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Kognitiv-affektive Neuropsychologie der Binge-Eating-Störung

Cognitive-affective neuropsychology of binge eating disorder

  • Schwerpunkt: Psychotherapie bei Essstörungen: Neue Forschungsergebnisse - Übersichten
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Zusammenfassung

Hintergrund

Eine erhöhte Belohnungssensitivität, kognitive Verzerrungen („cognitive bias“) bei der Verarbeitung von Essensreizen und damit verbundene psychophysiologische Aktiviertheit (Arousal) sowie ein verstärktes Verlangen nach Essen (Craving) werden gemeinsam mit reduzierter kognitiver und behavioraler Kontrolle als aufrechterhaltende Faktoren für die Binge-Eating-Störung (BES) diskutiert.

Ziel der Arbeit

Der vorliegende Beitrag gibt einen Überblick über Studien zu kognitiven und affektiven Mechanismen der Verarbeitung störungstypischer und -übergreifender Stimuli bei der BES und beschreibt Implikationen für die Praxis.

Material und Methode

Vor dem Hintergrund bestehender theoretischer Modelle zur Aufrechterhaltung der BES werden grundlagenorientierte Befunde zur Verarbeitung störungstypischer und -übergreifender Stimuli referiert und darauf aufbauend Implikationen für die therapeutische Praxis abgeleitet.

Ergebnisse

Im Einklang mit entsprechenden Modellvorstellungen weisen Personen mit BES im Vergleich zu gesunden Kontrollpersonen mit ähnlichem Körpergewicht eine erhöhte Belohnungssensitivität in Bezug auf Essensreize auf. Zudem zeigen sie in verschiedenen Phasen der Informationsverarbeitung (z. B. Aufmerksamkeitszuwendung bzw. -abwendung) Verzerrungen („bias“), die mit erhöhter psychophysiologischer Aktiviertheit (Arousal) und stärkerem Verlangen nach Nahrung (Craving) einhergehen. Des Weiteren ist die BES mit einer reduzierten kognitiven und behavioralen Kontrolle assoziiert.

Schlussfolgerung

Die meisten Studien sind korrelativer Natur, wenngleich erste Befunde auch Hinweise auf eine kausale Beteiligung einzelner Faktoren liefern. Dies wiederum bietet mittelfristig die Möglichkeit, psychotherapeutische Interventionen gezielt auf die aufrechterhaltenden Mechanismen der BES auszurichten.

Abstract

Background

Increased reward sensitivity, cognitive biases in response to food cues and associated psychophysiological arousal and craving as well as a reduced cognitive and behavioral control are assumed to be maintaining factors for binge eating disorder (BED).

Objective

The present article gives an overview of studies on cognitive and affective mechanisms regarding the processing of stimuli typical for the disorder and general stimuli in BED.

Material and methods

Against the background of theoretical maintenance models of BED, fundamental studies on the processing of stimuli typical for the disorder and general stimuli are presented and implications for interventions are discussed.

Results

In accordance with the corresponding model assumptions individuals with BED show an increased reward sensitivity in response to food cues compared to weight-matched controls. Furthermore, in various phases of information processing they display a range of cognitive biases associated with increased arousal and craving. Additionally, a reduced cognitive and behavioral control is typical for individuals with BED.

Conclusion

Most studies are of correlational nature, even though there is initial evidence of a causal influence for some factors. This, in turn, may lead to psychotherapeutic interventions that target the respective maintaining mechanisms.

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Abb. 1

Notes

  1. S = Merkmale vorausgehender interner und externer Bedingungen; O = situationsübergreifende Organismusvariablen; R = kognitive, emotionale, physiologische und verhaltensbezogene Reaktionen; K = Kontingenz; C = Konsequenz (engl.)

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Authors and Affiliations

  1. Fachbereich Psychologie, Klinische Psychologie und Psychotherapie, Eberhard Karls Universität Tübingen, Schleichstr. 4, 72076, Tübingen, Deutschland

    Jennifer Svaldi

  2. Institut für Psychologie und Pädagogik, Differentielle Psychologie und Psychologische Diagnostik, Universität Ulm, Ulm, Deutschland

    Florian Schmitz

  3. Institut für Psychologie, Klinische Psychologie und Psychotherapie, Albert-Ludwigs-Universität Freiburg, Freiburg i. Br., Deutschland

    Brunna Tuschen-Caffier

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  1. Jennifer Svaldi
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Correspondence to Jennifer Svaldi.

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J. Svaldi, F. Schmitz und B. Tuschen-Caffier geben an, dass kein Interessenkonflikt besteht.

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Svaldi, J., Schmitz, F. & Tuschen-Caffier, B. Kognitiv-affektive Neuropsychologie der Binge-Eating-Störung. Psychotherapeut 62, 194–203 (2017). https://doi.org/10.1007/s00278-017-0190-z

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