) and anxiety (8.5 versus 2.7, P=0.003). Linear regression indicated that BED diagnosis and internalizing symptoms accounted for 30% of the variance in kcal intake. Results from path analysis suggested that BED mediates the influence of internalizing symptoms on total kcal intake (empirical P<0.001
). The associations between internalizing symptoms and food intake are best described as operating indirectly through a BED diagnosis. This suggests that symptoms of depression and anxiety influence whether one engages in binge eating, which influences kcal intake. Greater understanding of the mechanisms underlying the associations between mood, binge eating, and food intake will facilitate the development of more effective prevention and treatment strategies for both BED and obesity.">
暴食症介导抑郁症状之间的联系,焦虑,和热量摄取超重和肥胖的女性</t我tle>
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<h1 class="articleHeader__title">暴食症介导抑郁症状之间的联系,焦虑,和热量摄取超重和肥胖的女性</h1>
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<span class="articleHeader__authors_author"><strong>Roseann e·彼得森</年代trong><a href="//www.newsama.com/cdn-cgi/l/email-protection" aria-label="Mail Option"><span role="img" class="anticon">
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<h4 class="header" id="abstract">文摘</h4>
<p>尽管相当大的发病率之间的情绪障碍,暴食症(床),和肥胖,底层机制仍没有解决。因此,本研究的目的是检验模型的抑郁和焦虑的内化行为影响超重/肥胖妇女的食物摄入量。32妇女(15床,17控制)参与了实验室eating-episode和完成问卷评估焦虑和抑郁的症状。路径分析是用来测试中介和适度模型确定机制内在症状影响千卡(千卡)的摄入量。床组支持更多抑郁的症状(10.1和4.8,<年代vg height="11.1" id="M1" style="vertical-align:-0.17555pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 11.1" width="63.962502" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.1)">
<g transform="translate(72,-63.12)">
<text transform="matrix(1,0,0,-1,-71.95,63.35)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="44.810753" y="0">
5</t年代p一个n>
</text>
</g>
</g>
</svg>)和焦虑(8.5和2.7,<年代vg height="10.9125" id="M2" style="vertical-align:-0.17555pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 10.9125" width="63.962502" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
<g transform="translate(72,-63.27)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="44.810753" y="0">
3</t年代p一个n>
</text>
</g>
</g>
</svg>)。线性回归表明,床上诊断和内在症状占30%的方差千卡的摄入量。路径分析结果表明,床调和内在症状的影响在千卡摄入总量(经验<年代vg height="11.0625" id="M3" style="vertical-align:-0.30096pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 11.0625" width="63.962502" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.0625)">
<g transform="translate(72,-63.15)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
<</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="44.810753" y="0">
1</t年代p一个n>
</text>
</g>
</g>
</svg>)。内在症状之间的关系和食物摄入量最好被描述为操作间接通过诊断床上。这表明,抑郁和焦虑症状的影响是否从事暴食,影响千卡的摄入量。更大的理解机制之间的关系心情,暴饮暴食,进食会促进更有效的预防和治疗策略的发展对床和肥胖。</p>
<span class="end-abs"></span>
<h4 id="introduction">1。介绍</h4>
<p>尽管肥胖之间存在相当大的疾病,饮食失调,和其他主要精神疾病,这些关联机制还没有得到解决。暴食症(床),常与高体重和情绪障碍,是在考虑包含在精神障碍的诊断与统计手册》第五版(dsm - v)。床是临时进食障碍诊断精神疾病诊断与统计手册定义的特点是反复发作的暴食没有体重控制补偿行为,包括(1)”吃饭,在一个离散的时间内(例如,在任何一个两个小时的时间段内),数量的食物绝对是比大多数人会吃什么在一个类似的一段时间,在类似的情况下”,(2)“一种缺乏在集控制饮食。“此外,床上的人必须经历痛苦的暴食和支持三个以下症状:吃比平时更快,吃到令人不安的完整,大量吃不饿的时候,吃就因为尴尬,感觉恶心,抑郁,或内疚暴饮暴食<一个href="#B1">1</一个>]。</p>
<p>尽管肥胖不是床上的诊断要求,研究表明,大约有70%的那些会议标准床是肥胖<一个href="#B2">2</一个>]。床上的患病率在社区样本范围从2 - 5%,约有30%的肥胖个体寻求控制体重治疗床上满足标准(<一个href="#B3">3</一个>,<一个href="#B4">4</一个>]。床所独有的复发暴饮暴食,以及缺乏补偿的淘气鬼们的“招牌行为与暴食症(BN),最有可能负责高频的肥胖组。实验室研究表明肥胖床个人消费更多千卡(千卡)在一个暴饮暴食一集比肥胖个体没有床诊断(<一个href="#B5">5</一个>- - - - - -<一个href="#B13">13</一个>]。</p>
<p>精神疾病,包括抑郁和焦虑,都与肥胖和床上。重度抑郁症的终生患病率(MDD)和焦虑症在美国估计为17%和29%,分别为(<一个href="#B14">14</一个>]。然而,在肥胖人群中,报道终生患病率增加了抑郁和焦虑(30.5%至32.8%<一个href="#B15">15</一个>]。此外,老澳等人发现成年人电流或终生抑郁或焦虑的诊断更有可能从事不健康的行为,如缺乏身体活动和肥胖<一个href="#B15">15</一个>]。此外,研究表明,肥胖患者抑郁和焦虑共病床上有更大的利率比肥胖个体没有床(<一个href="#B2">2</一个>,<一个href="#B16">16</一个>- - - - - -<一个href="#B19">19</一个>]。例如,Grilo等人的报告,在404年的一项研究床病人,一生的历史估计被提升到52%,心情为37.1%,焦虑障碍(<一个href="#B17">17</一个>]。</p>
