Boutelle Kerri N, Kuckertz Jennie M, Carlson Jordan, Amir Nader
Department of Pediatrics, University of California, San Diego, 9500 Gilman Drive, MC 0874, La Jolla, CA 92037, United States; Department of Psychiatry, University of California, San Diego, La Jolla, CA 92037, United States.
Department of Psychiatry, University of California, San Diego, La Jolla, CA 92037, United States; Department of Psychology, San Diego State University, San Diego, CA, United States.
Appetite. 2014 May;76:180-5. doi: 10.1016/j.appet.2014.01.075. Epub 2014 Feb 8.
There are a number of neurocognitive and behavioral mechanisms that contribute to overeating and obesity, including an attentional bias to food cues. Attention modification programs, which implicitly train attention away from specific cues, have been used in anxiety and substance abuse, and could logically be applied to food cues. The purpose of this study was to evaluate the initial efficacy of a single session attention modification training for food cues (AMP) on overeating in overweight and obese children. Twenty-four obese children who eat in the absence of hunger participated in two visits and were assigned to an attention modification program (AMP) or attentional control program (ACC). The AMP program trained attention away 100% of the time from food words to neutral words. The ACC program trained attention 50% of the time to neutral and 50% of the time to food. Outcome measures included the eating in the absence of hunger free access session, and measures of craving, liking and salivation. Results revealed significant treatment effects for EAH percent and EAH kcal (group by time interactions p<.05). Children in the ACC condition showed a significant increase over time in the number of calories consumed in the free access session (within group t=3.09, p=.009) as well as the percent of daily caloric needs consumed in free access (within group t=3.37, p=.006), whereas children in the AMP group demonstrated slight decreases in these variables (within group t=-0.75 and -0.63, respectively). There was a trend suggesting a beneficial effect of AMP as compared to ACC for attentional bias (group by time interaction p=.073). Changes in craving, liking and saliva were not significantly different between groups (ps=.178-.527). This is the first study to demonstrate that an AMP program can influence eating in obese children. Larger studies are needed to replicate and extend these results.
有许多神经认知和行为机制会导致暴饮暴食和肥胖，包括对食物线索的注意力偏差。注意力调节程序通过隐式训练使注意力远离特定线索，已被应用于焦虑症和药物滥用治疗，从逻辑上讲也可应用于食物线索。本研究的目的是评估针对超重和肥胖儿童暴饮暴食的单次注意力调节训练（AMP）的初步疗效。24名在不饥饿时进食的肥胖儿童参加了两次就诊，并被分配到注意力调节程序（AMP）组或注意力控制程序（ACC）组。AMP程序将100%的时间用于训练注意力从食物词汇转移到中性词汇。ACC程序将50%的时间用于训练注意力到中性词汇，50%的时间用于训练注意力到食物词汇。结果测量包括不饥饿时自由进食环节、渴望程度、喜好程度和唾液分泌的测量。结果显示，在无饥饿进食百分比和无饥饿进食千卡数方面有显著的治疗效果（组间与时间交互作用p<0.05）。ACC组的儿童在自由进食环节消耗的卡路里数量（组内t=3.09，p=0.009）以及自由进食环节消耗的每日热量需求百分比（组内t=3.37，p=0.006）随时间显著增加，而AMP组的儿童在这些变量上略有下降（组内t分别为-0.75和-0.63）。有一个趋势表明，与ACC相比，AMP对注意力偏差有有益影响（组间与时间交互作用p=0.073）。两组之间在渴望程度、喜好程度和唾液分泌方面的变化没有显著差异（p值为0.178 - 0.527）。这是第一项证明AMP程序可以影响肥胖儿童进食的研究。需要更大规模的研究来重复和扩展这些结果。
