Binge Eating: Clinical Patterns & Biological Correlates

这项研究的长期目标是探索通过进食量来定义神经性暴食症暴饮暴食发作的效用，并揭示导致暴食症症状发展或维持的因素。另一个目标是提高对类似于神经性贪食症清除亚型的替代症状群的识别，不同的是，感知到的狂欢发作在客观上并不涉及大量食物。最近的研究表明，相当数量的年轻女性患有这种替代症状群(主观性神经性暴食症-SBN)，这表明SBN代表着一个重大的公共卫生问题。这项研究的一个具体目的是检验这一假设，即与患有DSM-IV神经性暴食症的女性一样，患有SBN的女性表现出显著的临床痛苦和损害水平。第二个目的是证明SBN不同于DSM-IV神经性贪食症，因此不应该在一个诊断类别中与这种综合征相结合。这项研究建议扩展初步数据，这些数据表明，与患有SBN的女性相比，患有神经性贪食症的女性具有更高的冲动水平。此外，这项研究提出了一项新的研究，即与患有SBN的女性相比，患有神经性暴食症的女性在休息后是否表现出较低的饱腹感和钝化的胆囊素(CCK)释放。这项研究将包括30名患有DSM-IV神经性暴食症净化亚型的女性，30名患有SBNm的女性和30名非进食障碍的对照女性。受试者将完成心理评估，包括结构化的临床访谈和标准化的问卷评估，包括抑郁、焦虑、冲动以及社会和职业功能。受试者还将参与餐后饱腹感和CCK释放的评估。这项研究将测试神经性暴食症的模型，在该模型中，缺乏饱腹感信号无法降低进食的冲动，再加上不良的冲动控制，增加了经历客观上大量暴食的可能性，并揭示了神经性暴食症客观上大量暴饮暴食的病因或维持因素。此外，这项研究有可能确定一种值得研究、治疗和纳入病因学方案的新的进食障碍亚型。

The long term objectives of this study are to explore the utility of defining binge-eating episodes in bulimia nervosa by the amount of food consumed and to reveal factors that contribute to the development or maintenance of bulimic symptoms. An additional objective is to improve the recognition of an alternative symptom cluster that resembles bulimia nervosa-purging subtype, except that perceived binge episodes do not involve objectively large amounts of food. Recent research indicates that a substantial number of young women suffer from this alternative symptom cluster (subjective bulimia nervosa-SBN) suggesting that SBN represents a significant public health concern. One specific aim of this study is to test the hypothesis that, like women with DSM-IV bulimia nervosa, women with SBN demonstrate clinically significant levels of distress and impairment. A second aim is to demonstrate that SBN is distinct from DSM-IV bulimia nervosa and thus should not be combined with this syndrome within one diagnostic category. The study proposes to extend preliminary data suggesting that women with bulimia nervosa have higher levels of impulsiveness compared to women with SBN. In addition, this study proposes a novel examination of whether, compared to women with SBN, women with bulimia nervosa demonstrate lower levels of satiety and blunted cholecystokin (CCK) release following a rest meal. The study will include 30 women with DSM-IV bulimia nervosa-purging subtype, 30 women with SBNm and 30 non-eating disordered control females. Subjects will complete psychological assessments including structured clinical interviews and standardized questionnaire assessments of depression, anxiety, impulsiveness, and social and occupational functioning. Subjects will also participate in assessments of post-prandial satiety and CCK release. This study will test a model of bulimia nervosa in which deficient satiety signals fail to decrease the impulse to eat which, combined with poor impulse control, increases the liability to experience objectively large binge-eating episodes by the amount of food consumed and reveal etiologic or maintaining factors for objectively large bing episodes in bulimia nervosa. Further, this study has the potential to identify a new subtype of eating disorder that is worthy of study, treatment, and inclusion in nosological schemes.