<p>尽管一般认为体重之间的关系,床上,这些关系和伴发精神障碍、机制在很大程度上仍未知。以前,我们报道,超重/肥胖女性的床上消耗显著千卡摄入量在实验室吃集大于weight-matched没有床上的女人(2305和1462千卡)<一个href="#B13">13</一个>]。延长这项工作,我们评估抑郁和焦虑的症状在这个示例并试图审视内在行为和床上可能与在实验室吃一千卡的摄入量。根据文献,我们假设参与者会议床标准认可的抑郁和焦虑症状明显多于weight-matched non-BED控制。然而,床上的影响诊断和症状的抑郁和焦虑千卡摄入量是不太清楚有几个潜在的机制负责协会。有可能增加千卡摄入量是床症状的结果。例如,那些床可能用暴饮暴食来缓解或摆脱抑郁和焦虑的症状。此外,在交谈,可能床症状如痛苦有关专门提升内在症状缺乏控制暴饮暴食。例如,抑郁症可能会增加食物摄入量通过增加食欲,非典型抑郁亚型的临床特征。此外,它是可能的,床上的诊断和高架的抑郁和焦虑的症状表现为协同作用影响非相加的方式进食。</p>
<p>常见的统计方法来研究变量之间的关系是路径分析,在选择模型可以应用于评估理论的关系,确定方向的影响。我们评估了三种替代模型,图中所示<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1</一个>确定协会的机制,最适合我们的数据。路径分析来评估三个潜在的模型:抑郁和焦虑的症状(1)易感性增加到床上,进而影响卡路里的摄入量(图<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1(一)</一个>),(2)床上诊断影响抑郁和焦虑的症状,后来影响热量摄入(图<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1 (b)</一个>)和(3)床诊断和抑郁和焦虑症状的功能相互依存地与能量摄入(图<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1 (c)</一个>)。</p>
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<td>理论模型研究:(一)暴食症调和内在症状之间的关联和千卡摄入量,(b)内在症状调解暴食症和千卡摄入量之间的关系,和(c)暴食症与内在症状的预测千卡的摄入量。注意:内化:抑郁和焦虑的症状。</td>
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<h4 id="methods">2。方法</h4>
<h5 id="sec2.1">2.1。参与者</h5>
<p>参与者被报纸和在线广告邀请女性至少50磅体重过重和18 - 45岁之间的参与研究。32岁女性,包括15会议dsm - iv标准的床和17超重/肥胖控制没有任何暴饮暴食或进食障碍的历史行为,参与了这项研究。这些女性被招募为研究的一部分食物摄入和能量消耗测量通过双标记水方法(<一个href="#B13">13</一个>,<一个href="#B20">20.</一个>]。</p>
<h5 id="sec2.2">2.2。小组作业</h5>
<p>潜在参与者采访了dsm - iv轴结构化临床采访障碍,患者版(SCID-I / P) [<一个href="#B21">21</一个>),和进食障碍检查(爱德),版本12.0 d [<一个href="#B22">22</一个>)确定研究的可行性和组分配。此外,病史、体检和实验室测试的电池完成检测不稳定的医疗条件,如糖尿病和甲状腺功能受损,从而影响资格。参与者被排除在研究如果他们有任何医学或精神状况不稳定,符合dsm - iv标准物质滥用或依赖在6个月的时间参与,目前节食或参加减肥计划。那些任何历史的BN或补偿行为也被排除在外。Non-BED控制没有任何现在或过去的饮食失调的症状。协议是审查和批准的机构审查委员会明尼苏达大学,和所有参与者参加了知情同意过程和签署了同意书。参与者被支付了300美元在完成整个研究方案。</p>
<h5 id="sec2.3">2.3。实验室暴食一集</h5>
<p>本研究利用一个协议我们组曾报道(<一个href="#B12">12</一个>,<一个href="#B13">13</一个>,<一个href="#B23">23</一个>]。总之,研究营养师采访的参与者关于他们的饮食习惯和食物,他们通常吃零食或吃过量。他们表示哪些项目的标准化列表中零食吸引他们,可能意味着额外的食物和食谱。根据收集的信息在面试的时候,一盘暴食物是为每个参与者将他们个性化的零食的偏好。每个参与者收到6到10的点心盘不同种类的食物。食品提出了数量过多(他们赞同吃两到三次在狂欢)以确保暴的大小不是由数量有限的食物。</p>
<p>参与者被承认的一般临床研究中心(GCRC)过夜参与一些研究活动。他们被指示不要吃任何食物或热量饮料12和5点之间。大约在下午5:30,他们提出了一系列多元素的食物,包括个性化的狂欢托盘和一个标准的医院晚餐,被要求“让自己去吃你喜欢的。“他们独自留在一个私人房间,只要他们喜欢吃,标志着护理人员时完成。GCRC代谢厨房工作人员测量和餐后大量的食物。热量和大量营养素摄入量的实验室吃第四集计算使用营养学家(<一个href="#B24">24</一个>]。</p>
<h5 id="sec2.4">2.4。自我评定抑郁和焦虑的措施</h5>
<p>初步评估期间,参与者完成了贝克抑郁量表(BDI)和贝克焦虑量表(BAI)组成的广泛应用自我报告问卷项目解决人在上周和感觉如何测量抑郁和焦虑症状的严重程度(<一个href="#B25">25</一个>,<一个href="#B26">26</一个>]。天平具有较高的内部一致性系数(即。,BDI upwards of 0.80), and validity with other clinical assessments [<一个href="#B27">27</一个>,<一个href="#B28">28</一个>]。这些指数得分范围从0到63,对应于正常(0 - 9 BDI、鹿呗),轻度(10 - 18 BDI、白8 - 15日),中等(第16 - 25 19-29 BDI、白)和严重(30 - 63 BDI, 26 - 63白)抑郁和焦虑。</p>
<h5 id="sec2.5">2.5。分析策略和模型验证</h5>
<p>一组三个,理论上驱动路径模型(见图<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1</一个>)测试使用Mplus version 5.0 [<一个href="#B29">29日</一个>]。麦克金南博士和他的同事们(<一个href="#B30">30.</一个>)表明,传统的<我>因果的步骤方法</我>(<一个href="#B31">31日</一个>,<一个href="#B32">32</一个>]可能缺乏统计发现一些有意义的间接影响。中介介绍的分析利用<我>系数的乘积</我>策略<一个href="#B30">30.</一个>,<一个href="#B33">33</一个>)来评估预测的程度影响的结果通过一些中介变量(数字<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1(一)</一个>和<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1 (b)</一个>)。在这一过程中,<我>间接影响</我>派生通过路径系数的乘积的比率(1)自变量中介和(2)中介的因变量normal-theory标准错误的产品(例如,<年代vg height="13.55" id="M4" style="vertical-align:-2.29482pt;width:58.724998px;" version="1.1" viewbox="0 0 58.724998 13.55" width="58.724998" xmlns="http://www.w3.org/2000/svg">
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</svg>),对结果的评估<我>Z</我>分布。适量(图<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1 (c)</一个>通过部分路径系数)是评估产品术语(例如,<年代vg height="16.6" id="M6" style="vertical-align:-4.74141pt;width:38.162498px;" version="1.1" viewbox="0 0 38.162498 16.6" width="38.162498" xmlns="http://www.w3.org/2000/svg">
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</svg>)的存在对其单个组件和评估<我>t</我>分布。</p>
