Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey.
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina.
Int J Eat Disord. 2019 Sep;52(9):971-976. doi: 10.1002/eat.23147. Epub 2019 Jul 30.
Anorexia nervosa (AN) is a complex and life-threatening eating disorder. Current models of AN onset and maintenance have largely focused on the role of negative affect, while fewer models have described the role of positive affect (PA). Given that these theoretical models have informed current treatment approaches, and that treatment remains minimally effective for adults with AN, we advocate that targeting PA is one avenue for advancing maintenance models and by extension, treatment. We specifically propose that AN may arise and be chronically and pervasively maintained as a function of dysregulated PA in response to weight loss and weight loss behaviors (e.g., restriction, excessive exercise), to a degree that is not accounted for in existing models of AN. We present evidence from multiple domains, including biological, behavioral, and self-report, supporting the hypothesis that PA dysregulation in AN contributes to the maintenance of the disorder. We conclude with several specific avenues for treatment development research as well as a call for future work elucidating the biological correlates of PA.
神经性厌食症（AN）是一种复杂且危及生命的饮食失调症。目前关于 AN 发病和维持的模型主要集中在负性情绪的作用上，而较少的模型描述了正性情绪（PA）的作用。鉴于这些理论模型为当前的治疗方法提供了依据，而且治疗对 AN 成人的效果仍然微乎其微，我们主张针对 PA 是推进维持模型，进而推进治疗的一个途径。我们特别提出，AN 可能是由于对体重减轻和减轻体重行为（例如，限制、过度运动）的反应中 PA 失调而出现并持续存在，其程度超出了现有的 AN 模型的解释范围。我们从多个领域提供了证据，包括生物学、行为和自我报告，支持了 PA 失调在 AN 中有助于维持该疾病的假说。最后，我们提出了一些具体的治疗开发研究途径，并呼吁未来的工作阐明 PA 的生物学相关性。
