Attachment Style And Cortisol Response To Psychosocial Stress In Eating Disorder Patients

2016 ◽  
Vol 33 (S1) ◽  
pp. S426-S427
Author(s):  
R. Giugliano ◽  
A.M. Monteleone ◽  
F. De Riso ◽  
M. Nigro ◽  
F. Monaco ◽  
...  

IntroductionStress exposure is a risk factor for both the onset and the maintenance of Eating Disorders (EDs). The attachment theory may provide a framework to explain the relationship between social stress and EDs, since secure attachment promotes the seeking for support in order to help people to face stressful events. The endogenous stress response system, including the hypothalamus-pituitary-adrenal (HPA) axis, is likely involved in mediating the role of attachment in the subjects’ coping with stressful situations.Objectives and aimsWe explored cortisol responses to the Trier Social Stress Test (TSST) of patients with EDs in order to evaluate possible associations between subjects’ attachment styles and HPA axis functioning.MethodsTwenty-one adult patients with EDs (7 with secure attachment and 14 with insecure attachment) filled in the Experience in Close Relationship (ECR) questionnaire, which assesses the adult attachment style, and were exposed to the TSST. Saliva samples were collected before and after the stress in order to measure cortisol levels.ResultsAs compared to ED patients with secure attachment, those with insecure attachment showed a significant different pattern of the HPA response to the stress test.DiscussionPresent findings suggest that attachment style may influence the HPA response to stress in patients with EDs and this effect may have relevant implications for the pathophysiology of EDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Author(s):  
Sisitha Udara Jayasinghe ◽  
Sarah Janet Hall ◽  
Susan Jane Torres ◽  
Anne Isabella Turner

While the patterns of response within the sympatho-adrenal medullary (SAM) system and hypothalamo-pituitary adrenal (HPA) axis are interesting and important in their own accord, the overall response to acute psychological stress involves reactivity of both pathways We tested the hypothesis that consideration of the integrated response of these pathways may reveal dysregulation of the stress systems that is not evident when considering either system alone. Age matched lean and overweight/obese men were subjected to a Trier Social Stress Test and reactivity of the SAM system (salivary alpha amylase, systolic blood pressure, diastolic blood pressure and heart rate) and the HPA axis (salivary cortisol) were measured. Relative reactivity of SAM system and HPA axis was calculated as the ratio between the measures from each pathway. While analysis of reactivity of individual stress pathways showed no evidence of dysfunction in overweight/obese compared with lean men, analysis of HPA/SAM reactivity revealed significantly lower cortisol over systolic blood pressure (CoSBP) and cortisol over diastolic blood pressure (CoDBP) reactivity in overweight/obese compared with lean men. Other measures of HPA/SAM reactivity and all measures of SAM/HPA reactivity were unaltered in overweight/obese compared with lean men. These findings suggest that the cortisol response per unit of blood pressure response is blunted in men with elevated adiposity. Further, these findings support a notion of a coordinated overall approach to activation of the stress pathways with the degree of activation in one pathway being related to the degree of activation of the other.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S15-S15
Author(s):  
Philippa Clery ◽  
Angela Rowe ◽  
Marcus Munafò ◽  
Liam Mahedy