<p>防止潜在的偏见提出的小样本的大小,证据的意义是通过置换评估测试(<一个href="#B34">34</一个>]。从最初的观测数据,一万年的小说《数据集通过随机生成个人价值观的重新排序在床和千卡的摄入量。这个过程是在R 2.9.1版本执行<一个href="#B35">35</一个>]。每个交换数据集可以被重新分析在Mplus 5.0版(<一个href="#B29">29日</一个>),对三种替代模型描绘在图<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1</一个>,每个迭代和测试统计数据可以用于生成零分布的影响被审查。(即标准意义。,经验<我>P</我>可以使用公式计算值)(<年代vg height="13.55" id="M7" style="vertical-align:-2.29482pt;width:33.237499px;" version="1.1" viewbox="0 0 33.237499 13.55" width="33.237499" xmlns="http://www.w3.org/2000/svg">
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</svg>是零的数量比测试进行测试,更重要的原始数据和n的总数排列(即。重新运行,10000年)的分析。因此,我们可以评估每个假设模型是否会在一个更大的样本(即实现意义。,320000),我们观察到的样本的特性。</p>
<h4 id="results">3所示。结果</h4>
<h5 id="sec3.1">3.1。描述性统计</h5>
<p>32的女性参与者,27日欧美,3是非洲裔美国人(9.4%),和2是亚裔美国人(6.3%)。均值和标准差的总能量摄入量,抑郁和焦虑分数,协变量和潜在(即。、年龄、BMI)是诊断表中对角线上了床<一个href="//www.newsama.com/journals/jobe/2012/407103/tab1/" target="_blank">1</一个>。方差分析表明,有显著的组抑郁得分(10.1和4.8,差异<年代vg height="13.45" id="M10" style="vertical-align:-2.21957pt;width:104.7px;" version="1.1" viewbox="0 0 104.7 13.45" width="104.7" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,13.45)">
<g transform="translate(72,-61.24)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="7.7268538" y="0">
(</t年代p一个n>
<tspan style="font-size: 12.50px; " x="11.890353" y="0">
1</t年代p一个n>
<tspan style="font-size: 12.50px; " x="18.141853" y="0">
,</t年代p一个n>
<tspan style="font-size: 12.50px; " x="23.343102" y="0">
3</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.594601" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="35.8461" y="0">
)</t年代p一个n>
<tspan style="font-size: 12.50px; " x="43.485435" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="55.525822" y="0">
9</t年代p一个n>
<tspan style="font-size: 12.50px; " x="61.777325" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="64.903076" y="0">
3</t年代p一个n>
<tspan style="font-size: 12.50px; " x="71.154572" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="77.406075" y="0">
8</t年代p一个n>
</text>
</g>
</g>
</svg>,<年代vg height="11.1" id="M11" style="vertical-align:-0.17555pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 11.1" width="63.962502" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.1)">
<g transform="translate(72,-63.12)">
<text transform="matrix(1,0,0,-1,-71.95,63.35)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="44.810753" y="0">
5</t年代p一个n>
</text>
</g>
</g>
</svg>)和焦虑得分(8.5和2.7,<年代vg height="13.45" id="M12" style="vertical-align:-2.21957pt;width:112.5125px;" version="1.1" viewbox="0 0 112.5125 13.45" width="112.5125" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,13.45)">
<g transform="translate(72,-61.24)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="7.7268538" y="0">
(</t年代p一个n>
<tspan style="font-size: 12.50px; " x="11.890353" y="0">
1</t年代p一个n>
<tspan style="font-size: 12.50px; " x="18.141853" y="0">
,</t年代p一个n>
<tspan style="font-size: 12.50px; " x="23.343102" y="0">
3</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.594601" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="35.8461" y="0">
)</t年代p一个n>
<tspan style="font-size: 12.50px; " x="43.485435" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="55.525822" y="0">
1</t年代p一个n>
<tspan style="font-size: 12.50px; " x="61.777325" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="68.028824" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="71.154572" y="0">
8</t年代p一个n>
<tspan style="font-size: 12.50px; " x="77.406075" y="0">
3</t年代p一个n>
<tspan style="font-size: 12.50px; " x="83.65757" y="0">
0</t年代p一个n>
</text>
</g>
</g>
</svg>,<年代vg height="10.9125" id="M13" style="vertical-align:-0.17555pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 10.9125" width="63.962502" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
<g transform="translate(72,-63.27)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="44.810753" y="0">
