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Recovery from Adolescent Anorexia Nervosa and Associations with Diurnal Patterns of Salivary Stress Hormones: A Case Report

In the neurodevelopment of adolescent anorexia nervosa (AN), dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is proposed to be a central component. Furthermore, a therapeutic milieu focusing on affect regulation can contribute much to treatment, given the emotional processing difficul...

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Autores principales: Oskis, Andrea, Loveday, Catherine, Hucklebridge, Frank, Wood, David, Clow, Angela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530225/
https://www.ncbi.nlm.nih.gov/pubmed/23304603
http://dx.doi.org/10.1155/2012/798512
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author Oskis, Andrea
Loveday, Catherine
Hucklebridge, Frank
Wood, David
Clow, Angela
author_facet Oskis, Andrea
Loveday, Catherine
Hucklebridge, Frank
Wood, David
Clow, Angela
author_sort Oskis, Andrea
collection PubMed
description In the neurodevelopment of adolescent anorexia nervosa (AN), dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is proposed to be a central component. Furthermore, a therapeutic milieu focusing on affect regulation can contribute much to treatment, given the emotional processing difficulties associated with this disorder. Studies of HPA axis function following such specialist treatments for adolescent AN, however, are rare. This study describes the diurnal pattern of HPA axis activation, including the cortisol awakening response (CAR), in a 16-year-old female diagnosed with AN both during illness and at clinical recovery following milieu therapy with a focus on affect regulation. Specialised single-case study statistics were used to assess whether the patient's data were significantly different from the healthy “norm” at illness and recovery. During illness, her measure of affective problems was outside of the normal range and cortisol and DHEA secretory profiles were significantly elevated across the diurnal period. However, at recovery both her affective state and HPA axis function became comparable to healthy controls. This case study suggests that salivary markers of HPA axis function can be feasibly incorporated into the clinical regime within a specialist adolescent AN residential service and could be used by clinicians to monitor prognosis and interventions.
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spelling pubmed-35302252013-01-09 Recovery from Adolescent Anorexia Nervosa and Associations with Diurnal Patterns of Salivary Stress Hormones: A Case Report Oskis, Andrea Loveday, Catherine Hucklebridge, Frank Wood, David Clow, Angela Case Rep Psychiatry Case Report In the neurodevelopment of adolescent anorexia nervosa (AN), dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis is proposed to be a central component. Furthermore, a therapeutic milieu focusing on affect regulation can contribute much to treatment, given the emotional processing difficulties associated with this disorder. Studies of HPA axis function following such specialist treatments for adolescent AN, however, are rare. This study describes the diurnal pattern of HPA axis activation, including the cortisol awakening response (CAR), in a 16-year-old female diagnosed with AN both during illness and at clinical recovery following milieu therapy with a focus on affect regulation. Specialised single-case study statistics were used to assess whether the patient's data were significantly different from the healthy “norm” at illness and recovery. During illness, her measure of affective problems was outside of the normal range and cortisol and DHEA secretory profiles were significantly elevated across the diurnal period. However, at recovery both her affective state and HPA axis function became comparable to healthy controls. This case study suggests that salivary markers of HPA axis function can be feasibly incorporated into the clinical regime within a specialist adolescent AN residential service and could be used by clinicians to monitor prognosis and interventions. Hindawi Publishing Corporation 2012 2012-12-11 /pmc/articles/PMC3530225/ /pubmed/23304603 http://dx.doi.org/10.1155/2012/798512 Text en Copyright © 2012 Andrea Oskis et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Oskis, Andrea
Loveday, Catherine
Hucklebridge, Frank
Wood, David
Clow, Angela
Recovery from Adolescent Anorexia Nervosa and Associations with Diurnal Patterns of Salivary Stress Hormones: A Case Report
title Recovery from Adolescent Anorexia Nervosa and Associations with Diurnal Patterns of Salivary Stress Hormones: A Case Report
title_full Recovery from Adolescent Anorexia Nervosa and Associations with Diurnal Patterns of Salivary Stress Hormones: A Case Report
title_fullStr Recovery from Adolescent Anorexia Nervosa and Associations with Diurnal Patterns of Salivary Stress Hormones: A Case Report
title_full_unstemmed Recovery from Adolescent Anorexia Nervosa and Associations with Diurnal Patterns of Salivary Stress Hormones: A Case Report
title_short Recovery from Adolescent Anorexia Nervosa and Associations with Diurnal Patterns of Salivary Stress Hormones: A Case Report
title_sort recovery from adolescent anorexia nervosa and associations with diurnal patterns of salivary stress hormones: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530225/
https://www.ncbi.nlm.nih.gov/pubmed/23304603
http://dx.doi.org/10.1155/2012/798512
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