青少年慢性心理社会应激，认知控制和肥胖关系的2年队列研究
发布时间：2018-12-18 15:32
【摘要】：背景 青少年超重和肥胖的流行趋势在全球范围内升高,造成了他们进入成年早期就会面临慢性代谢紊乱风险的增加。现有的流行病学已经表明慢性心理社会应激和儿童青少年肥胖相关。研究认为慢性应激可促进过度饮食和体重增加,一部分原因是生理机制的失调,包括应激下皮质醇等生物标志的分泌增加可引起身体对能量需求的增加,导致大脑信号对糖和脂肪等食物卡路里摄入的需求,与此同时,长期慢性应激暴露使大脑和自我认知控制能力相关的中心区域功能活动受损,而控制卡路里的摄入和体重的增长需要自我认知控制能力,因此本研究主要评价青少年慢性心理社会应激对BMI变化的预测作用以及慢性心理社会应激如何通过影响认知情绪控制能力而促进肥胖的发展,并尝试从神经心理学角度去验证应激应答—认知控制网络和肥胖的相关关系。 目的 阐明慢性心理社会应激是否促进青少年肥胖的发展以及认知控制功能在这一过程中作用。具体目的包括：①通过随访研究评价慢性心理社会应激对青少年BMI的影响：②探讨认知情绪控制在慢性应激致青少年BMI增加中的中介作用；③从神经心理学角度验证应激应答—认知控制网络和肥胖关系。 方法 研究一的对象为徐州城区初一和高一年级的中学生,采用方便整群抽样方法于2011年9月分别在徐州城区选取10所中学(5所初中,5所高中),以所有在校的学生作为研究对象,进行2年的随访研究。基线收集人口统计学、社会心理应激、情绪症状和生活行为方式等信息,采用青少年多维生活事件量表(Multidimensional Life Events Rating Questionnaire, MLERQ)作为社会心理应激暴露测定,该量表包括家庭生活事件、学校生活事件、同伴关系、两性关系及健康成长五大维度,基线调查共获得5473名中学生(男性2841名,女性2632名)完整数据资料。2013年9月获取第二轮体格检查数据,队列研究共获得完整数据资料4316名(其中男性2171名,女性2145名)。研究二对在随访研究中体重增加的超重肥胖青少年,并同时获取基线的认知情绪控制信息,使用认知情绪控制量表(Cognitive Emotion Regulation Questionnaire, CERQ)作为评价认知情绪控制的工具,用来作为应激致BMI增加的中介因素的评价。研究三选取初中女性青少年39人,其中肥胖组20人,同时选取同龄(出生日期相差不超过±3个月),身高相近(相差不超过±3cm),同班级,青春发育等级相当的正常体重者19人。使用特里尔社会应激实验(Trier Social Stress Test for Children, TSST-C)作为心理应激源,测定应激前后皮质醇反应度,同时使用自我控制实验室任务—延迟折扣(Delay Discounting, DD)实验程序来评价青少年延迟满足能力。 结果 基线调查中女性青少年慢性应激总分和BMI-Z分在控制了年龄、青春发育等级、社会经济状况和生活行为方式等协变量后相关性依然显著。随访研究表明基线超重肥胖的女性青少年应激总分和随访BMI-Z分增加相关有显著统计学意义,而在男性中,基线调查中应激总分和BMI-Z分的相关性无显著统计学意义,随访研究显示无论在体重正常或超重肥胖组,应激总分和随访BMI-Z分变化的相关性无显著统计学意义。 超重肥胖女性青少年暴露于慢性应激下可致2年后体重的增加,而高水平慢性应激可使正向认知情绪控制能力下降,从而会导致2年后BMI的增加,提示认知情绪控制能力在应激致BMI增加中的中介作用。 肥胖组女性青少年和正常体重组相比具有更高的皮质醇反应度和更低的延迟折扣率,同时,肥胖组青少年皮质醇反应度高者延迟折扣率更低,两者呈显著负相关,且相关性具有显著统计学意义,而在体重正常组两者相关性无显著统计学意义。 结论 慢性心理社会应激暴露可导致青春期超重肥胖女性未来的BMI增加,女性超重肥胖青少年为慢性应激心理社会致体重增加的易感人群。同时结果也显示认知情绪控制在超重肥胖青少年慢性应激致体重增加中的中介效应(即慢性社会心理应激—认知情绪控制—BMI),提示在这些人群中进行认知情绪干预以控制未来体重增长非常必要。最后,研究从神经心理学角度验证了应激应答—认知控制网络和肥胖关系,提出了肥胖青少年中HPA轴高活动性可影响延迟折扣水平(即延迟满足能力),以此推测应激应答系统的过敏性可能导致对美味高能食物需求的控制能力减弱,从而导致能量摄入过多使体重增加。
[Abstract]:background The prevalence of overweight and obesity among adolescents is rising globally, creating an increase in the risk of chronic metabolic disorders that they face in early adulthood. The current epidemiology has shown that chronic psychosocial stress and childhood obesity The study found that chronic stress can promote over-eating and weight gain, a part of which is the disorder of the physiological mechanism, including the increase in the secretion of biological markers such as cortisol, which can lead to increased body-to-energy demand, resulting in the need for food-calorie intake of the brain signal to sugar and fat At the same time, chronic stress exposure, at the same time, has impaired the function of the central region associated with the brain and self-cognitive control, while the control of caloric intake and body weight requires self-cognitive control. Therefore, this study mainly evaluates the effect of chronic psychological and social stress on the change of BMI, and how to promote the development of obesity by influencing the control ability of cognitive emotion. Exhibitions and attempts to validate stress response, cognitive control network, and related to obesity from a neuropsychological point of view Department. Objective To study whether the chronic psychological social stress promotes the development of juvenile obesity and the function of cognitive control. The purpose of this study was to evaluate the effect of chronic psychological social stress on the BMI of adolescents by follow-up study: to explore the intermediate role of cognitive-emotional control in the increase of BMI of young people with chronic stress, and to verify the cognitive control network of stress response from the point of neuropsychology. and fertilizer The aim of the method is to select the middle school students of the first and the second grades of Xuzhou urban area, and select 10 secondary schools (5 junior high schools and 5 high schools) in Xuzhou City in September 2011, respectively, to take all the students in the school as a study object, A 2-year follow-up study was conducted. Baseline collection of information such as demographic, psychosocial stress, mood symptoms, and lifestyle behavior was measured using the Multi-dimensional Life Events Rating Questionnaire (MLERQ) as a psychosocial stress exposure, which included family life In the five dimensions of events, school life events, peer relationship, sexual relations and healthy growth, a total of 5473 middle school students (2841 males and 2632 females) were obtained from the baseline survey, and a second round of physical examination data was obtained in September 2013, and a total of 4316 complete data were obtained from the cohort study. Of these, 2,171 men Two pairs of overweight and obese adolescents with weight gain in the follow-up study were studied, and the cognitive mood control information of the