3</t年代p一个n>
</text>
</g>
</g>
</svg>)与床参与者平均得分显著高于控制在这些指标。没有发现关于BMI(组间差异<年代vg height="13.45" id="M14" style="vertical-align:-2.21957pt;width:104.7px;" version="1.1" viewbox="0 0 104.7 13.45" width="104.7" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,13.45)">
<g transform="translate(72,-61.24)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="7.7268538" y="0">
(</t年代p一个n>
<tspan style="font-size: 12.50px; " x="11.890353" y="0">
1</t年代p一个n>
<tspan style="font-size: 12.50px; " x="18.141853" y="0">
,</t年代p一个n>
<tspan style="font-size: 12.50px; " x="23.343102" y="0">
3</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.594601" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="35.8461" y="0">
)</t年代p一个n>
<tspan style="font-size: 12.50px; " x="43.485435" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="55.525822" y="0">
3</t年代p一个n>
<tspan style="font-size: 12.50px; " x="61.777325" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="64.903076" y="0">
2</t年代p一个n>
<tspan style="font-size: 12.50px; " x="71.154572" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="77.406075" y="0">
3</t年代p一个n>
</text>
</g>
</g>
</svg>,<年代vg height="10.9125" id="M15" style="vertical-align:-0.17555pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 10.9125" width="63.962502" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
<g transform="translate(72,-63.27)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
7</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
8</t年代p一个n>
<tspan style="font-size: 12.50px; " x="44.810753" y="0">
4</t年代p一个n>
</text>
</g>
</g>
</svg>),或年龄(<年代vg height="13.45" id="M16" style="vertical-align:-2.21957pt;width:112.5125px;" version="1.1" viewbox="0 0 112.5125 13.45" width="112.5125" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,13.45)">
<g transform="translate(72,-61.24)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="7.7268538" y="0">
(</t年代p一个n>
<tspan style="font-size: 12.50px; " x="11.890353" y="0">
1</t年代p一个n>
<tspan style="font-size: 12.50px; " x="18.141853" y="0">
,</t年代p一个n>
<tspan style="font-size: 12.50px; " x="23.343102" y="0">
3</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.594601" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="35.8461" y="0">
)</t年代p一个n>
<tspan style="font-size: 12.50px; " x="43.485435" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="55.525822" y="0">
1</t年代p一个n>
<tspan style="font-size: 12.50px; " x="61.777325" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="68.028824" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="71.154572" y="0">
7</t年代p一个n>
<tspan style="font-size: 12.50px; " x="77.406075" y="0">
3</t年代p一个n>
<tspan style="font-size: 12.50px; " x="83.65757" y="0">
7</t年代p一个n>
</text>
</g>
</g>
</svg>,<年代vg height="11.0375" id="M17" style="vertical-align:-0.17555pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 11.0375" width="63.962502" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,11.0375)">
<g transform="translate(72,-63.17)">
<text transform="matrix(1,0,0,-1,-71.95,63.4)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
6</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
7</t年代p一个n>
<tspan style="font-size: 12.50px; " x="44.810753" y="0">
4</t年代p一个n>
</text>
</g>
</g>
</svg>)。表<一个href="//www.newsama.com/journals/jobe/2012/407103/tab2/" target="_blank">2</一个>报告的患病率一生临床抑郁和焦虑诊断组。床组轻度抑郁的患病率大大提高(60 17.6%,<年代vg height="16.924999" id="M18" style="vertical-align:-2.53308pt;width:63.662498px;" version="1.1" viewbox="0 0 63.662498 16.924999" width="63.662498" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,16.925)">
<g transform="translate(72,-58.46)">
<text transform="matrix(1,0,0,-1,-71.95,61.03)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
</text>
<text transform="matrix(1,0,0,-1,-63.39,66.03)">
<tspan style="font-size: 8.75px; " x="0" y="0">
