Michopoulos Vasiliki, Powers Abigail, Moore Carla, Villarreal Stephanie, Ressler Kerry J, Bradley Bekh
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr. NE, Atlanta, GA 30303, USA; Yerkes National Primate Research Center, Atlanta, GA, USA.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr. NE, Atlanta, GA 30303, USA.
Appetite. 2015 Aug;91:129-36. doi: 10.1016/j.appet.2015.03.036. Epub 2015 Apr 9.
Exposure to childhood adversity is implicated in the etiology of adverse health outcomes, including depression, posttraumatic stress disorder (PTSD), and obesity. The relationship between childhood trauma and obesity may be related to the association of childhood trauma and risk for emotional eating. One pathway between trauma exposure, psychopathology, and emotional eating may be through emotion dysregulation and depression. The current study was undertaken to characterize demographic, environmental, and psychological risk factors for emotional eating in a primarily African American, low socioeconomic status (SES), inner-city population (N = 1110). Emotional eating was measured using the Dutch Eating Behavioral Questionnaire and the Emotional Dysregulation Scale was used to assess emotion regulation. The Beck Depression Inventory and the modified PTSD Symptom Scale were used to assess depression and PTSD, respectively. Higher levels of emotional eating were associated with body mass index, income, childhood and adulthood trauma exposure, depressive and PTSD symptoms, negative affect and emotion dysregulation. Childhood emotional abuse was the most associated with emotional eating in adulthood. Hierarchical linear regression and mediation analyses indicated that the association between childhood trauma exposure (and emotional abuse specifically) and emotional eating was fully mediated by depression symptoms and emotion dysregulation, with emotional dysregulation contributing more to the mediation effect. Together these findings support a model in which obesity and related adverse health outcomes in stress- and trauma-exposed populations may be directly related to self-regulatory coping strategies accompanying emotion dysregulation. Our data suggest that emotion dysregulation is a viable therapeutic target for emotional eating in at-risk populations.
童年时期经历逆境与包括抑郁症、创伤后应激障碍(PTSD)和肥胖症在内的不良健康结果的病因有关。童年创伤与肥胖之间的关系可能与童年创伤和情绪化进食风险的关联有关。创伤暴露、精神病理学和情绪化进食之间的一条途径可能是通过情绪失调和抑郁症。本研究旨在描述主要为非裔美国人、社会经济地位较低(SES)的市中心人群(N = 1110)中情绪化进食的人口统计学、环境和心理风险因素。使用荷兰饮食行为问卷测量情绪化进食,并使用情绪失调量表评估情绪调节。分别使用贝克抑郁量表和改良的创伤后应激障碍症状量表评估抑郁症和创伤后应激障碍。较高水平的情绪化进食与体重指数、收入、童年和成年期的创伤暴露、抑郁和创伤后应激障碍症状、负面情绪和情绪失调有关。童年期情感虐待与成年期情绪化进食的关联最为密切。分层线性回归和中介分析表明,童年创伤暴露(特别是情感虐待)与情绪化进食之间的关联完全由抑郁症状和情绪失调介导,情绪失调对中介效应的贡献更大。这些发现共同支持了一个模型,即压力和创伤暴露人群中的肥胖症及相关不良健康结果可能直接与伴随情绪失调的自我调节应对策略有关。我们的数据表明,情绪失调是高危人群中情绪化进食的一个可行治疗靶点。