Yale University, Department of Psychiatry, United States; Yale University, Department of Psychology, United States.
Yale University, Department of Psychology, United States.
Clin Psychol Rev. 2018 Mar;60:32-44. doi: 10.1016/j.cpr.2017.12.004. Epub 2017 Dec 23.
Binge Eating Disorder (BED) is a newly-established eating disorder diagnosis in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Although systematic research on BED is in its infancy and many studies feature small samples, several observations emerge. First, we review diagnostic, developmental, and socio-demographic features of BED. Next, although BED and obesity are linked and frequently co-occur, we review data suggesting that BED is a distinct phenotype. Importantly, we take a mechanism-focused approach and propose four psychological processes with neurobiological bases that may uniquely differentiate BED from obesity: emotion reactivity, food-cue reactivity, food craving, and cognitive control. Further, we propose that interactions between impairments in cognitive control and increased emotional reactivity, food-cue reactivity, and craving may underlie emotion dysregulation and promote binge eating. Consistently, neuroimaging studies point towards neural alterations in the response to rewards and to food specifically, and suggest preliminary links between impaired cognitive-control-related neural activity and binge eating. However, additional systematic work is required in this area. We conclude with a detailed review of treatment approaches to BED; specifically, we suggest that psychological and pharmacological treatments that target core mechanisms - including cognitive control and emotion/craving dysregulation - may be particularly effective.
暴食障碍（BED）是在《精神障碍诊断与统计手册》第五版（DSM-5）中新确立的一种饮食障碍诊断。尽管对 BED 的系统研究还处于起步阶段，许多研究的样本都很小，但还是有一些观察结果出现。首先，我们回顾了 BED 的诊断、发展和社会人口学特征。其次，尽管 BED 和肥胖症有关联，并且经常同时发生，但我们回顾的数据表明，BED 是一种独特的表型。重要的是，我们采取了一种以机制为重点的方法，并提出了四个具有神经生物学基础的心理过程，这些过程可能将 BED 与肥胖症区分开来：情绪反应、食物线索反应、食物渴望和认知控制。此外，我们提出，认知控制受损和情绪反应、食物线索反应以及渴望增加之间的相互作用可能是情绪失调的基础，并促进暴食。一致的是，神经影像学研究指向了对奖励和食物的反应中的神经改变，并表明认知控制相关神经活动受损与暴食之间存在初步联系。然而，这一领域还需要更多的系统研究。我们最后详细回顾了 BED 的治疗方法；具体来说，我们建议针对核心机制（包括认知控制和情绪/渴望失调）的心理和药物治疗可能特别有效。
