合併睡眠困擾對於暴食傾向族群在食物相關刺激之注意力偏誤的影響

研究背景與目的：過去研究發現暴食傾向者面對食物刺激時會有注意力偏誤現象，且經常伴隨睡眠相關困擾。睡眠困擾除了會使個體對食物的渴望程度上升，也會造成個體的抑制功能下降及注意力控制能力變差，可能因此加劇暴食傾向者的注意力偏誤。然而，過去鮮少研究探討合併睡眠困擾對暴食傾向者之注意力偏誤的影響。本研究的主要目的在探討合併睡眠困擾對於暴食傾向者在食物相關刺激之注意力偏誤的影響。研究方法：本研究主要透過網路招募參與者，透過線上填寫暴食問卷與失眠嚴重度指標，然後根據兩項量表的得分將參與者區分為暴食傾向合併失眠組（BNS組；N = 19，平均年齡 = 22，標準差 = 2.19）、暴食傾向組（BN組；N = 22，平均年齡 = 22.68，標準差 = 2.53）和控制組（N = 24，平均年齡 = 22.25，標準差 = 2.75）。所有參與者在第一階段先填寫飲食與情緒相關問卷；接著第二階段填寫兩週的睡眠日誌；第三階段參與者先在眼動儀上完成注意力偏誤作業，參與者被要求自由觀看一系列包含食物的圖片，圖片又可分為只包含高卡路里食物、只包含低卡路里食物以及同時包含高低卡路里食物三類圖片，最後再次填答睡眠相關問卷以及食物渴望問卷。結果：本研究結果顯示，在單獨呈現高或低卡路里食物的情境下，BN組和BNS組對食物的初次凝視潛伏時間都比控制組更長；BN組對高卡路里食物的初次凝視潛伏時間比低卡路里食物短，其餘兩組則無此差異。BN組和BNS組對高卡路里食物的初次注視停留時間均比低卡路里食物短，控制組對兩類食物則沒有明顯差異。整體而言，參與者對高卡路里食物的總凝視時間比低卡路里食物長，總凝視次數也較多。在同時呈現高低卡路里食物的情境下，整體而言，參與者注意到高卡路里食物的速度比低卡路里食物快。BNS組與控制組對高卡路里食物的初次注視停留時間都比低卡路里食物長，但BN組對兩類食物則沒有明顯差異。三組參與者對不同食物類型的總凝視時間均沒有明顯差異。然而，BN組對高卡路里食物的凝視次數比低卡路里食物多，並且對高卡路里食物的凝視次數明顯高於另外兩組；控制組則相反，對低卡路里食物的凝視次數比高卡路里食物多，並且對低卡路食物的凝視次數明顯高於另外兩組；BNS組對兩類食物的凝視次數則沒有明顯差異。結論：本研究結果顯示未合併睡眠困擾的暴食傾向參與者，對於高卡路里食物會有警覺迴避的現象，且在同時呈現高低卡路里食物圖片時，對高卡路里食物有過度掃視的現象。合併睡眠困擾的暴食傾向參與者對食物的注意力會因情境而有所不同，只有在單獨呈現高或低卡路里食物圖片時，對高卡路里食物會有注意力迴避的現象。

關鍵字

暴食；失眠；食物渴望；注意力偏誤；眼球追蹤

並列摘要

Background and purpose：Previous research suggests that individuals with binge eating tendency demonstrate attentional bias to food-related stimuli. Individuals with binge eating tendency commonly experience sleep disturbance. Sleep disturbance may increase individuals’ craving for food and decrease their inhibitory control. Moreover, sleep disturbance may impede attentional control ability in individuals with binge eating tendency and thus may exaggerate their attentional bias for food. However, few studies have explored how sleep disturbance influences attention bias in individuals with binge eating tendency. The present study aims to investigate the effect of combined sleep on the attention bias of food-related stimuli in individuals with binge eating tendency. Method：Participants were recruited via internet advertising. Eligibility was assessed by completing an online survey including the Bulimia Investigatory Test (BITE) and the Insomnia Severity Index (ISI). Participants were assigned to the binge eating tendency with insomnia group (BNS group; N = 19; Mage = 22, SD = 2.19), binge eating tendency without insomnia group (BN group; N = 22; Mage = 22.68, SD = 2.53), or control group (N=24; Mage = 22.25, SD = 2.75) based on their BITE and ISI scores. This study was conducted in three phases: First, participants completed a battery of questionnaires measuring symptoms of eating disorder and levels of anxiety and depression. Second, participants were required to fill out the sleep diary every day for two weeks. Third, participants were invited to the laboratory to complete the eye movement task. They were asked to freely view at a series of images that contained food items. There were three types of images: images containing only high-calorie food, images containing only low-calorie food, and images containing both high- and low-calorie food. After completion of the eye movement task, participants completed self-report inventories assessing sleep quality and levels of food craving. Result：The results showed that, when presenting with images containing only high-calorie food or images containing only low-calorie food, the BN and BNS groups had longer latencies to first fixation on food than the control group. The BN group had a shorter latency to first fixation on high-calorie food than on low-calorie food while the other two groups did not show differences between the two food types. Moreover, both the BN and BNS groups showed a shorter first gaze duration to high-calorie foods than low-calorie foods. There was no significant difference between food types in the first gaze duration in the control group. All participants overall had a longer total fixation time and more fixation counts for high-calorie foods than low-calorie foods. When presenting with images containing both high- and low-calorie foods, participants overall had shorter latencies to first fixation on high-calorie foods than low-calorie foods. The BNS and control groups had longer first gaze durations for high-calorie foods than low-calorie foods. However, the BN group showed no significant difference between the two food types in the first gaze duration. Participants demonstrated no significant differences in the total fixation time for different food types, regardless of groups. Nevertheless, the BN group had more fixation counts for high-calorie foods than low-calorie foods. BN participants also had significantly more fixation counts for high-calorie foods than participants in the BNS and control groups. On the contrary, the control group had more fixation counts for low-calorie foods than high-calorie foods. Participants in the control group also had significantly more fixation counts for low-calorie foods than participants in the BN and BNS groups. The BNS group had no significant difference in the fixation counts between the two food types. Conclusion：The present study suggests that BN participants show a vigilance-avoidance pattern of attentional processing to high-calorie foods. They also exhibit a hypervigilance which indexes by increased fixation counts for high-calorie foods when presenting with images containing both high- and low-calorie foods. BNS participants demonstrate attentional avoidance from high-calorie foods only when they are presented with images containing only high-calorie foods and images containing only low-calorie foods.