Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA.
Department of Pediatrics, Section of Endocrinology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado, USA.
Int J Eat Disord. 2024 May;57(5):1213-1223. doi: 10.1002/eat.24177. Epub 2024 Feb 28.
Among adolescents, disinhibited eating and anxiety commonly co-occur. Precision intervention approaches targeting unique mechanistic vulnerabilities that contribute to disinhibited eating and anxiety may therefore be helpful. However, the effectiveness of such interventions hinges on knowledge of between- and within-person associations related to disinhibited eating, anxiety, and related processes.
A sample of 39 adolescent females (12-17 years) with elevated anxiety and above-average weight (BMI %ile ≥ 75th) completed measures of theoretically driven social and cognitive-behavioral variables, disinhibited eating, and anxiety via ecological momentary assessment over 7 days. Data were analyzed using mixed-effects models.
Between-person differences in social stressors were linked to emotional eating, eating in the absence of hunger, and anxiety, whereas between-person differences in negative thoughts were associated with all disinhibited eating variables and anxiety. Between-person differences in avoidance were not related to any outcome. Additionally, between-person differences in social stressors and negative thoughts-as well as within-person deviations (from person-average levels) of social stressors, negative thoughts, and avoidance-were associated with anxiety. In turn, between-person differences in anxiety predicted eating in the absence of hunger and emotional eating, and within-person deviations in anxiety were associated with emotional eating at any given time point.
Findings support elements of both the interpersonal and cognitive-behavioral models of disinhibited eating. Differential trigger effects on anxiety, both at the between- and within-person levels, and significant associations between anxiety and all eating-related outcomes, highlight the potential utility of interventions targeting individual differences in sensitivity to anxiety triggers.
Findings provide support for the interpersonal and cognitive-behavioral models of disinhibited eating, highlighting anxiety as a salient vulnerability and potential mechanistic factor underlying disinhibited eating. Social, cognitive, and behavioral variables were differentially related to anxiety across participants, suggesting potential for future intervention tailoring and intervention selection based on adolescents' sensitivity to anxiety as a trigger for disinhibited eating behavior.
在青少年中，抑制失调的进食和焦虑通常同时存在。针对导致抑制失调的进食和焦虑的独特机制弱点的精准干预方法可能因此会有所帮助。然而，这种干预的有效性取决于与抑制失调的进食、焦虑和相关过程有关的个体间和个体内关联的知识。
一个由 39 名有焦虑症状和超重（BMI%ile≥75 分位）的青春期女性（12-17 岁）组成的样本，通过 7 天的生态瞬时评估，完成了理论驱动的社会和认知行为变量、抑制失调的进食和焦虑的测量。使用混合效应模型分析数据。
个体间的社会压力源差异与情绪化进食、无饥饿感进食和焦虑有关，而个体间的消极思维差异与所有抑制失调的进食变量和焦虑有关。个体间的回避差异与任何结果都没有关系。此外，社会压力源和消极思维的个体间差异，以及社会压力源、消极思维和回避的个体内偏差（与个体平均水平的偏差），与焦虑有关。反过来，个体间的焦虑差异预测了无饥饿感进食和情绪化进食，而焦虑的个体内偏差与任何给定时间点的情绪化进食有关。
研究结果支持了抑制失调进食的人际和认知行为模型的元素。焦虑在个体间和个体内水平上的差异触发效应，以及焦虑与所有与进食相关的结果之间的显著关联，突出了针对焦虑触发个体差异的干预措施的潜在效用。
研究结果为抑制失调进食的人际和认知行为模型提供了支持，强调了焦虑作为一个显著的脆弱性和潜在的机制因素，是抑制失调进食行为的基础。在参与者之间，社会、认知和行为变量与焦虑的关系存在差异，这表明未来的干预可能需要根据青少年对焦虑作为抑制失调进食行为触发因素的敏感性进行调整和选择。