baseline was acquired at the same time, and the cognitive mood control scale (CERQ) was used as an evaluation. A tool for cognitive mood control, which is used as a stress-induced BMI. The middle school of the middle school is 39 people, among which 20 are the obese group, while the same age is selected (the date of birth is not more than 3 months), the height is close (the phase difference is not more than 3 cm), the same class and the level of the development of the youth are comparable. The response of cortisol before and after stress was measured using the Trier Social Stress Test for Children (TSST-C) as a source of psychological stress. green and small The annual delay meets the capacity. The total score of chronic stress and BMI-Z in female adolescents in the baseline survey are controlled by age, level of youth development, socio-economic status and life The correlation was still significant after covariates of the formula. The follow-up study showed significant statistical significance for the overall score of stress and the follow-up of BMI-Z for women with overweight and obese, whereas in men, the total score of stress and BMI-Z in the baseline survey The correlation of the scores was not statistically significant, and the follow-up study showed that the total score of the stress and the follow-up BMI-Z were varied, either in the normal or overweight obese group, There is no significant statistical significance in the correlation between overweight and obese women. The exposure of overweight and obese women to chronic stress can increase the body weight after 2 years, while the high level of chronic stress can lead to a decrease in the control ability of the positive cognitive mood, which can lead to an increase in BMI after 2 years, indicating the control ability of the cognition. The intermediate effect of the increase of the stress-induced BMI is that the obese group has higher cortisol response and lower delayed discount rate as compared with the normal body recombination, while the higher the delayed discount rate of the higher of the hypercortisolism in the obese group, both of which are significant. There was a negative correlation, and the correlation was statistically significant, and in the body heavy-and-right Conclusion The exposure of chronic psychological social stress can lead to the increase of the future BMI of the overweight and obese women and the overweight and obesity of the female. The results also show the intermediate effect of cognitive mood control in the weight gain of overweight and obese adolescents with chronic stress (i.e., chronic social psychological stress and cognitive mood control, BMI), suggesting that in these people Cognitive emotion intervention is necessary to control the future weight growth. Finally, the study of the cognitive control network and the obesity relation of stress response from the angle of neuropsychology has put forward the high HPA axis in obese adolescents. Activity may affect the delay discount level (i.e., the delay meets the ability) to infer that the response to the stress response system may lead to a control of the demand for a delicious high-energy food
【学位授予单位】：安徽医科大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R723.14
本文编号：2386054
[Abstract]:background The prevalence of overweight and obesity among adolescents is rising globally, creating an increase in the risk of chronic metabolic disorders that they face in early adulthood. The current epidemiology has shown that chronic psychosocial stress and childhood obesity The study found that chronic stress can promote over-eating and weight gain, a part of which is the disorder of the physiological mechanism, including the increase in the secretion of biological markers such as cortisol, which can lead to increased body-to-energy demand, resulting in the need for food-calorie intake of the brain signal to sugar and fat At the same time, chronic stress exposure, at the same time, has impaired the function of the central region associated with the brain and self-cognitive control, while the control of caloric intake and body weight requires self-cognitive control. Therefore, this study mainly evaluates the effect of chronic psychological and social stress on the change of BMI, and how to promote the development of obesity by influencing the control ability of cognitive emotion. Exhibitions and attempts to validate stress response, cognitive control network, and related to obesity from a neuropsychological point of view Department. Objective To study whether the chronic psychological social stress promotes the development of juvenile obesity and the function of cognitive control. The purpose of this study was to evaluate the effect of chronic psychological social stress on the BMI of adolescents by follow-up study: to