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From the Departments of Psychology (J.H.K.-L., K.C.L., S.S.G.), Dental Ecology (N.C.), and Psychiatry (K.C.L., S.S.G.), University of North Carolina at Chapel Hill, Chapel Hill, NC.
Address reprint requests to: Susan S. Girdler, PhD, Department of Psychiatry, CB 7175, University of North Carolina, Chapel Hill, NC 27599-7175.
OBJECTIVE: Cardiovascular, neuroendocrine, and psychosocial profiles were investigated in women with eating disorder tendencies, but who had never met clinical criteria for an eating disorder, and in healthy controls.
METHODS: Twenty-six women who scored in the highest distribution of the Eating Disorder Inventory bulimia subscale (HEDI women) and 27 women who scored in the lowest distribution (LEDI women) completed psychosocial questionnaires, underwent a speech reactivity task for measures of blood pressure and heart rate reactivity, and also underwent 24-hour ambulatory blood pressure monitoring and urinary neuroendocrine collection.
RESULTS: The HEDI women exhibited increased blood pressure and heart rate reactivity to the speech task and increased 24-hour urinary cortisol, but decreased 24-hour urinary norepinephrine compared with LEDI women. There were no overall group differences in 24-hour ambulatory blood pressure levels, but negative mood and tension were associated with greater systolic blood pressures for all women. Finally, HEDI women reported greater depressive symptoms and anxiety, lower self-esteem and sense of mastery, less social support, poor coping skills, and greater emotional impact of daily stressors relative to LEDI women.
CONCLUSIONS: These results indicate that the same pattern of neuroendocrine and psychosocial profiles seen in prior studies of bulimia nervosa are also present in women with eating disorder tendencies.
Key Words: eating disorders • bloodpressure • norepinephrine • cortisol • psychological profiles • ambulatoryblood pressure monitoring
Abbreviations: HEDI = High Eating Disorder Inventory women; LEDI = LowEating Disorder Inventory women; BN = bulimia nervosa; NE =norepinephrine; EPI = epinephrine; SAM =sympathetic-adrenal-medullary; HPAC =hypothalamic-pituitary-adrenal-cortical; ABPM = ambulatory bloodpressure monitoring; EDI = Eating Disorder Inventory; SCID-NP= Structured Clinical Interview, nonpatient edition; DA =dopamine; RIA = radioimmunoassay; HPLC = high performanceliquid chromatography; SBP = systolic blood pressure; DBP =diastolic blood pressure; MAP = mean arterial pressure; HR =heart rate; ANOVA = analysis of variance; ANCOVA = analysisof covariance; VAS = Visual Analogue Scale.
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