Disordered eating as a repercussion of sexual assault: a consequence to consider

Malet-Karas, Aurore; Bernard, Delphine; Piet, Emmanuelle; Bertin, Éric

doi:10.1007/s40519-021-01356-5

Cited by 11 publications

(10 citation statements)

References 94 publications

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“…Binge eating, purging and substance abuse are EDrelated behaviors that are particularly associated with stressful life events, childhood maltreatment and PTSD [13,251,[365][366][367][368][369][370]. Suicidal behavior and other forms of impulsive self-injurious behaviors are also common in eating disordered individuals with histories of abuse and trauma-related disorders [371][372][373][374][375]. Taken together, the adoption of health risk behaviors by traumatized ED patients is a natural outcome of ACEs, their biopsychosocial contributions (genetics, epigenetics, social/local contexts), their resulting disruption of neurodevelopment and consequent impairment in social, emotional and cognitive processing.…”

Section: Adoption Of Health Risk Behaviormentioning

confidence: 99%

Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span

Brewerton

2022

J Eat Disord

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Background Multiple published sources from around the world have confirmed an association between an array of adverse childhood experiences (ACEs) and other traumatic events with eating disorders (EDs) and related adverse outcomes, including higher morbidity and mortality. Methods In keeping with this Special Issue’s goals, this narrative review focuses on the ACEs pyramid and its purported mechanisms through which child maltreatment and other forms of violence toward human beings influence the health and well-being of individuals who develop EDs throughout the life span. Relevant literature on posttraumatic stress disorder (PTSD) is highlighted when applicable. Results At every level of the pyramid, it is shown that EDs interact with each of these proclaimed escalating mechanisms in a bidirectional manner that contributes to the predisposition, precipitation and perpetuation of EDs and related medical and psychiatric comorbidities, which then predispose to early death. The levels and their interactions that are discussed include the contribution of generational embodiment (genetics) and historical trauma (epigenetics), social conditions and local context, the ACEs and other traumas themselves, the resultant disrupted neurodevelopment, subsequent social, emotional and cognitive impairment, the adoption of health risk behaviors, and the development of disease, disability and social problems, all resulting in premature mortality by means of fatal complications and/or suicide. Conclusions The implications of these cascading, evolving, and intertwined perspectives have important implications for the assessment and treatment of EDs using trauma-informed care and trauma-focused integrated treatment approaches. This overview offers multiple opportunities at every level for the palliation and prevention of EDs and other associated trauma-related conditions, including PTSD.

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Section: Adoption Of Health Risk Behaviormentioning

confidence: 99%

Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span

Brewerton

2022

J Eat Disord

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“…In their integrated cognitive behavioral theory of PTSD and transdiagnostic theory of eating disorders, Mitchell and colleagues proposed that DE symptoms function in large part to regulate PTSD symptoms and negative affect and distress associated with (Dworkin, 2020;Malet-Karas et al, 2022). We note that postseparation trauma/stressor exposure included an item about sexual assault.…”

Section: Discussionmentioning

confidence: 92%

“…Further, when we examined multiple types of trauma exposure concurrently, only the indirect associations of postseparation trauma/stressor exposure with DE via shape and weight concerns remained significant among men. Much of previous literature among nonveterans has focused on the association of DE with sexual trauma (Dworkin, 2020; Malet-Karas et al, 2022). We note that postseparation trauma/stressor exposure included an item about sexual assault.…”

Section: Discussionmentioning

confidence: 99%

Gender differences in direct and indirect associations of trauma types with disordered eating in a national U.S. veteran sample.

