The food craving experience: Thoughts, images and resistance as predictors of craving intensity and consumption.

The Elaborated-Intrusion Theory of Desire (Kavanagh, Andrade, & May, 2005) suggests that cravings are made up of two distinct stages whereby an initial, seemingly spontaneous craving-related thought is sufficiently intrusive and pleasant for it then to be elaborated with vivid mental imagery. Previous questionnaire studies have investigated the craving experience with a particular focus on the role of imagery. The present study sought to provide a fuller account of the craving process by investigating the role of craving-related thoughts alongside imagery in predicting craving intensity. Further, the present study sought to investigate predictors of craving-related consumption, including spontaneous strategies used to resist cravings. Two-hundred and forty-nine women completed an online questionnaire which asked about their most recent food craving experience. Results showed that around a third of participants reported craving-related thoughts and about half reported craving-related imagery. Craving-related imagery appeared to be a more important predictor of craving intensity than craving-related thoughts; however, neither predicted craving-related consumption. One resistance strategy, 'recognised it was just a thought', was successful in decreasing the likelihood of eating in response to craving. Theoretical and practical implications are discussed in the context of the Elaborated-Intrusion Theory.

Cognitive defusion and guided imagery tasks reduce naturalistic food cravings and consumption: A field study.

The present study investigated the effect of two craving reduction techniques, namely, cognitive defusion and guided imagery, on naturalistic food cravings. These techniques targeted the intrusion and elaboration stages of the craving process, respectively (Kavanagh, Andrade, & May, 2005). Participants underwent a seven-day baseline period followed by a seven-day intervention period, during which they recorded their food cravings as they occurred using online diaries accessed via smartphone. In the intervention period, participants were randomly assigned to one of cognitive defusion, guided imagery or control conditions. Participants in the cognitive defusion and guided imagery conditions listened to three-minute audio clips containing their respective instructions every time they experienced a food craving, and rated their craving intensity before and after the intervention, while the control participants recorded their cravings as they did in the baseline week. Results showed that both cognitive defusion and guided imagery techniques reduced craving frequency, intensity, the likelihood of consumption following cravings, and craving-related calorie intake, consistent with predictions. These findings show that cognitive defusion and guided imagery are useful for dealing with naturally occurring cravings across a range of foods, and can reduce craving-related consumption in everyday life.

Acceptance- and imagery-based strategies can reduce chocolate cravings: A test of the elaborated-intrusion theory of desire.

The elaborated-intrusion theory of desire proposes that craving is a two-stage process whereby initial intrusions about a desired target are subsequently elaborated with mental imagery. The present study tested whether the craving reduction strategies of cognitive defusion and guided imagery could differentially target the intrusion and elaboration stages, respectively, and thus differentially impact the craving process. Participants were randomly assigned to a cognitive defusion, a guided imagery or a mind-wandering control condition. Pre- and post-intervention chocolate-related thoughts, intrusiveness of thoughts, vividness of imagery, craving intensity, and chocolate consumption were compared. Experiment 1 recruited a general sample of young women (n = 94), whereas Experiment 2 recruited a sample of chocolate cravers who wanted to reduce their chocolate consumption (n = 97). Across both experiments, cognitive defusion lowered intrusiveness of thoughts, vividness of imagery and craving intensity. Guided imagery reduced chocolate-related thoughts, intrusiveness, vividness and craving intensity for chocolate cravers (Experiment 2), but not for the general sample (Experiment 1). There were no group differences in chocolate consumption in either experiment. Results add to existing evidence supporting the elaborated-intrusion theory of desire in the food domain, and suggest that acceptance- and imagery-based techniques have potential for use in combatting problematic cravings.

MOG-IgG in NMO and related disorders: a multicenter study of 50 patients. Part 4: Afferent visual system damage after optic neuritis in MOG-IgG-seropositive versus AQP4-IgG-seropositive patients.

BACKGROUND: Antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG) have been reported in patients with aquaporin-4 antibody (AQP4-IgG)-negative neuromyelitis optica spectrum disorders (NMOSD). The objective of this study was to describe optic neuritis (ON)-induced neuro-axonal damage in the retina of MOG-IgG-positive patients in comparison with AQP4-IgG-positive NMOSD patients. METHODS: Afferent visual system damage following ON was bilaterally assessed in 16 MOG-IgG-positive patients with a history of ON and compared with that in 16 AQP4-IgG-positive NMOSD patients. In addition, 16 healthy controls matched for age, sex, and disease duration were analyzed. Study data included ON history, retinal optical coherence tomography, visual acuity, and visual evoked potentials. RESULTS: Eight MOG-IgG-positive patients had a previous diagnosis of AQP4-IgG-negative NMOSD with ON and myelitis, and eight of (mainly recurrent) ON. Twenty-nine of the 32 eyes of the MOG-IgG-positive patients had been affected by at least one episode of ON. Peripapillary retinal nerve fiber layer thickness (pRNFL) and ganglion cell and inner plexiform layer volume (GCIP) were significantly reduced in ON eyes of MOG-IgG-positive patients (pRNFL = 59 ± 23 µm; GCIP = 1.50 ± 0.34 mm3) compared with healthy controls (pRNFL = 99 ± 6 µm, p < 0.001; GCIP = 1.97 ± 0.11 mm3, p < 0.001). Visual acuity was impaired in eyes after ON in MOG-IgG-positive patients (0.35 ± 0.88 logMAR). There were no significant differences in any structural or functional visual parameters between MOG-IgG-positive and AQP4-IgG-positive patients (pRNFL: 59 ± 21 µm; GCIP: 1.41 ± 0.27 mm3; Visual acuity = 0.72 ± 1.09 logMAR). Importantly, MOG-IgG-positive patients had a significantly higher annual ON relapse rate than AQP4-IgG-positive patients (median 0.69 vs. 0.29 attacks/year, p = 0.004), meaning that on average a single ON episode caused less damage in MOG-IgG-positive than in AQP4-IgG-positive patients. pRNFL and GCIP loss correlated with the number of ON episodes in MOG-IgG-positive patients (p < 0.001), but not in AQP4-IgG-positive patients. CONCLUSIONS: Retinal neuro-axonal damage and visual impairment after ON in MOG-IgG-positive patients are as severe as in AQP4-IgG-positive NMOSD patients. In MOG-IgG-positive patients, damage accrual may be driven by higher relapse rates, whereas AQP4-IgG-positive patients showed fewer but more severe episodes of ON. Given the marked damage in some of our MOG-IgG-positive patients, early diagnosis and timely initiation and close monitoring of immunosuppressive therapy are important.

