Friederich Hans-Christoph, Kumari Veena, Uher Rudolf, Riga Marianthy, Schmidt Ulrike, Campbell Iain C, Herzog Wolfgang, Treasure Janet
Eating Disorders Unit, Institute of Psychiatry, King's College London, London, UK.
Psychol Med. 2006 Sep;36(9):1327-35. doi: 10.1017/S0033291706008129. Epub 2006 Jun 22.
Abnormal perceptions of food and shape underpin the cognitive behavioural model of eating disorders (EDs). The aim of this study was to investigate motivational processing of disorder-specific and standard emotional cues in anorexia (AN) and bulimia nervosa (BN) using startle eyeblink modulation (SEM). SEM was used because it is sensitive to motivational states of approach (appetitive response) and withdrawal (aversive response), which are independent of conscious intentional control.
Acoustically elicited SEM and subjective anxiety ratings were measured in 30 female patients with an ED (n=15 AN, n=15 BN) and 30 female control subjects while they viewed ED-relevant stimuli (food, female bodies) and standardized emotional pictures.
BN subjects showed an appetitive response (startle inhibition) to food relative to neutral cues that differed significantly from AN subjects. By contrast, self-reports indicated significantly increased anxiety related to food cues across both ED groups. To female body picture (relative to neutral) cues, no significant between-group differences were found for SEM. ED subjects unexpectedly showed an aversive response (startle potentiation) to positive cues, in contrast to controls, who showed the established startle attenuation.
These preliminary results suggest that BN patients demonstrated an exaggerated appetitive response to food but not to standardized positive cues, whereas SEM in AN patients points to a generalized failure to activate the appetitive motivational system. Differences in motivational salience to food cues are in line with distinctions between AN and BN in eating behaviour and food consumption and support differential treatment requirements.
对食物和体型的异常认知是饮食失调（EDs）认知行为模型的基础。本研究旨在使用惊吓眨眼调制（SEM）来调查神经性厌食症（AN）和神经性贪食症（BN）中特定于饮食失调的和标准情绪线索的动机加工。使用SEM是因为它对趋近（积极反应）和回避（厌恶反应）的动机状态敏感，而这些状态独立于有意识的意向控制。
在30名患有饮食失调的女性患者（n = 15名AN患者，n = 15名BN患者）和30名女性对照受试者观看与饮食失调相关的刺激物（食物、女性身体）和标准化情绪图片时，测量听觉诱发的SEM和主观焦虑评分。
与中性线索相比，BN受试者对食物表现出积极反应（惊吓抑制），这与AN受试者有显著差异。相比之下，自我报告表明，两个饮食失调组中与食物线索相关的焦虑均显著增加。对于女性身体图片（相对于中性）线索，SEM在组间未发现显著差异。与对照组不同，饮食失调受试者对积极线索意外地表现出厌恶反应（惊吓增强），而对照组表现出既定的惊吓减弱。
这些初步结果表明，BN患者对食物表现出夸张的积极反应，但对标准化的积极线索没有，而AN患者的SEM表明其普遍未能激活积极的动机系统。对食物线索的动机显著性差异与AN和BN在饮食行为和食物消费方面的差异一致，并支持不同的治疗需求。
