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Impaired cortisol awakening response in eating disorder women with childhood trauma exposure: evidence for a dose-dependent effect of the traumatic load

Published online by Cambridge University Press:  29 August 2017

A. M. Monteleone ,
P. Monteleone ,
U. Volpe ,
F. De Riso ,
G. Fico ,
R. Giugliano ,
M. Nigro  and
M. Maj
A. M. Monteleone
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
P. Monteleone*
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, Section of Neurosciences, University of Salerno, Salerno, Italy
U. Volpe
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
F. De Riso
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
G. Fico
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
R. Giugliano
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
M. Nigro
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
M. Maj
Affiliation:
Department of Psychiatry, University of Naples SUN, Naples, Italy
*
*Address for correspondence: P. Monteleone, M.D., Department of Medicine, Surgery and Dentristy ‘Scuola Medica Salernitana’, Section of Neurosciences, University of Salerno, Via Allende, Baronissi, Salerno 80049, Italy. (Email: [email protected])
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Abstract

Background

Childhood trauma is a non specific risk factor for adult eating disorders (ED), and the hypothalamic-pituitary-adrenal (HPA) axis seems to mediate such a risk. Here we explored the impact of different types of childhood trauma and of traumatic load on the cortisol awakening response (CAR) of women with anorexia nervosa (AN) or bulimia nervosa (BN).

Methods

Saliva samples were collected at awakening and after 15, 30, 60 min to measure cortisol levels by 121 women (44 AN patients, 36 BN patients and 41 healthy women). Participants filled in the Childhood Trauma Questionnaire.

Results

AN and BN patients with childhood maltreatment exhibited an attenuated CAR compared with non-maltreated ones. In the whole ED patient group, the CAR showed a progressive impairment with the increasing number of reported trauma types. Although significant negative correlations emerged between the type or the number of traumas and the CAR, only the number of traumas remained significantly associated with the CAR in a stepwise multiple regression analysis.

Conclusions

Present findings confirm that childhood trauma is associated with an impaired CAR in adult AN and BN patients and demonstrate for the first time a negative dose-dependent effect of the traumatic load on HPA axis activity.

Keywords

Anorexia nervosabulimia nervosacortisoleating disorderstrauma
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 6 , April 2018 , pp. 952 - 960
Copyright
Copyright © Cambridge University Press 2017 

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