Emotional reactivity to binge food and erotic cues in women with bulimia nervosa symptoms

This work was supported by the MECD [grant numbers FPU16/01200], 'Doctoral College "Imaging the Mind" (FWF; W1233-B)', a grant from Junta de Andalucia, Spain [Grant Code P12.SEJ.391], and a grant from the Spanish Ministry of Economy and Competitiveness/MINECO (Grant Code: PSI2013-43777-P).Background: Studies on food cue reactivity have documented that altered responses to high-calorie food are associated with bulimic symptomatology, however, alterations in sexual motivations and behaviors are also associated clinical features in this population, which justify their inclusion as a research target. Here, we study responses to erotic cues—alongside food, neutral and aversive cues—to gain an understanding of specificity to food versus a generalized sensitivity to primary reinforcers. Methods: We recorded peripheral psychophysiological indices –the startle reflex, zygomaticus, and corrugator responses—and self-reported emotional responses (valence, arousal, and dominance) in 75 women completing the Bulimia Test-Revised (BULIT-R). Multiple regression analysis tested whether BULIT-R symptoms were predicted by selfreported and psychophysiological responses to food versus neutral and erotic versus neutral images. Results: The results showed that individuals with higher bulimic symptoms were characterized by potentiated eye blink startle response during binge food (vs. neutral images) and more positive valence ratings during erotic (vs. neutral) cues. Conclusions: The results highlight the negative emotional reactivity of individuals with elevated bulimic symptoms toward food cues, which could be related to the risk of progression to full bulimia nervosa and thereby addressed in prevention efforts. Results also point to the potential role of reactivity to erotic content, at least on a subjective level. Theoretical models of eating disorders should widen their conceptual scope to consider reactivity to a broader spectrum of primary reinforcers, which would have implications for cue exposure-based treatments. Plain English summary: We examined appetitive and aversive cue responses in college women to investigate how bulimic symptoms relate to primary reinforcers such as food and erotic images. We recorded peripheral psychophysiological indices (the startle reflex, zygomaticus, and corrugator responses) and self-reported emotional responses (valence, arousal, and dominance) in 75 college women that were presented with the Spanish version of the Bulimia Test-Revised. The results showed that bulimic symptoms increase both psychophysiological defensiveness toward food cues and subjective pleasure toward erotic cues. The findings suggest a generalized sensitivity to primary reinforcers in the presence of bulimic symptoms, and emphasize the relevance of adopting a wider framework in research and treatment on bulimia nervosa.MECD FPU16/01200Doctoral College "Imaging the Mind" (FWF) W1233-BJunta de Andalucia European Commission P12.SEJ.391Spanish Ministry of Economy and Competitiveness/MINECO PSI2013-43777-