2</t年代p一个n>
</text>
<text transform="matrix(1,0,0,-1,-55.04,61.03)">
<tspan style="font-size: 12.50px; " x="0" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="12.027886" y="0">
6</t年代p一个n>
<tspan style="font-size: 12.50px; " x="18.279387" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="21.405136" y="0">
1</t年代p一个n>
<tspan style="font-size: 12.50px; " x="27.656635" y="0">
0</t年代p一个n>
</text>
</g>
</g>
</svg>,<年代vg height="10.9125" id="M19" style="vertical-align:-0.17555pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 10.9125" width="63.962502" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
<g transform="translate(72,-63.27)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
1</t年代p一个n>
<tspan style="font-size: 12.50px; " x="44.810753" y="0">
4</t年代p一个n>
</text>
</g>
</g>
</svg>),轻/中度焦虑(33.3和5.9%,<年代vg height="16.924999" id="M20" style="vertical-align:-2.53308pt;width:63.662498px;" version="1.1" viewbox="0 0 63.662498 16.924999" width="63.662498" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,16.925)">
<g transform="translate(72,-58.46)">
<text transform="matrix(1,0,0,-1,-71.95,61.03)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
</text>
<text transform="matrix(1,0,0,-1,-63.39,66.03)">
<tspan style="font-size: 8.75px; " x="0" y="0">
2</t年代p一个n>
</text>
<text transform="matrix(1,0,0,-1,-55.04,61.03)">
<tspan style="font-size: 12.50px; " x="0" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="12.027886" y="0">
3</t年代p一个n>
<tspan style="font-size: 12.50px; " x="18.279387" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="21.405136" y="0">
9</t年代p一个n>
<tspan style="font-size: 12.50px; " x="27.656635" y="0">
4</t年代p一个n>
</text>
</g>
</g>
</svg>,<年代vg height="10.9125" id="M21" style="vertical-align:-0.17555pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 10.9125" width="63.962502" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
<g transform="translate(72,-63.27)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
4</t年代p一个n>
<tspan style="font-size: 12.50px; " x="44.810753" y="0">
7</t年代p一个n>
</text>
</g>
</g>
</svg>),焦虑症(46.7和11.8%,<年代vg height="16.924999" id="M22" style="vertical-align:-2.53308pt;width:63.662498px;" version="1.1" viewbox="0 0 63.662498 16.924999" width="63.662498" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,16.925)">
<g transform="translate(72,-58.46)">
<text transform="matrix(1,0,0,-1,-71.95,61.03)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
</text>
<text transform="matrix(1,0,0,-1,-63.39,66.03)">
<tspan style="font-size: 8.75px; " x="0" y="0">
2</t年代p一个n>
</text>
<text transform="matrix(1,0,0,-1,-55.04,61.03)">
<tspan style="font-size: 12.50px; " x="0" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="12.027886" y="0">
4</t年代p一个n>
<tspan style="font-size: 12.50px; " x="18.279387" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="21.405136" y="0">
8</t年代p一个n>
<tspan style="font-size: 12.50px; " x="27.656635" y="0">
0</t年代p一个n>
</text>
</g>
</g>
</svg>,<年代vg height="10.9125" id="M23" style="vertical-align:-0.17555pt;width:63.962502px;" version="1.1" viewbox="0 0 63.962502 10.9125" width="63.962502" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
<g transform="translate(72,-63.27)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
2</t年代p一个n>
<tspan style="font-size: 12.50px; " x="44.810753" y="0">
8</t年代p一个n>
</text>
</g>
</g>
</svg>)。详细检查食物摄入和能量消耗在这些参与者报告从我们组额外的手稿<一个href="#B13">13</一个>,<一个href="#B20">20.</一个>]。</p>
<div class="floats-partial-section partial-other-wrapper" data-section="tab1">
<div class="floats-partial-footer">
<div class="floats-partial-caption">
<span class="caption-text">表1</年代p一个n>
<a aria-label="View full page" class="caption-partial-url" href="//www.newsama.com/journals/jobe/2012/407103/tab1/" title="" target="_blank"></a>
</div>
<div class="floats-partial-caption-text">
集团为研究手段和组间关联变量。</d我v>
