The association of traumatic events and posttraumatic stress disorder with greater eating disorder and comorbid symptom severity in residential eating disorder treatment centers

• Published in: The International journal of eating disorders 2020-12, Vol.53 (12), p.2061-2066
• Main Authors: Brewerton, Timothy D., Perlman, Molly M., Gavidia, Ismael, Suro, Giulia, Genet, Jessica, Bunnell, Douglas W.
• Format: Article
• Language: English
• Subjects: anxiety; Comorbidity; depression; Eating disorders; Post traumatic stress disorder; posttraumatic stress disorder (PTSD); Quality of life; residential treatment; trauma
• ISSN: 0276-3478; 1098-108X
• DOI: 10.1002/eat.23401

Objective Traumatic events, posttraumatic stress disorder (PTSD) and related symptoms are commonly associated with eating disorders (ED). Several clinical features indicative of a more severe and complex course have been associated with traumatized ED patients, especially those with PTSD, who may be more likely admitted to residential treatment (RT). Research in this population is sparse but of increasing interest. Method Adult participants (96.7% female) with EDs entering RT (n = 642) at seven sites in the U.S. completed validated self‐report assessments of ED, PTSD, major depression, state–trait anxiety, and quality of life. Presumptive diagnoses of DSM‐5 PTSD (PTSD+) were made via the Life Events Checklist‐5 and the PTSD Symptom Checklist for DSM‐5. Results PTSD+ occurred in 49.3% of patients. PTSD+ patients had significantly higher scores on all assessment measures (p ≤ .001), including measures of ED psychopathology, depression, state–trait anxiety, and quality of life. Those with PTSD+ had significantly higher numbers of lifetime traumatic event types, higher rates of almost all lifetime traumatic events, and a greater propensity toward binge‐type EDs. Discussion Results confirm that ED‐PTSD+ patients in RT are more symptomatic and have worse quality of life than ED patients without PTSD+. Integrated treatment approaches that effectively address ED‐PTSD+ are greatly needed.