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Habitual Response to Stress in Recovering Adolescent Anorexic Patients

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Abstract

Objective Although previous research has investigated the stress response in acutely anorexic patients, there is currently little research addressing this response in recovering adolescent anorexic girls. Therefore, this study investigated partially and fully weight-restored anorexic adolescent girls’ psychological and physiological response to a standardized stressor. Methods We measured the heart rate and affect of 17 adolescent recovering anorexic patients and 40 healthy age-matched controls during two conditions of the Stress Induced Speech Task (SIST): Free Association and Stress Task. Recovering patients were either partially or fully weight-restored. Results Compared to the controls, the recovering anorexic girls reported greater overall habitual psychological distress and higher levels of negative affect during the standardized stressor. However, recovering patients did not show a muted heart rate response during the stressor. Neither recovering anorexics nor controls demonstrated a correspondence between heart rate and positive or negative affect. Discussion Although the physiological stress response of recovering adolescent anorexic patients was similar to controls, the psychological response of partially and fully weight-restored anorexic adolescents appears similar to that of acutely anorexic adolescents. Treatment implications are discussed in terms of the persistence of negative affect and treatment resistance.

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References

  1. Garner DM, Olmsted MP, Polivy J (1983) Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int J Eat Disord 2:15–34. doi:10.1002/1098-108X(198321)2:2<15::AID-EAT2260020203>3.0.CO;2-6

    Article  Google Scholar 

  2. Zonnevylle-Bender M, van Goozen S, Cohen-Kettenis P, Jansen L, van Elburg A, van Engeland H (2005) Adolescent anorexia nervosa patients have a discrepancy between neurophysiological responses and self-reported emotional arousal to psychosocial stress. Psychiatry Res 135:45–52. doi:10.1016/j.psychres.2004.11.006

    Article  PubMed  Google Scholar 

  3. Deering CG (1987) Developing a therapeutic alliance with the anorexia nervosa client. J Psychosoc Nurs Ment Health Serv 25:10–17

    Google Scholar 

  4. Miller S, Redlich A, Steiner H (2003) The stress response in anorexia nervosa. Child Psychiatry Hum Dev 33:295–306. doi:10.1023/A:1023036329399

    Article  PubMed  Google Scholar 

  5. Holtkamp K, Muller B, Heussen N, Remschmidt H, Herpertz-Dahlmann B (2005) Depression, anxiety, and obsessionality in long-term recovered patients with adolescent-onset anorexia nervosa. Eur Child Adolesc Psychiatry 14:106–110. doi:10.1007/s00787-005-0431-5

    Article  PubMed  Google Scholar 

  6. Meehan K, Loeb K, Roberto C, Attia E (2006) Mood change during weight restoration in patients with anorexia nervosa. Int J Eat Disord 39:587–589. doi:10.1002/eat.20337

    Article  PubMed  Google Scholar 

  7. Pollice C, Kaye WH, Greeno CG, Weltzin TE (1997) Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa. Int J Eat Disord 21:367–376. doi:10.1002/(SICI)1098-108X(1997)21:4<367::AID-EAT10>3.0.CO;2-W

    Article  PubMed  Google Scholar 

  8. Lattimore P, Gowers S, Wagner H (2000) Autonomic arousal and conflict avoidance in anorexia nervosa: a pilot study. Eur Eat Disord Rev 8:31–33. doi:10.1002/(SICI)1099-0968(200002)8:1<31::AID-ERV298>3.0.CO;2-4

    Article  Google Scholar 

  9. Kreipe R, Goldstein B, DeKing D, Tipton R (1994) Heart rate power spectrum analysis of autonomic dysfunction in adolescents with anorexia nervosa. Int J Eat Disord 16:159–165. doi:10.1002/1098-108X(199409)16:2<159::AID-EAT2260160207>3.0.CO;2-H

