夜食症的心理特征及相关因素

夜食症是指以持续的夜间进食异常及所伴随的心理行为问题为特征的精神疾病。夜食症与暴食症、神经性贪食症等行为有所不同,表现出夜间过度进食或夜行性进食、早晨厌食、睡眠问题等,通常会给患者的情感、躯体、人际关系等带来负面影响。夜食症与性别、年龄、压力生活事件等因素均有关联。本文对夜食症的心理特征(包括认知、情绪和人格)及相关因素(如性别、年龄和压力生活事件等)进行了系统的回顾,以期为夜食症的研究及临床干预提供参考。     

Re-emergence of hypothalamically elicited eating following change in food

Rats with lateral hypothalamic electrodes were administered electrical stimulation until the elicited eating of one type of food had emerged to asymptotic levels. Experimental animals later were presented with a different diet, and elicited eating underwent another emergence process. This re-emergence occurred despite the fact that animals had had deprivation experience with the second food immediately prior to stimulation experience with it. These data present interpretative difficulties for the hypothesis that elicited behavior reflects the activation of neural systems underlying deprivation-induced consummatory activity and that the anomalous characteristics of elicited responding can be attributed to an emotionality state which theoretically is also evoked by the stimulation.     

Book Review

Abstract

Bereavement: Reactions, Consequences, and Care, edited by Marian Osterweis, Frederic Solomon, and Morris Green     

Introduction: Novel perspectives on the psychology and psychotherapy of eating disorders

The aim of this introduction to this issue is to review and summarize significant new psychological perspectives and psychotherapeutic interventions in the treatment of eating disorder (EDs). In this issue, five novel therapeutic strategies for the treatment of EDs are presented. These include a combination of psychodynamic psychotherapy and neuropsychology, two recent modifications of cognitive behavioral therapy (the MANTRA, and the conceptualization of change in patients with ED in terms of sense of agency), a specific group movement therapy, and an innovative rehabilitation treatment. In addition, one article offers an historic review of the development of psychotherapy of EDs, and two articles highlight specific considerations related to the treatment of EDs: compulsory treatment, and culturally sensitive treatment.     

限制性饮食的神经机制

本文分别从认知限制和去抑制进食倾向两个维度回顾了限制性饮食的ERP和脑成像研究,初步提出限制性饮食者对食物的"冷—热"加工模型,并对今后的研究提出了展望。     

Binge eating in overweight treatment-seeking adolescents

OBJECTIVE: To examine the frequency and recency of binge eating in relation to psychopathology in overweight, treatment-seeking adolescents. METHODS: We investigated psychological correlates of the frequency and recency of reported loss of control (LOC) eating episodes in 160 overweight (body mass index [BMI]: 40.7 +/- 8.8 kg/m(2)) adolescents. On the basis of the responses to the eating disorder examination (EDE), participants were categorized into one of four groups: full-syndrome binge eating disorder (BED); recent but infrequent binge eating (episodes within the 3 months before interview; RECENT-BINGE); remote and infrequent LOC eating (episodes occurring >3 months before assessment; PAST-LOC), or no history of LOC episodes (NE). RESULTS: The BED group reported higher EDE scores (global, p < .01), and more negative mood and anxiety than all other groups (p's < .01). Compared with NE, RECENT-BINGE also reported more anxiety and higher EDE scores (p's < .01). CONCLUSIONS: Overweight, treatment-seeking adolescents with BED are clearly distinguishable from teens without the disorder on measures of eating-related psychopathology, mood, and anxiety. RECENT-BINGE, but not PAST-LOC, is also associated with significantly greater eating-related and general psychopathology.     

A dimensional examination of eating disorder symptoms in relation to cognitive processing: An event‐related potentials study

Identifying neurocognitive mechanisms involved in individuals experiencing eating disorder (ED) symptoms may be important for preventing EDs and improving rates of recovery. The present pilot study assessed how cognitive functioning may be associated with ED symptoms in college students (N = 41). Cognitive functioning was examined using electroencephalography during an auditory response inhibition task to measure the P3 component of event‐related potentials. Multiple regression analysis revealed that longer P3 latencies in the frontal region of the cortex were significantly and linearly associated with greater ED symptoms F(3, 37) = 13.62, p < .001, R² = 0.525, Adj. R² = 0.486. These pilot findings build upon prior work in clinical samples in that they indicate that functional brain differences are observable across a wide span of ED symptoms, not just in those with diagnosed ED. The present findings provide support for further exploration of changes in P3 latencies among individuals with ED symptoms to enhance our understanding of neural mechanisms that may pertain to the dimensional aspects of disordered eating attitudes and behaviors.     

