Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA.
Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA.
Int J Eat Disord. 2024 May;57(5):1160-1171. doi: 10.1002/eat.24070. Epub 2023 Sep 30.
Individuals with eating disorders transdiagnostically engage in binge eating (BE) and/or purging, despite life-threatening consequences. Little is known about factors that contribute to the persistence of these behaviors. This study explored whether habitual control over binge/purge (B/P) spectrum behaviors contributes to symptom persistence and whether negative reinforcement via reductions in negative affect is less influential in maintaining B/P behaviors that are under habitual control and are persistent.
Women with BE and/or purging (N = 81) completed self-report measures assessing habit strength of BE and purging. Then, they completed a 14-day ecological momentary assessment (EMA) protocol during which they completed measures of negative affect, BE, and purging multiple times per day.
Habitual control over purging was associated with a greater frequency of purging during the EMA period. However, habitual control over BE was not associated with the severity of loss of control eating or the frequency of BE episodes. Habitual control did not moderate temporal relations between negative affect and B/P behaviors during the EMA period. However, exploratory analyses revealed that individuals with a longer duration of BE and greater habitual control over BE showed a less pronounced reduction in negative affect following BE.
Overall, these findings suggest that purging may be maintained by habitual stimulus-response learning. In addition, they support the possibility that reduction in negative affect may play a less prominent role in maintaining BE that is habitual and persistent.
This study investigated whether habit contributes to the persistence of symptoms in women with binge/purge spectrum behaviors and whether negative reinforcement via reductions in negative affect is less influential in maintaining binge/purge behaviors that are under habitual control. The findings suggest that purging may be maintained through habit. This supports the potential utility of habit reversal interventions to decrease habitual purging.
尽管存在危及生命的后果，患有饮食障碍的个体仍会表现出暴食（BE）和/或清除行为。对于导致这些行为持续存在的因素知之甚少。本研究探讨了习惯性控制暴食/清除（B/P）谱行为是否有助于症状持续存在，以及通过减少负性情绪来进行负性强化是否对习惯性控制和持续存在的 B/P 行为的维持作用较小。
有 BE 和/或清除行为的女性（N=81）完成了评估 BE 和清除习惯性强度的自我报告量表。然后，她们完成了为期 14 天的生态瞬时评估（EMA）方案，在此期间，她们每天多次完成负性情绪、BE 和清除的测量。
清除行为的习惯性控制与 EMA 期间清除行为的频率更高有关。然而，BE 的习惯性控制与失控进食的严重程度或 BE 发作的频率无关。习惯性控制并没有调节 EMA 期间负性情绪和 B/P 行为之间的时间关系。但是，探索性分析表明，BE 持续时间更长且对 BE 的习惯性控制更强的个体在 BE 后负性情绪的减少程度较低。
总体而言，这些发现表明，清除行为可能是通过习惯性刺激-反应学习来维持的。此外，它们支持这样一种可能性，即减少负性情绪可能在维持习惯性和持续性的 BE 方面的作用较小。
本研究调查了习惯是否有助于有暴食/清除谱行为的女性症状的持续存在，以及通过减少负性情绪来进行负性强化是否对习惯性控制的暴食/清除行为的维持作用较小。研究结果表明，清除行为可能是通过习惯来维持的。这支持了习惯反转干预减少习惯性清除的潜在效用。
