Department of Psychology, University of Illinois at Chicago.
J Abnorm Psychol. 2013 Nov;122(4):1132-41. doi: 10.1037/a0034487.
Bulimia nervosa (BN) and obsessive-compulsive disorder (OCD) co-occur at greater rates than chance and may have shared mechanisms of dysfunction. One of these proposed mechanisms is a hyper-responsive aversive system as indicated by heightened startle response to aversive stimuli. The present study examined this hypothesis using 2 types of aversive stimuli: disorder specific (e.g., high-caloric food pictures for BN, contamination pictures for OCD) and nondisorder specific (e.g., knife). Temporal parameters of aversive responding were also examined by assessing startle response in anticipation of and following picture presentation. The sample consisted of 114 undergraduate women selected to have a broad range of BN and/or OCD symptomatology. OCD symptoms were associated with increased startle potentiation during the anticipation and presentation of contamination pictures, and BN symptoms were associated with increased startle potentiation during disorder-related contamination pictures (e.g., sink, toilet). BN symptoms were also associated with increased startle potentiation during and following the presentation of food pictures (though the former effect was only a trend). Additionally, the interaction of BN and OCD symptoms was associated with elevated startle responding during the presentation of contamination and threat stimuli. Overall, the present study provides evidence that BN and OCD symptoms are associated with heightened aversive responding to disorder-specific stimuli, and comorbid BN and OCD symptoms are associated with heightened aversive responding across disorder-specific and nonspecific aversive stimuli. Clinical and theoretical implications are discussed.
神经性贪食症（BN）和强迫症（OCD）的发生率高于偶然发生的情况，并且可能具有共同的功能失调机制。其中一个提出的机制是厌恶系统的超反应性，表现为对厌恶刺激的惊跳反应增强。本研究使用两种类型的厌恶刺激来检验这一假设：特定于疾病的（例如，高卡路里食物图片用于 BN，污染图片用于 OCD）和非特定于疾病的（例如，刀）。通过评估在图片呈现之前和之后的惊跳反应，还检查了厌恶反应的时间参数。该样本包括 114 名本科女性，她们的 BN 和/或 OCD 症状范围广泛。OCD 症状与污染图片呈现前和呈现期间的惊跳增强有关，而 BN 症状与与疾病相关的污染图片（例如，水槽、厕所）呈现期间的惊跳增强有关。BN 症状也与食物图片呈现期间和之后的惊跳增强有关（尽管前者只是一个趋势）。此外，BN 和 OCD 症状的相互作用与在呈现污染和威胁刺激时的惊跳反应升高有关。总的来说，本研究提供了证据表明 BN 和 OCD 症状与对特定于疾病的刺激的增强的厌恶反应有关，并且共病的 BN 和 OCD 症状与对特定于疾病和非特定于疾病的厌恶刺激的增强的厌恶反应有关。讨论了临床和理论意义。