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</div>
</div>
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<div class="floats-partial-footer">
<div class="floats-partial-caption">
<span class="caption-text">表2</年代p一个n>
<a aria-label="View full page" class="caption-partial-url" href="//www.newsama.com/journals/jobe/2012/407103/tab2/" title="" target="_blank"></a>
</div>
<div class="floats-partial-caption-text">
一生临床抑郁和焦虑诊断组。</d我v>
<a class="table-thumb-overlay" href="//www.newsama.com/journals/jobe/2012/407103/tab2" target="_blank" aria-label="View full page"></a>
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<p>皮尔逊相关系数的二元关系中提出了研究变量非对角的细胞在表<一个href="//www.newsama.com/journals/jobe/2012/407103/tab1/" target="_blank">1</一个>。在每一个细胞,联想分别提出了对参与者被诊断为床(上),weight-matched控制(中),在整个样本(底部)。千卡摄入量与抑郁症之间存在显著正相关性被发现,千卡摄入量和焦虑,抑郁和焦虑在完整的样品。当评估群体内部,没有明显的抑郁和焦虑量表之间的相关性被发现除了对照组。因为无论是床上还是内在症状是与年龄和体重指数有关,这些后者变量并不包括在下面描述的路径模型。</p>
<h5 id="sec3.2">3.2。模型拟合</h5>
<p>独立路径模型运行测试(a)床的中介作用在抑郁和焦虑症状之间的联系和热量摄取,(b)抑郁和焦虑症状的中介作用在床和卡路里的摄入量之间的联系,和(c)的互动影响床,抑郁和焦虑症状的卡路里摄入量。在每种情况下,理论模型占大量的方差(~ 30%)能量摄入。然而,考试三个可供选择的理论模型显示重要机械床之间的关系的差异和抑郁和焦虑的症状,他们共同影响能量摄入。模型(表的结果<一个href="//www.newsama.com/journals/jobe/2012/407103/tab3/" target="_blank">3</一个>)中描述的数据<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1(一)</一个>和<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1 (b)</一个>表明,千卡摄入量显著影响抑郁和焦虑症状(<年代vg height="16.975" id="M40" style="vertical-align:-5.03984pt;width:134.7px;" version="1.1" viewbox="0 0 134.7 16.975" width="134.7" xmlns="http://www.w3.org/2000/svg">
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</svg>)。模型中描述图的结果<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1 (c)</一个>表明,床和抑郁和焦虑的症状不相互依存地影响热量摄取,也就是说,模型包括抑郁和模型包括焦虑产生重要的部分路径系数床之间的交互和相应的抑郁或焦虑症状(<年代vg height="16.975" id="M58" style="vertical-align:-5.03984pt;width:149.3625px;" version="1.1" viewbox="0 0 149.3625 16.975" width="149.3625" xmlns="http://www.w3.org/2000/svg">
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n</t年代p一个n>
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x</t年代p一个n>
<tspan style="font-size: 8.75px; " x="12.637888" y="0">
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<tspan style="font-size: 8.75px; " x="15.070944" y="0">
e</t年代p一个n>
<tspan style="font-size: 8.75px; " x="18.878063" y="0">
t</t年代p一个n>
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=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
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<tspan style="font-size: 12.50px; " x="32.307751" y="0">
6</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
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</text>
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</svg>)在考虑主要影响相结合,在每种情况下占总方差的比例不到1%。</p>
<div class="floats-partial-section partial-other-wrapper" data-section="tab3">
<div class="floats-partial-footer">
<div class="floats-partial-caption">
<span class="caption-text">表3</年代p一个n>
<a aria-label="View full page" class="caption-partial-url" href="//www.newsama.com/journals/jobe/2012/407103/tab3/" title="" target="_blank"></a>
</div>
<div class="floats-partial-caption-text">
标准化的影响系数,标准错误,和相应的<年代vg height="10.325" id="M62" style="vertical-align:-0.0pt;width:11.75px;" version="1.1" viewbox="0 0 11.75 10.325" width="11.75" xmlns="http://www.w3.org/2000/svg">
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</t年代p一个n>
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</g>
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</svg>中介模型值。</d我v>
<a class="table-thumb-overlay" href="//www.newsama.com/journals/jobe/2012/407103/tab3" target="_blank" aria-label="View full page"></a>
</div>
</div>
