Skip to main content
SpringerLink
Log in

Neural Circuits, Neurotransmitters, and Behavior

Serotonin and Temperament in Bulimic Syndromes

  • Chapter
  • First Online:
Behavioral Neurobiology of Eating Disorders

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 6))

Abstract

In bulimia nervosa (BN), and in related binge–purge syndromes, factors affecting central serotonin (5-hydroxytryptamine, 5-HT) function appear to contribute not only to appetitive dysregulation but also to temperamental and personality manifestations. Drawing upon findings from neurobiological, molecular-genetic, and brain-imaging studies, we present an integrative model of the role of 5-HT function in bulimic syndromes. At the core of our model is a consideration of the ways in which diverse hereditary and environmental influences impact the action of the 5-HT system. We believe that our model helps account for heterogeneous traits seen in the bulimic population, for disproportionate representation of individuals displaying pathological personality traits and exposure to severe environmental stressors, and for interindividual variations as to treatment response.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Akkermann K, Nordquist N, Oreland L, Harro J (2010) Serotonin transporter gene promoter polymorphism affects the severity of binge eating in general population. Prog Neuropsychopharmacol Biol Psychiatry 34:111–114

    Google Scholar 

  • Anderson IM, Parry-Billings M, Newsholme EA, Fairburn CG, Cowen PJ (1990) Dieting reduces plasma tryptophan and alters brain 5-HT function in women. Psychol Med 20:785–791

    Article  CAS  PubMed  Google Scholar 

  • Anguelova M, Benkelfat C, Turecki G (2003) A systematic review of association studies investigating genes coding for serotonin receptors and the serotonin transporter: II suicidal behaviour. Mol Psychiatry 8:646–653

    Article  CAS  PubMed  Google Scholar 

  • Bailer UF, Price JC, Meltzer CC, Mathis CA, Frank GK, Weissfeld L, McConaha CW, Henry SE, Brooks-Achenbach S, Barbarich NC, Kaye WH (2004) Altered 5-HT2A receptor binding after recovery from bulimia type anorexia nervosa: relationships to harm avoidance and drive for thinness. Neuropsychopharmacology 29:1143–1155

    Article  CAS  PubMed  Google Scholar 

  • Bailer UF, Frank G, Henry S, Price J, Meltzer C, Mathis C et al (2007) Exaggerated 5-HT1A but normal 5-HT2A receptor activity in individuals ill with anorexia nervosa. Biol Psychiatry 61(9):1090–1099

    Article  CAS  PubMed  Google Scholar 

  • Bailer UF, Kaye WH (2010) Serotonin: imaging findings in eating disorders. Curr Topics Behav Neurosci DOI 10.1007/7854_2010_78

    Google Scholar 

  • Barr S, Newman TK, Becker ML, Parker CC, Champoux M, Lesch KP, Goldman D, Suomi SJ, Higley JD (2003) The utility of the non-human primate model for studying gene by environment interactions in behavioral research. Genes Brain Behav 2:336–340

    Article  CAS  PubMed  Google Scholar 

  • Blundell JE (1986) Serotonin manipulations and the structure of feeding behaviour. Appetite 7 Suppl:39–56

    CAS  PubMed  Google Scholar 

  • Brewerton TD (1995) Toward a unified theory of serotonin dysregulation in eating and related disorders. Psychoneuroendocrinology 20:561–590

    Article  CAS  PubMed  Google Scholar 

  • Bruce K, Steiger H (2006) Prognostic implications of personality disorders in eating disorders. In: Sansone RA, Levitt JL (eds) Personality disorders and eating disorders: exploring the frontier. Routledge, New York, pp 247–262

    Google Scholar 

  • Bruce KR, Steiger H, Koerner N, Israel M, Young SM (2004) Bulimia nervosa with co-morbid avoidant personality disorder: behavioural characteristics and serotonergic function. Psychol Med 34:113–124

    Article  CAS  PubMed  Google Scholar 

  • Bruce KR, Steiger H, Ng Ying Kin NMK, Israel M (2005a) Reduced platelet [3H]paroxetine binding in anorexia nervosa: relationship to eating symptoms and personality pathology. Psychiatry Res 142:225–232

    Article  CAS  Google Scholar 

  • Bruce K, Steiger H, Joober R, Ng Ying Kin NM, Israel M, Young SN (2005b) Association of the promoter polymorphism –1438G/A of the 5-HT2A receptor gene with behavioural impulsiveness and serotonin function in women with bulimia nervosa. Am J Med Genet B Neuropsychiatr Genet 13:40–44