AimsIdentifying factors that contribute to mental health difficulties in young people as early in life as possible are needed to inform prevention strategies. One area of interest is attachment. Although existing research has suggested an association between insecure attachment styles and mental health difficulties, these studies often have small sample sizes, use cross-sectional designs, and measure attachment as a discrete variable at a single point or use romantic relationship attachment as a proxy for childhood attachment. It is also unclear whether these associations persist into late adolescence. In this large prospective study we aimed to determine whether an insecure attachment style measured at repeated points in early childhood, is associated with depression and self-harm at 18 years.MethodWe used data from the Avon Longitudinal Study of Parents and Children cohort. Mothers completed attachment related questionnaires when their child was 18, 30, and 42 months old. Offspring depression and lifetime self-harm was assessed at 18 years in clinic using the Clinical Interview Schedule-Revised. Attachment was derived as a continuous latent variable in a structural equation modelling framework. Logistic regression was performed on participants with complete attachment data (n = 7032) to examine the association between attachment style and depression and self-harm, with adjustment for potential confounders. Differential dropout was accounted for using multiple imputation.ResultWe found some evidence for an association between a more insecure attachment style in childhood, and a diagnosis of depression and life-time self-harm at age 18. In the fully adjusted imputed model, a one standard deviation increase in insecure attachment was associated with a 13% increase in the odds of depression (OR = 1.13; 95%CI = 1.00 to 1.27) and a 14% increase in the odds of self-harm at age 18 (OR = 1.14; 95%CI = 1.02 to 1.25), for children who had more insecure attachment in early childhood, compared with children who had more secure attachment.ConclusionThis is the largest longitudinal study to examine the prospective association between childhood attachment and depression and self-harm in late adolescence. Our findings strengthen the evidence suggesting that a childhood insecure attachment style is associated with mental health difficulties in late adolescence. Policies and interventions to support parenting behaviours that foster the development of secure attachment styles, or attachment-based therapies to improve attachment quality, could help reduce depression and self-harm in adolescence/young adulthood.Philippa Clery is supported by the Elizabeth Blackwell Institute for Health Research at the University of Bristol and the Wellcome Trust Institutional Strategic Support Fund.


2013 ◽  
Vol 44 (2) ◽  
pp. 160-166 ◽  
Author(s):  
Hans IJzerman ◽  
Johan C. Karremans ◽  
Lotte Thomsen ◽  
Thomas W. Schubert

Does physical warmth lead to caring and sharing? Research suggests that it does; physically warm versus cold conditions induce prosocial behaviors and cognitions. Importantly, previous research has not traced the developmental origins of the association between physical warmth and affection. The association between physical warmth and sharing may be captured in specific cognitive models of close social relations, often referred to as attachment styles. In line with this notion, and using a dictator game set-up, the current study demonstrates that children who relate to their friends with a secure attachment style are more generous toward their peers in warm than in cold conditions. This effect was absent for children who relate to friends with an insecure attachment style. Notably, however, these children not just always shared less: They allocated more stickers to a friend than to a stranger. These findings provide an important first step to understand how fundamental embodied relations develop early in life. We discuss broader implications for grounded cognition and person perception.


2011 ◽  
Vol 41 (9) ◽  
pp. 1963-1969 ◽  
Author(s):  
P. Monteleone ◽  
P. Scognamiglio ◽  
B. Canestrelli ◽  
I. Serino ◽  
A. M. Monteleone ◽  
...  

BackgroundThe stress response involves the activation of the hypothalamic–pituitary–adrenal (HPA) axis and the sympathetic nervous system (SNS). As a role for stress in determining of the onset and the natural course of eating disorders (EDs) has been proposed, the study of the psychobiology of the stress response in patients with anorexia nervosa (AN) and bulimia nervosa (BN) should be helpful in understanding the pathophysiology of these disorders. The two neurobiological components of the stress response can be easily explored in humans by the measurement of salivary cortisol and α-amylase response to a stressor. Therefore, we assessed salivary cortisol and α-amylase responses to the Trier Social Stress Test (TSST) in symptomatic patients with AN and BN compared to healthy controls.MethodSeven AN women, eight BN women and eight age-matched healthy females underwent the TSST between 1530 and 1700 h. Salivary cortisol and α-amylase levels were measured by an enzyme-linked immunosorbent assay (ELISA).ResultsCompared to healthy women, AN patients showed a normal cortisol response to the TSST, although this occurred at significantly increased hormone levels, and an almost complete absence of response of α-amylase. BN women, however, exhibited enhanced pre-stress levels of salivary α-amylase but a normal response of the enzyme and cortisol to the TSST.ConclusionsThese 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.