Zelkowitz¹,

Sienkiewicz²,

Vogt³

et al. 2023

Psychological Trauma: Theory, Research, Practice, and

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Objective: Disordered eating (DE) in military veterans has been linked to trauma exposure, but the mechanisms underlying this association remain unclear. The current study documented the direct associations of DE with multiple trauma types in a gender-balanced sample of veterans and examined indirect associations of trauma and DE via self-reported PTSD symptoms and concerns about shape and weight. Method: Participants included 1,187 veterans (50% women, 46% men, 4% another) from multiple service eras. Sampling weights were applied to enhance representativeness to the national veteran population. Results: Gender-stratified, weighted models revealed associations of premilitary, warfare, and postseparation trauma with DE in men and associations of premilitary, military sexual (MST), and postseparation trauma with DE in women. Monte Carlo estimation of indirect effects showed support for indirect associations of premilitary, warfare, and postseparation-related trauma/stressor exposure with DE via PTSD symptoms among men; postseparation stressors were also indirectly associated with DE via shape and weight concerns. Among women, each trauma type was indirectly associated with DE via shape and weight concerns but not PTSD symptoms. When trauma exposures were examined concurrently, MST and postseparation trauma exposure were uniquely associated with DE via shape and weight concerns among women. Only the indirect association of postseparation trauma/stressor exposure with DE via shape and weight concerns was significant among men. Conclusions: Findings support the need for gender-specific interventions that target different mechanisms contributing to DE symptoms among veterans. Clinical Impact StatementTrauma exposures were linked to DE in both veteran men and women. Both PTSD symptoms and shape/weight concerns may link trauma exposures and DE among veteran men. In veteran women, shape/weight concerns appeared more salient. These results suggest the need to tailor interventions by gender.

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“…However, due to the body-focused evaluations and consequences of these experiences, it has been suggested that sexual harassment may act as a more disorder-specific risk factor, promoting the development of disordered eating [ 3 , 13 ]. It is agreed consistently that early experiences of sexual harassment and/or sexual abuse can have negative long-term consequences that can progress into adulthood [ 14 ]. Importantly, previous research has highlighted that posttraumatic stress symptoms can moderate the relationship between childhood sexual abuse and disordered eating in an adult sample and thus the importance of considering mediating factors in the relationship between sexual harassment and disordered eating in the current study [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…Previous research has also found that posttraumatic stress disorder (PTSD) symptoms; which are often a result of sexual harassment and other adverse experiences, are also associated with greater disordered eating behaviours and higher rates of utilising food for comfort [ 16 ]. It has also highlighted that the combination of sexual violence and disordered eating is associated with severe psychological consquences [ 14 ].Thus, further investigation into psychological distress as an additional mediator of the relationship between sexual harassment and its outcomes is required to fully understand whether predictive links can be identified and thus considered in future interventions.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal relationship between experience of sexual harassment and 2-year body image and weight outcomes in adolescence: mediation through self-objectification and psychological distress

et al. 2022

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Background The current study investigated the experience of sexual harassment as a risk factor for weight gain and weight/shape concerns in a community sample of adolescents, with potential mediating factors self-objectification and psychological distress. Method 1034 Australian adolescents (aged 11 to 19 years) from the EveryBODY longitudinal study of disordered eating pathology participated. Data were collected through online surveys annually for 3 years. Participants completed self-report measures of demographics, sexual harassment, psychological distress, self-objectification, weight/shape concerns and BMI percentile. Results A parallel mediation model adjusting for baseline scores found no direct effect between baseline experiences of sexual harassment and change in BMI percentile or weight/shape concern after 2 years. Experiences of sexual harassment significantly increased self-objectification scores after 1 year in female adolescents. Subsequently, higher self-objectification significantly increased the risk of greater weight/shape concern after 1 year in female adolescents. However, no significant mediating relationship was found in the relationship between sexual harassment and weight/shape concern or BMI percentile for either gender. Psychological distress was found to be a clear risk factor for weight/shape concern in both genders after 1 year. Conclusions Intervention programmes in schools should focus on developing policies to reduce sexual harassment, self-objectification and distress in adolescents. Level of evidence Level IV, longitudinal multiple time series without intervention.

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Disordered eating as a repercussion of sexual assault: a consequence to consider

Cited by 11 publications

References 94 publications

Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span

Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span

Gender differences in direct and indirect associations of trauma types with disordered eating in a national U.S. veteran sample.

Longitudinal relationship between experience of sexual harassment and 2-year body image and weight outcomes in adolescence: mediation through self-objectification and psychological distress

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