Vander Wal Jillon S, Maraldo Toni M, Vercellone Allison C, Gagne Danielle A
Department of Psychology, Saint Louis University, 3700 Lindell Blvd., St. Louis, MO 63108, USA.
Department of Psychology, Saint Louis University, 3700 Lindell Blvd., St. Louis, MO 63108, USA.
Appetite. 2015 Jun;89:136-44. doi: 10.1016/j.appet.2015.01.024. Epub 2015 Feb 4.
Night eating syndrome (NES) is a circadian rhythm disorder in which food intake is shifted toward the end of the day, interfering with sleep. According to the biobehavioral model of NES, the disorder is the result of a genetic predisposition that, coupled with stress, leads to enhanced reuptake of serotonin, thereby dysregulating circadian rhythms and decreasing satiety. Using the biobehavioral model as a guide, we developed a brief behavioral intervention using education, relaxation strategies, and exercise to address the core symptoms of NES. In this pilot randomized controlled clinical trial, 44 participants with NES were randomly assigned to an educational group (E; n = 14), E plus progressive muscle relaxation therapy (PMR; n = 15); or PMR plus exercise (PMR Plus, n = 15). Participants received a baseline intervention with 1- and 3-week follow-up sessions. Effectiveness analyses showed that participants in all three groups evidenced significant reductions on measures of NES symptoms (p < .001), depression (p < .05), anxiety (p < .01), and perceived stress (p < .05). However, the only significant between group change was for the percent of food eaten after the evening meal, with the PMR group showing the greatest reduction (-30.54%), followed by the PMR Plus group (-20.42%) and the E group (-9.5%); only the difference between the PMR and E groups was statistically significant (p = .012). Reductions in NES scores were significantly associated with reductions on measures of depression (r = .47; p < .01) and perceived stress (r = .37; p < .05), but not anxiety (r = .26, p = ns). Results support the role of education and relaxation in the behavioral treatment of NES.
夜间进食综合征(NES)是一种昼夜节律紊乱,其食物摄入向一天结束时转移,干扰睡眠。根据NES的生物行为模型,该病症是遗传易感性的结果,这种易感性与压力相结合,导致血清素再摄取增强,从而使昼夜节律失调并降低饱腹感。以生物行为模型为指导,我们开发了一种简短的行为干预措施,利用教育、放松策略和运动来解决NES的核心症状。在这项初步随机对照临床试验中,44名NES患者被随机分配到教育组(E组;n = 14)、E组加渐进性肌肉松弛疗法(PMR组;n = 15);或PMR组加运动(PMR加运动组,n = 15)。参与者接受了基线干预,并在1周和3周时进行随访。有效性分析表明,所有三组参与者在NES症状(p <.001)、抑郁(p <.05)、焦虑(p <.01)和感知压力(p <.05)的测量指标上均有显著降低。然而,组间唯一显著的变化是晚餐后进食的食物百分比,PMR组降低幅度最大(-30.54%),其次是PMR加运动组(-20.42%)和E组(-9.5%);只有PMR组和E组之间的差异具有统计学意义(p = 0.012)。NES评分的降低与抑郁(r = 0.47;p <.01)和感知压力(r = 0.37;p <.05)测量指标的降低显著相关,但与焦虑无关(r = 0.26,p =无统计学意义)。结果支持了教育和放松在NES行为治疗中的作用。