2017 ◽  
Vol 41 (S1) ◽  
pp. S91-S91
Author(s):  
F. Marciello ◽  
V.-M. Buonomenna ◽  
V. Caivano ◽  
G. Cascino ◽  
G. D’Agostino ◽  
...  

IntroductionChildhood trauma exposure is associated with the risk of eating disorders (EDs) in adulthood. The biological basis of this link may involve a persistent dysregulation of the endogenous stress response system, in particular the hypothalamic-pituitary-adrenal (HPA) axis, as a consequence of early life maltreatment.ObjectiveAdult patients with EDs and history of childhood trauma may have a dysregulation of the HPA axis that could be different from EDs patients without childhood trauma exposure.AimsIn order to assess the effects of childhood trauma experiences on HPA-axis activity in EDs, we compared the salivary cortisol response to the Trier Social Stress Test (TSST) of adult patients with EDs according to their history of childhood trauma.MethodTwenty-seven EDs patients and 13 healthy women participated in the study. Salivary cortisol responses during exposure to the TSST was measured. Participants also completed the childhood trauma questionnaire (CTQ) and eating-related psychopathological rating scales.ResultsAccording to CTQ, 15 individuals with EDs reported childhood maltreatment whereas 12 EDs patients and all the healthy women did not experience childhood maltreatment. Compared with the control group, non-maltreated EDs patient group exhibited a slightly enhanced cortisol response to TSST, whereas the group of non-maltreated EDs patients showed a normal cortisol response. Moreover, EDs patients with childhood maltreatment exhibited statistically significant blunting of cortisol compared to non-maltreated ones.ConclusionsThe present findings support the evidence that, in patients with EDs, there is a dysregulation of HPA-axis activity and that childhood trauma exposure may contribute to this dysregulation.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 12 ◽  
Author(s):  
Qian Liu ◽  
Jianhui Wu ◽  
Liang Zhang ◽  
Xiaofang Sun ◽  
Qing Guan ◽  
...  

Psychological factors can modulate the hypothalamic–pituitary–adrenal (HPA) axis activity toward stressors. Animal studies demonstrated that uncontrollability was one critical factor associated with HPA axis stress response, but the results in human studies were inconsistent. The current study adopted a standardized laboratory stress induction procedure, the Trier Social Stress Test (the TSST), as the stressor to regulate the objective controllability level, and young adult participants were asked to rate their subjectively perceived control level toward the stressor and measured their cortisol stress responses (N=54; 19 females and 35 males) to address this concern. Results showed that participants’ perceived control on the TSST was related to the cortisol stress response. In other words, under the stress of a certain objective controllability level, the lower the subjectively perceived control level, the greater the HPA axis response. This finding suggested that, in addition to objective controllability, subjectively perceived control is a psychological factor that regulates activation of the HPA axis in young adults.


2021 ◽  
Vol 8 (4) ◽  
Author(s):  
Ahmadreza Askari Ashtiani ◽  
Vahid Shaygannejad ◽  
Foad Ghobadi ◽  
Roozbeh Bathaie ◽  
Shima Shahyad ◽  
...  

