The Impact of Affect Regulatory Mechanisms and Binge Eating on Drug Recovery

描述（由申请人提供）：越来越多的证据支持药物依赖和暴饮暴食之间强有力的和多方面的关联。流行病学调查证实了暴饮暴食和物质使用障碍之间的高共患病率;动物模型显示，成瘾样行为在物质（包括食物）中普遍存在;神经生物学研究揭示了食物和非法药物的共同奖励途径。为了更好地界定这一协会的性质，目前的提案每天审查 治疗人群中最常滥用的药物（即阿片类药物）与暴饮暴食行为之间的行为关联。具体来说，我将研究如何从成瘾中恢复的个体中戒断阿片类药物与情感驱动的暴饮暴食相关，以及这些失调的饮食模式如何与阿片类药物失效和复发的风险纵向相关。我的研究目标是：1）建立一个理想的评估系统，用于量化从阿片类药物成瘾中恢复的个体的每日热量和营养摄入以及暴食行为; 2）测试从阿片类药物成瘾中恢复的个体和人口统计学上匹配的对照之间的负面情绪和暴食之间的关系是否不同; 3）确定时间特异性（例如，压力）和个人特异性（例如，人格）因素，加剧影响驱动的暴饮暴食作为缓和的成瘾状态;和4）测试的影响，各种应对策略，特别是影响驱动的暴饮暴食的做法，对纵向风险复发之间的恢复阿片类药物成瘾。为了实现这些目标，我将研究至少N = 106参与者从两个治疗设施的药物成瘾和N = 35人口统计学上可比的健康对照从社区样本的地理附近的治疗中心。参与者将在连续14天内每天三次回答电子信号，回答有关药物使用和渴望，负面影响和白天发生的饮食行为的问题。从成瘾中恢复的个人也将在24个月内每两周进行一次评估，以确定复发，物质使用和其他健康结果的持续风险。通过整合我提出的研究计划与计划，接受正式的培训和指导教师的专业知识，在情感模型的药物使用，治疗药物成瘾，狂欢 饮食和成瘾的神经生物学，拟议的职业发展奖补充了我在定量方法学方面的背景，通过提供培训，我需要开发一个独立的和富有成效的研究路线，致力于了解成瘾和暴食行为的共同发生，特别是在关系到影响失调。我提议的研究和培训将导致提交R 01提案，该提案将提供向独立研究职业的过渡，并有助于告知临床医生和客户暴饮暴食影响阿片类药物使用障碍治疗个人恢复努力的方式。

DESCRIPTION (provided by applicant): Accumulating evidence increasingly supports a strong and multifaceted association between drug dependence and binge eating. Epidemiological investigations confirm high comorbidity between binge eating and substance use disorders; animal models reveal that addiction-like behaviors generalize across substances (including food); and neurobiological studies reveal common reward pathways for both food and illicit drugs. To better define the nature of this association, the current proposal examines daily behavioral associations between the most commonly abused drug among treatment populations, namely opiates, and binge eating behaviors. Specifically, I will investigate how abstinence from opiates among individuals recovering from addiction is associated with affect-driven binge eating, and how these dysregulated eating patterns are longitudinally associated with risk for opiate lapse and relapse. My research aims are to: 1) establish an ideal assessment system for quantifying daily caloric and nutritional intake and binge eating behavior in individuals recovering from opiate addiction; 2) test whether the relationship between negative affect and binge eating differs for individuals recovering from opiate addiction and demographically-matched controls; 3) identify time- specific (e.g., stress) and person-specific (e.g., personality) factors that exacerbate affect-driven binge eating as moderated by addiction status; and 4) test the effects of various coping strategies, and particularly the practice of affet-driven binge eating, on the longitudinal risk for relapse among those in recovery from opiate addiction. To accomplish these aims, I will study a minimum of N = 106 participants from two treatment facilities for drug addiction and N = 35 demographically comparable healthy controls from a community sample in the geographic vicinity of the treatment centers. Participants will respond to electronic signals three times daily over fourteen consecutive days by answering questions about drug use and cravings, negative affect, and eating behaviors occurring during the day. Individuals recovering from addiction will also be assessed every two weeks over 24 months to determine ongoing risk for relapse, substance use and other health outcomes. By integrating my proposed research plan with a plan to receive formal training and mentorship from faculty with expertise in affective models of drug use, the treatment of drug addiction, binge eating, and the neurobiology of addiction, the proposed Career Development Award complements my background in quantitative methodology by providing training I need to develop an independent and productive line of research dedicated to understanding the co-occurrence of addictive and binge eating behaviors, particularly in relationship to affect dysregulation. The research and training that I propose will lead to the submission of an R01 proposal that will provide a transition to an independent research career and serve to inform clinicians and clients about the ways in which binge eating influences recovery efforts for individuals in treatment for opiate use disorder.