The relationship between trauma and weight status among adolescents in eating disorder treatment

Hicks, Ashley A.; Pratt, Keeley J.; Cottrill, Casey B.

doi:10.1016/j.appet.2018.06.034

Cited by 30 publications

(29 citation statements)

References 35 publications

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“…This finding is consistent with other research showing a cumulative effect of multiple adversities on a range of negative health outcomes [41]. The strength of the associations in the present study is comparable to previous studies finding OR's in the range of 2-3 for different types of adversities including emotional, physical and sexual child abuse, sexual assault, family disruption, parental psychiatric illness, parental teasing, and bullying [3,26,40,[42][43][44][45]. We have previously reported associations between school-age bullying and EDs in the same sample as the present study, with a similar pattern of results [28].…”

Section: Discussionsupporting

confidence: 92%

“…Rape, other sexual assault, and emotional abuse were significantly more common in the ED group as a whole than in the control group, and this held true for all ED subtypes with the exception of AN-R. This is consistent with previous research reporting a stronger association between a range of SLEs and binge-eating/ purging EDs than restrictive AN [4,12,26,39,40]. The event category "other SLE" was significantly more common in all ED groups, and certain SLEs (bereavement and life-threatening disease) were more common for only some ED subtypes.…”

Section: Discussionsupporting

confidence: 90%

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Stressful life events among individuals with a history of eating disorders: a case-control comparison

et al. 2021

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Background Experiencing stressful life events (SLEs) can negatively impact mental health and increase risk for psychiatric disorders including eating disorders (EDs). Previous research has shown that childhood sexual abuse is associated with some EDs, but less is known about the association between other non-sexual SLEs and EDs. Method A case-control study of individuals with (n = 495, age mean ± SD = 29.1 ± 9.8 years) and without (n = 395, age = 30.2 ± 11.7) self-reported lifetime history of EDs was conducted to compare history of self-reported SLEs. Participants reported history of sexual (e.g., rape, other sexual assault) and non-sexual (e.g., emotional abuse, assault, bereavement) life events using an adaptation of the Stressful Life Events Screening Questionnaire. Individuals with EDs were divided into ED subtypes along the restricting – binge eating/purging spectrum to examine subtype differences. Logistic regressions were conducted for each SLE and ED subtype to obtain odds ratios (ORs). We report p-values corrected for multiple comparisons. Results Exposure to any SLE was significantly more common in individuals with EDs than in controls (OR = 2.47, p < .001). Specifically, rape, other sexual assault, and emotional abuse were significantly more common among individuals with a history of binge-eating/purging ED subtypes (ORs = 2.15–3.58, p’s < .01) compared with controls. Furthermore, history of life-threatening disease and loss of a close relative/partner/friend were associated with some ED subtypes. The association between SLEs and EDs was stronger for individuals who had experienced multiple SLEs. Conclusion By investigating a range of different SLEs, we showed that both sexual and non-sexual SLEs were more common in individuals with a history of EDs (binge-eating/purging subtypes) than controls. Results highlight the importance of assessing a variety of past SLEs in risk assessment for different EDs.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Stressful life events among individuals with a history of eating disorders: a case-control comparison

et al. 2021

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“…Patients with EDs and a history of childhood maltreatment may benefit from care that specifically targets this history [ 47 ]. Furthermore, the symptom pathway leading to an ED in individuals with a history of childhood maltreatment has been described as specific to this group.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Retrospective Childhood Maltreatment on Eating Disorders as Mediated by Food Addiction: A Cross-Sectional Study

et al. 2020

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Background: The current study aimed to test whether food addiction (FA) might mediate the relationship between the presence of a history of childhood maltreatment and eating disorder (ED) symptom severity. Methods: Participants were 231 patients with ED presenting between May 2017 and January 2020 to a daycare treatment facility for assessment and management with mainly the Eating Disorder Inventory-2 (EDI-2), the Child Trauma Questionnaire (CTQ), and the Yale Food Addiction Scale (YFAS 2.0). Results: Participants had a median age of 24 (interquartile range (IQR) 20–33) years and manifested anorexia nervosa (61.47%), bulimia nervosa (16.88%), binge-eating disorders (9.09%), and other types of ED (12.55%). They were grouped into those likely presenting FA (N = 154) and those without FA (N = 77). The group with FA reported higher scores on all five CTQ subscales, as well as the total score of the EDI-2 (p < 0.001). Using mediation analysis; significant indirect pathways between all CTQ subscales and the EDI-2 total score emerged via FA, with the largest indirect effect emerging for physical neglect (standardized effect = 0.208; 95% confidence interval (CI) 0.127–0.29) followed by emotional abuse (standardized effect = 0.183; 95% CI 0.109–0.262). Conclusion: These results are compatible with a model in which certain types of childhood maltreatment, especially physical neglect, may induce, maintain, and/or exacerbate ED symptoms via FA which may guide future treatments.

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“…In one sample of adult patients with EDs from Sweden ( n = 853), a quarter had a lifetime diagnosis of PTSD [ 134 ]. Other estimates suggest traumatic events occur in over a third of adolescents in ED outpatients ( n = 182), and the prevalence is highest among those with BN [ 135 ]. A recent review article suggests that the prevalence of comorbid PTSD and EDs ranges from 9% to 24% [ 136 ], although estimates are consistently higher when looking specifically at binge-type EDs [ 137 , 138 , 139 , 140 , 141 ].…”

Section: Trauma and Ptsdmentioning

confidence: 99%

Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint

Wiss

Brewerton

2020

Nutrients

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Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate regarding the value of a food addiction “diagnosis” among those with eating disorders such as anorexia nervosa binge/purge-type, bulimia nervosa, and binge eating disorder. Much of the food addiction research in eating disorder populations has failed to account for dietary restraint, which can increase addiction-like eating behaviors and may even lead to false positives. Some have argued that the concept of food addiction does more harm than good by encouraging restrictive approaches to eating. Others have shown that a better understanding of the food addiction model can reduce stigma associated with obesity. What is lacking in the literature is a description of a more comprehensive approach to the assessment of food addiction. This should include consideration of dietary restraint, and the presence of symptoms of other psychiatric disorders (substance use, posttraumatic stress, depressive, anxiety, attention deficit hyperactivity) to guide treatments including nutrition interventions. The purpose of this review is to help clinicians identify the symptoms of food addiction (true positives, or “the signal”) from the more classic eating pathology (true negatives, or “restraint”) that can potentially elevate food addiction scores (false positives, or “the noise”). Three clinical vignettes are presented, designed to aid with the assessment process, case conceptualization, and treatment strategies. The review summarizes logical steps that clinicians can take to contextualize elevated food addiction scores, even when the use of validated research instruments is not practical.

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The relationship between trauma and weight status among adolescents in eating disorder treatment

Cited by 30 publications

References 35 publications

Stressful life events among individuals with a history of eating disorders: a case-control comparison

Stressful life events among individuals with a history of eating disorders: a case-control comparison

The Impact of Retrospective Childhood Maltreatment on Eating Disorders as Mediated by Food Addiction: A Cross-Sectional Study

Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint

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