EFFECT OF DIETING ON ALCOHOL AND DRUG USE IN YOUNG WOMEN

横断面调查研究显示了很高的共存率 关于年轻女性节食者饮食失调和药物滥用的研究。动物 研究表明，药物摄入量的增加可能是由食物引起的 剥夺。因为临床上有意义的进食障碍的出现 通常在临床上有意义的药物滥用开始之前 患有这两种疾病的患者群体，我们假设卡路里 在年轻女性节食者中的限制导致更多的发展 药物滥用问题。一项初步的纵向研究，在 密歇根大学已经记录了节食和 大学一年级女生暴食症行为及其发病情况 一年级时发生的神经性暴食症。初步研究 PI进一步表明，有暴食症行为史的女性， 在没有达到DSM III R标准的神经性暴食症的情况下，在 一种比没有暴食症行为的受试者更病态的方式。 然而，目前还没有关于节食和暴食症行为所起作用的数据 在年轻女性的物质使用方面的发展。这样的调查 这一临床共病现象的病因学需要 节食严重程度、暴食症行为和 在风险最高的时期(即大学期间)使用药物。我们 建议开展节食三波纵向调查研究 一大批大学女生的行为和物质使用情况。结果是 应该更好地界定节食与饮食之间的关系 暴食症的行为、亚临床暴食行为和临床症状 神经症以及吸毒和酗酒。新药的效度及临床意义 的调查结果将在一定程度上由平行的、较小的 通过结构化访谈对重度节食者和非节食者进行研究。这个 数据将使我们能够：(1)使用节食和饮食行为评估 识别未来滥用药物的高危女性；(2)设计 针对节食的年轻女性的药物滥用预防方案 以及(3)包括旨在减少老年人节食的干预措施 女性药物滥用者的治疗。

Cross-sectional survey studies have shown very high rates of coprevalence of eating disorders and substance abuse in young women dieters. Animal studies have suggested that increased drug intake may be caused by food deprivation. Because the onset of clinically significant eating disorders usually antedates the onset of clinically significant substance abuse in patient populations with both disorders, we hypothesize that caloric restriction among young women dieters leads to increased development of substance abuse problems. A preliminary, longitudinal study conducted at the University of Michigan has documented the prevalence of dieting and bulimic behaviors in freshman women as well as the number of incident cases of bulimia nervosa occurring during the freshman year. A preliminary study by the PI shows further that women with a history of bulimic behaviors, but without meeting DSM III R criteria for bulimia nervosa, use substances in a more pathological manner than do subjects without bulimic behaviors. However, no data exist on the role that dieting and bulimic behaviors play in the development of substance use in young women. Such an investigation of the etiology of this clinical phenomenon of comorbidity would require the prospective assessment of dieting severity, bulimic behaviors, and substance use during a period of maximum risk (i.e. the college years). We propose to carry out a longitudinal, three-wave survey study of dieting behaviors and substance use in a large cohort of college women. The results of this study should better define the relationships between dieting behaviors, subclinical bulimic behaviors, the clinical syndrome of bulimia nervosa and drug and alcohol use. The validity and clinical significance of the survey results will be, in part, determined by a parallel, smaller study of severe dieters and nondieters using structured interviews. The data will allow us to: (1) use assessments of dieting and eating behavior to identify women at high risk for future substance abuse; (2) design substance abuse prevention programs targeted at young women who diet severely; and (3) include interventions designed to decrease dieting in the treatment of female substance abusers.