    Google Scholar 

  • Bruce KR, Steiger H, Young SN, Ng Ying Kin NMK, Israël M, Lévesque M (2009) Impact of acute tryptophan depletion on mood and eating-related urges in bulimic and nonbulimic women. J Psychiatry Neurosci 34:376–382

    PubMed  Google Scholar 

  • Carrillo M, Ricci LA, Coppersmith GA, Melloni RH Jr (2009) The effect of increased serotonergic neurotransmission on aggression: a critical meta-analytical review of preclinical studies. Psychopharmacology 205:349–368

    Article  CAS  PubMed  Google Scholar 

  • Caspi A, Sugden K, Moffit T, Taylor A, Craig IW, Harrington HL, McClay J, Mill J, Martin J, Braithwaite A, Poulton R (2003) Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science 301:386–389

    Article  CAS  PubMed  Google Scholar 

  • Cassin SE, Von Ranson KM (2005) Personality and eating disorders: a decade in review. Clin Psychol Rev 25:895–916

    Article  PubMed  Google Scholar 

  • Di Bella DD, Catalano M, Cavallini HC, Riboldi C, Bellodi L (2000) Serotonin transporter linked polymorphic region in anorexia nervosa and bulimia nervosa. Molec Psychiatry 5:233–241

    Article  CAS  Google Scholar 

  • Cloninger CR, Svrakic DM, Przybeck TR (1993) A psychobiological model of temperament and character. Arch Gen Psychiatry 50:975–990

    CAS  PubMed  Google Scholar 

  • Fairburn CG, Cooper Z, Doll HA, O’Connor ME, Bohn K, Hawker DM, Wales JA, Palmer RL (2009) Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: a two-site trial with 60-week follow-up. Am J Psychiatry 166:311–319

    Article  PubMed  Google Scholar 

  • Frankle WG, Lombardo I, New AS, Goodman M, Talbot PS, Huang Y, Hwang D-R, Slifstein M, Curry S, Abi-Dargham A, Laruelle M, Siever LJ (2005) Brain serotonin transporter distribution in subjects with impulsive aggressivity: a positron emission study with [11C]McN 5652. Am J Psychiatry 162:915–923

    Article  PubMed  Google Scholar 

  • Goodwin GM, Fairburn CG, Cowen PJ (1987) The effects of dieting and weight loss on neuroendocrine tesponses to tryptophan, clonidine, and apomorphine in volunteers: important implications for neuroendocrine investigations in depression. Arch Gen Psychiatry 44:952–957

    CAS  PubMed  Google Scholar 

  • Groleau P, Richardson J, Steiger H, Israel M, Bruce K, Joober R, Howard H, De Guzman R. Evidence for the implication of the tryptophan hydroxylase-2 gene in eating and psychopathological symptom severity in bulimia eating syndromes. Poster presentation at the 15th annual meeting of the eating disorders research society, New York, September 2009

    Google Scholar 

  • Heinz A, Braus DF, Smolka MN. Woaser J, Puls I, Hermann D et al (2005) Amygdala-prefrontal coupling depends on a genetic variation of the serotonin transporter. Nature Neuroscience 81:20–21

    Article  CAS  Google Scholar 

  • Hollander E (1998) Treatment of obsessive-compulsive spectrum disorders with SSRIs. Br J Psychiatry Suppl 35:7–12

    PubMed  Google Scholar 

  • Hu XZ, Lipsky RH, Zhu G (2006) Serotonin transporter promoter gain of function genotypes are linked to obsessive–compulsive disorder. Am J Hum Genet 78:815–826

    Article  CAS  PubMed  Google Scholar 

  • Huether G, Zhou D, Ruther E (1997) Long-term modulation of presynaptic 5-HT-output: experimentally induced changes in cortical 5-HT-transporter density, tryptophan-hydroxylase content and 5-HT innervations density. J Neural Transm 104:993–1004

    Article  CAS  PubMed  Google Scholar 

  • Kaye WH (2008) Neurobiology of anorexia and bulimia nervosa. Physiol Behav 94:121–135

    Article  CAS  PubMed  Google Scholar 

  • Kaye WH, Wagner A, Fudge JL, Paulus M (2010) Neurocircuity of eating disorders. Curr Topics Behav Neurosci DOI 10.1007/7854_2010_85

    Google Scholar 

  • Lesch KP, Mossner R (1998) Genetically driven variations in serotonin uptake: is there a link to affective spectrum, neurodevelopmental, and neurodegenerative disorders? Biol Psychiatry 44:179–192

