Trauma and dissociation in obese patients with and without binge eating disorder: A case – control study

Palmisano, Giovanni Luca; Innamorati, Marco; Sarracino, Diego; Bosco, Andrea; Pergola, Filippo; Scaltrito, Daniela; Giorgio, Bartolomeo; Vanderlinden, Johan

doi:10.1080/23311908.2018.1470483

Cited by 11 publications

(7 citation statements)

References 159 publications

(203 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To date, associations between SLEs and EDs are more consistent for binge-eating/purging subtypes (i.e., BN and BED) than restricting (i.e., AN) subtypes [3,4,[8][9][10][11][12]. A recent review of published risk factor metaanalyses investigating a range of risk factors found evidence for childhood sexual abuse as a risk factor for BN, while the evidence was weaker for the other ED subtypes [13].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

View full text Add to dashboard Cite

show abstract

“…This specific transition has been shown to entail a worse clinical picture with a longer duration of illness and worse outcomes [6][7][8]. In line with this, when compared to AN-R, cases involving BPB are associated with a higher prevalence of past traumatic experience [9], comorbid mental disorders [10,11], maladaptive personality traits [12], suicidality [10], as well as higher levels of somatic and dissociative symptoms (i.e., an interruption in consciousness, identity, environmental awareness, or memory-which is normally well integrated in a healthy person) [1,13]. From a purely behavioral point of view, AN-R is characterized by a focus on weight loss (accomplished primarily through dieting, fasting and/or excessive exercise) while AN-BP, bulimia nervosa (BN) and binge-eating disorder (BED) are characterized by recurrent episodes of binging (eating large amounts of food in relatively short time while experiencing a sense of loss of control).…”

Section: Introductionmentioning

confidence: 99%

The transition from restrictive anorexia nervosa to binging and purging: a systematic review and meta-analysis

et al. 2021

Self Cite

View full text Add to dashboard Cite

Numerous studies addressed the topic of behavioral and symptomatic changes in eating disorders. Rates of transition vary widely across studies, ranging from 0 to 70.8%, depending on the diagnoses taken into account and the study design. Evidence shows that the specific transition from restrictive-type anorexia nervosa (AN-R) to disorders involving binging and purging behaviors (BPB) is related to a worsening of the clinical picture and worse long-term outcomes. The aim of this systematic review and meta-analysis is to focus on this specific transition, review existing literature, and summarize related risk factors. Medline and PsycINFO databases were searched, including prospective and retrospective studies on individuals with AN-R. The primary outcome considered was the rate of onset of BPB. Twelve studies (N = 725 patients) were included in the qualitative and quantitative analysis. A total of 41.84% (95% CI 33.58–50.11) of patients with AN-R manifested BPB at some point during follow-up. Risk factors for the onset of BPB included potentially treatable and untreatable factors such as the family environment, unipolar depression and higher premorbid BMI. These findings highlight that patients with AN-R frequently transition to BPB over time, with a worsening of the clinical picture. Existing studies in this field are still insufficient and heterogeneous, and further research is needed. Mental health professionals should be aware of the frequent onset of BPB in AN-R and its risk factors and take this information into account in the treatment of AN-R. Level of evidence Evidence obtained from a systematic review and meta-analysis, Level I.

show abstract

“…Third, this is a cross-sectional study and cannot lend itself to causational conclusions, Fourth, we operationalized the experience of traumatic life events as their frequency, without taking into consideration the type of traumatic events experienced. Although this approach has been adopted in previous studies of obesity ( Palmisano et al, 2018 ), it is less than ideal. Studies that have examined the effects of specific types of trauma on EDs and BD have generally focused on sexual trauma in childhood, which was not a major focus in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Mitchell et al (2016), for instance, reported that the relationship between PTSD symptoms and disordered eating, food addiction and overweight in elderly male veterans was mediated by the suppression of expressions of fear, hostility, guilt and sadness, underscoring a specific link between trauma, problems in emotional expression and disordered eating. Palmisano et al (2018) conducted a case control study of patients with obesity and no ED, patients with BED, and controls with average body mass index (BMI; kg/m 2 ) They found that the participants with obesity reported higher levels of dissociation, and within the obese group, those with BED reported more childhood trauma than those without. Longo et al (2019) found that in an ED treatment center, patients with ANBP reported more traumatic life events, especially sexual trauma, prior to the onset of the ED than patients with restrictive AN.…”

Section: Introductionmentioning

confidence: 99%

“… Palmisano et al (2018) conducted a case control study of patients with obesity and no ED, patients with BED, and controls with average body mass index (BMI; kg/m 2 ) They found that the participants with obesity reported higher levels of dissociation, and within the obese group, those with BED reported more childhood trauma than those without. Longo et al (2019) found that in an ED treatment center, patients with ANBP reported more traumatic life events, especially sexual trauma, prior to the onset of the ED than patients with restrictive AN.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Eating for numbing: a community-based study of trauma exposure, emotion dysregulation, dissociation, body dissatisfaction and eating disorder symptoms

Lev‐Ari

Zohar

Bachner‐Melman

2021

PeerJ

View full text Add to dashboard Cite

Objective The current study tests the relationship between eating disorder (ED) symptoms and trauma exposure. The mechanisms via which trauma is related to ED symptoms have not been sufficiently examined. This study examines the complex role of dissociation and emotional dysregulation in the context of trauma, BMI, ED symptoms and body dissatisfaction (BD). We hypothesized that dissociation and emotional dysregulation would mediate the relationship between trauma exposure and ED symptoms/BD. We further hypothesized that BMI would play a moderating role in this association. Method A community sample of 229 (16.2% male) participants, with a mean age of 29.08 ± 10.68 reported online on traumatic events (Life Events Checklist), dissociation (Dissociative Experiences Scale-II), emotional dysregulation (Difficulties in Emotional Regulation Scale), ED symptoms (Eating Disorders Examination-Questionnaire) and BD (Figure Rating Scale). Results Participants reported experiencing a mean of 2.87 ± 2.27 traumatic events, with a relatively high percentage (~86%) reporting at least one. The most commonly reported traumatic events were transportation accidents and physical assault. Although frequency of traumatic events did not directly predict ED symptoms, BMI, dissociation, emotional dysregulation and BD did. An SEM model showed that traumatic events predicted ED symptoms indirectly through dissociation, emotional dysregulation and BMI. Dissociation and emotional dysregulation predicted ED symptoms directly. BMI also moderated the association between traumatic events and both ED symptoms and BD. Conclusions Therapists treating patients with high BMI or obesity should be aware of these relationships and investigate the possibility that trauma and/or PTSD may underlie the presenting disordered eating or eating disorder.

show abstract

Trauma and dissociation in obese patients with and without binge eating disorder: A case – control study

Cited by 11 publications

References 159 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 transition from restrictive anorexia nervosa to binging and purging: a systematic review and meta-analysis

Eating for numbing: a community-based study of trauma exposure, emotion dysregulation, dissociation, body dissatisfaction and eating disorder symptoms

Contact Info

Product

Resources

About