Consumo de tabaco y alcohol en una muestra en proceso de desahucio

Introduction: In Spain, the current economic crisis has led to an unfortunate phenomenon little known until now: the eviction process. The aim was to eval­uate unhealthy habits such as consumption of tobacco and alcohol in a group of Granada as at risk of losing their residence. Methods: Participated 205 adult un­dergoing an eviction process from their homes (122 women and 83 men) who were given the items of health-related habits of the Andalusian Health Survey 2011. All participants were linked to the Platform Af­fected by Mortgage, Stop Desahucios of Granada. Results: Consumption of tobacco: observe higher percentage of daily smokers among men (54.22 %), people who live as a couple and workers. People who have entered the judicial process smoke more ciga­rettes per day (t = 1944, p = .055) and perceived an increase in the consumption of tobacco from the pro­cess of eviction. (c2 = 8.494, p = .037). Consumption of alcohol: find higher percentage in men (c2= 10.005, p = .019) and in people who do not live with a partner (c2= 8,553, p = .036); men perceive a greater increase in alcohol consumption due to the eviction process (c2 = 20,375, p = .000). Conclu­sions: The eviction process negatively affects health-related habits and should therefore be prioritized in Public Health policies as a population at riskResumenIntroducción: En España, la actual crisis económica nos ha llevado a un lamentable fenómeno poco conocido hasta ahora: el proceso del desahucio. Nuestro objetivo ha sido evaluar hábitos poco saludables como el consumo del tabaco y alcohol en un grupo de granadinos/as en riesgo de perder su vivienda habitual. Método: Han participado 205 personas adultas (122 mujeres y 83 hombres) a los que se les administró los ítems de hábitos relacionados con la salud de la Entrevista Andaluza de Salud 2011. Todos los participantes estaban vinculados a la Plataforma de Afectados por la Hipoteca Stop Desahucios de Granada. Resultados: Consumo de tabaco: observamos mayor porcentaje de fumadores a diario en hombres (54.22 %), personas que no viven en pareja y trabajadores. Las personas que han entrado en el proceso judicial fuman más cigarrillos al día (t = -1.944, p = .055) y perciben un aumento en el consumo de tabaco debido al proceso de desahucio (c2 = 8.494, p = .037). Consumo de alcohol: encontramos mayor porcentaje en hombres c2 = 10.005, p = .019) y en personas que no viven en pareja c2 = 8.553, p = .036); los hombres perciben un mayor aumento en el consumo de alcohol debido al proceso de desahucio (c2 = 20.375, p = .000). Conclusiones: El proceso de desahucio afecta negativamente a los hábitos relacionados con la salud por lo que debería priorizarse en las políticas de Salud Pública como una población de riesgo. AbstractIntroduction: In Spain, the current economic crisis has led to an unfortunate phenomenon little known until now: the eviction process. The aim was to eval­uate unhealthy habits such as consumption of tobacco and alcohol in a group of Granada as at risk of losing their residence. Methods: Participated 205 adult un­dergoing an eviction process from their homes (122 women and 83 men) who were given the items of health-related habits of the Andalusian Health Survey 2011. All participants were linked to the Platform Af­fected by Mortgage, Stop Desahucios of Granada. Results: Consumption of tobacco: observe higher percentage of daily smokers among men (54.22 %), people who live as a couple and workers. People who have entered the judicial process smoke more ciga­rettes per day (t = 1944, p = .055) and perceived an increase in the consumption of tobacco from the pro­cess of eviction. (c2 = 8.494, p = .037). Consumption of alcohol: find higher percentage in men (c2= 10.005, p = .019) and in people who do not live with a partner (c2= 8,553, p = .036); men perceive a greater increase in alcohol consumption due to the eviction process (c2 = 20,375, p = .000). Conclu­sions: The eviction process negatively affects health-related habits and should therefore be prioritized in Public Health policies as a population at ris

The Emotional and Attentional Impact of Exposure to One's Own Body in Bulimia Nervosa: A Physiological View

Background: Body dissatisfaction is the most relevant body image disturbance in bulimia nervosa (BN). Research has shown that viewing one's own body evokes negative thoughts and emotions in individuals with BN. However, the psychophysiological mechanisms involved in this negative reaction have not yet been clearly established. Our aim was to examine the emotional and attentional processes that are activated when patients with BN view their own bodies. Method: We examined the effects of viewing a video of one's own body on the physiological (eye-blink startle, cardiac defense, and skin conductance) and subjective (pleasure, arousal, and control ratings) responses elicited by a burst of 110 dB white noise of 500 ms duration. The participants were 30 women with BN and 30 healthy control women. The experimental task consisted of two consecutive and counterbalanced presentations of the auditory stimulus preceded, alternatively, by a video of the participant's own body versus no such video. Results: The results showed that, when viewing their own bodies, women with BN experienced (a) greater inhibition of the startle reflex, (b) greater cardiac acceleration in the first component of the defense reaction, (c) greater skin conductance response, and (d) less subjective pleasure and control combined with greater arousal, compared with the control participants. Conclusion: Our findings suggest that, for women with BN, peripheral-physiological responses to self-images are dominated by attentional processes, which provoke an immobility reaction caused by a dysfunctional negative response to their own body.The present research was supported by grants from the Spanish Ministry of Economy and Competitiveness [PSI2009-08417 and PSI2012-31395]. P.P. was supported by grants from the Spanish Ministry of Science and Innovation and University Jaume I [ECO2011-23634, P1-1B2012-27, and JCI-2010-06790]

Affective Pictures and the Open Library of Affective Foods (OLAF): Tools to Investigate Emotions toward Food in Adults

