Blunted Cortisol Awakening Response and Poor Self‐Perceived Health in Informal Caregivers of People with Eating Disorders

Abstract

Caring for offspring diagnosed with eating disorders (EDs) entails being under high chronic stress, with negative consequences for health. However, most previous research has only evaluated self-report measures of health, biological markers being poorly studied. In this regard, the evaluation of the cortisol awakening response (CAR) could add significant information about the biological basis of health disturbances in this population. The main aim of the present study was to compare CAR and self-reported health between informal caregivers (ICs) of people with EDs and non-caregivers. Furthermore, we explored the effect of the nature of the diagnosis, comparing ICs of people with anorexia and bulimia nervosa. ICs had a blunted CAR, and more anxiety and insomnia, and social dysfunction, together with poorer perceived general health than non-caregivers. ICs of people with anorexia nervosa had higher levels of morning cortisol and burden, and more social dysfunction and severe depression than those of people with bulimia nervosa. Our results demonstrate marked health problems in ICs of people with EDs, especially when the care recipient has anorexia nervosa. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

The impact of preschool child and maternal attention-deficit/hyperactivity disorder (ADHD) symptoms on mothers’ perceived chronic stress and hair cortisol

“…None of these variables were associated with maternal HCC in the present study. In contrast to previous findings of hypocortisolism in caregivers of children with a psychological disorder; schizophrenia: (Gonzalez-Bono et al 2011 ); autism: (Radin et al 2019 ; Seltzer et al 2010 ); eating disorders: (Ruiz-Robledillo et al 2016 ), providing care for a child with ADHD was not associated with altered HPA axis activity in this study. There are several possible explanations for this result.…”

“…Thus, mothers of preschool children might not yet have been overwhelmed (long) enough for physiological changes to occur. Furthermore, the parents examined in previous studies were older than the mothers in the current study ((Gonzalez-Bono et al 2011 ), [ M age = 63.61]; (Seltzer et al 2010 ), [ M age = 53.9]; (Ruiz-Robledillo et al 2016 ), [ M age = 50.86]). Older individuals typically have poorer health (Lovell and Wetherell 2011 ), which may make them more vulnerable to stress-related physiological changes.…”

“…First, the lack of association may be due to the young age of the children included in this study. With the exception of Radin et al ( 2019 ), who examined children between the ages of 2 and 16 years, previous studies exclusively included caregivers of adolescent and adult offspring (Gonzalez-Bono et al 2011 ; Seltzer et al 2010 ; Ruiz-Robledillo et al 2016 ). According to the model of allostatic load, physiological changes induced through chronic stress mostly occur only after a long-standing, intensive stress load (McEwen 1998 ).…”

“…The chronic stress of caregiving has been associated with altered HPA axis activity. More specifically, a hypoactive HPA axis has been found in the caregivers of adult offspring with ASD (Seltzer et al 2010 ), eating disorders (Ruiz-Robledillo et al 2016 ), and schizophrenia (Gonzalez-Bono et al 2011 ). However, these studies used salivary cortisol samples to determine HPA axis activity.…”

Blunted cortisol response to stress in patients with eating disorders: Its association to bulimic features

“…Hypercortisolism has been described in patients with anorexia nervosa (AN) and bulimia nervosa (BN) and can be explained as a direct consequence of the affectation of the HPA axis . This seems to apply not only to AN and BN patients, but also to their relatives, although the characteristics and the severity of the HPA axis dysfunction could be different in both groups of patients . One way or the other, clinical research has yielded inconclusive results.…”