Schyns Ghislaine, Roefs Anne, Smulders Fren T Y, Jansen Anita
Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
J Behav Ther Exp Psychiatry. 2018 Mar;58:68-77. doi: 10.1016/j.jbtep.2017.09.002. Epub 2017 Sep 5.
This study tested whether two sessions of food cue exposure therapy reduced eating in the absence of hunger (EAH), specified for exposed and non-exposed food, in overweight and obese adolescents, and whether habituation of food cue reactivity and reduced CS-US expectancies predicted a decrease in EAH.
41 overweight adolescents (aged 12-18 years) were randomly assigned to a cue exposure intervention or a lifestyle intervention (control condition). Habituation of food cue reactivity (self-reported desire to eat and salivation) and CS-US expectancy were measured during both sessions, and EAH was measured at the end of session two.
Compared to the control condition, the cue exposure condition showed less EAH for the exposed food item as well as for the non-exposed food items. Larger within-session (WSH) and between-session habituation (BSH) of cue reactivity were not related to less EAH, change in CS-US expectancy was unrelated to EAH.
The study was underpowered, and compliance to homework instructions between sessions was poor, intervention effects might have been larger when participants adhered to daily homework exercises.
Food cue exposure was effective to reduce EAH of exposed and non-exposed food items, indicating generalisability of the exposure effect. In line with exposure effects in anxiety disorders, habituation was not found to benefit outcome, though the present data do also not provide evidence that CS-US expectancy violation predicts EAH.
本研究旨在测试两阶段的食物线索暴露疗法是否能减少超重和肥胖青少年在无饥饿感时的进食行为（EAH），并分别针对暴露和未暴露的食物进行明确分析；同时探讨食物线索反应性的习惯化以及条件刺激-无条件刺激预期的降低是否能预测EAH的减少。
41名超重青少年（年龄在12 - 18岁之间）被随机分配到线索暴露干预组或生活方式干预组（对照组）。在两个阶段均测量食物线索反应性的习惯化（自我报告的进食欲望和唾液分泌）以及条件刺激-无条件刺激预期，在第二阶段结束时测量EAH。
与对照组相比，线索暴露组在暴露食物项目以及未暴露食物项目上的EAH均较少。线索反应性在阶段内（WSH）和阶段间的习惯化（BSH）程度较大与EAH减少无关，条件刺激-无条件刺激预期的变化与EAH无关。
该研究的样本量不足，且各阶段之间对家庭作业指导的依从性较差，若参与者坚持每日家庭作业练习，干预效果可能会更大。
食物线索暴露对减少暴露和未暴露食物项目的EAH有效，表明暴露效应具有普遍性。与焦虑症中的暴露效应一致，未发现习惯化对结果有帮助，尽管目前的数据也未提供证据表明条件刺激-无条件刺激预期违背可预测EAH。
