Integrating evidence-based PTSD treatment into intensive eating disorders treatment: a preliminary investigation

Abstract

Purpose Given data suggesting common co-occurrence and worse outcomes for individuals with eating disorders (EDs) and post-traumatic stress disorder (PTSD), it is critical to identify integrated treatment approaches for this group of patients. Past work has explored the feasibility and initial efficacy of intervention approaches that draw on evidence-based treatments for both EDs and PTSD; however, this work remains limited in scope. In the current study, we explored the feasibility and naturalistic outcomes of PTSD treatment delivered within the context of intensive ED treatment. Method Participants were 57 adult men and women with DSM-5 EDs and comorbid PTSD who completed a course of either Prolonged Exposure (PE; n = 22) or Cognitive Processing Therapy (CPT; n = 35) (Msessions = 10.40; SD = 5.13) and weekly validated measurements of clinical symptoms while enrolled in ED programming. Results Multi-level models for PTSD symptoms indicated a significant linear effect of time, such that participants demonstrated significant decreases over time in PTSD symptoms, regardless of treatment modality. Conclusion Our preliminary investigation provides support for the feasibility and efficacy of an integrated approach to treating EDs and PTSD. It is critical for future work to undertake randomized tests of this integrated approach using large, heterogeneous samples. Level of evidence Level IV, multiple time series with intervention

Discordant conceptualisations of eating disorder recovery and their influence on the construct of terminality

“…Some existing models of care may not consider cooccurring psychological symptoms and impacts, which, if under-addressed or unresolved, may impede ED recovery. While treatment models have been developed to address EDs and co-occurring diagnoses [80,[163][164][165][166][167], many such approaches have not been integrated into mainstream treatment for EDs [46]. Widely used treatment models enforce inflexible 'behavioural protocols' and emphasise 'focusing on the ED first' at the expense of meeting the treatment needs of some individuals [80] who may otherwise benefit from approaches that address self-concept and embodiment (which can be disrupted and disembodied in individuals with EDs) [168].…”

Treatment of patients with anorexia nervosa and comorbid post-traumatic stress disorder; where do we stand? A systematic scoping review

“…However, patients with anorexia nervosa were not included as participants were not eligible if they had a significantly low body weight; in a randomized controlled trial by Trottier and colleagues, a BMI ≥ 18.5 was required in order to be included in the study ( 22 ). In a study by Claudat and colleagues, patients were eligible with a minimum weight of 85% Ideal Body Weight ( 23 ).…”

Psychogenic Nonepileptic Seizures Associated with an Eating Disorder and PTSD Are Responsive to Cognitive Processing Therapy

“…Prior histories of trauma and the development of posttraumatic stress disorder (PTSD) and related disorders in the context of EDs have been well-established in the scientific literature [3][4][5][6][7][8][9][10]. Furthermore, integrated treatment approaches that include trauma-focused treatments have emerged as viable treatments for these complex multimorbidities [11][12][13][14][15].…”