<p>如上所述,事后分析与10000年进行交换的数据集来确定结果观察到的第一个理论模型(即。,BEDmediating the association between symptoms of depression and anxiety and caloric intake) were simply due to chance and/or an artifact of the modest size of the present sample. The null distributions generated from these analyses suggested that the indirect effects of both depression and anxiety through BED were highly significant; as far fewer than 5% of the tests exceeded the<我>P</我>在原始数据值。事实上,10000年的随机生成的数据集,只有7个产生间接影响抑郁通过床比效果观察到更重要的原始数据(<年代vg height="10.9125" id="M70" style="vertical-align:-0.17555pt;width:71.775002px;" version="1.1" viewbox="0 0 71.775002 10.9125" width="71.775002" xmlns="http://www.w3.org/2000/svg">
<g transform="matrix(1.25,0,0,-1.25,0,10.9125)">
<g transform="translate(72,-63.27)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="44.810753" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="51.062252" y="0">
8</t年代p一个n>
</text>
</g>
</g>
</svg>),只有38个间接影响的焦虑在床上超过了观察的重要性水平(<年代vg height="11.0375" id="M71" style="vertical-align:-0.27588pt;width:71.775002px;" version="1.1" viewbox="0 0 71.775002 11.0375" width="71.775002" xmlns="http://www.w3.org/2000/svg">
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<g transform="translate(72,-63.17)">
<text transform="matrix(1,0,0,-1,-71.95,63.5)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
<tspan style="font-size: 12.50px; " x="10.890113" y="0">
=</t年代p一个n>
<tspan style="font-size: 12.50px; " x="22.930502" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="29.182001" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="32.307751" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="38.559254" y="0">
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<tspan style="font-size: 12.50px; " x="44.810753" y="0">
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<tspan style="font-size: 12.50px; " x="51.062252" y="0">
9</t年代p一个n>
</text>
</g>
</g>
</svg>)。</p>
<h4 id="discussion">4所示。讨论</h4>
<p>本研究的目的是检验模型的内在的抑郁和焦虑的症状影响超重/肥胖妇女的食物摄入量。我们的研究结果表明,床上的女人支持更多的抑郁和焦虑的症状。此外,线性回归表明,床上诊断和内在症状占30%的方差千卡的摄入量。此外,路径分析结果表明床介导对总kcal-intake内在症状的影响,这表明内在症状之间的关联和食物摄入量最好被描述为操作间接通过诊断床上。</p>
<p>目前的研究发现,超重/肥胖女性和床上支持抑郁和焦虑的症状比non-BED weight-matched控制。平均分数BDI和白表示轻度抑郁和焦虑在床上但正常水平在对照组。其他的研究也发现抑郁和焦虑分数升高在床上个人(<一个href="#B5">5</一个>,<一个href="#B9">9</一个>,<一个href="#B18">18</一个>,<一个href="#B19">19</一个>,<一个href="#B36">36</一个>,<一个href="#B37">37</一个>]。例如,在一项由Fandino et al .,抑郁和焦虑分数显著更大的床组比肥胖对照组症状的评估检查表90年BDI [<一个href="#B37">37</一个>]。MDD的终生患病率在床上,对照组是46.7%和29.4%,分别。这些利率在床上类似于先前的报道<一个href="#B2">2</一个>,<一个href="#B16">16</一个>- - - - - -<一个href="#B19">19</一个>)和non-BED肥胖组(<一个href="#B15">15</一个>]。一生抑郁焦虑障碍患病率相似率在床上组(46.7%),但在对照组(11.8%)要低得多。焦虑症的低利率可能在对照组是由于超重女性的包容或工件的样本容量有限。</p>
<p>实验室研究已经证明,那些床上有更大的食物总摄入量比肥胖控制要求吃得过饱时(<一个href="#B5">5</一个>- - - - - -<一个href="#B13">13</一个>]。两个这样的研究已经报道了食物摄取和抑郁症状(<一个href="#B5">5</一个>,<一个href="#B9">9</一个>]。样本10肥胖床上女人和9肥胖控制,Yanovski et al<我>。</我>发现床组消耗更多千卡(2962和2017)和有更高的抑郁分数的BDI比控制(18.9和5.4)。此外,他们之间观察到显著正相关性千卡摄入和BDI评分(<年代vg height="13.9875" id="M72" style="vertical-align:-0.17555pt;width:59.337502px;" version="1.1" viewbox="0 0 59.337502 13.9875" width="59.337502" xmlns="http://www.w3.org/2000/svg">
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</t年代p一个n>
</text>
<text transform="matrix(1,0,0,-1,-66.85,66.03)">
<tspan style="font-size: 8.75px; " x="0" y="0">
2</t年代p一个n>
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<tspan style="font-size: 12.50px; " x="21.405136" y="0">
4</t年代p一个n>
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1</t年代p一个n>
</text>
</g>
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</svg>暴饭之间)和能量摄入和BDI (<年代vg height="13.9875" id="M73" style="vertical-align:-0.17555pt;width:59.337502px;" version="1.1" viewbox="0 0 59.337502 13.9875" width="59.337502" xmlns="http://www.w3.org/2000/svg">
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<text transform="matrix(1,0,0,-1,-71.95,61.03)">
<tspan style="font-size: 12.50px; " x="0" y="0">
</t年代p一个n>
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<text transform="matrix(1,0,0,-1,-66.85,66.03)">
<tspan style="font-size: 8.75px; " x="0" y="0">
2</t年代p一个n>
