title: Blunted neuroendocrine stress reactivity in young women with eating disorders.
abstract: OBJECTIVE
  Stress is known to influence risk and progression of eating disorders (EDs). However, studies investigating physiological and psychological stress responses under laboratory conditions in patients with Anorexia nervosa or Bulimia nervosa are scarce and often produce conflicting findings. We therefore aimed to compare the neuroendocrine and affective stress response in ED inpatients and healthy controls.
  
  
  METHODS
  Twenty-eight female inpatients with Anorexia or Bulimia nervosa and 26 healthy women were exposed to the Trier Social Stress Test (TSST). Salivary cortisol and alpha-amylase (sAA) levels were assessed before as well as repeatedly after stress exposure, while heart rate and heart rate variability were determined before and during the TSST. Negative affective state was assessed at baseline and post-TSST.
  
  
  RESULTS
  Compared to healthy controls, ED patients showed blunted cortisol stress responses combined with overall attenuated sAA levels. The latter was reflected in generally enhanced parasympathetic activity indicated by lower heart rate and stronger high-frequency heart rate variability throughout the TSST. Although patients reported more negative affect overall, they did not differ in their affective stress response.
  
  
  CONCLUSIONS
  In summary, patients suffering from eating disorders show a blunted HPA axis reactivity to stress exposure and a generally reduced sympathetic/exaggerated parasympathetic nervous system activity. This combination may contribute to elevated health risks seen in eating disorder patients, such as enhanced inflammatory activity, and thus provide insight into the underlying stress-related mechanisms.
authors.affiliation: Department of Cognitive Psychology, Ruhr-University Bochum, Germany.
authors.forename: Serkan
authors.initials: S
authors.lastname: Het
authors.affiliation: Department of Clinical Psychology and Psychotherapy, Osnabrück University, Germany.
authors.forename: Silja
authors.initials: S
authors.lastname: Vocks
authors.affiliation: Department of Psychology, Brandeis University, Waltham, USA.
authors.forename: Jutta M
authors.initials: JM
authors.lastname: Wolf
authors.affiliation: Christoph-Dornier Clinic for Psychotherapy, Münster, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Hammelstein
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic, Ruhr-University Bochum, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Herpertz
authors.affiliation: Department of Cognitive Psychology, Ruhr-University Bochum, Germany. Electronic address: oliver.t.wolf@rub.de.
authors.forename: Oliver T
authors.initials: OT
authors.lastname: Wolf
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000378:metabolism / Q000503:physiopathology*; D052018:Bulimia Nervosa / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology*; D010913:Pituitary-Adrenal System / Q000503:physiopathology*; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D055815:Young Adult; D000516:alpha-Amylases / Q000378:metabolism
chemical_list: D000516:alpha-Amylases; D006854:Hydrocortisone
keywords: Anorexia nervosa; Bulimia nervosa; Cortisol; Hypothalamus–pituitary–adrenal (HPA) axis; Stress; Sympathetic nervous system (SNS)