On Pathogenetic Diagnosis and Treatment Based on Conditioned Emotional Response and Self Body Image in Eating Disorders

我们假设以身体形象为条件的情绪反应可能参与神经性厌食症的发病机制。对14例神经性厌食症患者（DSM-III）和18例性别和年龄匹配的健康年轻女性进行身体形象估计和事件相关电位（ERPs）测定。受试者对自己身体的真实形状和理想形状以及模仿女性身体的可乐瓶的真实形状进行估计。患者倾向于高估真实体型，而低估理想体型。此外，与健康组相比，患者组对可乐瓶形状的估计过高。当使用与饮食行为有关的词语作为警告刺激时，患者的erp负慢电位（CNV）振幅增加（S1）。无论这些词的内容如何，当患者对这些词做出不愉快的情绪反应时，他们表现出比健康组更大的s1相关P300和晚期CNV成分。2 .患者组的erp与S1的体形“胖子”和父母“母亲”的不愉快反应相似。自我体形高估组与健康组相比，自我体形高估组的CNV幅度增加，而自我体形低估组与健康组之间无显著差异。这些结果支持了我们的假设，即高估自己体型的厌食症患者可能对体型有显著的条件情绪反应。

We hypothesized that emotional response conditioned on body image might involve in pathogenesis of anorexia nervosa. The body image estimation and the event-related potentials (ERPs) were obtained from 14 patients with anorexia nervosa (DSM-III) and 18 sex- and age-matched healthy young women.1. The subject estimated real and ideal shapes of self body as well as real shape of a coke bottle imitative of a female body. The patients tended to overestimate the real body shape and to underestimate the ideal body shape. In addition, the patient group overestimated the coke bottle shape as compared with the healthy group.2. Negative slow potential (CNV) of the ERPs increased in amplitude for the patients when the words concerned with eating behaviors were used as a warning stimulus (S1). The patients showed larger components of the S1-related P300 and the late CNV when they responded with unpleasant emotion to these words irrespective of their contents than the healthy group did. The patient group showed the ERPs similar to those with the unpleasant response when the words of S1 were the body shape "fatty" and the parent "mother" .3. The CNV of the patients with overestimation of self body shape increased in amplitude as compared with the healthy group with the overestimation, but there was no significant difference between the patient and healthy groups with the underestimation. These results support our hypothesis that the anorexic patients who overestimate their own body shape may have remarkable conditioned emotional responses to body shape.