Identifying Mechanisms that Predict Obesity Using Ecological Momentary Assessment

描述(申请人提供)：在青少年中，进食失控(LOC)与进食病理增加、一般心理社会问题和心理症状有关，1-6并预示体重超标7和恶化的进食病理，包括完全综合征暴饮暴食障碍。8青春期女孩进食LOC的比率很高，9、10，特别是在寻求治疗的样本中，其患病率估计约为30%。2、11、12尽管其不良相关，但对进食LOC的病因，尤其是促进LOC的瞬间过程，知之甚少。一个假想的解释LOC进食的模型是人际模型，它假设人际问题先于并预测负效应，而负效应又先于并预测LOC进食的发作。13迄今为止，许多LOC研究依赖于自我报告或实验室评估策略，这些策略受限于参与者需要总结几周或几个月的行为，或者可能不反映自然环境中的行为。本研究的目的是在现有研究的基础上，通过动态监测来检验LOC的人际模式在女孩的自然主义环境中的有效性。使用电子数字掌上电脑，患有LOC的女孩将被询问她们的互动和人际关系、情绪和进食情况，因为它们发生在一天中，为期两周。由于数据表明，在饮食紊乱的人中，识别和报告情绪的能力可能特别突出，因此，情绪将通过自我报告和心率变异性进行双重衡量。本研究的具体目的包括以下几个方面：目标一：通过动态监测，以生态有效性和时效性的方式检验LOC进食的人际模式的可行性。目的二：评估自我报告的负面情绪和心率变异性之间的瞬时联系。目的三：评价人际关系模型的有效性，该模型假设人际问题先于并预测负性情绪，而负性情绪先于并预测低脂饮食的发作。参与者将是30名超重的青春期女孩，她们在评估前一个月报告了LOC进食事件。主观--女孩的互动和关系、情绪和进食情况的报告将使用数字掌上电脑在一天中的两周内以分层的间隔收集。心率变异性将同时监测两天。结果将阐明可能伴随或预测低脂饮食的心理社会和生理机制，这有可能在整个发育过程中减少暴食或进食病理的出现。 公共卫生相关性：了解互动、情绪和饮食行为之间的瞬时关系，将为报告这种行为的女孩的饮食失控(LOC)提供潜在的干预策略。由于进食LOC很常见，而且已被证明可以预测体重增加和恶化的进食病理，因此在进食LOC时进行干预可能有助于减少一生中出现完全综合征暴饮暴食障碍的情况。除了饮食和体重紊乱领域的研究结果的影响外，本研究还将有助于理解青少年自我报告的负面情绪与心率变异性之间的关系。心率变异性被认为反映了自主神经平衡和压力，这两个概念与许多心理障碍高度相关。

DESCRIPTION (provided by applicant): In youth, loss of control (LOC) eating is associated with increased eating pathology and general psychosocial problems and psychological symptoms,1-6 and is predictive of excess weight gain7 and worsening eating pathology including full syndrome binge eating disorder.8 Rates of LOC eating among adolescent girls are high,9, 10 especially among treatment-seeking samples in which prevalence estimates are around 30%.2, 11, 12 Despite its adverse correlates, little is known about the etiology of LOC eating, specifically, the moment-to- moment processes that promote LOC. One model hypothesized to explain LOC eating is the Interpersonal Model, which posits that interpersonal problems precede and predict negative effect, which in turn precedes and predicts episodes of LOC eating.13 Many studies of LOC to date rely on self-report or laboratory assessment strategies, which are limited by the need for participants to summarize behaviors over weeks or months, or which may not reflect behavior in the natural environment. The present study aims to extend upon knowledge from existing research by using ambulatory monitoring to examine the validity of the Interpersonal Model of LOC in girls' naturalistic settings. Using electronic digital palm top computers, girls with LOC will be queried regarding their interactions and relationships, mood, and eating episodes, as they occur throughout the day, for a period of two weeks. Because data suggest that inability to identify and report emotions may be especially salient among individuals with disordered eating, affect will be dually measured by self-report and heart rate variability. Specific Aims of the current study include the following: Aim One: To test the feasibility of examining the Interpersonal Model of LOC eating in an ecologically valid and temporally sensitive manner using ambulatory monitoring. Aim Two: To evaluate momentary associations between self-reported negative affect and heart rate variability. Aim Three: To evaluate the validity of the Interpersonal Model which hypothesizes that interpersonal problems precede and predict negative affect and that negative affect precedes and predicts episodes of LOC eating. Participants will be 30 overweight adolescent girls who report episodes of LOC eating in the month prior to assessment. Subjective-reports of girls' interactions and relationships, mood, and eating episodes will be collected at stratified intervals throughout the day for two weeks using digital palm top computers. Heart rate variability will be concurrently monitored for two days. Results will illuminate psychosocial and physiological mechanisms that may accompany or predict LOC eating, which has potential to reduce the emergence of binge eating or eating pathology throughout development. PUBLIC HEALTH RELEVANCE: Understanding the momentary relationships between interactions, mood, and eating behaviors will inform potential intervention strategies for loss of control (LOC) eating among girls who report this behavior. Since LOC eating is common and has been shown to predict weight gain and worsening eating pathology, intervening at the point of LOC eating may help reduce the emergence of full syndrome binge eating disorder across the life span. Extending beyond the impact of findings in the field of eating and weight disorders, the present study will contribute to understanding the relationship between self-reported negative affect and heart rate variability among adolescents. Heart rate variability is thought to reflect autonomic balance and stress, concepts which are highly relevant to a number of psychological disorders.