Early traumatic experiences and eating disorders: a focus on the endogenous stress response system

Francesca Marciello 1, Alessio Maria Monteleone 2, Giammarco Cascino 1 2, Giuseppina Patriciello 2, Francesca Pellegrino 2, Gianmarco Fiorenza 1, Palmiero Monteleone 1

1 Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, University of Salerno, Salerno, Italy; 2 Department of Psychiatry, University of Campania L. Vanvitelli, Naples, Italy

Exposure to trauma during childhood is believed to be a major risk factor for lifelong psychiatric disorders, including eating disorders (EDs). Moreover, both an association between stressful life events and the onset/maintenance of EDs and higher presence of traumatic experiences in people with EDs have been documented. The aim of this review was to summarize the current knowledge concerning mechanisms involved in the connection between early trauma exposure and the risk to develop an ED by focusing on body stress response system. Several researches confirm that childhood trauma impairs the biological response to stress so dysregulations of the activity of the hypothalamic-pituitary adrenal (HPA) axis have been proposed as one of the main mechanisms underlying the early trauma-related risk for EDs across the life span. The data presented in this review support the existence of a “maltreated ecophenotype” in EDs characterized by specific clinic and neurobiological features resulting from early stressful environmental experiences. This concept may have important implications in treatment programming for such a type of patients.

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