Stress, Binge Eating, and Metabolic Abnormalities

描述（由申请人提供）：目前，7800万美国成年人肥胖，在减少患有这种复杂问题的人数方面几乎没有取得进展。肥胖最严重的后果是代谢异常，这是冠心病、中风和2型糖尿病的主要预测因素。它对人类的福祉至关重要 因此，我们必须鼓励个人和社会参与制定有效的干预措施，但只有在确定了具体的干预目标之后才能做到这一点。为此，该奖学金申请的目的是提供重要的培训经验，使候选人能够发展成为一名强大的护士研究人员所需的知识和技能，在肥胖，暴饮暴食，结构方程模型和生物行为研究方面具有相当大的和不断增长的专业知识。这个基础是必要的，以实现候选人的长期职业目标，成为一个独立和富有成效的护士科学家谁有助于解决肥胖流行病。作为培训计划的一部分，候选人将进行二级数据分析，以检查将压力与代谢异常联系起来的生物行为途径-这是一个公认的联系，但机制尚不清楚。暴饮暴食是解释压力和代谢异常之间关系的一种机制。虽然有强有力的理论支持暴食介导压力和代谢异常之间的关系，但实证检验是必要的。因此，本研究的具体目的是：1）确定压力自我报告之间的关系（早期创伤和慢性、近期和感知压力）、暴食和成人代谢异常; 2）确定成人自我报告的压力、皮质醇觉醒反应、暴食和代谢异常之间的关系;以及3）探索这些关系的调节因素（年龄、性别和社会经济地位）。本研究将使用从压力、自我控制和成瘾跨学科研究联盟（PL 1-DA 024859和UL 1-DE 019859）收集的数据，并将使用结构方程模型进行分析。候选人还将参加课程，研究和教学经验的独特组合，以帮助她实现她的培训目标。这项建议解决了国家护理研究所的使命，加强健康促进和疾病预防，从这项研究中获得的知识将提供具体的目标，预防和治疗肥胖干预。此外，这项研究将作为更广泛的研究计划的第一步，以更充分地了解暴饮暴食和肥胖的复杂性，并制定干预措施，以预防和治疗所有年龄段人群的暴饮暴食和肥胖。

DESCRIPTION (provided by applicant): Currently, 78 million U.S. adults are obese and little progress has been made in reducing the number of individuals with this complex problem. The most serious consequences of obesity are metabolic abnormalities, which are the major predictors of coronary heart disease, stroke, and type 2 diabetes. It is crucial for the well being of individuals and society to develop effective interventions, but this can only be done once specific intervention targets are identified. To that end, the purpose of this fellowship applicatin is to provide vital training experiences so that the candidate can develop the knowledge and skills necessary to become a strong nurse researcher with considerable and growing expertise in obesity, binge eating, structural equation modeling, and biobehavioral research. This foundation is necessary to accomplish the candidate's long-term career objective of becoming an independent and productive nurse scientist who contributes solutions to the obesity epidemic. As part of the training plan, the candidate will conduct a secondary data analysis to examine the biobehavioral pathways linking stress to metabolic abnormalities-a well-recognized link, but with mechanisms that are unclear. One mechanism that would account for how and why the relationship between stress and metabolic abnormalities occurs is binge eating. Though there is strong theoretical support for the idea that binge eating mediates the relationship between stress and metabolic abnormalities, empirical testing is necessary. Thus, the specific aims of this study are to: 1) Identify the relationships among self-reports of stress (early trauma and chronic, recent, and perceived stress), binge eating, and metabolic abnormalities in adults, 2) identify the relationships among self-reports of stress, the cortisol awakening response, binge eating, and metabolic abnormalities in adults; and 3) explore moderators (age, gender, and socioeconomic status) of these relationships. This study will use data collected from the Interdisciplinary Research Consortium on Stress, Self-Control, and Addiction (PL1-DA024859 and UL1- DE019859), and will be analyzed using structural equation modeling. The candidate will also participate in a unique combination of coursework, research, and teaching experiences to help her achieve her training goals. This proposal addresses the National Institute of Nursing Research's mission of enhancing health promotion and disease prevention, as the knowledge gained from this study will provide specific targets for preventative and therapeutic obesity interventions. Furthermore, this study will serve as the first step in a broader research program to more fully understand the complexities of binge eating and obesity, and to develop interventions to prevent and treat binge eating and obesity in people of all ages.