Treatment-resistant blunted HPA activity, but reversible cardiovascular stress reactivity in young women with eating disorders

  • Previous research has provided evidence for a reduced neuroendocrine stress response in women with eating disorders (EDs). In the present study female in-patients with Anorexia and Bulimia nervosa were compared to female healthy controls (HC) before and after completing an in-patient treatment program. Salivary cortisol, alpha-amylase (sAA), heart rate response (HR), high-frequency heart rate variability (HF-HRV) and negative affective state were measured before, during and after exposure to the Trier Social Stress Test (TSST) at pre- and post-treatment. Patients with EDs (\(\it n\) = 13) showed significantly less ED symptoms at post-treatment. Compared to HC (\(\it n\) = 22), patients displayed a blunted cortisol stress response combined with overall attenuated sAA levels at pre-treatment. At post-treatment, the blunted cortisol stress response was still observable, while the differences in sAA responses disappeared. HR was attenuated at pre-treatment in patients, also indicated by a stronger HF-HRV throughout the TSST. These cardiovascular differences disappeared at post-treatment. Patients reported in general (pre- and post-treatment) more negative affect compared to HC. This study provides further evidences of a hypo-reactive hypothalamus–pituitary–adrenal axis (HPA) in patients with EDs which persists even after symptom recovery while initial low cardiovascular stress reactivity apparently can be restored by psychotherapy. Given the small sample size the findings have to be considered preliminary.

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Metadaten
Author:Serkan HetORCiDGND, Silja VocksGND, Jutta Manuela WolfGND, Stephan HerpertzORCiDGND, Oliver T. WolfORCiDGND
URN:urn:nbn:de:hbz:294-75913
DOI:https://doi.org/10.3389/fpsyt.2020.00726
Parent Title (English):Frontiers in psychiatry
Publisher:Frontiers Research Foundation
Place of publication:Lausanne
Document Type:Article
Language:English
Date of Publication (online):2020/10/23
Date of first Publication:2020/07/22
Publishing Institution:Ruhr-Universität Bochum, Universitätsbibliothek
Tag:Open Access Fonds
Trier Social Stress Test (TSST); alpha amylase; anorexia nervosa; bulimia nervosa; cortisol; eating disorder; hypothalamus–pituitary–adrenal (HPA) axis; stress
Volume:11
Issue:Article 726
First Page:726-1
Last Page:726-10
Note:
Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum.
Institutes/Facilities:Institut für Kognitive Neurowissenschaft, Abteilung Kognitionspsychologie
Fakultät für Psychologie, Abteilung Kognitionspsychologie
Research Department of Neuroscience
Sonderforschungsbereich 874, Integration und Repräsentation sensorischer Prozesse
Sonderforschungsbereich 1280, A09 - Der Einfluss von Stress und Stresshormonen auf Extinktion, Renewal, Reinstatement und Rekonsolidierung
open_access (DINI-Set):open_access
Licence (English):License LogoCreative Commons - CC BY 4.0 - Attribution 4.0 International