explore the intermediate role of cognitive-emotional control in the increase of BMI of young people with chronic stress, and to verify the cognitive control network of stress response from the point of neuropsychology. and fertilizer The aim of the method is to select the middle school students of the first and the second grades of Xuzhou urban area, and select 10 secondary schools (5 junior high schools and 5 high schools) in Xuzhou City in September 2011, respectively, to take all the students in the school as a study object, A 2-year follow-up study was conducted. Baseline collection of information such as demographic, psychosocial stress, mood symptoms, and lifestyle behavior was measured using the Multi-dimensional Life Events Rating Questionnaire (MLERQ) as a psychosocial stress exposure, which included family life In the five dimensions of events, school life events, peer relationship, sexual relations and healthy growth, a total of 5473 middle school students (2841 males and 2632 females) were obtained from the baseline survey, and a second round of physical examination data was obtained in September 2013, and a total of 4316 complete data were obtained from the cohort study. Of these, 2,171 men Two pairs of overweight and obese adolescents with weight gain in the follow-up study were studied, and the cognitive mood control information of the baseline was acquired at the same time, and the cognitive mood control scale (CERQ) was used as an evaluation. A tool for cognitive mood control, which is used as a stress-induced BMI. The middle school of the middle school is 39 people, among which 20 are the obese group, while the same age is selected (the date of birth is not more than 3 months), the height is close (the phase difference is not more than 3 cm), the same class and the level of the development of the youth are comparable. The response of cortisol before and after stress was measured using the Trier Social Stress Test for Children (TSST-C) as a source of psychological stress. green and small The annual delay meets the capacity. The total score of chronic stress and BMI-Z in female adolescents in the baseline survey are controlled by age, level of youth development, socio-economic status and life The correlation was still significant after covariates of the formula. The follow-up study showed significant statistical significance for the overall score of stress and the follow-up of BMI-Z for women with overweight and obese, whereas in men, the total score of stress and BMI-Z in the baseline survey The correlation of the scores was not statistically significant, and the follow-up study showed that the total score of the stress and the follow-up BMI-Z were varied, either in the normal or overweight obese group, There is no significant statistical significance in the correlation between overweight and obese women. The exposure of overweight and obese women to chronic stress can increase the body weight after 2 years, while the high level of chronic stress can lead to a decrease in the control ability of the positive cognitive mood, which can lead to an increase in BMI after 2 years, indicating the control ability of the cognition. The intermediate effect of the increase of the stress-induced BMI is that the obese group has higher cortisol response and lower delayed discount rate as compared with the normal body recombination, while the higher the delayed discount rate of the higher of the hypercortisolism in the obese group, both of which are significant. There was a negative correlation, and the correlation was statistically significant, and in the body heavy-and-right Conclusion The exposure of chronic psychological social stress can lead to the increase of the future BMI of the overweight and obese women and the overweight and obesity of the female. The results also show the intermediate effect of cognitive mood control in the weight gain of overweight and obese adolescents with chronic stress (i.e., chronic social psychological stress and cognitive mood control, BMI), suggesting that in these people Cognitive emotion intervention is necessary to control the future weight growth. Finally, the study of the cognitive control network and the obesity relation of stress response from the angle of neuropsychology has put forward the high HPA axis in obese adolescents. Activity may affect the delay discount level (i.e., the delay meets the ability) to infer that the response to the stress response system may lead to a control of the demand for a delicious high-energy food
【学位授予单位】：安徽医科大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R723.14
【参考文献】
相关期刊论文 前2条
1 胡燕;陶芳标;苏普玉;齐秀玉;邢超;黄朝辉;;中学生生活事件多维评定问卷的编制和信效度检验[J];中国学校卫生;2010年02期
2 杨娟;侯燕;杨瑜;张庆林;;特里尔社会应激测试(TSST)对唾液皮质醇分泌的影响[J];心理学报;2011年04期
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