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暴饮暴食障碍成年患者中情绪、情绪失调与不同类型失控性进食之间的即时中介关联

Momentary Mediational Associations Among Affect, Emotion Dysregulation, and Different Types of Loss of Control Eating Among Adults With Binge Eating Disorder.

作者信息

Romano Kelly A, Peterson Carol B, Forester Glen, Wonderlich Joseph A, Wonderlich Stephen A, Engel Scott E, Crosby Ross D

机构信息

Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

Center for Biobehavioral Research, Sanford Research, Fargo, North Dakota, USA.

出版信息

Int J Eat Disord. 2025 Jun;58(6):1072-1084. doi: 10.1002/eat.24415. Epub 2025 Mar 15.

Abstract

OBJECTIVE

Few studies have directly assessed the mechanistic role of transdiagnostic self-regulatory factors that are theorized to promote core disinhibited disordered eating behaviors that characterize binge eating disorder (BED) in the natural environment, such as emotion dysregulation. The present study used ecological momentary assessment (EMA) to address this research gap by examining whether: (1) emotion dysregulation mediated associations between negative and positive affect and loss of control (LOC) eating at the within-person level; (2) these associations varied across distinct LOC eating dimensions.

METHOD

Adults with BED (N = 107; M  = 39.87, SD = 13.35) responded to six surveys per day for a 7-day EMA period. Multilevel structural equation models examined whether momentary emotion dysregulation mediated momentary associations between negative and positive affect, and different LOC eating outcomes ("general" [subjective experience of] LOC while eating; difficulties resisting eating; difficulties stopping eating after starting; feeling driven/compelled to eat; not paying attention to one's eating; feeling disconnected while eating [e.g., numb, zoned out]).

RESULTS

Experiencing a sequential worsening of negative affect and, in turn, emotion dysregulation over a day mapped onto higher levels of certain LOC eating outcomes ("general" LOC eating, difficulties resisting eating, driven/compelled to eat, disconnected while eating) but not others (difficulties stopping eating, not paying attention to one's eating). All momentary mediational pathways involving positive affect as a predictor were not significant.

DISCUSSION

These findings support emotion dysregulation as a mechanistic process that can precipitate certain types of LOC eating in daily life and may be leveraged to improve BED theory, research, and real-time interventions.

摘要

目的

很少有研究直接评估跨诊断自我调节因素的机制作用,这些因素被认为会促进在自然环境中表征暴饮暴食症(BED)的核心抑制失调饮食行为,比如情绪失调。本研究采用生态瞬时评估(EMA)来填补这一研究空白,方法是检验:(1)情绪失调在个体内部层面上是否介导了消极和积极情绪与失控(LOC)饮食之间的关联;(2)这些关联在不同的LOC饮食维度上是否存在差异。

方法

患有BED的成年人(N = 107;M = 39.87,SD = 13.35)在为期7天的EMA期间每天回复6次调查问卷。多级结构方程模型检验了瞬时情绪失调是否介导了消极和积极情绪之间的瞬时关联,以及不同的LOC饮食结果(“一般”[进食时的主观体验]LOC;抗拒进食困难;开始进食后停止进食困难;感觉被驱使/被迫进食;不注意自己的饮食;进食时感觉脱节[例如,麻木、走神])。

结果

在一天中经历消极情绪的持续恶化,进而情绪失调,与某些LOC饮食结果(“一般”LOC饮食;抗拒进食困难;被驱使/被迫进食;进食时脱节)的较高水平相关,但与其他结果(停止进食困难;不注意自己的饮食)无关。所有以积极情绪为预测因子的瞬时中介路径均不显著。

讨论

这些发现支持情绪失调是一种机制过程,它可在日常生活中促成某些类型的LOC饮食,并且可用于完善BED理论、研究和实时干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e30/12138863/59e7b387772f/EAT-58-1072-g001.jpg

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