从预期和强化敏感化的角度理解失控饮食
Understanding Loss of Control Eating Through the Lens of Expectancies and Reinforcement Sensitization.
作者信息
Burr Emily K, Dvorak Robert D, De Leon Ardhys N, Klaver Samantha J, Peterson Roselyn, Hayden Emma R, Maynard Madison H, Almeyda Sabrina, Medina Alejandra
出版信息
Psychiatry. 2025 Spring;88(1):55-70. doi: 10.1080/00332747.2024.2403664. Epub 2024 Oct 28.
OBJECTIVE
Prior research has indicated that outcome expectancies, sensitivity to punishment, and sensitivity to reward may predict harmful health behaviors concurrently, including disordered eating. Loss-of-control eating (LOCE), feeling unable to resist eating or stop once one has started, is associated with expectancies that eating alleviates negative affect (NA reduction expectancies) and expectancies that eating is rewarding (reward expectancies).
METHOD
A survey battery was administered examining LOCE pathology, sensitivity to punishment, sensitivity to reward, and eating expectancies to a sample of 1660 adults in the United States ( = 39.24 (14.51), 73.86% assigned female at birth). It was hypothesized that sensitivity to punishment would have a potentiating effect on the relationship between NA reduction expectancies and LOCE (a two-way interactive effect). This relationship was theorized to be moderated by the effect of reward sensitivity (a three-way interactive effect), as reward sensitivity has been found to interact with punishment sensitivity. Similarly, reward expectancies on LOCE were thought to be potentiated by sensitivity to reward (a two-way interactive effect) and this relationship was also thought to be influenced by sensitivity to punishment (a three-way interactive effect).
RESULTS
Hypotheses were partially supported. Sensitivity to punishment significantly moderated a two-way interactive relationship between reward sensitivity and reward expectancies on LOCE, attenuating this two-way interaction at low sensitivity to punishment. Similarly, the interaction between sensitivity to punishment and NA reduction expectancies on LOCE was only significant when reward sensitivity was low or at its mean.
CONCLUSION
Sensitivity to punishment and sensitivity to reward evince nuanced interactions with each other and eating expectancies to predict LOCE. Findings have treatment implications for cognitive interventions in LOCE.
目的
先前的研究表明，结果预期、对惩罚的敏感性和对奖励的敏感性可能同时预测有害健康行为，包括饮食失调。失控进食（LOCE），即一旦开始进食就感觉无法抗拒或停止，与进食能减轻负面影响的预期（消极情绪减轻预期）和进食是有回报的预期（奖励预期）有关。
方法
对1660名美国成年人（平均年龄=39.24岁（14.51），73.86%出生时被指定为女性）进行了一系列调查，考察了LOCE病理、对惩罚的敏感性、对奖励的敏感性和饮食预期。研究假设，对惩罚的敏感性会对消极情绪减轻预期与LOCE之间的关系产生增强作用（双向交互效应）。从理论上讲，这种关系会受到奖励敏感性的调节（三向交互效应），因为已发现奖励敏感性与惩罚敏感性相互作用。同样，对奖励的敏感性被认为会增强奖励预期与LOCE之间的关系（双向交互效应），并且这种关系也被认为会受到对惩罚的敏感性的影响（三向交互效应）。
结果
部分假设得到支持。对惩罚的敏感性显著调节了奖励敏感性与LOCE奖励预期之间的双向交互关系，在对惩罚敏感性较低时减弱了这种双向交互作用。同样，对惩罚的敏感性与LOCE消极情绪减轻预期之间的交互作用仅在奖励敏感性较低或处于均值时显著。
结论
对惩罚的敏感性和对奖励的敏感性与彼此以及饮食预期之间表现出细微的相互作用，以预测LOCE。研究结果对LOCE的认知干预具有治疗意义。
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