Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, The Miriam Hospital/Weight Control and Diabetes Research Center, Providence, RI, USA.
Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, IL, USA.
Appetite. 2018 May 1;124:43-49. doi: 10.1016/j.appet.2017.03.010. Epub 2017 Mar 18.
Difficulties with executive functioning may underlie both overweight and loss of control (LOC) eating behavior across the age spectrum, but there is a relative paucity of research in children with both conditions. This study aimed to characterize general executive functioning among children with overweight and LOC eating as compared to their overweight and normal-weight peers. Participants were 75 racially diverse children (58.7% female; 81.3% African-American), aged 9-12y (M age = 10.5 ± 1.1), of whom 26 were overweight/obese and endorsed LOC eating (OW-LOC), 34 were overweight controls (OW-CON), and 15 were normal-weight controls (NW-CON). All children completed interview-based measures of eating pathology, and behavioral measures of executive functioning. Parents reported on behavioral facets of children's executive functioning. Groups were compared across parent-report measures and behavioral tasks using analyses of covariance (ANCOVAs) and multivariate analyses of covariance (MANCOVAs) which adjusted for general intellectual functioning. Significant group differences were revealed on a behavioral measure of planning, the Tower of London task [F (5,65) = 3.52; p = 0.007], and a behavioral measure of working memory, the List Sorting task [F (2,71) = 6.45; p = 0.003]. Post-hoc tests revealed that OW-LOC and OW-CON performed worse than NW-CON on the Tower of London, with relative decrements in accuracy rather than performance time. Further, OW-LOC performed worse than both OW-CON and NW-CON on the List Sorting task. Overweight with or without concomitant LOC eating in children may characterize a unique pattern of executive dysfunction. Interventions for eating- and weight-related problems in youth should address underlying deficits in planning and working memory.
执行功能障碍可能是超重和失控（LOC）进食行为在整个年龄范围内的基础，但在同时患有这两种疾病的儿童中，相关研究相对较少。本研究旨在比较超重和 LOC 进食的儿童与超重和正常体重的同龄人之间的一般执行功能。参与者为 75 名不同种族的儿童（58.7%为女性；81.3%为非裔美国人），年龄在 9-12 岁（M 年龄= 10.5 ± 1.1），其中 26 名超重/肥胖且有 LOC 进食（OW-LOC），34 名超重对照组（OW-CON），15 名正常体重对照组（NW-CON）。所有儿童均完成了基于访谈的饮食病理学评估和行为执行功能评估。父母报告了儿童执行功能的行为方面。使用协方差分析（ANCOVA）和多元协方差分析（MANCOVA）比较了组间差异，这些分析调整了一般智力功能。在伦敦塔任务（Tower of London task）[F (5,65) = 3.52；p = 0.007]和工作记忆行为测量任务（List Sorting task）[F (2,71) = 6.45；p = 0.003]中，三组之间存在显著差异。事后检验显示，OW-LOC 和 OW-CON 在伦敦塔任务中的表现不如 NW-CON，准确性下降，而非表现时间。此外，OW-LOC 在列表排序任务中的表现不如 OW-CON 和 NW-CON。儿童超重或伴有 LOC 进食可能表现出独特的执行功能障碍模式。针对青少年饮食和体重相关问题的干预措施应针对计划和工作记忆的潜在缺陷。