    Article  CAS  PubMed  Google Scholar 

  • Lesch KP, Bengel D, Heils A, Sabol SZ, Greenberg BD, Petri S (1996) Association of anxiety-related traits with a polymorphism in the serotonin transporter gene regulatory region. Science 274:1527–1530

    Article  CAS  PubMed  Google Scholar 

  • Lilenfeld LR, Wonderlich S, Riso LP, Crosby R, Mitchell J (2006) Eating disorders and personality: a methodological and empirical review. Clin Psychol Rev 26:299–320

    Article  PubMed  Google Scholar 

  • Marsh R (2009) Dysfunctional frontostriatal control systems in bulimia nervosa. Future Neurol 4:383–387

    Article  Google Scholar 

  • Monteleone P, Santonastaso P, Tortorella A, Favaro A, Fabrazzo M, Castaldo E, Caregaro L, Fuschino A, Maj M (2005) Serotonin transporter polymorphism and potential response to SSRIs in bulimia nervosa. Mol Psychiatry 10:716–718

    Article  CAS  PubMed  Google Scholar 

  • Monteleone P, Santonastaso P, Mauri M, Bellodi L, Erzegovesi S, Fushino A, Favaro A, Rotondo A, Castaldo E, Maj M (2006) Investigation of the serotonin transporter regulatory region polymorphism in bulimia nervosa: relationships to harm avoidance, nutritional parameters, and psychiatric comorbidity. Psychosom Med 68:99–103

    Article  PubMed  Google Scholar 

  • Monteleone P, Tortorella A, Martiadis V, Serino I, Di Filippo C, Maj M (2007) Association between A218C polymorphism of the tryptophan-hydroxylase-1 gene, harm avoidance and binge eating behavior in bulimia nervosa. Neurosci Lett 421:42–46

    Article  CAS  PubMed  Google Scholar 

  • Munafò MR, Brown SM, Hariri AR (2008) Serotonin transporter (5-HTTLPR) genotype and amygdala activation: a meta-analysis. Biol Psychiatry 63:852–857

    Article  PubMed  CAS  Google Scholar 

  • Nishiguchi N, Matsushita S, Suzuki K, Murayama M, Shirakawa O, Higuchi S (2001) Association between 5HT2A receptor gene promoter region polymorphism and eating disorders in Japanese patients. Biol Psychiatry 50:123–128

    Article  CAS  PubMed  Google Scholar 

  • Paaver M, Kurrikoff T, Nordquist N, Oreland L, Havoo J (2008) The effect of 5-HTT gene promoter polymorphism on impulsivity depends on family relations in girls. Prog Neuropsychopharmacol Biol Psychiatry 32:1263–1268

    Article  CAS  Google Scholar 

  • Ramacciotti CE, Coli E, Paoli R, Marazziti D, Dell’Osso L (2003) Serotonergic activity measured by platelet [3H] paroxetine binding in patients with eating disorders. Psychiatry Res 118:33–38

    Article  CAS  PubMed  Google Scholar 

  • Reif A, Lesch KP (2003) Toward a molecular architecture of personality. Behav Brain Res 139:1–20

    Article  CAS  PubMed  Google Scholar 

  • Ribases M, Fernandez-Aranda F, Gratacos M, Mercader JM, Casasnovas C, Nunez A, Vallejo J, Estivill X (2008) Contribution of the serotoninergic system to anxious and depressive traits that may be partially responsible for the phenotypical variability of bulimia nervosa. J Psychiatr Res 42:50–57

    Article  PubMed  Google Scholar 

  • Richardson J, Steiger H, Schmitz N, Joober N, Bruce K, Israel M et al (2008) Relevance of the 5HTTLPR polymorphism and childhood abuse to increased psychiatric comorbidity in women with bulimia-spectrum disorders. J Clin Psychiatry 69:981–990

    Article  CAS  PubMed  Google Scholar 

  • Risch N, Herrell R, Lehner T, Liang K-Y, Eaves L, Hoh J, Griem A, Kovacs M, Ott J, Merikangas KR (2009) Interaction between the serotonin transporter gene (5-HTTLPR), stressful life events, and risk of depression: a meta-analysis. JAMA 301:2462–2471

    Article  CAS  PubMed  Google Scholar 

  • Sander T, Harms H, Dufeu P, Kuhn S, Hoehe M, Lesch KP, Rommelspacher H, Schmidt LG (1998) Serotonin transporter gene variants in alcohol-dependent subjects with dissocial personality disorder. Biol Psychiatry 43:908–912

