Department of Psychiatry,University of Naples SUN,Naples,Italy.
Psychol Med. 2018 Apr;48(6):952-960. doi: 10.1017/S0033291717002409. Epub 2017 Aug 29.
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).
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.
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.
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.
童年创伤是成年饮食失调（ED）的一个非特异性风险因素，而下丘脑-垂体-肾上腺（HPA）轴似乎介导了这种风险。在这里，我们探讨了不同类型的童年创伤和创伤负荷对厌食症（AN）或贪食症（BN）女性皮质醇觉醒反应（CAR）的影响。
采集 121 名女性（44 名 AN 患者、36 名 BN 患者和 41 名健康女性）的觉醒时和觉醒后 15、30、60 分钟的唾液样本，通过 121 名女性（44 名 AN 患者、36 名 BN 患者和 41 名健康女性）测量皮质醇水平。参与者填写了童年创伤问卷。
与未受虐待的患者相比，遭受过童年虐待的 AN 和 BN 患者的 CAR 减弱。在整个 ED 患者组中，随着报告的创伤类型数量的增加，CAR 逐渐受损。尽管报告的创伤类型或数量与 CAR 之间存在显著的负相关，但在逐步多元回归分析中，只有创伤数量与 CAR 仍存在显著相关性。
目前的研究结果证实，童年创伤与成年 AN 和 BN 患者的 CAR 受损有关，并首次证明 HPA 轴活动的创伤负荷呈负剂量依赖性。
