Characterizing Acute Exercise Response in Restrictive Eating Disorders

项目摘要 进食障碍（ED）是所有精神疾病中最致命的。然而， ED仅对大约40%的青少年患者有效。治疗效果的一个障碍是 强迫性运动（DEx;以强迫性方式锻炼以控制体重和/或调节情绪）， 在许多被诊断为限制性ED的青少年中报告的症状（59-73%）。其他负面 后遗症，DEX与自杀行为、较差的治疗结局、增加的共病相关 精神病理学和复发风险此外，虽然已经验证了多个进食相关任务， 区分ED患者和健康人群，目前还没有经过充分验证的任务 直接评估艾德人群对运动的敏感性和反应性。由于DEx是一种鲜为人知的 症状在艾德维持中起着关键作用，研究其生物行为基础至关重要 重要性现有的研究指出了锻炼的奖励和威胁功能，这可能会驱动和 使ED患者的DEX永久化。运动的奖励和威胁功能的评价 ED将提高对该艾德特征的机械理解;最终，提高对DEx的理解 将告知治疗目标。拟议的项目将招募青少年和年轻成年女性（16- 22岁）， （n = 67）和无（n = 33）ED从两个网站参加急性运动的综合评价 反应目前的项目将1）表征生物行为反应的变异性，在实验室暴露于 中度强度的运动在那些有和没有ED; 2）创建和完善的任务，捕捉 参与奖励和威胁相关的系统在运动过程中;和3）测试假设，急性运动 反应在ED患者中更为明显，急性运动反应与艾德有关 症状严重程度、DEx和自由生活活动。详细解释个人之间的急性运动效应 与ED在一个受控的设置将有显着的影响，实证研究的ED，特别是（i） 改进对DEx风险和功能的评估（ii）阐明DEx风险的可测试模型和（iii）建议目标 进行地塞米松干预在这个项目中验证的方法将提高对DEX的理解，DEX是一种治疗方法， 抗艾德腐蚀特性。这些方法也将为更大规模的临床研究奠定基础， 艾德治疗中的最佳DEX靶点。

PROJECT SUMMARY Eating disorders (EDs) are among the deadliest of all psychiatric disorders. However, first-line treatments for EDs are effective for only roughly 40% of adolescent patients. One barrier to treatment efficacy is the persistence of driven exercise (DEx; exercising in a compulsive manner to control weight and/or regulate emotion), a hallmark symptom reported among many adolescents diagnosed with restrictive EDs (59-73%). Among other negative sequelae, DEx is associated with suicidal behavior, poorer treatment outcome, increased comorbid psychopathology, and risk for relapse. Further, while multiple eating-related tasks have been validated that discriminate between individuals with EDs and healthy populations, there are currently no well-validated tasks that directly assess sensitivity and responsivity to exercise in ED populations. As DEx is a poorly understood symptom that plays a key role in ED maintenance, investigating its biobehavioral underpinnings is of critical importance. Existing research points towards both reward and threat functions of exercise, which may drive and perpetuate DEx among those with EDs. Evaluation of both reward and threat functions of exercise among those with EDs will improve mechanistic understanding of this ED feature; ultimately, improved understanding of DEx will inform treatment targets. The proposed project will recruit adolescent and young adult females (16-22y) with (n = 67) and without (n = 33) EDs from two sites to participate in a comprehensive evaluation of acute exercise response. The current project will 1) characterize variability in biobehavioral response to in-lab exposure to moderate-intensity exercise among those with and without EDs; 2) create and refine tasks that capture engagement of reward- and threat-related systems during exercise; and 3) test hypotheses that acute exercise response is more pronounced among individuals with EDs and that acute exercise response relates to ED symptom severity, DEx, and free-living activity. Detailed explication of acute exercise effects among individuals with EDs in a controlled setting will have significant impact on the empirical study of EDs, specifically to (i) improve assessment of DEx risk and function (ii) elucidate a testable model of DEx risk and (iii) suggest targets for DEx intervention. The methods validated in this project will improve understanding of DEx, a treatment- resistant ED feature. These methods will also lay the groundwork for larger-scale, clinical research which clarifies optimal targets for DEx in ED treatment.