    Article  CAS  PubMed  Google Scholar 

  • Schinka JA, Busch RM, Robichaux-Keene N (2004) A meta-analysis of the association between the serotonin transporter gene polymorphism (5-HTTLPR) and trait anxiety. Mol Psychiatry 9:197–202

    Article  CAS  PubMed  Google Scholar 

  • Smith KA, Fairburn CG, Cowen PJ (1999) Symptomatic relapse in bulimia nervosa following acute tryptophan depletion. Arch Gen Psychiatry 56:171–176

    Article  CAS  PubMed  Google Scholar 

  • Soubrie P (1986) Reconciling the role of central serotonin neurons in human and animal behavior. Behav Brain Sci 9:319–364

    Article  Google Scholar 

  • Steiger H (2004) Eating disorders and the serotonin connection: state, trait and developmental effects. J Psychiatry Neurosci 29:20–29

    PubMed  Google Scholar 

  • Steiger H, Bruce KR (2007) Phenotypes, endophenotypes, and genotypes in bulimia spectrum eating disorders. Can J Psychiatry 52:220–227

    PubMed  Google Scholar 

  • Steiger H, Young SM, Ng Ying Kin NMK, Koerner N, Israel M, Lageix P, Paris J (2001a) Implications of impulsive and affective symptoms for serotonin function in bulimia nervosa. Psychol Med 31:85–95

    Article  CAS  PubMed  Google Scholar 

  • Steiger H, Koerner N, Engleberg M, Israël M, Ng Ying Kin NMK, Young SN (2001b) Self-destructiveness and serotonin function in bulimia nervosa. Psychiatry Res 103:15–26

    Article  CAS  PubMed  Google Scholar 

  • Steiger H, Israel M, Gauvin L, Ng Ying Kin NMK, Young SM (2003) Implications of compulsive and impulsive traits for serotonin status in women with bulimia nervosa. Psychiatry Res 120:219–229

    Article  CAS  PubMed  Google Scholar 

  • Steiger H, Gauvin L, Israel M, Ng Ying Kin NMK, Young SM, Roussin J (2004) Serotonin function, personality-trait variations, and childhood abuse in women with bulimia-spectrum eating disorders. J Clin Psychiatry 65:830–837

    Article  CAS  PubMed  Google Scholar 

  • Steiger H, Richardson J, Israel M, Ng Ying Kin NMK, Brug K, Mansour S, Pareut AM (2005a) Reduced density of plalelet-binding sites for 3H-paroxetine in remitted, bulimic women. Neuropsychopharmacology 30:1028–1032

    Article  CAS  PubMed  Google Scholar 

  • Steiger H, Joober R, Israel M, Young SM, Ng Ying Kin NMK, Gauvin L, Bruce KR, Joncas J, Torkaman-Zehi A (2005b) The 5HTTLPR polymorphism, psychopathological symptoms, and platelet [3H-] paroxetine binding in bulimic syndromes. Int J Eat Disord 37:1–4

    Article  Google Scholar 

  • Steiger H, Gauvin L, Joober R, Israel M, Ng Ying Kin NMK, Bruce K, Richardson J, Young S, Hakim J (2006) Intrafamilial correspondences on platelet [3H-] paroxetine-binding indices in bulimic probands and their unaffected first-degree relatives. Neuropsychopharmacology 31:1785–1792

    Article  CAS  PubMed  Google Scholar 

  • Steiger H, Richardson J, Joober R, Gauvin L, Israel M, Bruce KR, Ng Ying Kin NMK, Howard H, Young SN (2007) The 5HTTLPR polymorphism, prior maltreatment and dramatic–erratic personality manifestations in women with bulimic syndromes. J Psychiatry Neurosci 32:354–362

    PubMed  Google Scholar 

  • Steiger H, Richardson J, Joober R, Israel M, Bruce K, Ng Ying Kin NMK, Howard H, Anestin A, Dandurand C, Gauvin L (2008a) Dissocial behavior, the 5HTTLPR polymorphism and maltreatment in women with bulimic syndromes. Am J Med Genet B Neuropsychiatr Genet 147B:128–130

    Article  PubMed  Google Scholar 

  • Steiger H, Joober R, Gauvin L, Bruce K, Richardson J, Israel M, Anestin A, Groleau P (2008b) Serotonin-system polymorphisms (5HTTLPR and -1438G/A) and responses of patients with bulimic syndromes to multimodal treatments. J Clin Psychiatry 69:1565–1571

