执行功能缺陷是暴饮暴食症的根本原因吗?有和没有暴饮暴食病理的超重女性的比较。

Do executive functioning deficits underpin binge eating disorder? A comparison of overweight women with and without binge eating pathology.

作者信息

Manasse Stephanie M, Forman Evan M, Ruocco Anthony C, Butryn Meghan L, Juarascio Adrienne S, Fitzpatrick Kathleen Kara

机构信息

Department of Psychology, Drexel University, Philadelphia, Pennsylvania.

Department of Psychology, University of Toronto Scarborough, Toronto, Canada.

出版信息

Int J Eat Disord. 2015 Sep;48(6):677-83. doi: 10.1002/eat.22383. Epub 2015 Jan 27.

Abstract

OBJECTIVE

Deficits in executive function (EF)-including inhibitory control, cognitive flexibility, decision-making, and working memory-may be risk or maintenance factors for binge eating disorder (BED). However, there is mixed evidence regarding EF deficits in individuals with BED. Significant methodological weaknesses (e.g., use of a single EF measure, omission of relevant covariates) in the current literature represent one reason for lack of consensus.

METHOD

This study compared EF in a sample of overweight women with (n = 31) and without (n = 43) full or subthreshold BED, with the aim of conducting a multifaceted investigation of the neurocognitive profile of BED. A neuropsychological battery of EF was administered to all participants.

RESULTS

After controlling for IQ and age, individuals with binge eating displayed significantly poorer performance on tasks of problem-solving and inhibitory control, and displayed higher prioritization of immediate versus delayed rewards, but the two groups did not appear to differ on set-shifting, working memory, and risk taking. Differences in inhibitory control were no longer statistically significant when depressive symptomology was added as a covariate and correction for multiple comparisons was applied. Exploratory analyses indicated that full and sub-threshold BED groups did not differ in EF.

DISCUSSION

Results partially support the hypothesis of relative EF deficits in individuals with BED, suggesting that binge eating may be maintained by cognitive factors distinct from those of obesity. Future research should aim to replicate with a larger sample, control for a wider range of psychiatric comorbidities, and examine whether EF deficits predict treatment outcome.

摘要

目的

执行功能(EF)缺陷,包括抑制控制、认知灵活性、决策制定和工作记忆,可能是暴饮暴食症(BED)的风险因素或维持因素。然而,关于BED患者EF缺陷的证据并不一致。当前文献中显著的方法学弱点(例如,使用单一的EF测量方法、遗漏相关协变量)是缺乏共识的一个原因。

方法

本研究比较了超重女性样本中患有(n = 31)和未患有(n = 43)完全或亚阈值BED的女性的EF,旨在对BED的神经认知特征进行多方面调查。对所有参与者进行了一套EF神经心理学测试。

结果

在控制智商和年龄后,暴饮暴食的个体在解决问题和抑制控制任务上表现明显较差,并且在即时奖励与延迟奖励的优先级上更高,但两组在任务转换、工作记忆和冒险方面似乎没有差异。当将抑郁症状作为协变量并应用多重比较校正时,抑制控制的差异不再具有统计学意义。探索性分析表明,完全和亚阈值BED组在EF方面没有差异。

讨论

结果部分支持了BED个体存在相对EF缺陷的假设,表明暴饮暴食可能由与肥胖不同的认知因素维持。未来的研究应旨在用更大的样本进行重复研究,控制更广泛的精神共病,并检查EF缺陷是否能预测治疗结果。

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