    Article  PubMed  Google Scholar 

  10. Centers for Disease Control and Prevention, National Center for Health Statistics (2000) CDC growth charts: United States. http://www.cdc.gov/growthcharts/

  11. Weinberger DA, Schwartz GE (1990) Distress and restraint as superordinate dimensions of self-reported adjustment: a typological perspective. J Pers 58:381–417. doi:10.1111/j.1467-6494.1990.tb00235.x

    Article  PubMed  Google Scholar 

  12. Shaw RJ, Ryst E, Steiner H (1996) Temperament as a correlate of adolescent defense mechanisms. Child Psychiatry Hum Dev 27:105–114. doi:10.1007/BF02353804

    Article  PubMed  Google Scholar 

  13. Allor KM, Troutman SR, Hartmann DC, Pivarnik JM (1999) Mini-Logger reliability and validity for estimating energy expenditure and heart rate in adolescents. Res Q Exerc Sport 70:70–74

    PubMed  Google Scholar 

  14. Steiner H, Ryst E, Berkowitz J, Gschwendt M, Carrion V, Koopman C (2002) Boys’ and girls’ responses to stress: affect and heart rate during a speech task. J Adolesc Health 30:14–21. doi:10.1016/S1054-139X(01)00387-1

    Article  PubMed  Google Scholar 

  15. Weintraub W, Aronson H (1962) The application of verbal behavior analysis to the study of psychological defense mechanisms: methodology and preliminary report. J Nerv Ment Dis 134:169–181. doi:10.1097/00005053-196202000-00008

    Article  PubMed  Google Scholar 

  16. Godart NT, Perdereau F, Rein Z, Berthoz S, Wallier J, Jeammet P et al (2007) Comorbidity studies of eating disorders and mood disorders: critical review of the literature. J Affect Disord 97:37–49. doi:10.1016/j.jad.2006.06.023

    Article  PubMed  Google Scholar 

  17. Taylor GJ, Bagby RM, Parker JDA (1997) Disorders of affect regulation: Alexithymia in medical and psychiatric illness. Cambridge University Press, Cambridge, UK

    Book  Google Scholar 

  18. Polivy J, Herman CP (2002) Causes of eating disorders. Annu Rev Psychol 53:187–213

    Article  PubMed  Google Scholar 

  19. Corstorphine E, Mountford V, Tomlinson S, Waller G, Meyer C (2007) Distress tolerance in the eating disorders. Eat Behav 8:91–97. doi:10.1016/j.eatbeh.2006.02.003

    Article  PubMed  Google Scholar 

  20. Spindler A, Milos G (2007) Links between eating disorder symptom severity and psychiatric comorbidity. Eat Behav 8:364–373. doi:10.1016/j.eatbeh.2006.11.012

    Article  PubMed  Google Scholar 

  21. Ackard DM, Fulkerson JA, Neumark-Sztainer D (2007) Prevalence and utility of DSM-IV eating disorder diagnostic criteria among youth. Int J Eat Disord 40:409–417. doi:10.1002/eat.20389

    Article  PubMed  Google Scholar 

  22. Wagner A, Barbarich-Marsteller NC, Frank GK, Bailer UF, Wonderlich SA, Crosby RD et al (2006) Personality traits after recovery from eating disorders: do subtypes differ? Int J Eat Disord 39:276–284. doi:10.1002/eat.20251

    Article  PubMed  Google Scholar 

  23. American Psychiatric Association (2006) Practice guideline for the treatment of patients with eating disorders, 3rd edn. American Psychiatric Association Work Group on Eating Disorders. Am J Psychiatry 163:4-4

    Google Scholar 

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Miller, S.P., Erickson, S.J., Branom, C. et al. Habitual Response to Stress in Recovering Adolescent Anorexic Patients. Child Psychiatry Hum Dev 40, 43–54 (2009). https://doi.org/10.1007/s10578-008-0112-y

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  • DOI: https://doi.org/10.1007/s10578-008-0112-y

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