    Article  CAS  PubMed  Google Scholar 

  • Steiger H, Richardson J, Schmitz N, Joober R, Israel M, Bruce KR, Gauvin L, Dandurand C, Annestin A (2009) Association of trait-defined, eating-disorder sub-phenotypes with (biallelic and triallelic) 5HTTLPR variations. J Psychiatr Res 43:1086–1094

    Article  PubMed  Google Scholar 

  • Stein DJ, Hollander E, Liebowitz M (1993) Neurobiology of Impulsivity and the impulse control disorders. J Neuropsychiatry Clin Neurosci 5:9–17

    CAS  PubMed  Google Scholar 

  • Tauscher J, Pirker W, Willeit M, de Zwaan M, Bailer U, Neumeister A, Asenbaum S, Lernkh C, Praschak-Rieder N, Brücke T, Kasper S (2001) Beta-CIT and single photon emission computer tomography reveal reduced brain serotonin transporter availability in bulimia nervosa. Biol Psychiatry 49:326–332

    Article  CAS  PubMed  Google Scholar 

  • Tiihonen J, Keski-Rahkonen A, Lopponen M, Muhonen M, Kajander J, Allonen T, Någren K, Hietala J, Rissanen A (2004) Brain serotonin 1A receptor binding in bulimia nervosa. Biol Psychiatry 55:871–873

    Article  CAS  PubMed  Google Scholar 

  • Van Gestel S, Van Broeckhoven C (2003) Genetics of personality: are we making progress? Mol Psychiatry 8:840–852

    Article  PubMed  CAS  Google Scholar 

  • Wagner S, Baskaya O, Lieb K, Dahmen N, Tadic A (2009) The 5-HTTLPR Polymorphism modulates the association of serious life events (SLE) and impulsivity in patients with Borderline Personality Disorder. J Psychiatr Res 43:1067–1072

    Article  PubMed  Google Scholar 

  • Waller DA, Sheinberg AL, Gullion C, Moeller FG, Cannon DS, Petty F, Hardy BW, Orsulak P, Rush AJ (1996) Impulsivity and neuroendocrine response to buspirone in bulimia nervosa. Biol Psychiatry 39:371–374

    Article  CAS  PubMed  Google Scholar 

  • Weltzin TE, Fernstrom MH, Fernstrom JD, Neuberger SK, Kaye WH (1995) Acute tryptophan depletion and increased food intake and irritability in bulimia nervosa. Am J Psychiatry 152:1668–1671

    CAS  PubMed  Google Scholar 

  • Wonderlich SA, Crosby RD, Joiner T, Peterson CB, Bardone-Cone A, Klein M, Crow S, Mitchell JE, LeGrange D, Steiger H, Kolden G, Johnson F, Vrshek S (2005) Personality subtyping and bulimia nervosa: psychopathological and genetic correlates. Psychol Med 35:649–657

    Article  PubMed  Google Scholar 

  • Young SN, Leyton M (2002) The role of serotonin in human mood and social interaction insight from altered tryptophan levels. Pharmacol Biochem Behav 71:857–865

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Eating Disorders Program, Douglas University Institute, 6875 LaSalle Blvd, Montreal (Verdun), QC, Canada, H4H 1R3

    Howard Steiger, Kenneth R. Bruce & Patricia Groleau

  2. Department of Psychiatry, McGill University, Montreal, QC, Canada

    Howard Steiger, Kenneth R. Bruce & Patricia Groleau

  3. Department of Psychology, McGill University, Montreal, QC, Canada

    Howard Steiger, Kenneth R. Bruce & Patricia Groleau

Authors
  1. Howard Steiger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kenneth R. Bruce
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patricia Groleau
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Howard Steiger .

Editor information

Editors and Affiliations

  1. Neuroscience, Dept. Pharmacology, Rudolf Magnus Institute of, Universiteitsweg 100, Utrecht, 3508 AB, Netherlands

    Roger A.H. Adan

  2. Dept. Psychiatry, University of California, San Diego, La Jolla Drive 8950, La Jolla, 92037, California, USA

    Walter H. Kaye

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Steiger, H., Bruce, K.R., Groleau, P. (2010). Neural Circuits, Neurotransmitters, and Behavior. In: Adan, R., Kaye, W. (eds) Behavioral Neurobiology of Eating Disorders. Current Topics in Behavioral Neurosciences, vol 6. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2010_88

Download citation

Publish with us

Policies and ethics

Search

Navigation