Restrictive eating is common and associated with negative psychological outcomes across the life span and eating disorder (ED) severity levels. Little is known about functional processes that maintain restriction, especially outside of narrow diagnostic categories (e.g., anorexia nervosa). Here, we extend research on operant four-function models (identifying automatic negative, automatic positive, social negative, and social positive reinforcement functions) that have previously been applied to nonsuicidal self-injury (NSSI), binge eating, and purging to restricting. We assessed restrictive eating functions in three samples: clinically heterogeneous adolescents (Study 1: N = 457), transdiagnostic adults (Study 2: N = 145), and adults with acute or recently weight-restored anorexia nervosa (Study 3: N = 45). Study 1 indicated the four-function model was a good fit for restricting (root mean square error of approximation [RMSEA] = .06, Tucker-Lewis index [TLI] = .88). This factor structure replicated in Study 2 (comparative fit index [CFI] = .97, RMSEA = .07, TLI = .97, standardized root mean square residual [SRMR] = .09). Unlike NSSI, binge eating, and purging, which have been found to primarily serve automatic negative reinforcement functions, all three present studies found automatic positive reinforcement was most highly endorsed (by up to 85% of participants). In Studies 1 and 3, automatic functions were associated with poorer emotion regulation (ps < .05). In Study 1, social functions were associated with less social support (ps < .001). Across studies, automatic functions were associated with greater restriction ps < .05). Functions varied slightly by ED diagnosis. Across ED presentation, severity, and developmental stage, restrictive eating may be largely maintained by automatic positive reinforcement, with some variability across presentations. Continued examination of restrictive eating functions will establish processes that maintain restriction, allowing more precise treatment targeting for these problematic behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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限制性饮食的功能评估：一项三项临床异质性和跨诊断研究。

限制性饮食很常见，并且与整个生命周期和饮食失调 (ED) 严重程度的负面心理结果有关。关于维持限制的功能过程知之甚少，特别是在狭窄的诊断类别之外（例如，神经性厌食症）。在这里，我们将以前应用于非自杀性自伤 (NSSI)、暴饮暴食和清除的操作性四功能模型（识别自动消极、自动积极、社会消极和社会积极强化功能）的研究扩展到限制。我们评估了三个样本中的限制性饮食功能：临床异质性青少年（研究 1：N = 457）、经诊断的成人（研究 2：N = 145）和患有急性或最近体重恢复的神经性厌食症的成人（研究 3：N = 45 ）。研究 1 表明四函数模型非常适合限制（近似的均方根误差 [RMSEA] = .06，Tucker-Lewis 指数 [TLI] = .88）。该因子结构在研究 2 中重复（比较拟合指数 [CFI] = .97，RMSEA = .07，TLI = .97，标准化均方根残差 [SRMR] = .09）。与已发现主要服务于自动负强化功能的 NSSI、暴食和清除不同，目前的所有三项研究都发现自动正强化得到了最高的认可（高达 85% 的参与者）。在研究 1 和 3 中，自动功能与较差的情绪调节有关 (ps < .05)。在研究 1 中，社会功能与较少的社会支持相关（ps < .001）。在所有研究中，自动功能与更大的限制相关（ps < .05）。功能因 ED 诊断而略有不同。在 ED 表现、严重程度和发育阶段，限制性饮食可能在很大程度上通过自动正强化来维持，但表现之间存在一些差异。对限制性饮食功能的持续检查将建立维持限制的过程，从而针对这些有问题的行为进行更精确的治疗。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。允许针对这些有问题的行为进行更精确的治疗。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。允许针对这些有问题的行为进行更精确的治疗。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。