Monteleone Alessio Maria, Marciello Francesca, Cascino Giammarco, Cimino Monica, Ruzzi Valeria, Pellegrino Francesca, Del Giorno Chiara, Monteleone Palmiero
Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy.
Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy.
Psychoneuroendocrinology. 2020 May;115:104644. doi: 10.1016/j.psyneuen.2020.104644. Epub 2020 Mar 5.
Childhood trauma is a non-specific risk factor for eating disorders (EDs). It has been suggested that this risk is exerted through trauma-induced long-lasting changes in the body stress response system. Therefore, we explored the activity of the hypothalamus-pituitary-adrenal axis and of the sympathetic nervous system in adult ED patients with or without a history of childhood trauma exposure. Salivary cortisol and alpha-amylase, a marker of the sympathetic nervous system activity, were measured at awakening and after 15, 30 and 60 min in 35 women with EDs. The Childhood Trauma Questionnaire (CTQ) was employed to assess exposure to childhood trauma and, according to the CTQ cut-off scores, 21 ED women were classified as maltreated (Mal) participants and 14 women as no-maltreated (noMal) ED participants. Compared to noMal ED women, Mal ED participants showed significantly decreased cortisol awakening response (between group difference: p = 0.0003) and morning salivary alpha-amylase secretion (between group difference: p = 0.02). Present results confirm that the cortisol awakening response of adult ED patients with childhood trauma exposure is lower than that of adult ED patients without childhood trauma experiences and show for the first time that also the morning secretion of salivary alpha-amylase is decreased in adult ED patients who have been exposed to early traumatic experiences. These results point for the first time to a dampening in the basal activity of both components of the endogenous stress response system in childhood maltreated adult ED women.
童年创伤是进食障碍（EDs）的一个非特异性风险因素。有人认为，这种风险是通过创伤诱导的身体应激反应系统的长期变化来施加的。因此，我们探讨了有或没有童年创伤暴露史的成年进食障碍患者下丘脑-垂体-肾上腺轴和交感神经系统的活动。在35名患有进食障碍的女性中，测量了她们醒来时以及15、30和60分钟后的唾液皮质醇和作为交感神经系统活动标志物的α-淀粉酶。采用儿童创伤问卷（CTQ）来评估童年创伤暴露情况，根据CTQ的临界分数，21名患有进食障碍的女性被归类为受虐待（Mal）参与者，14名女性被归类为未受虐待（noMal）的进食障碍参与者。与noMal进食障碍女性相比，Mal进食障碍参与者的皮质醇觉醒反应显著降低（组间差异：p = 0.0003），早晨唾液α-淀粉酶分泌也显著降低（组间差异：p = 0.02）。目前的结果证实，有童年创伤暴露史的成年进食障碍患者的皮质醇觉醒反应低于没有童年创伤经历的成年进食障碍患者，并且首次表明，有早期创伤经历的成年进食障碍患者早晨唾液α-淀粉酶的分泌也会减少。这些结果首次表明，童年受虐待的成年进食障碍女性内源性应激反应系统两个组成部分的基础活动受到了抑制。
