Asymmetry of salivary cortisol and α-amylase responses to psychosocial stress in anorexia nervosa but not in bulimia nervosa

Monteleone, Palmiero; Scognamiglio, Pasquale; Canestrelli, Benedetta; Serino, Ismene; Monteleone, Alessio Maria; Maj, M.

doi:10.1017/s0033291711000092

Cited by 51 publications

(57 citation statements)

References 34 publications

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“…The present results also implicate differences in HPA axis activation. The only previous study to examine both sympathetic and HPA axis activation found blunted cortisol stress reactivity in bulimic patients, but blunted a-amylase reactivity in patients with anorexia nervosa, suggesting some specificity in the two branches of the stress effector system (Monteleone et al, 2011). Others have proposed that sympathetic and HPA activation can be dissociated in some circumstances (Frankenhaeuser, 1982;Dickerson and Kemeny, 2004).…”

Section: Discussionmentioning

confidence: 98%

“…It is important to determine whether dysregulation of the stress response is characteristic of both branches, of the stress effector system: hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system. The one study, to date, to examine this issue measured cortisol and a-amylase, considered a marker of sympathetic nervous system activation (Chatterton et al, 1996), to a standard laboratory stress exposure (Monteleone et al, 2011) in women with anorexia nervosa and bulimia. Relative to those with anorexia nervosa, women with bulimia showed blunted cortisol reactivity, whereas women with anorexia nervosa showed blunted a-amylase reactivity.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Disordered eating behaviour is associated with blunted cortisol and cardiovascular reactions to acute psychological stress

Ginty¹,

Phillips²,

Higgs³

et al. 2012

Psychoneuroendocrinology

104

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Disordered eating behaviour is associated with blunted cortisol and cardiovascular reactions to acute psychological stress

Ginty¹,

Phillips²,

Higgs³

et al. 2012

Psychoneuroendocrinology

104

View full text Add to dashboard Cite

“…The AUC G cortisol outcome measure was selected a priori as our primary end-point. Based on previous investigations in other pathological conditions with sample sizes of 10-14 participants per group (Chopra et al 2009;Monteleone et al 2011), our study was powered to detect a 1.5-fold group difference on AUC G cortisol levels with an expected large effect size d = 0.80 (Cohen, 1988), with 50.80 power and α = 0.05. Data are presented as mean ± standard error of the mean (S.E.M.).…”

Section: Discussionmentioning

confidence: 99%

A sustained hypothalamic–pituitary–adrenal axis response to acute psychosocial stress in irritable bowel syndrome

et al. 2014

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Background. Despite stress being considered a key factor in the pathophysiology of the functional gastrointestinal (GI) disorder irritable bowel syndrome (IBS), there is a paucity of information regarding the ability of IBS patients to respond to acute experimental stress. Insights into the stress response in IBS could open the way to novel therapeutic interventions. To this end, we assessed the response of a range of physiological and psychological parameters to the Trier Social Stress Test (TSST) in IBS.Method. Thirteen female patients with IBS and 15 healthy female age-matched control participants underwent a single exposure to the TSST. Salivary cortisol, salivary C-reactive protein (CRP), skin conductance level (SCL), GI symptoms, mood and self-reported stress were measured pre-and post-exposure to the TSST.Results. The hypothalamic-pituitary-adrenal (HPA) axis response to the TSST was sustained in IBS, as shown by a greater total cortisol output throughout (p = 0.035) and higher cortisol levels measured by an area under the curve with respect to ground (AUC G ) analysis (p = 0.044). In IBS patients, GI symptoms increased significantly during the recovery period following exposure to the TSST (p = 0.045). Salivary CRP and SCL activity showed significant changes in relation to stress but with no differential effect between experimental groups.Conclusions. Patients with IBS exhibit sustained HPA axis activity, and an increase in problematic GI symptoms in response to acute experimental psychosocial stress. These data pave the way for future interventional studies aimed at identifying novel therapeutic approaches to modulate the HPA axis and GI symptom response to acute psychosocial stress in IBS.

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“…It has been recently proposed that ghrelin may mediate the rewarding aspects of eating that are separated from eating-associated body weight homeostasis [36] and, therefore, its rise after stress exposure could be involved in stress-induced feeding where the ingestion of food is aimed at reducing negative emotions by increasing food-derived feelings of pleasure. Therefore, since in our BN patients the ghrelin secretion in response to TSST was amplified, we could speculate that when BN patients are in conditions of negative mood states, the psychological distress may induce an exaggerated ghrelin secretion which could constitute a strong signal of hunger and/or urge to eat, thereby prompting binge eating.…”

Section: Discussionmentioning

confidence: 99%

The Acute Salivary Ghrelin Response to a Psychosocial Stress Is Enhanced in Symptomatic Patients with Bulimia Nervosa: A Pilot Study

Monteleone

Tortorella²,

Scognamiglio³

et al. 2012

Neuropsychobiology

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Background: Stress is a precipitating factor for both binge eating and bulimia nervosa (BN); however, the biological mechanisms through which it may trigger binge eating are poorly understood. There is evidence that the adrenal hormone cortisol and the gastric peptide ghrelin might be involved in stress-induced food ingestion. We hypothesized that symptomatic patients with BN might disclose deranged responses of ghrelin and/or cortisol to stressors and that this could be related to their binge-eating behaviour. Methods: Here we investigated salivary cortisol and ghrelin responses to the Trier Social Stress Test (TSST) in 10 women with acute BN and 10 age-matched healthy females. Eating-related psychopathology and behaviours were assessed by self-report measures. Results: No significant differences emerged between bulimic patients and healthy controls in the pre-stress salivary levels of both cortisol and ghrelin. The BN patients displayed normal cortisol but enhanced ghrelin responses to TSST. No significant correlations emerged between stress-induced salivary hormone changes and self-report measures of binge eating. Conclusion: To our knowledge, this is the first study showing deranged salivary ghrelin reactivity to a psychosocial stressor in symptomatic patients with BN. The extent to which this could contribute to the binge-eating behaviour of BN subjects awaits clarification.

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Asymmetry of salivary cortisol and α-amylase responses to psychosocial stress in anorexia nervosa but not in bulimia nervosa

Abstract: These findings demonstrate, for the first time, the occurrence of an asymmetry between the HPA axis and SNS components of the stress response in the acute phase of AN but not in BN. The pathophysiological significance of this asymmetry remains to be determined.

Cited by 51 publications

References 34 publications

Disordered eating behaviour is associated with blunted cortisol and cardiovascular reactions to acute psychological stress

Disordered eating behaviour is associated with blunted cortisol and cardiovascular reactions to acute psychological stress

A sustained hypothalamic–pituitary–adrenal axis response to acute psychosocial stress in irritable bowel syndrome

The Acute Salivary Ghrelin Response to a Psychosocial Stress Is Enhanced in Symptomatic Patients with Bulimia Nervosa: A Pilot Study

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