Sysko Robyn, Ojserkis Rachel, Schebendach Janet, Evans Suzette M, Hildebrandt Tom, Walsh B Timothy
One Gustave L. Levy Place, Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10028, United States.
226 Dealy Hall, Department of Psychology, Fordham University, Bronx, NY 10458, United States.
Appetite. 2017 May 1;112:1-8. doi: 10.1016/j.appet.2017.01.005. Epub 2017 Jan 7.
Many patients with bulimia nervosa (BN) also meet criteria for a lifetime alcohol use disorder (AUD). In order to understand possible mechanisms contributing to the co-occurrence and perpetuation of these disorders, this study investigated the importance of impulsivity and test meal intake among patients with BN by comparing women with BN only (n = 18), BN and current/past AUDs (n = 13), and healthy controls (n = 12). All participants completed assessments of eating disorder symptoms, frequency of alcohol use, binge eating, and purging via questionnaires and semi-structured interviews over two sessions. Measures of impulsivity consisted of computerized and self-report measures, and laboratory test meals. Significant differences between individuals with BN with/without comorbid AUDs were not found for test meal intake, impulsivity measures, or self-reported psychological symptoms. As hypothesized, compared to healthy controls, individuals with BN had significantly higher scores on two subscales and the total score of the Barratt Impulsiveness Scale, a trait measure of impulsivity, and consumed significantly more calories in the binge instruction meal. Total Barratt Impulsiveness Scale scores were also significantly related to kcal consumed during the laboratory test meal when individuals were instructed to binge eat (BN groups). Data from this study add to the existing literature implicating impulsivity in the psychopathology of disorders of binge eating, including BN, and also support the use of laboratory meals as a symptom-specific measure of this trait in eating disorder populations.
许多神经性贪食症（BN）患者也符合终生酒精使用障碍（AUD）的标准。为了了解导致这些障碍同时出现和持续存在的可能机制，本研究通过比较仅患有BN的女性（n = 18）、患有BN且目前/过去患有AUD的女性（n = 13）和健康对照者（n = 12），调查了冲动性和试验餐摄入量在BN患者中的重要性。所有参与者通过问卷调查和两个阶段的半结构化访谈，完成了对饮食失调症状、饮酒频率、暴饮暴食和催吐的评估。冲动性测量包括计算机化测量、自我报告测量和实验室试验餐。在试验餐摄入量、冲动性测量或自我报告的心理症状方面，未发现患有/未患有共病AUD的BN患者之间存在显著差异。正如所假设的，与健康对照者相比，BN患者在Barratt冲动性量表（一种冲动性特质测量工具）的两个子量表和总分上得分显著更高，并且在暴饮暴食指导餐中摄入的热量显著更多。当个体被指示暴饮暴食时（BN组），Barratt冲动性量表总分也与实验室试验餐期间消耗的千卡数显著相关。本研究的数据补充了现有文献，表明冲动性与包括BN在内的暴饮暴食障碍的精神病理学有关，也支持将实验室餐作为饮食失调人群中该特质的症状特异性测量方法。
