Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
Oregon Research Institute, Eugene, OR, USA.
Psychol Med. 2023 Apr;53(6):2252-2262. doi: 10.1017/S0033291721004049. Epub 2021 Oct 12.
Findings from brain imaging studies with small samples can show limited reproducibility. Thus, we tested whether the evidence that a transdiagnostic eating disorder treatment reduces responsivity of brain valuation regions to thin models and high-calorie binge foods, the intervention targets, from a smaller earlier trial emerged when we recruited additional participants.
Women with DSM-5 eating disorders ( = 138) were randomized to the dissonance-based (BPT) or a waitlist control condition and completed functional magnetic resonance imaging (fMRI) scans assessing neural response to thin models and high-calorie foods at pretest and posttest.
BPT control participants showed significantly greater reductions in responsivity of regions implicated in reward valuation (caudate) and attentional motivation (precuneus) to thin average-weight models, echoing findings from the smaller sample. Data from this larger sample also provided novel evidence that BPT control participants showed greater reductions in responsivity of regions implicated in reward valuation (ventrolateral prefrontal cortex) and food craving (hippocampus) to high-calorie binge foods low-calorie foods, as well as significantly greater reductions in eating disorder symptoms, abstinence from binge eating and purging behaviors, palatability ratings for high calorie foods, monetary value for high-calorie binge foods, and significantly greater increases in attractiveness ratings of average weight models.
Results from this larger sample provide evidence that BPT reduces valuation of the thin ideal and high-calorie binge foods, the intervention targets, per objective brain imaging data, and produces clinically meaningful reductions in eating pathology.
样本量较小的脑成像研究结果可能显示出有限的可重复性。因此，我们测试了一个跨诊断饮食障碍治疗是否能减少大脑对瘦模特和高卡路里暴食食物的反应性，这是干预的目标，从一个较小的早期试验中招募更多的参与者时，证据是否会出现。
患有 DSM-5 饮食障碍的女性（n=138）被随机分配到基于不和谐的治疗（BPT）或等待名单对照组，并在预测试和后测试时完成功能磁共振成像（fMRI）扫描，评估对瘦模特和高卡路里食物的神经反应。
BPT 对照组参与者对瘦平均体重模特的奖励估值（尾状核）和注意力动机（楔前叶）相关区域的反应性显著降低，这与较小样本的发现相呼应。来自更大样本的数据还提供了新的证据，表明 BPT 对照组参与者对奖励估值（腹外侧前额叶皮层）和食物渴望（海马体）相关区域的反应性降低，对高热量暴食食物和低热量食物的反应性降低，以及饮食障碍症状、暴食和清除行为的戒除、高热量食物的可接受性评分、高热量暴食食物的货币价值、以及平均体重模特的吸引力评分的显著增加。
这个更大样本的结果提供了证据，表明 BPT 减少了对瘦理想和高热量暴食食物的估值，这是干预的目标，根据客观的脑成像数据，并且产生了有临床意义的饮食病理减少。
