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)，或热量和营养摄入不足，是一种与严重的医疗和心理后果相关的令人震惊的常见做法。DR预测超重和饮食失调的发展。在其极端情况下，DR可发展为神经性厌食症(AN)，这是一种严重的慢性疾病，与相当大的发病率和高达20%的终身死亡率有关。尽管DR有负面影响，但推动这一行为的心理过程几乎没有受到关注，也仍然知之甚少。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检验。因此，对糖尿病视网膜病变的治疗是不够的。目前还没有找到治疗成人AN的有效方法，DR会干扰其他饮食障碍的治疗，而且在治疗其他相关疾病(如抑郁症)时解决DR的指南也没有具体说明。研究设计问题阻碍了对DR的理解和治疗的进展。传统上，随机对照试验(RCT)被用于研究DR的治疗，但这往往是研究治疗靶点的不切实际的第一步。此外，不可靠的饮食行为自我报告指标被过度利用。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)的简短干预对行为测量的影响，这些干预针对假设影响DR的不同心理过程(自我控制、情绪失调)，与积极控制相比，对限制进食者在试餐中减少卡路里摄入量的努力量的影响。被确认为经常进行DR的人将被告知，他们将被要求饮用自己选择的数量的高卡路里奶昔，并参与一项可能有助于他们忍受这种经历的干预。然后，受试者将被随机接受3种简短的计算机指导干预中的一种：1)认知重建(目标自我控制)，2)情绪调节技能(目标情绪失调)，或3)营养信息(对照)。在干预之后，受试者可以选择工作(通过按下电脑任务上的空格键)来：1)减少他们预计消耗的卡路里数量，或者2)增加金钱补偿。主要的因变量将是受试者为减少摄入量而使用的按钮按下次数(即，努力)。这项研究是创新的，因为使用了：1)针对心理过程的简短干预，而不是随机对照试验，代表了一种评估DR有希望的心理目标的时间和成本效益的手段；2)与自我报告方法相反，对DR相关结果的行为测量，呈现了更高的方法学精确度。这项研究的结果将提供有关DR涉及的心理过程的信息，为DR的治疗开发提供信息。这可能会产生重大影响，因为目前尚无有效的治疗DR的方法，尽管它具有共性，并有可能导致严重后果。

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.