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Sex Differences Precipitating Anorexia Nervosa in Females: The Estrogen Paradox and a Novel Framework for Targeting Sex-Specific Neurocircuits and Behavior

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Biological Basis of Sex Differences in Psychopharmacology

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 8))

Abstract

In anorexia nervosa (AN), reward contamination likely plays a significant role in maintenance of the illness. Reward contamination is a context in which patients’ behaviors of self-starvation and excessive exercise, while initially rewarding, become aversive, even punishing; but patients may not recognize the punishing and conflicted/contaminated behaviors. An emerging neurocircuit encompassing the anterior cingulate cortex (ACC) has been functionally linked to symptoms including reward contamination and body dysmorphic processing. Owing to the significantly greater prevalence of AN in females, evidence from clinical literature and preclinical models is spearheaded to provide a novel rationale for estrogen triggering sensitivity to the experience of stress and reward, precipitating AN disproportionately in females at the time of puberty. Paradoxically, however, estrogen may facilitate response to pharmacological interventions and (desensitization of the identified neurocircuits) via its contribution to serotonin modulation, hypothalamo-pituitary adrenal (HPA)-axis attenuation, and effects on dopamine.

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Authors and Affiliations

  1. Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital, 1st floor, Old Baker Building, Commercial Road, Prahran, VIC, 3181, Australia

    Charlotte Keating

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Editors and Affiliations

  1. Bradford School of Pharmacy, University Bradford, Bradford, W.Yorkshire, BD7 1DP, United Kingdom

    Jo C. Neill

  2. Monash Alfred Psychiatry Research Centre, Commercial Rd., Melbourne, 3004, Australia

    Jayashri Kulkarni

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Keating, C. (2010). Sex Differences Precipitating Anorexia Nervosa in Females: The Estrogen Paradox and a Novel Framework for Targeting Sex-Specific Neurocircuits and Behavior. In: Neill, J., Kulkarni, J. (eds) Biological Basis of Sex Differences in Psychopharmacology. Current Topics in Behavioral Neurosciences, vol 8. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2010_99

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