Background: It has long been suspected that exposure to stress is a major factor that can increase the risk of Multiple Sclerosis (MS) and exacerbate it, as a stress-related disorder. Therefore, we conducted this study to investigate the response of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adrenal-medullar (SAM) system to acute social stress. Methods: A total of 46 MS patients and 23 age-sex-matched healthy controls were recruited in the study. The Trier Social Stress Test (TSST) was used to induce acute psychosocial stress. We measured salivary cortisol (SC) to evaluate the HPA axis. In addition, electrocardiography (ECG) was recorded to evaluate the SAM system based on the linear and non-linear features of Heart Rate Variation (HRV). Then, SC and HRV were measured before and after the stress exposure. We also used the Depression Anxiety Stress Scale (DASS) and Emotional Visual Analog Scale (EVAS) to conduct the psychometric assessment and evaluate the perceived stress level, respectively. Results: The mean age of the MS group was 35.38 ± 15 years, with a mean disease duration of 7.4 ± 60. Besides, the HC group's mean age was 35.8 ± 9 years. There were no significant differences in demographic features and DASS scores between the two groups. In response to TSST, both MS and healthy individuals showed a significant increase in the SC levels and EVAS scores, as well as changes in the HRV indices. Notably, significant differences were also found between the two groups regarding the basic and post-stress SC levels, EVAS score, and HRV indices. Unlike the HC group, the SC level returned to its baseline after recovery in the MS group, and the sympathetic tone was more sensitive. Conclusions: Our results indicated that both MS and healthy individuals respond to acute stress regarding neuroendocrine assessment; however, patients with multiple sclerosis show some impairments in this response.


2020 ◽  
pp. 1-12 ◽  
Author(s):  
Ethan S. Young ◽  
Jenalee R. Doom ◽  
Allison K. Farrell ◽  
Elizabeth A. Carlson ◽  
Michelle M. Englund ◽  
...  

Abstract Stressful experiences affect biological stress systems, such as the hypothalamic–pituitary–adrenal (HPA) axis. Life stress can potentially alter regulation of the HPA axis and has been associated with poorer physical and mental health. Little, however, is known about the relative influence of stressors that are encountered at different developmental periods on acute stress reactions in adulthood. In this study, we explored three models of the influence of stress exposure on cortisol reactivity to a modified version of the Trier Social Stress Test (TSST) by leveraging 37 years of longitudinal data in a high-risk birth cohort (N = 112). The cumulative stress model suggests that accumulated stress across the lifespan leads to dysregulated reactivity, whereas the biological embedding model implicates early childhood as a critical period. The sensitization model assumes that dysregulation should only occur when stress is high in both early childhood and concurrently. All of the models predicted altered reactivity, but do not anticipate its exact form. We found support for both cumulative and biological embedding effects. However, when pitted against each other, early life stress predicted more blunted cortisol responses at age 37 over and above cumulative life stress. Additional analyses revealed that stress exposure in middle childhood also predicted more blunted cortisol reactivity.


2011 ◽  
Vol 36 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Philip A. Fisher ◽  
Hyoun K. Kim ◽  
Jacqueline Bruce ◽  
Katherine C. Pears

Dysregulated hypothalamic-pituitary-adrenocortical (HPA) axis stress response has been reported among individuals with prenatal substance exposure and those with early adversity exposure. However, few researchers have examined the combined effects of these risk factors. Patterns of HPA reactivity among maltreated foster children with and without prenatal substance exposure ( N = 53; ages 9–12 years) were examined using the Trier Social Stress Test for Children. Area under the curve with respect to increase (AUCI) analyses revealed that prenatal substance exposure or physical abuse significantly increased the likelihood of a negative AUCI (i.e., little or no HPA reactivity). Among children with prenatal substance exposure and physical abuse, 85% exhibited a negative AUCI. The results underscore the importance of addressing this combined risk.


2021 ◽  
Vol 25 (111) ◽  
pp. 183-190
Author(s):  
Francis Segundo Cevallos Robayo ◽  
Diana Carolina Garcia Ramos ◽  
Carmen Varina Barba Guzman ◽  
Gabriela Lorena Abril Lucero