The authors wish to thank Jaime Vila for comments on earlier versions of the manuscript and Oscar Cervilla, Irene Forte, Alba Garrido, Laura Krutman, Lisa Mazzoni, and Teresa Mena for help with data collection and reduction.Recently, several sets of standardized food pictures have been created, supplying both food images and their subjective evaluations. However, to date only the OLAF (Open Library of Affective Foods), a set of food images and ratings we developed in adolescents, has the specific purpose of studying emotions toward food. Moreover, some researchers have argued that food evaluations are not valid across individuals and groups, unless feelings toward food cues are compared with feelings toward intense experiences unrelated to food, that serve as benchmarks. Therefore the OLAF presented here, comprising a set of original food images and a group of standardized highly emotional pictures, is intended to provide valid between-group judgments in adults. Emotional images (erotica, mutilations, and neutrals from the International Affective Picture System/IAPS) additionally ensure that the affective ratings are consistent with emotion research. The OLAF depicts high-calorie sweet and savory foods and low-calorie fruits and vegetables, portraying foods within natural scenes matching the IAPS features. An adult sample evaluated both food and affective pictures in terms of pleasure, arousal, dominance, and food craving, following standardized affective rating procedures. The affective ratings for the emotional pictures corroborated previous findings, thus confirming the reliability of evaluations for the food images. Among the OLAF images, high-calorie sweet and savory foods elicited the greatest pleasure, although they elicited, as expected, less arousal than erotica. The observed patterns were consistent with research on emotions and confirmed the reliability of OLAF evaluations. The OLAF and affective pictures constitute a sound methodology to investigate emotions toward food within a wider motivational framework. The OLAF is freely accessible at digibug.ugr.es.Yeshttp://www.plosone.org/static/editorial#pee

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

The skin conductance response to the startle-defense noise in the Bulimia (BN) and Control (CN) groups during the Sound Only trial (A) and the Own Body trial (B) presented first, and the Own Body trial (C) and the Sound Only trial (D) presented second.

<p>In general, the BN group showed a larger response to both trial types, irrespective of the presentation order. Also, when both trials were presented second (C and D), the amplitude of the response decreased significantly after Median 2 in the BN and HC groups, suggesting a habituation effect. However, at the start of this second presentation (Median 1), the response was larger for the Own Body trial than for the Sound Only trial, and for the BN group compared to the HC group, indicating less habituation.</p

The eye-blink reflex magnitude to the startle-defense noise during the Sound Only and Own Body trials for both groups of participants.

<p>The eye-blink reflex magnitude to the startle-defense noise during the Sound Only and Own Body trials for both groups of participants.</p

The general characteristics of participants.

<p>Values are means (S.D.).</p><p>*The bulimia nervosa (BN) group was composed of 7 women conforming to the BN-purging subtype and 23 women conforming to the BN-non-purging subtype.</p><p>Note: BN  =  bulimia nervosa; HC  =  healthy control; BMI  =  body mass index; BITE  =  Bulimic Investigatory Test, Edinburgh; BSQ  =  Body Shape Questionnaire.</p

Modulación emocional de los reflejos defensivos mediante visualización de imágenes afectivas

Tras un siglo de investigación de la personalidad constatamos la necesidad de abordar una aproximación integradora de la pluralidad de enfoques y trabajos realizados. En esta línea, presentamos un esbozo de una nueva teoría biológica y filogenética. Este modelo pretende integrar diversas teorías y paradigmas y organizar en una estructura coherente los principales logros de la investigación empírica. También reinterpreta el Five Factor Model, al proponer una taxonomía conceptual de los factores primarios de las grandes dimensiones; éstos emergen a partir de la teoría y permiten definir la esfera de la personalidad. La teoría incluye el temperamento, el carácter y el intelecto, describe la estructura y los procesos e intenta explicar las bases biológicas de la personalidad normal y de la psicopatología

The heart-rate response to the startle-defense noise in the Bulimia (BN) and Control (CN) groups during the Sound Only trial (A) and the Own Body trial (B) presented first, and the Own Body trial (C) and the Sound Only trial (D) presented second.

<p>The typical cardiac defense response pattern was observed only in the response to the Sound Only trial presented first (A). In the Own Body trial presented first, the healthy control (HC) group showed no response, whereas the bulimia nervosa (BN) group showed the initial acceleration-deceleration pattern followed by a return to baseline (B). When both trials were presented second, the response pattern did not appear (C and D).</p