Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, USA.
Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.
Ann Behav Med. 2021 Jul 22;55(8):758-768. doi: 10.1093/abm/kaaa061.
Stress is a dynamic construct that predicts a range of health behaviors and conditions, including binge eating and excess weight. Thus far, there have been limited and inconsistent findings regarding stress responses in binge-eating disorder (BED) and insufficient consideration of temporal patterns of stress responses across the weight spectrum.
The present study used ecological momentary assessment (EMA) to examine stress reactivity (i.e., the magnitude of the initial stress response), recovery (i.e., how long the stress response lasts before returning to baseline), and pileup (i.e., accumulation of repeated experiences of stressors and responses over time) as predictors of binge-eating symptoms (BES) and food craving in BED.
Adults with BED (N = 115) completed a 7 day EMA protocol assessing stressful events, perceived stress, binge eating, and food craving prior to being randomized to a behavioral intervention.
Generalized estimating equations indicated that moments of greater stress pileup predicted greater subsequent BES (within-person effect). Participants with higher perceived stress and pileup reported greater overall BES and craving, and those with better recovery reported higher overall craving (between-person effects).
Findings highlight the importance of considering the dynamic nature of stress responses and, particularly, that the accumulation of stress over the day is an important trigger for BES.
压力是一个动态的概念，它可以预测一系列的健康行为和状况，包括暴食和超重。迄今为止，关于暴食症（BED）中的压力反应的研究结果有限且不一致，对压力反应在体重谱上的时间模式也没有足够的考虑。
本研究使用生态瞬时评估（EMA）来研究压力反应性（即初始压力反应的强度）、恢复性（即压力反应恢复到基线之前持续的时间）和堆积性（即随着时间的推移，反复经历压力源和反应的积累）作为暴食症状（BES）和暴食障碍中食物渴望的预测指标。
115 名 BED 成人完成了为期 7 天的 EMA 方案，在随机分配到行为干预之前，评估了压力事件、感知压力、暴食和食物渴望。
广义估计方程表明，更大的压力堆积瞬间预测了更大的随后 BES（个体内效应）。感知压力和堆积较高的参与者报告了更高的整体 BES 和渴望，恢复较好的参与者报告了更高的整体渴望（个体间效应）。
研究结果强调了考虑压力反应动态性质的重要性，特别是压力在一天中的积累是 BES 的一个重要触发因素。
