The maltreated eco-phenotype of eating disorders: A new diagnostic specifier? A systematic review of the evidence and comprehensive description

Table_3.xlsx

“…When the participants had the opportunity to report multiple lifetime ED diagnoses, it was shown that these participants (e.g., AN/BN and AN/BN/BED) had a higher prevalence than the participants with a single lifetime ED diagnosis (e.g., AN, BN or BED; Reyes-Rodríguez et al, 2011;Lie et al, 2021). The finding that the participants reporting multiple lifetime ED diagnoses, exhibits a higher prevalence of NTE compared to those with a single lifetime ED diagnosis, aligns with the findings of Rossi et al (2024), which show an increased prevalence of the so-called diagnostic crossover in the maltreated eco-phenotype. The presence of diagnostic crossovers, such as individuals experiencing multiple forms of eating pathology over their lifetime, underscores the dynamic nature of EDs and emphasizes the need for a more nuanced understanding of ED that considers the interplay between trauma exposure, symptom expression, and diagnostic trajectories.…”

“…Highly stressful and traumatic events are regarded as potential precipitating factors for the onset of ED, and studies indicate that individuals with an ED are more prone to report a history of trauma (Garner and Garfinkel, 1980;Meneguzzo et al, 2021;Sundhedsstyrelsen, 2021;Rienecke et al, 2022). This was also highlighted in the systematic review by Rossi et al (2024) on the concept of the maltreated eco-phenotype of ED, exploring the distinctive biological and clinical features associated with childhood maltreatment (CM). Rossi et al (2024) synthesized evidence revealing significant neuroanatomical changes, stress response alterations, inflammation markers, and gut microbiota composition differences among individuals with EDs who had experienced CM.…”

“…This was also highlighted in the systematic review by Rossi et al (2024) on the concept of the maltreated eco-phenotype of ED, exploring the distinctive biological and clinical features associated with childhood maltreatment (CM). Rossi et al (2024) synthesized evidence revealing significant neuroanatomical changes, stress response alterations, inflammation markers, and gut microbiota composition differences among individuals with EDs who had experienced CM. Importantly, these findings stress the significance of viewing CM and interpersonal trauma not only as risk factors but also as causal agents shaping various eco-phenotypic variants of EDs.…”

“…This raises the question of whether there is also evidence of an association between NTE and ED across studies. The majority of studies examining the link between trauma and ED tend to focus on interpersonal traumas as observed by Rossi et al (2024), thus leaving NTE relatively understudied (Trottier and MacDonald, 2017). The primary domains of interpersonal trauma that have been investigated in the literature of ED, are physical-, emotional-, and sexual abuse (Forman-Hoffman et al, 2012;Kothari et al, 2015;Trottier and MacDonald, 2017).…”

Table_1.docx

“…Highly stressful and traumatic events are regarded as potential precipitating factors for the onset of ED, and studies indicate that individuals with an ED are more prone to report a history of trauma (Garner and Garfinkel, 1980;Meneguzzo et al, 2021;Sundhedsstyrelsen, 2021;Rienecke et al, 2022). This was also highlighted in the systematic review by Rossi et al (2024) on the concept of the maltreated eco-phenotype of ED, exploring the distinctive biological and clinical features associated with childhood maltreatment (CM). Rossi et al (2024) synthesized evidence revealing significant neuroanatomical changes, stress response alterations, inflammation markers, and gut microbiota composition differences among individuals with EDs who had experienced CM.…”