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暴食障碍中的情绪调节。

Emotion regulation in binge eating disorder.

机构信息

Uniwersytet Kardynała Stefana Wyszyńskiego w Warszawie, Instytut Psychologii.

Szpital Nowowiejski w Warszawie.

出版信息

Psychiatr Pol. 2021 Dec 31;55(6):1433-1448. doi: 10.12740/PP/OnlineFirst/122212.

Abstract

A review of the literature on emotion regulation in binge eating disorder (BED) published both in English and Polish between 1990 and 2020. BED might be considered as an impulsive and compulsive disorder associated with altered reward sensitivity and food-related attentional bias. The growing body of research indicated that there were corticostriatal circuitry alterations in BED, comparable to those observed in substance abuse, including altered function of orbitofrontal, prefrontal and insular cortices with the striatum included. Negative emotions and deficits in their regulation play a significant role in BED. Processing of anger, anxiety and sadness appear to be particularly important in this disorder. Research results identified an increase in negative emotions preceding episodes of binge eating. However, there is still inconsistency when it comes to whether these episodes alleviate negative affect. Individuals with BED more often use non-adaptive emotion regulation strategies, such as rumination and suppression of negative sensations. Whereas adaptive ones, for instance, cognitive reappraisal, are used less often. Clinical implications, besides pharmacology, highlight the high effectiveness of enhanced cognitive behavioral therapy (CBT-E), dialectic-behavioral therapy (DBT) and psychodynamic therapy in the treatment of emotional dysregulation in BED. Further studies, including ecological momentary assessment (EMA), should focus on emotional changes related to the binge cycle and the identification of reinforcing factors of BED.

摘要

对 1990 年至 2020 年间发表的关于暴食障碍(BED)情绪调节的英文和波兰文文献进行回顾。BED 可被视为一种与改变的奖赏敏感性和与食物相关的注意力偏差有关的冲动和强迫障碍。越来越多的研究表明,BED 存在皮质纹状体回路改变,与观察到的物质滥用相似,包括眶额、前额和脑岛皮质以及纹状体的功能改变。负面情绪及其调节的缺陷在 BED 中起着重要作用。愤怒、焦虑和悲伤的处理在这种障碍中似乎特别重要。研究结果表明,在暴食发作之前,负面情绪会增加。然而,关于这些发作是否能减轻负面情绪,仍然存在不一致之处。BED 患者更经常使用非适应性情绪调节策略,例如沉思和抑制负面感觉。而适应性的策略,例如认知重评,使用得较少。除了药理学之外,临床意义还强调了增强认知行为疗法(CBT-E)、辩证行为疗法(DBT)和心理动力学疗法在治疗 BED 情绪失调方面的高度有效性。进一步的研究,包括生态瞬时评估(EMA),应该集中在与暴食周期相关的情绪变化以及识别 BED 的强化因素上。

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