Update on Psychological Trauma, Other Severe Adverse Experiences and Eating Disorders: State of the Research and Future Research Directions

Abstract

Trauma exposure and other severe adverse experiences (e.g., emotional abuse) in both childhood and adulthood are associated with eating disorders. The relationship between traumatic and other adverse experiences and eating disorders appears to be mediated by emotional and behavioral dysregulation, as well as by cognitive factors such as self-criticism. Biological vulnerabilities may also be relevant to this relationship. Overall, the literature is limited by predominantly cross-sectional designs. There is clear evidence of a correlational relationship between trauma exposure and other severe adverse events, and eating disorders. Both risk and maintenance factor hypotheses have been put forth; however, prospective research testing these hypotheses remains limited. Future research should use prospective designs and focus on trauma-related symptoms (rather than trauma exposure) in order to advance research on risk and maintaining factors for eating disorders and inform treatment directions.

Women’s Constructions of Childhood Trauma and Anorexia Nervosa: a Qualitative Meta-Synthesis

“…The challenges identified in the earliest feminist analyses and throughout this introduction continue to remain a research priority (Trottier and MacDonald 2017). In this article, we argue that there is room to develop this work further by cultivating new ideas and paradigms.…”

“…In positioning any one aspect of women's subjective experience, such as the idealization of thinness in women over other aspects, risks relegating women's embodied experiences as extraneous to their sexual subjectivities, overlooking the role of language within cultural practice, or nullifying or excluding aspects of materiality such as power inequalities or childhood trauma that is increasingly being shown to reside at the heart of women's distressing experiences with their bodies and all forms of eating distress (Trottier and MacDonald 2017;Ussher 2000). What is needed is a multidimensional analysis that incorporates factors at the corporeal/material level, the discursive level, and the intrapsychic level (Ussher 2000).…”

Illness pathways between eating disorder and post‐traumatic stress disorder symptoms: Understanding comorbidity with network analysis

“…Trottier, Wonderlich, Monson, Crosby, and Olmsted () proposed that PTSD symptoms serve as a maintaining factor for ED symptoms. ED behaviors, such as binge eating, purging, and restriction, may facilitate escape and avoidance of distressing memories, thoughts, and feelings of PTSD (Mitchell, Porter, Boyko, & Field, ; Trottier et al, ; Trottier & MacDonald, ). Although avoidance provides short‐term relief, it prevents an individual from addressing the distressing symptoms and maintains the disorder long term.…”

“…This relationship may be explained by the development of a self‐critical view of self, which then drives individuals to use ED behaviors to achieve an ideal body image (Dunkley, Masheb, & Grilo, ). It has also been proposed that deficits in emotion regulation and impulsivity resulting from a traumatic experience may maintain ED symptoms (Mitchell et al, ; Trottier & MacDonald, ). This literature suggests that binge eating, purging, fasting, body dissatisfaction, self‐criticism, and emotion dysregulation may be implicated as illness pathways connecting ED and PTSD.…”

Correlates of co-occurring eating disorders and substance use disorders: a case for dialectical behavior therapy

“…Regarding specific disorders, the non-statistically significant elevation in the likelihood of PTSD in the ED-SUD group compared to the ED alone group suggests that trauma symptoms may be a relevant treatment target for ED patients generally. Indeed, groups are working to develop protocols for the concurrent treatment of ED and PTSD (e.g., Trottier & MacDonald, 2017), while existing trauma protocols are commonly used to treat PTSD in these populations such as the DBT/Prolonged Exposure protocol (Harned et al, 2012).…”