Neuromyelitis optica does not impact periventricular venous density versus healthy controls: a 7.0 Tesla MRI clinical study.

OBJECTIVE: To quantify the periventricular venous density in neuromyelitis optica spectrum disease (NMOSD) in comparison to that in patients with multiple sclerosis (MS) and healthy control subjects. MATERIALS AND METHODS: Sixteen patients with NMOSD, 16 patients with MS and 16 healthy control subjects underwent 7.0-Tesla (7T) MRI. The imaging protocol included T2*-weighted (T2*w) fast low angle-shot (FLASH) and fluid-attenuated inversion recovery (FLAIR) sequences. The periventricular venous area (PVA) was manually determined by a blinded investigator in order to estimate the periventricular venous density in a region of interest-based approach. RESULTS: No significant differences in periventricular venous density indicated by PVA were detectable in NMOSD versus healthy controls (p = 0.226). In contrast, PVA was significantly reduced in MS patients compared to healthy controls (p = 0.013). CONCLUSION: Unlike patients with MS, those suffering from NMOSD did not show reduced venous visibility. This finding may underscore primary and secondary pathophysiological differences between these two distinct diseases of the central nervous system.

Bias modification training can alter approach bias and chocolate consumption.

Recent evidence has demonstrated that bias modification training has potential to reduce cognitive biases for attractive targets and affect health behaviours. The present study investigated whether cognitive bias modification training could be applied to reduce approach bias for chocolate and affect subsequent chocolate consumption. A sample of 120 women (18-27 years) were randomly assigned to an approach-chocolate condition or avoid-chocolate condition, in which they were trained to approach or avoid pictorial chocolate stimuli, respectively. Training had the predicted effect on approach bias, such that participants trained to approach chocolate demonstrated an increased approach bias to chocolate stimuli whereas participants trained to avoid such stimuli showed a reduced bias. Further, participants trained to avoid chocolate ate significantly less of a chocolate muffin in a subsequent taste test than participants trained to approach chocolate. Theoretically, results provide support for the dual process model's conceptualisation of consumption as being driven by implicit processes such as approach bias. In practice, approach bias modification may be a useful component of interventions designed to curb the consumption of unhealthy foods.

MRI phase changes in multiple sclerosis vs neuromyelitis optica lesions at 7T.

OBJECTIVE: To characterize paramagnetic MRI phase signal abnormalities in neuromyelitis optica spectrum disorder (NMOSD) vs multiple sclerosis (MS) lesions in a cross-sectional study. METHODS: Ten patients with NMOSD and 10 patients with relapsing-remitting MS underwent 7-tesla brain MRI including supratentorial T2*-weighted imaging and supratentorial susceptibility weighted imaging. Next, we analyzed intra- and perilesional paramagnetic phase changes on susceptibility weighted imaging filtered magnetic resonance phase images. RESULTS: We frequently observed paramagnetic rim-like (75 of 232 lesions, 32%) or nodular (32 of 232 lesions, 14%) phase changes in MS lesions, but only rarely in NMOSD lesions (rim-like phase changes: 2 of 112 lesions, 2%, p < 0.001; nodular phase changes: 2 of 112 lesions, 2%, p < 0.001). CONCLUSIONS: Rim-like or nodular paramagnetic MRI phase changes are characteristic for MS lesions and not frequently detectable in NMOSD. Future prospective studies should ask whether these imaging findings can be used as a biomarker to distinguish between NMOSD- and MS-related brain lesions.

Association between smoking and presence of mycoplasma pneumoniae in circulating leukocytes.

PRINCIPLES: The morbidity and mortality of infectious diseases due to smoking are not widely appreciated by physicians. However, cigarette smoking appears to be a major risk factor for respiratory tract and other systemic infections. Only limited data are available on the association between smoking and Mycoplasma (M) pneumoniae. We raise the question of whether smoking increases the presence of M pneumoniae in circulating leukocytes. Furthermore we have studied whether the combination of smoking and M pneumoniae infection affects circulating levels of inflammatory biomarkers. METHODS: Prevalence of latent M pneumoniae infection was analysed in a total of 122 subjects by polymerase chain reaction. Smoking status was documented at presentation. Circulating levels of c-reactive protein, macrophage chemoattractant protein-1 and complement factor 5a were determined by commercial enzyme linked immuno-sorbent assays. RESULTS: We found a significant association between smoking and latent M pneumoniae infection (p = 0.009). This association remained significant after correction for age, gender and diabetes (OR 3.4; 95% CI 1.3-9.4; p = 0.017). There was no correlation between circulating levels of the inflammatory biomarkers studied and smoking or M pneumoniae infection, respectively. CONCLUSIONS: Our data indicate that smoking is associated with the presence of M pneumoniae in circulating leukocytes. This could contribute to the pro-inflammatory effects of smoking. Despite the low number of subjects included in this study, this is an interesting finding demanding further investigation.