title: Childhood trauma and cortisol awakening response in symptomatic patients with anorexia nervosa and bulimia nervosa.
abstract: OBJECTIVE
  Exposure to trauma during childhood is a risk factor for eating disorders (EDs) in adulthood. The biological mechanisms underlying such increased risk seem to involve the endogenous stress response system (i.e., the hypothalamic-pituitary-adrenal [HPA] axis), which undergoes trauma-induced functional changes that may persist later in life. In the present study, we examined the effects of childhood trauma experiences on HPA-axis activity, comparing saliva cortisol awakening response (CAR) in adult patients with anorexia nervosa (AN) or bulimia nervosa (BN) with CAR in adult healthy controls.
  
  
  METHODS
  Twenty-three patients with symptomatic AN, 21 patients with symptomatic BN, and 29 healthy women collected saliva samples at awakening and again after 15, 30, and 60 min. Participants also completed the Childhood Trauma Questionnaire and eating-related psychopathological rating scales.
  
  
  RESULTS
  According to the Childhood Trauma Questionnaire, 13 individuals with AN and 12 individuals with BN, but none of the healthy women, reported childhood maltreatment. Compared with the control group, the non-maltreated AN patient group exhibited an enhanced CAR, whereas the group of non-maltreated BN patients showed a normal CAR. Moreover, both AN and BN patient groups with childhood maltreatment exhibited statistically significant blunting of CAR compared with non-maltreated groups.
  
  
  CONCLUSIONS
  The present findings add to the evidence supporting the concept that there is a dysregulation of HPA-axis activity in symptomatic patients with EDs and suggest that childhood trauma exposure may contribute to such dysregulation.
authors: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors: Alessio Maria
authors: AM
authors: Monteleone
authors: Department of Psychiatry, University of Naples SUN, Naples, Italy.|Neurosciences Section, Department of Medicine and Surgery, University of Salerno, Salerno, Italy.
authors: Palmiero
authors: P
authors: Monteleone
authors: Department of Experimental Medicine, University of Naples SUN, Naples, Italy.
authors: Ismene
authors: I
authors: Serino
authors: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors: Pasquale
authors: P
authors: Scognamiglio
authors: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors: Monica
authors: M
authors: Di Genio
authors: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors: Mario
authors: M
authors: Maj
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000378:metabolism* / Q000523:psychology; D052018:Bulimia Nervosa / Q000378:metabolism* / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D000068099:Trauma and Stressor Related Disorders / Q000378:metabolism* / Q000523:psychology; D055815:Young Adult
chemical_list: D006854:Hydrocortisone