Feeding Styles and Responsiveness in Mothers with Eating Disorders

描述（由申请人提供）：饮食失调，如神经性厌食症和神经性贪食症，尤其对年轻女性来说是一个重大的公共卫生问题，影响了美国约2.4%的育龄妇女。有饮食失调史的母亲所生的孩子，其自身出现饮食问题的风险似乎特别高。然而，很少有研究调查有这种历史的母亲如何在喂养环境中与年幼的孩子互动。早期喂养的一个重要组成部分是母亲的反应。母亲对儿童饥饿和饱腹感线索的反应增强与儿童饮食自我调节能力的增强以及对饮食或暴饮暴食的控制能力的降低有关。患有饮食失调症的母亲可能会发现，由于吃饭时的高度焦虑和对孩子体重增加的恐惧，在喂食时很难对孩子做出反应。尽管母亲喂养反应对健康儿童饮食行为的发展非常重要，但它在饮食失调方面仍未得到研究。这个提议的Kirschstein-NRSA个人奖学金（F30）旨在通过观察、自我报告和生理方法的结合使用，确定有饮食失调史的母亲是否与健康母亲在识别和回应孩子饥饿和饱腹暗示的能力上有所不同。该奖学金将为申请人提供营养、饮食失调和发展心理学方面的独特综合培训，以进一步实现她作为一名研究精神疾病发展起源和早期营养在饮食失调发展中的作用的内科科学家的职业目标。本F30的具体目的是：1)确定与没有饮食失调史的母亲相比，有饮食失调史的母亲在喂养过程中对儿童线索的反应是否表现出不同的视频记录；2)比较饮食失调史妇女与健康对照母亲在喂养方式、育儿自我效能感和育儿压力方面的自我报告；3)确定有饮食失调史的母亲与健康对照的母亲在与孩子进行喂养互动时的生理反应差异的程度。本研究将有助于我们了解有饮食失调史的母亲对喂养环境的情绪和生理反应。最终，这项工作将为如何最好地针对这些母亲的特定问题喂养行为进行干预提供指导，以帮助降低其后代饮食失调的风险。

DESCRIPTION (provided by applicant): Eating disorders such as anorexia nervosa and bulimia nervosa represent a significant public health problem for young women in particular, affecting an estimated 2.4% of women of childbearing age in the United States. The children of mothers with eating disorder histories appear to be at especially high-risk for developing eating problems themselves. Yet, very little research has investigated how mothers with such histories interact with their young children in the feeding environment. An important component of early feeding is maternal responsiveness. Increased maternal responsiveness to child hunger and fullness cues is associated with the development of greater self-regulation of eating in childhood and decreased loss of control over eating or binge eating. Mothers with eating disorders may find it difficult to be responsive to their child during feeding due to heightened anxiety at mealtimes and fears about child weight gain. Despite the great importance of maternal feeding responsiveness for development of healthy child eating behavior, it remains unstudied in eating disorders. This proposed Kirschstein-NRSA individual fellowship (F30) aims to determine if mothers with histories of eating disorders differ from healthy mothers in their ability to recognize and respond to their child's hunger and fullness cues through the combined use of observational, self-report, and physiologic methods. This fellowship will provide the applicant with a uniquely integrated training in nutrition, eating disorders, and developmental psychology to further her career goals as a physician-scientist investigating the developmental origins of mental illness and the role of early nutrition in development of eating disorders. The specific aims of this F30 are: 1) to determine if mothers with histories of eating disorders display different responsiveness to child cues during a feeding episode that is video-recorded compared to mothers with no history of eating disorders; 2) to compare self-report of feeding style, parenting self-efficacy, and parenting stress in women with histories of eating disorders and healthy control mothers; and 3) to determine the extent to which mothers with histories of eating disorders differ from healthy control mothers in their physiologic response to feeding interactions with their child. This study will contribute to our understanding of the maternal emotional and physiologic response to the feeding environment in mothers with histories of eating disorders. Ultimately, this work will provide guidance on how best to target specific problematic feeding behaviors in interventions for these mothers designed to help reduce the risk of eating disorder development in their offspring. PUBLIC HEALTH RELEVANCE: Through this research, we determine if mothers with eating disorders respond differently than mothers without eating disorders to child feeding situations across behavioral, psychological, and physiological domains. This work will provide valuable background for the development of future interventions in mothers with eating disorders to promote healthier mealtimes and potentially decrease risk of disordered eating in their offspring.