Evaluating the effect of brief interventions on effort to restrict dietary intake

描述（由申请人提供）：饮食限制（DR），或热量和营养消耗不足，是一种令人震惊的常见做法，与严重的医疗和心理后果有关。DR预示着超重和饮食失调的发展。在极端情况下，厌食症可发展为神经性厌食症（AN），这是一种严重的慢性疾病，与相当高的发病率和高达20%的终生死亡率相关。尽管DR有负面影响，但驱动这种行为的心理过程很少受到关注，而且仍然知之甚少。虽然某些心理过程（例如，过度的自我控制；情绪失调）被假设与DR有关，但提出这些过程重要性的模型尚未得到充分的测试。因此，DR的治疗是不充分的。成人AN患者没有有效的治疗方法，而且DR会干扰其他饮食失调的治疗，在治疗其他相关失调（如抑郁症）时解决DR的指南也未明确。研究设计问题阻碍了理解和治疗DR的进展。传统上，随机对照试验（rct）被用来研究DR的治疗方法，但这通常是研究治疗目标的不切实际的第一步。此外，不可靠的自我报告饮食行为测量已被过度使用。目前的研究建议通过检查两种针对不同心理过程（自我控制，情绪失调）的简短干预措施的影响来解决这些问题，假设会影响DR，与主动控制相比，限制饮食者在测试餐中努力减少热量摄入的行为测量。被确定为频繁DR的个体将被告知，他们将被要求喝一定量的高热量奶昔，并参与一项可能帮助他们忍受这种经历的干预。然后，受试者将随机接受3个简短的计算机引导干预中的一个：1)认知重构（以自我控制为目标），2)情绪调节技能（以情绪失调为目标），或3)营养信息（控制）。在干预之后，受试者将被给予选择（通过按计算机任务上的空格键）：1)减少他们预期消耗的卡路里数量，或2)增加货币补偿。主要的因变量将是受试者为减少摄入而按下按钮的次数（即努力）。本研究的创新之处在于：1)与随机对照试验相反，针对心理过程的简短干预是一种时间和成本有效的评估DR有希望的心理目标的方法；2)与自我报告方法相反，对dr相关结果的行为测量，呈现出更精确的方法。本研究的结果将提供有关DR所涉及的心理过程的信息，为DR的治疗发展提供信息。这有可能产生重大影响，因为目前尚无针对DR的有效治疗方法，尽管其共性和潜在的严重后果。

DESCRIPTION (provided by applicant): Dietary restriction (DR), or inadequate caloric and nutrient consumption, is a shockingly common practice associated with serious medical and psychological consequences. DR predicts development of both overweight and eating disorders. At its extreme, DR can develop into anorexia nervosa (AN), a serious and chronic disorder associated with considerable morbidity and lifetime mortality up to 20%. Despite the negative effects of DR, the psychological processes driving this behavior have received little attention and remain poorly understood. While certain psychological processes (e.g., excessive self-control; emotion dysregulation) have been hypothesized to be involved in DR, the models proposing the importance of these processes have not been adequately tested. As a result, treatments of DR are inadequate. No efficacious treatments have been identified for adults with AN and, DR interferes with treatment for other eating disorders, and the guidelines for addressing DR in treatment of other related disorders (e.g., depression) are unspecified. Research design issues hinder progress in understanding and treating DR. Traditionally, randomized, controlled trials (RCTs) have been used to investigate treatment for DR, yet this is often an impractical first step for investigating treatment targets. Further, self-report measures f eating behavior, which are unreliable, have been over-utilized. The current study proposes to address these problems by examining the effects of 2 brief interventions targeting different psychological processes (self-control, emotion dysregulation) hypothesized to affect DR, compared to an active control, on a behavioral measure of the amount of effort restrictive eaters exert to reduce caloric intake at a test meal. Individuals identified as engaging in frequent DR will be told they will be expected to consume a self-selected quantity of a high-calorie milkshake and participate in an intervention that may help them tolerate this experience. Subjects will then be randomized to receive 1 of 3 brief computer- guided interventions: 1) cognitive restructuring (targeting self-control), 2) emotion regulation skills (targeting emotion dysregulation), or 3) nutrition information (control). Following the intervention, subjects will be given the option to work (by pressing the space bar on a computer task) to either: 1) decrease the number of calories they will be expected to consume, or 2) increase monetary compensation. The primary dependent variable will be number of button presses (i.e., effort) subjects employ toward reducing intake. This study is innovative due to utilization of: 1) Brief interventions targeting psychological processes, as opposed to RCTs, representing a time- and cost- effective means of evaluating promising psychological targets for DR; 2) A behavioral measure of a DR-related outcome, as opposed to self-report methods, presenting a more methodological precision. Results of this study will provide information regarding the psychological processes involved in DR, informing treatment development for DR. This has potential to make a substantial impact, as currently no efficacious treatments exist for DR, despite its commonality and potential for severe outcomes.