficit in executing more effective ER strategies per se, but rather that individuals with ED symptoms might have difficulties related to the flexible context-dependent selection of the right strategies in the right moment. Newer models of ER haveincorporated a more dynamic approach by suggesting that successful ER might be related to 1. ER variability (e.g. the size of the strategy repertoire), 2. sensitivity to contextual changes and 3. ER flexibility, the covariation of the two. The proposed project will investigate each of these concepts, in both patients with EDs (AN and BN/BED syndrome using a laboratory assessment), as well as subclinical individuals with increased ED symptoms (dimensional approach using an online platform). Aim 1 investigates whether ER deficits are related to reduced ER variability. To this end, we apply ecological momentary assessment (via smartphones) to investigate the number of different ER strategies applied in real life. Aim 2 addresses sensitivity to contextual factors that have recently been shown to influence ER strategy choice in healthy individuals using an established ER strategy choice paradigm. To investigate influences of different stimulus characteristics (such as high/low negative intensity, or high/low caloric food) on strategy choice, the laboratory assessment not only includes strategy choice, but also objective measures of emotional reactivity and ER choice as well as success (pupil dilation and fMRI including MVPA). Influences of perceived effort and goalmanipulation on ER strategy choice will be assessed using adaptions of the same task in a large crowdsourced online sample. Aim 3 combines the data of Aim 1 and 2. Analyses will focus on a) whether there are associations between ER flexibility (covariation between ER variability and context changes) and ED symptoms or groups and b) whether ER variability and flexibility are associated with short- and long term success of applied strategies. The 3 aims of the proposed project promise to deliver a better understanding and more finegrained description of the apparent ER deficit in EDs as well as individuals with ED symptoms which can be used to develop new treatment approaches and preventative measures.