High prevalence of eating disorders in narcolepsy with cataplexy: a case-control study

STUDY OBJECTIVES: To study the prevalence of and symptoms of eating disorders in patients with narcolepsy. DESIGN: We performed a case-control study comparing symptoms of eating disorders in patients with narcolepsy versus healthy population controls, using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN 2.1). To study whether an increased body mass index (BMI) could be responsible for symptoms of an eating disorder, we also compared patients with BMI-matched controls, using the SCAN as well as the Eating Disorder Examination-Questionnaire. SETTING: University hospital. PATIENTS AND PARTICIPANTS: Patients with narcolepsy/cataplexy (n = 60) were recruited from specialized sleep centers. Healthy controls (n = 120) were drawn from a population study previously performed in the Netherlands. Separately, 32 BMI-matched controls were recruited. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: In total, 23.3% of the patients fulfilled the criteria for a clinical eating disorder, as opposed to none of the control subjects. Most of these were classified as Eating Disorder-Not Otherwise Specified, with an incomplete form of binge eating disorder. On the symptom level, half of the patients reported a persistent craving for food, as well as binge eating. Twenty-five percent of patients even reported binging twice a week or more often. When compared with BMI-matched controls, the significant increases persisted in symptoms of eating disorders among patients with narcolepsy. Except for a higher level of interference in daily activities due to eating problems in patients using antidepressants, medication use did not influence our findings. CONCLUSIONS: The majority of patients with narcolepsy experience a number of symptoms of eating disorders, with an irresistible craving for food and binge eating as the most prominent features. Eating disorder symptomatology interfered with daily activities. These findings justify more attention for eating disorders in the treatment of patients with narcolepsy.     

A sex difference in the response to fasting

We determined whether women and men would alter their pattern of food intake after they had deprived themselves of food. We found that women consumed 12% less food after fasting and that men ate 28% more food after fasting. Serving more food on the test day did not increase food intake of women. Women, who ate at a nearly constant rate (linear eaters), consumed less food than those eating at an initially high speed which decreased over the course of the meal (decelerated eaters). Women decreased their food intake after fasting as their eating pattern became more linear. After fasting, men increased their food intake, and the rate at which they ate became more decelerated. Food intake of both women and men was normalized after fasting by providing feedback that encouraged them to eat according to the pattern they showed in the non-fasted condition. The results support the hypothesis that linear eating, and the dieting that elicits linear eating, are risk factors for the development of the abnormal linear eating pattern that characterizes patients with anorexia nervosa. The data also provide additional support for the use of behavioral feedback to normalize the pattern of eating for individuals who have difficulty maintaining their body weight.     

超重/肥胖青少年的负性情绪与进食障碍倾向

目的:探讨超重/肥胖青少年的负性情绪与进食障碍倾向的关系。方法:根据"中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准"筛查出超重/肥胖青少年(非临床病例)138名,用流调中心用抑郁量表(CES-D)、正性负性情绪量表(PANAS)、状态-特质焦虑问卷(STAI)测量被试负性情绪体验水平,用进食障碍量表(EDI-1)测量其进食障碍倾向。依据情绪变量进行聚类分析,对聚类组的进食障碍倾向水平进行比较。采用偏相关、多重线性回归分析负性情绪(情绪变量平均Z分)与进食障碍倾向的关系。结果:K-聚类分析将样本分类成为1个高负性情绪组和1个低负性情绪组,分别占样本人数的48%、52%。高负性情绪组在CES-D、PANAS的负性情绪因子及STAI的两个因子上的得分均高于低负性情绪组[如,CES-D:(26.3±7.6)vs.(12.1±6.5),P<0.001],在PANAS的正性情绪因子上的得分低于低负性情绪组[(28.8±7.6)vs.(32.7±7.3),P<0.001]。高负性情绪组在除完美主义、恐怖成熟两个因子外的其他EDI-1因子上的得分均高于低负性情绪组[如,瘦身倾向:(7.8±5.3)vs.(5.8±4.6),P<0.05]。控制人口学因素后,负性情绪得分与EDI-1各因子分(除完美主义因子分外)均呈正相关(r=0.21~0.45,均P<0.01)。进食障碍倾向中的无效感和人际不信任能正向预测负性情绪(β=0.31、0.21,均P<0.05)。结论:超重、肥胖青少年的负性情绪体验与进食障碍倾向关系密切,提示对超重/肥胖者进行干预和治疗时,特别是在高负性情绪体验超重/肥胖者中,应把降低负性情绪作为重要策略包括其中。     

北京女青少年节食状况及相关问题研究

目的 :了解北京市女青少年节食状况。方法 :采用节食状况量表及进食障碍调查表中的求瘦欲望与不满体形两个分量表测查了北京市一所初中、一所高中、一所中等专业学校的 3 44名女生 ,同时搜集被试的年龄、体重、身高等人口学资料并计算出每个人的体形指数 ,结果 :5 7.3 %的被试从不节食 ,有时节食占 3 8.1% ,严重节食为 1.7% ;不同年龄组的被试节食状况无显著差异 ,但有年长组比年幼组严重的趋势 ;节食状况并不与体形指数相吻合 ,即一些体重正常甚至过瘦的女孩亦节食 ;被试的求瘦欲望显著高于 15年前的美国常模 ,2 5 %的被试对自己的体形强烈不满 ;不同年龄组的被试在求瘦欲望和对体形不满方面无显著差异 ;体重正常和较瘦的被试比过瘦者有更强的求瘦欲望和对体形的不满 ;对身体的病态态度越严重的女孩越可能有节食行为。     

The role of weight stigmatization in cumulative risk for binge eating

Previous research supports a positive association between weight stigmatization experiences and binge eating. However, the extent to which weight stigmatization accounts for binge eating in the context of other risk factors requires further investigation. Using a cumulative risk model, we examine previously studied risk factors (environmental stress, psychological functioning, negative coping, body dissatisfaction) as well as weight stigmatization as predictors of binge eating bariatric patients and undergraduate students. Results show a unique contribution of weight stigmatization. Analyses by sample indicated that this was only the case for the undergraduate student sample. Results support weight stigmatization as a meaningful predictor of binge eating and highlight the need for further work investigating how these experiences work to promote eating pathology.