</text>
<text transform="matrix(1,0,0,-1,-58.5,61.03)">
<tspan style="font-size: 12.50px; " x="0" y="0">
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<tspan style="font-size: 12.50px; " x="12.027886" y="0">
0</t年代p一个n>
<tspan style="font-size: 12.50px; " x="18.279387" y="0">
。</t年代p一个n>
<tspan style="font-size: 12.50px; " x="21.405136" y="0">
2</t年代p一个n>
<tspan style="font-size: 12.50px; " x="27.656635" y="0">
8</t年代p一个n>
</text>
</g>
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</svg>)。Geliebter和他的同事相比,消耗的液体试验餐30肥胖床个人55肥胖女性(18)和控制(43个女性)。床组消耗更多克(1032和737)的液体测试餐和支持显著高于抑郁得分由郑氏忧郁量表评估。然而,一个重要的相关性测试膳食摄入量和抑郁得分不存在。这种差异可能是由于几个研究设计差异,包括床,比例控制参与者,包容的男人,和类型的食物摄入量(固体和液体餐)。</p>
<p>此外,线性回归的结果表明床诊断和症状的抑郁和焦虑占大量的方差(~ 30%)的卡路里摄入量。然而,考试三个替代模型显示重要的机械床之间的关系的差异,抑郁症的症状,焦虑和随后的能量摄入。模型最适合我们的数据表明,床上介导抑郁和焦虑症状的影响千卡摄入总量(图<一个href="//www.newsama.com/journals/jobe/2012/407103/fig1/" target="_blank">1(一)</一个>)。具体地说,我们的研究结果表明,抑郁和焦虑的症状之间的关联发现和食物摄入量最好被描述为操作间接通过床上诊断,也就是说,抑郁和焦虑症状的影响是否从事病理暴食,这反过来,影响热量摄取。我们的研究结果并不支持模型b(床预测抑郁和焦虑的症状,进而影响千卡摄入),或模型c(明显的抑郁和焦虑症状之间的交互和床是千卡摄入的预测)。</p>
<p>这些结果强调情绪的重要性与床诊断和随后的卡路里摄入量。其他研究也涉及情绪在床上。Telch等人采访了60肥胖女性和床就暴食的定义,和33%的人表示这是饮食调节消极的影响(<一个href="#B38">38</一个>]。随着生态的评估程序(EMA),未来的前兆数据暴食的自然环境已经收集了(<一个href="#B39">39</一个>- - - - - -<一个href="#B43">43</一个>]。斯坦等人的研究发现33肥胖女性在床上,负面情绪prebinge倍大于nonbinge时候,参与者认为暴饮暴食情绪比饥饿更频繁或违反了极端的饮食限制(禁欲违反)[<一个href="#B41">41</一个>]。此外,通过希尔伯特和Tuschen-Caffier一项研究发现,情绪前暴食一集比心情更消极的常规饮食或随机评估之前与床(20肥胖妇女的样本<一个href="#B42">42</一个>]。此外,36 EMA的荟萃分析研究床和BN,负面影响也显著大于前暴食相对于平均影响和影响以前经常吃<一个href="#B43">43</一个>]。越来越多的文献其中牵扯到的负面影响,在床上暴食的前兆。</p>
<p>本研究的影响是潜在的相关临床治疗床和肥胖。研究表明,情绪和进食障碍诊断影响减肥,和其他治疗工作。例如,Pagoto等人报道,床和抑郁症有关减肥和抑郁相关的研究较少磨损(<一个href="#B44">44</一个>]。此外,在床上治疗,抑郁症状与磨损相关认知行为疗法和饮食失调的严重程度精神病理学(<一个href="#B45">45</一个>]。目前的结果表明,针对情绪可能是有用的治疗床上,突出的重要性,考虑在体重管理情绪和床上的地位。</p>
<p>这项研究的主要优点是利用路径分析测试床之间的关系,抑郁和焦虑的症状,千卡摄入量以及使用置换过程模型验证和统计的支持。EMA研究一贯表明消极的影响作为前体暴食(<一个href="#B43">43</一个>在床上)。然而,这些研究都依赖自我报告的食物摄入量。研究表明,肥胖和床上的人群倾向于低估他们的食物摄入量(<一个href="#B13">13</一个>,<一个href="#B20">20.</一个>,<一个href="#B46">46</一个>- - - - - -<一个href="#B51">51</一个>]。因此,进一步的工作强度是包含laboratory-measured进食以避免错误常与膳食摄入量的自我报告。潜在的局限性包括有限的样本大小和年龄,男性参与者的排斥,使用自我报告问卷测量抑郁和焦虑的症状。未来的研究需要确认我们的发现,应该寻求比较能量摄入,在男性和女性抑郁和焦虑。更大的理解机制的关联的抑郁和焦虑症状,暴食,热量摄入会促进更有效的预防和治疗策略的发展对床和肥胖。</p>
<h4 id="conflict-of-interests">利益冲突</h4>
<p>作者宣称没有利益冲突。</p>
<h4 id="acknowledgments">确认</h4>
<p>这项研究是由美国国立卫生研究院拨款(060199年R01 MH, MO1-RR00400),支持部分由明尼苏达州肥胖中心格兰特(e DK 60456)和国家药物滥用研究所(da - 26119)。特别感谢奥比美国马赫博士对置换过程和统计咨询Jennifer Hommerding心理学。安德里亚无爱,心理学。,for assistance with data collection.</p>
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<p class="referenceText">a . e .黑色,a·m·普伦蒂斯·g·r·戈德堡et al .,“总能量消耗的测量提供了洞察膳食能量摄入的测量结果的有效性,“<我>美国饮食协会杂志》上</我>,卷93,不。5,572 - 579年,1993页。</p>视图:<!-- -->
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<p class="referenceText">美国z Yanovski和n . g .车型”,记录食物摄入量的肥胖女性减肥,之前和之后暴食症”<我>饮食失调的国际期刊</我>,15卷,不。2、135 - 150年,1994页。</p>视图:<!-- -->
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<p class="referenceText">k . Westerterp和a·h·c·戈里”的有效性的评估膳食摄入量:谎报的问题,“<我>当前的临床营养与代谢护理</我>,5卷,不。5,489 - 493年,2002页。</p>视图:<!-- -->
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<p class="referenceText">f·b·Scagliusi e . Ferriolli k Pfrimer et al .,”特征的女性经常在报告他们的能量摄入:双重标记水的一项研究中,“<我>欧洲临床营养学杂志》上</我>,卷63,不。10日,1192 - 1199年,2009页。</p>视图:<!-- -->
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<h4 class="copyright-title" id="copyright">版权</h4>
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版权©2012 Roseann e·彼得森et al。这是一个开放的分布式下文章<一个rel="license" href="http://creativecommons.org/licenses/by/3.0/">知识共享归属许可</一个>,它允许无限制的使用、分配和复制在任何媒介,提供最初的工作是正确引用。</d我v>
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7405年</d我v>
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2799年</d我v>
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引用</d我v>
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