Restrictive and binge eating during adolescence: the role of negative self-related cognitions and social stress

这个以患者为导向的导师研究职业发展奖致力于阐明神经和 青春期饮食失调的心理社会机制。研究和培训计划旨在 让调查员做好准备，通过培训对青少年饮食失调进行独立研究 生物行为和心理社会机制以及复杂的评估方法。进食障碍 以身体和精神发病率高为特征，青春期是一种发育性疾病 饮食失调通常出现的阶段。消极的自我相关图式(即低自尊)和 据推测，不良的社会功能通过以下方式导致进食障碍的发生和/或维持 提倡适应不良的限制性进食和反复暴饮暴食。然而，很少有研究对此进行调查 自我报告领域之外的这些结构，以及与进食障碍直接相关的检查 行为是有限的。因此，自我相关的图式和不良的社会功能在进食障碍中的作用 病因和维持因素，以及它们作为治疗靶点的有效性，仍然是关键的经验差距。这 K23旨在通过测试消极的自我相关图式、社会图式之间的关联来解决这些差距 包括神经生理活动在内的分析单元的功能和进食障碍行为， 表型和实时被动监测。参与者将包括14-17岁的女性青少年 有适应不良的限制性进食(定义为AN，n=30)，反复暴饮暴食(定义为 神经性暴食症(BN)或暴饮暴食障碍(BED)的诊断(n=30)，以及健康对照组(n=30)。在… 基线，青少年将完成自我参照编码任务，而脑电数据是 获得性探索自我相关图式的行为和神经生理过程。要进行实时探测 社交流程，我们将利用智能手机技术，并在6- 持续衡量社交功能关键方面的月度--社交网络规模、频率 互动，以及互动的负面内容。饮食紊乱组的青少年将完成 生态瞬时评估1周/月，为期6个月，评估频率和强度 在自然环境中不适应、限制和暴饮暴食。将实现以下目标：第一， 我们将比较饮食紊乱青少年和青少年的自我相关图式和社会功能。 健康对照组(目标1)。其次，我们将检验自我相关图式和社会图式之间的联系 6个月以上饮食失调行为的频率和强度(目标2)。最后，我们会 测试负性自我相关图式与社会功能之间的交互作用以预测进食障碍 行为。目前的项目将阐明自我关系图式和社会功能是否有区别 患有进食障碍的青少年，与进食障碍行为有关。这些发现将 告知这些假想的机制作为治疗青少年饮食失调的目标的效用。

This Mentored Patient-Oriented Research Career Development Award is focused on elucidating neural and psychosocial mechanisms of eating disorders in adolescence. The research and training plans are designed to prepare the investigator to conducted independent research in adolescent eating disorders through training in biobehavioral and psychosocial mechanisms and sophisticated methods for their assessment. Eating disorders are characterized by high rates of physical and psychiatric morbidity, and adolescence is a developmental phase in which eating disorders commonly emerge. Negative self-related schema (i.e., low self-esteem) and poor social functioning are hypothesized to contribute to the onset and/or maintenance of eating disorders by promoting maladaptive restrictive eating and recurrent binge eating. However, few studies have investigated these constructs outside the self-report domain, and examinations of direct associations with eating disorder behavior are limited. Thus, the role of self-related schema and poor social functioning as eating disorder etiologic and maintenance factors, as well as their utility as treatment targets, remain key empirical gaps. This K23 aims to address these gaps by testing associations among negative self-related schema, social functioning, and eating disorder behavior across units of analysis including neurophysiological activity, phenotypes, and real-time passive monitoring. Participants will include female adolescents aged 14-17 years with maladaptive restrictive eating (defined by a diagnosis of AN, n = 30), recurrent binge eating (defined as a diagnosis of bulimia nervosa (BN) or binge eating disorder (BED), n = 30), and healthy controls (n = 30). At baseline, adolescents will complete a self-referential encoding task while electroencephalography data are acquired to probe behavioral and neurophysiological processes of self-related schema. To probe real-time social processes, we will leverage smartphone technology and use a passive sensing application over a 6- month period to continuously measure key aspects of social functioning—size of social network, frequency of interactions, and negative content of interactions. Adolescents in the eating disorder groups will complete ecological momentary assessment 1 week/month for six-months to assess the frequency and intensity of maladaptive restrictive and binge eating in the natural environment. The following aims will be addressed: First, we will compare self-related schema and social functioning between adolescents with an eating disorder and healthy controls (Aim 1). Second, we will test the associations between self-related schema and social functioning with the frequency and intensity of eating disorder behavior over 6-months (Aim 2). Last, we will test the interaction between negative self-related schema and social functioning to predict eating disorder behavior. The current project will elucidate whether self-related schema and social functioning distinguish adolescents with an eating disorder and are associated with eating disorder behavior. These findings will inform the utility of these hypothesized mechanisms as treatment targets for adolescents with eating disorders.