Boutelle Kerri N, Monreal Teresa, Strong David R, Amir Nader
Department of Pediatrics, University of California, San Diego, USA; Department of Psychiatry, University of California, San Diego, USA.
Department of Pediatrics, University of California, San Diego, USA.
J Behav Ther Exp Psychiatry. 2016 Sep;52:138-146. doi: 10.1016/j.jbtep.2016.04.005. Epub 2016 Apr 16.
Binge eating is prevalent and is associated with significant psychiatric and medical comorbidities. To date, the most effective psychological treatments for individuals who binge eat are not effective for all patients and they do not result in significant weight loss. Dual process theories suggest that implicit factors, such as attention bias, may influence behavior, even when the behavior is in opposition to long-term goals. Attention bias modification programs have been tested in other areas of psychopathology, and could be utilized to improve outcomes for people who binge eat. Thus, the aim of this open trial was to conduct a preliminary evaluation of an attention bias modification program (ABM-Food) designed to train attention away from food cues.
Adults who binge eat and were overweight or obese enrolled in an 8-week ABM-Food program, which consisted of one session in the lab each week and two training sessions at home. Nine participants completed the ABM-Food training program and the post-treatment assessment, and 8 completed the 3-month post-treatment assessment.
Results showed that the ABM-Food program is a feasible and acceptable treatment for adults who binge eat. Initial effectiveness data showed decreases in weight, eating disorder symptoms, binge eating, loss of control and responsivity to food in the environment, as well as changes in attention bias. The majority of these effects remained at the 3-month follow-up time point.
This study is limited by the single-group open label trial, and the small sample size.
This open trial provides initial evidence for the feasibility, acceptability and effectiveness of ABM-Food for individuals who binge eat and are overweight or obese.
暴饮暴食十分普遍,且与多种严重的精神和躯体共病相关。迄今为止,针对暴饮暴食者最有效的心理治疗方法并非对所有患者都有效,且不会带来显著的体重减轻。双加工理论表明,即使行为与长期目标相悖,诸如注意偏向等内隐因素也可能影响行为。注意偏向矫正程序已在其他精神病理学领域进行了测试,可用于改善暴饮暴食者的治疗效果。因此,本开放性试验的目的是对旨在训练将注意力从食物线索上转移开的注意偏向矫正程序(ABM-食物)进行初步评估。
暴饮暴食且超重或肥胖的成年人参加了为期8周的ABM-食物计划,该计划包括每周在实验室进行一次课程以及在家进行两次训练课程。9名参与者完成了ABM-食物训练计划及治疗后评估,8名参与者完成了治疗后3个月的评估。
结果显示,ABM-食物计划对于暴饮暴食的成年人是一种可行且可接受的治疗方法。初步有效性数据显示,体重、饮食失调症状、暴饮暴食、失控以及对环境中食物的反应性均有所下降,同时注意偏向也发生了变化。这些影响大多数在3个月的随访时间点仍持续存在。
本研究受限于单组开放标签试验以及样本量较小。
本开放性试验为ABM-食物计划对于暴饮暴食且超重或肥胖个体的可行性、可接受性和有效性提供了初步证据。