According to estimates from Public Health England, by 2034 70% of adults are expected to be overweight or obese, therefore understanding the underpinning aetiology is a priority. Eating in response to negative affect contributes towards obesity, however, little is known about the underlying mechanisms. Evidence that visceral afferent signals contribute towards the experience of emotion is accumulating rapidly, with the emergence of new influential models of ‘active inference’. No longer viewed as a ‘bottom up’ process, new interoceptive facets based on ‘top down’ predictions have been proposed, although at present it is unclear which aspects of interoception contribute to aberrant eating behaviour and obesity. Study one examined the link between eating behaviour, body mass index and the novel interoceptive indices; interoceptive metacognitive awareness (IAw) and interoceptive prediction error (IPE), as well as the traditional measures; interoceptive accuracy (IAc) and interoceptive sensibility (IS). The dissociation between these interoceptive indices was confirmed. Emotional eaters were characterised by a heightened interoceptive signal but reduced meta-cognitive awareness of their interoceptive abilities. In addition, emotional eating correlated with IPE; effects that could not be accounted for by differences in anxiety and depression. Study two confirmed the positive association between interoceptive accuracy and emotional eating using a novel unbiased heartbeat discrimination task based on the method of constant stimuli. Results reveal new and important mechanistic insights into the processes that may underlie problematic affect regulation in overweight populations.
There is continued interest in developing effective and innovative treatment approaches to manage and improve outcomes after traumatic brain injury (TBI). Included in this, is the potential use of repetitive Transcranial Magnetic Stimulation (rTMS), a neuromodulatory tool currently recommended by the National Institute for Health and Care Excellence as a treatment for depression. This review considers the application of rTMS after TBI, focussing on its therapeutic efficacy for a broad range of sequalae, whether an optimal and safe rTMS protocol can be determined, and recommendations for future clinical and research work. Five research databases (MEDLINE, CINAHL, PsychINFO, SCOPUS, and Web of Science) were electronically searched, identifying thirty empirical studies (single and multiple subject case reports; randomised controlled trials) for full review. Evidence suggest that rTMS has the potential to be an efficacious therapeutic intervention for multiple symptoms after TBI, including depression, dizziness, central pain, and visual neglect. However, the picture is less encouraging for prolonged disorders of consciousness and mixed for cognitive outcomes.Overall, rTMS was well-tolerated by patients, although some incidents of side effects and seizures have been reported. Recommendations are made for more comprehensive guidelines and sufficient reporting of rTMS parameters and procedures.
Difficulty identifying and describing emotions (alexithymia) has been related to impulsiveness and negative affect, emotional eating and obesity. However, previous research findings concerning the relationship between alexithymia and obesity have been mixed and inconsistent, raising the possibility that the relationship is indirect and mediated by multiple unknown factors. The aim of the study was to comprehensively explore the potential pathways between alexithymia and obesity via a novel theoretical model, and for the first time, incorporate negative affect, impulsiveness and emotional eating as potential mediating factors. Two questionnaire-based studies were conducted; the first as an exploratory analysis within a student sample (N=125), and the second as a self-replication within a more representative general population sample (N=342). Study One revealed that difficulty identifying feelings predicted Body Mass Index (BMI) both directly (B = .1694, CI = .0194-.3194) and indirectly via impulsiveness and emotional eating (B = .0074, CI = .0001-.0315). In contrast, Study Two revealed that alexithymia predicted BMI indirectly via negative affect (when depression was included in the model; B = .0335, CI = .0019-.0660) or impulsiveness (when anxiety was included in the model; B = .0021, CI = .0001-.0066). Our findings provide partial support for the hypothesised model and offer original insight into the relationship between alexithymia and obesity. Additionally, our findings highlight important methodological considerations for future research and suggest that ways to address an individual's ability to identify, describe and regulate emotions should be considered when designing interventions to assist weight loss and management.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.