Sexual and gender minority individuals report higher rates of lifetime traumas and current PTSD than cisgender heterosexual individuals admitted to residential eating disorder treatment

Brewerton, Timothy D.; Suro, Giulia; Gavidia, Ismael; Perlman, Molly M

doi:10.1007/s40519-021-01222-4

Cited by 22 publications

(28 citation statements)

References 44 publications

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“…Previous research suggests an association between eating disorder symptomatology in gender nonbinary and/or transgender individuals who experience minority stress and/or internalized transphobia [17]. Additional research from residential eating disorder programming also indicates that Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, Asexual (2SLGBTQIA+) individuals may experience more lifetime traumas and more eating disorder symptomatology than non-2SLGBTQIA+ clients [18]. Further research is needed to delve into the impact of the pandemic on the mental health of youth and adolescents who are gender non-binary, transgender, and/or identify as 2SLGBTQIA+, and how to best support them.…”

Section: Discussionmentioning

confidence: 99%

Presentation of Patients with Eating Disorders to a Pediatric Quaternary-Level Care Emergency Department During the COVID-19 Pandemic

2022

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Despite an overall decrease in utilization of emergency departments during COVID-19 (Hartnett et al. in MMWR Morb Mortal Wkly Rep. 69(23):699–704, 2020 ), US pediatric emergency departments experienced an increase in mental health visits for children and adolescents (Leeb et al. in MMWR Morb Mortal Wkly Rep. 69(45):1675–80, 2020 ). Simultaneously, individuals with eating disorders reported increasing symptomology (Termorshuizen et al. in Int J Eat Disord. 53(11):1780–90, 2020 ). This study compares Emergency Department utilization at a pediatric quaternary-level care center by patients with eating disorders during the pandemic (March–Dec 2020) vs March-Dec 2019. We hypothesize that there was an increase in presentation of patients with eating disorders. An Informatics for Integrating Biology and the Bedside query of the electronic medical record system identified patients with eating disorder diagnoses per ICD9/ICD10 codes aged 6–23 who presented to the Emergency Department between March 1 st and December 31 st of 2020 and 2019. Subsequent retrospective chart review was carried out. Patients were excluded from analysis if the presenting problem was not directly related to the eating disorder. During March–Dec 2019, 0.581% percent of all patients presented to the Emergency Department due to an eating disorder. During the same time frame in 2020, however, that percentage increased to 1.265%. Statistical significance was corrected using a Benjamini–Hochberg analysis. Despite a 66.5% decline in overall visits to the Emergency Department, the percentage of patients presenting with eating disorders doubled during the pandemic. During the pandemic, the total time spent awaiting placement significantly increased, and the number of patients identifying as transgender and/or nonbinary increased. Our data support the hypothesis that eating disorder presentation increased during the pandemic.

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Section: Discussionmentioning

confidence: 99%

Presentation of Patients with Eating Disorders to a Pediatric Quaternary-Level Care Emergency Department During the COVID-19 Pandemic

2022

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“…This study cannot make inferences about PTSD burdens in gender-diverse people due to the lack of primary studies adopting a non-binary understanding of sex and gender. Although there is increasing evidence that non-binary, trans and gender-diverse persons are disproportionately affected by trauma and adverse health outcomes (Brewerton et al, 2022;Newcomb et al, 2020), none of the studies included in our initial literature search that investigated gender beyond the binary (e.g. Hao et al, 2021;James et al, 2020) fulfilled our methodologically demanding inclusion criteria with regards to study design.…”

Section: Discussionmentioning

confidence: 99%

Higher risk – less data: A systematic review and meta-analysis on the role of sex and gender in trauma research

Haering¹,

Schulze²,

Geiling³

et al. 2022

Preprint

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Sex- and gender-sensitive research can help to understand differences in prevalence, manifestation, and etiology of mental disorders. It is acknowledged that men and women are at different risks for traumatization as well as for the development of posttraumatic stress disorder (PTSD). In this systematic review and meta-analysis, we examine sex/gender differences in PTSD risk within five time-intervals ranging from 1 month to 5 years post-trauma, and analyze how sex and gender are considered in prospective studies on PTSD development (k=45). Women had higher PTSD burdens across timepoints but were underrepresented in research (68.5% male, 31.5% female participants). Only one study used sex as discovery variable. Sex and gender aspects in design, data, and discussion were considered by only one third of studies each. Trauma research falls short of its potential to adequately consider sex and gender. Sex- and gender-sensitive practices can advance rigor, innovation and fairness in clinical research.

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“…Diagnoses of provisional PTSD per DSM‐5 (PTSD+) were made using the LEC‐5 for criterion A and the PCL‐5 for criteria B through E (American Psychiatric Association, 2013). As previously described in prior publications (Brewerton et al., 2020, 2021b), those classified as having provisional PTSD (PTSD+) met the following conditions: (1) endorsement of at least one life‐threatening event that happened to the individual and/or was witnessed, (2) having a PCL‐5 total score of ≥33, and (3) endorsing each of the B through E DSM‐5 criteria for PTSD as determined by PCL‐5 responses. Criterion F (duration of 1 month) was satisfied given that the PCL‐5 version assessing symptoms during the last month prior to admission was used.…”

Section: Methodsmentioning

confidence: 99%

“…Diagnoses of provisional PTSD per DSM-5 (PTSD+) were made using the LEC-5 for criterion A and the PCL-5 for criteria B through E (American Psychiatric Association, 2013). As previously described in prior publications (Brewerton et al, 2020(Brewerton et al, , 2021b, those classified as having provisional PTSD (PTSD+) met the following conditions:…”

Section: Assessmentsmentioning

confidence: 99%

Eating disorder onset during childhood is associated with higher trauma dose, provisional PTSD, and severity of illness in residential treatment

Brewerton

Gavidia²,

Suro³

et al. 2022

Euro Eating Disorders Rev

Self Cite

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Objective: Age of eating disorder (ED) onset has been of significant interest to both researchers and clinicians. The identification of factors associated with early or child onset has important prevention and treatment implications. The presence of prior trauma, resultant posttraumatic stress disorder (PTSD), ED severity, and comorbid psychopathology are of particular relevance to age of ED onset, but data are limited. Methods: Adults (≥18 years, 93% female, total n = 1283) admitted to residential ED treatment self-reported age of ED onset. Patients were divided into child onset (ages 5-10 years), adolescent onset (11-17 years), and adult onset (≥18 years) groups and compared on a number of clinical features and assessment measures. Results:The child onset group had significantly higher rates and doses of traumatic life events; higher current PTSD prevalence; higher BMIs, higher severity of ED, depression and state-trait anxiety symptoms; worse quality of life; and more prior inpatient and residential admissions for ED treatment, in comparison to both the adolescent and adult onset groups. Similarly, the adolescent onset group had significantly higher rates than the adult onset group. Conclusions: These results have important implications for prevention, treatment and long-term follow-up and highlight the need for early traumafocussed treatment of ED patients.

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Sexual and gender minority individuals report higher rates of lifetime traumas and current PTSD than cisgender heterosexual individuals admitted to residential eating disorder treatment

Cited by 22 publications

References 44 publications

Presentation of Patients with Eating Disorders to a Pediatric Quaternary-Level Care Emergency Department During the COVID-19 Pandemic

Presentation of Patients with Eating Disorders to a Pediatric Quaternary-Level Care Emergency Department During the COVID-19 Pandemic

Higher risk – less data: A systematic review and meta-analysis on the role of sex and gender in trauma research

Eating disorder onset during childhood is associated with higher trauma dose, provisional PTSD, and severity of illness in residential treatment

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