Pla-Sanjuanelo Joana, Ferrer-García Marta, Gutiérrez-Maldonado José, Riva Giuseppe, Andreu-Gracia Alexis, Dakanalis Antonios, Fernandez-Aranda Fernando, Forcano Laura, Ribas-Sabaté Joan, Riesco Nadine, Rus-Calafell Mar, Sánchez Isabel, Sanchez-Planell Luís
Department of Personality, Assessment and Psychological Treatments, University of Barcelona, Spain.
Department of Personality, Assessment and Psychological Treatments, University of Barcelona, Spain.
Appetite. 2015 Apr;87:81-9. doi: 10.1016/j.appet.2014.12.098. Epub 2014 Dec 16.
Binge eating behavior constitutes a central feature of both bulimia nervosa (BN) and binge eating disorder (BED). Cue exposure therapy (CET) has been proposed as an effective intervention.
To determine which situations and specific cues trigger higher levels of binge craving and to use the results in the development of virtual reality scenarios in which CET could be applied with BN and BED patients.
Participants were 101 outpatients, 50 with BED and 51 with BN, according to DSM-5 criteria, and 63 healthy undergraduate students who completed a self-administered questionnaire to assess binge craving.
The likelihood of binge craving in the clinical group was greater when alone at home, during the afternoon/early evening and in the late evening/at night, at weekends, and at dinner time or between meals. Higher levels of craving were produced in the kitchen, bedroom, dining room, and bakery situations. With regard to the specific cues reported, the presence of and access to high calorie food and snacks was the most commonly reported cue. Although some gender differences regarding triggering factors were obtained, no statistical differences were observed between ED subtypes. BN and BED patients showed significantly higher levels of binge craving than controls in all the contexts except when feeling positive affect; in this situation, levels of craving were low in both groups.
This information regarding trigger contexts and specific cues can be used to create valid and reliable virtual environments for CET. Indeed, the data from this study may serve to develop a wide range of situations with different levels of binge craving, in which the therapeutic aim is to extinguish conditioned responses and facilitate the generalization of craving extinction.
暴饮暴食行为是神经性贪食症（BN）和暴食症（BED）的核心特征。线索暴露疗法（CET）已被提议作为一种有效的干预措施。
确定哪些情况和特定线索会引发更高水平的暴食渴望，并将结果用于开发虚拟现实场景，以便对BN和BED患者应用CET。
根据《精神疾病诊断与统计手册》第5版标准，101名门诊患者参与研究，其中50名患有BED，51名患有BN，还有63名健康的本科生完成了一份自我管理问卷，以评估暴食渴望。
临床组在独自在家时、下午/傍晚和深夜/夜间、周末以及晚餐时间或两餐之间更有可能出现暴食渴望。在厨房、卧室、餐厅和面包店等场景中会产生更高水平的渴望。关于所报告的特定线索，高热量食物和零食的存在及可得性是最常报告的线索。尽管在触发因素方面存在一些性别差异，但在进食障碍亚型之间未观察到统计学差异。除了感到积极情绪时，BN和BED患者在所有情况下的暴食渴望水平均显著高于对照组；在这种情况下，两组的渴望水平都很低。
这些关于触发情境和特定线索的信息可用于创建用于CET的有效且可靠的虚拟环境。事实上，本研究的数据可用于开发各种具有不同程度暴食渴望的情境，其中治疗目标是消除条件反应并促进渴望消退的泛化。
