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遗传和环境因素对创伤后应激障碍症状和抑制性进食行为的影响。

Genetic and environmental influences on posttraumatic stress disorder symptoms and disinhibited eating behaviors.

机构信息

VA Center of Excellence for Stress and Mental Health, San Diego, California, USA.

Department of Psychiatry, University of California, San Diego, California, USA.

出版信息

Eat Disord. 2021 May-Jun;29(3):226-244. doi: 10.1080/10640266.2020.1864587. Epub 2021 Jan 6.

DOI:10.1080/10640266.2020.1864587
PMID:33404377
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8257777/
Abstract

Posttraumatic stress disorder (PTSD) and eating disorders (ED) frequently co-occur, but the mechanisms underlying this association remain unclear. EDs are characterized by features of maladaptive eating behaviors including disinhibited eating and cognitive dietary restraint. Identifying the genetic overlap between PTSD symptoms and maladaptive eating behaviors may elucidate biological mechanisms and potential treatment targets. A community sample of 400 same-sex twins (102 monozygotic and 98 dizygotic pairs) completed the PTSD Checklist-Civilian (PCL-C) for PTSD symptoms and the Three-Factor Eating Questionnaire-Reduced (TFEQ-R18) for eating behaviors (uncontrolled eating, emotional eating, and cognitive dietary restraint). We used biometric modeling to examine the genetic and environmental relationships between PCL-C and TFEQ-R18 total and subscales scores. Heritability was estimated at 48% for PTSD symptoms and 45% for eating behavior overall. Bivariate models revealed a significant genetic correlation between PTSD symptoms and eating behavior overall (=.34; CI:.07,.58) and Uncontrolled Eating ( =.53; CI:.24,.84), and a significant environmental correlation between PTSD symptoms and Emotional Eating ( =.30; CI:.12,.45). These findings suggest the influence of common etiology. Future research and clinical efforts should focus on developing integrated treatments.

摘要

创伤后应激障碍(PTSD)和饮食障碍(ED)经常同时发生,但这种关联的机制仍不清楚。ED 的特征是包括饮食不节制和认知性节食在内的适应性不良的饮食行为特征。确定 PTSD 症状和适应性不良的饮食行为之间的遗传重叠,可以阐明生物学机制和潜在的治疗靶点。一个由 400 对同性别双胞胎(102 对同卵双胞胎和 98 对异卵双胞胎)组成的社区样本完成了 PTSD 清单-平民版(PCL-C)的 PTSD 症状评估和三因素饮食问卷简化版(TFEQ-R18)的饮食行为评估(饮食不节制、情绪性进食和认知性节食限制)。我们使用生物计量模型来研究 PCL-C 和 TFEQ-R18 总分和子量表评分之间的遗传和环境关系。PTSD 症状的遗传度估计为 48%,整体饮食行为的遗传度估计为 45%。双变量模型显示 PTSD 症状与整体饮食行为(=.34;CI:.07,.58)和饮食不节制(=.53;CI:.24,.84)之间存在显著的遗传相关性,以及 PTSD 症状与情绪性进食(=.30;CI:.12,.45)之间存在显著的环境相关性。这些发现表明存在共同病因的影响。未来的研究和临床工作应集中于开发综合治疗方法。

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本文引用的文献

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Comparing the clinical presentation of eating disorder patients with and without trauma history and/or comorbid PTSD.比较有创伤史和/或并发 PTSD 的进食障碍患者与无创伤史和/或并发 PTSD 的进食障碍患者的临床表现。
Eat Disord. 2021 Jan-Feb;29(1):88-102. doi: 10.1080/10640266.2019.1642035. Epub 2019 Jul 26.
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Maladaptive Eating in Posttraumatic Stress Disorder: A Population-Based Examination of Typologies and Medical Condition Correlates.创伤后应激障碍中的适应不良进食:基于人群的类型学和医疗状况相关性研究。
J Trauma Stress. 2018 Oct;31(5):708-718. doi: 10.1002/jts.22323. Epub 2018 Oct 19.
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Relationships between health behaviors, posttraumatic stress disorder, and comorbid general anxiety and depression.健康行为、创伤后应激障碍与共患广泛性焦虑和抑郁的关系。
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