The objective of this study was to describe the styles of adult attachment and alcohol consumption in young adults, measured through the CaMir-R test and the AUDIT questionnaire, analyzed under the InfoStat statistical program, respectively. Based on a sample of 167 young adults, men and women, between the ages of 18 and 32. The results show that 82.6% of the population is a consumer of alcohol with the highest prevalence in the secure attachment style, followed by the preoccupied insecure, insecure avoidant attachment style and the disorganized attachment indicator. The higher the level of alcohol consumption, the secure attachment scores decrease and rise in preoccupied insecure attachment style. The result does not statistically infer the linear causality of the study variables. The secure attachment style can function as a protective factor and the preoccupied insecure attachment as a risk factor for increasing the level of alcohol consumption. Keywords: adult attachment, alcohol use, alcoholism, risk of addiction. References [1]Organización Panamericana de la Salud; Organización Mundial de la Salud, «Agenda de Salud Sostenible para las Américas 2018-2030: Un llamado a la acción para la salud y el bienestar en la región,» de 29.a Conferencia Sanitaria Panamericana, Washington, 2017. [2]Comisión Interamericana para el Control del Abuso de Drogas; Organización de los Estados Americanos , «Informe sobre el Consumo de Drogas en las Américas 2019,» Organización de los Estados Americanos, Washington, D.C., 2019. [3]Instituto Nacional de Estadísticas y Censos, «Compendio de Resultados de la Encuesta de Condiciones de Vida ECV 2014,» INEC, Quito, 2014. [4]E. Becoña Iglesias, E. Fernández del Río, A. Calafat and J. Fernández-Hermida, «Apego y consumo de sustancias en la adolescencia: Una revisión de aspectos conceptuales y metodológicos,» Adicciones, vol. 26, nº 1, pp. 1-11, 2014. [5]K. MacDonald, The Interfaces Between Sociobiology and Devolopmental Psychology, New York: Springer, 1988. [6]J. Feeney and P. Noller, Apego Adulto, Bilbao: Desclée de Brouwer, 2001. [7]J. Bowlby, Vínculos afectivos: Formación, Desarrollo y Pérdida, Madrid: Ediciones Morata, 2014. [8]O. Barroso, «El Apego Adulto: La relación de los Estilos de Apego Desarrollados en la Infancia en la Elección y las Dínamicas de Pareja,» Revista Digital de Medicina Psicosomática y PSicoterapia, vol. 4, nº 1, pp. 1-25, 2014. [9]S. Freud, El malestar de la cultura, Obras Completas, Buenos Aires: Amorrortu, 1930. [10]F. Naparstek, Introducción a la clínica con toxicomanías y alcoholismo, Buenos Aires: Grama Ediciones, 2005. [11]J. A. Miller, La experiencia de lo real en la cura psicoanalítica, Buenos Aires: Paidós, 2003. [12]M. Barradas, N. Fernández and L. Gutierrez, «Prevalencia de consumo de alcohol en estudiantes universitarios, » Revista Iberoamericana para la Investigación y el Desarrollo Educativo, vol. 6, nº 12, 2016. [13]M. Cornellà-Font, F. Viñas-Poch, J. Juárez-López, M. d. l. M. Martín-Perpiñá and S. Malo-Cerrato, «Temperament and attachment as predictive factors for the risk of addiction to substances in adolescents,» Revista De Psicopatología Y Psicología Clínica, vol. 23, nº 3, pp.179-187, 2019. [14]L. Anderson, J. Connor, J. Voisey, R. Young and M. Gullo, «The unique role of attachment dimensions and peer drinking in adolescent alcohol use,» Personality and Individual Differences, vol. 149, pp. 118-122, 2019. [15]C. Pinto-Cortez, M. Beyzaga, M. F. Cantero, X. Oviedo and V. Vergara, «Apego y psicopatología en adolescentes del Norte de Chile,» Revista de PsicologíaClínica con Niños y Adolescentes, vol. 5, nº 3, pp. 23-29, 2018. [16]K. Ward and G. Limb, «Emerging Adult Attachment and Alcohol Abuse Among American Indians Raised in Stepfamilies,» The British Journal of Social Work, vol. 49, nº 6, pp. 1452-1471, 2019. [17]C. Fairbairn, D. Briley, D. Kang, C. Fraley, B. Hankin and T. Ariss, «A meta-analysis of longitudinal associations between substance use and interpersonal attachment security,» Psychological Bulletin, vol. 144, nº 5, pp. 532-555, 2018.


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