Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
J Trauma Stress. 2018 Oct;31(5):708-718. doi: 10.1002/jts.22323. Epub 2018 Oct 19.
Posttraumatic stress disorder (PTSD) and eating pathology are frequently comorbid, and both are independent risk factors for various medical conditions. Using population-based data collected as part of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III; N = 36,309), the primary objectives of this study were to (a) identify eating pathology classes among PTSD and (b) investigate associations between maladaptive eating and medical conditions among PTSD. Using the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-5), we assessed PTSD and maladaptive eating symptoms in accordance with the DSM-5. We used a latent class analysis to identify maladaptive eating typologies among adults with lifetime PTSD (n = 2,339; 6.1%) and multivariable logistic regression models to examine associations between each of the six emergent maladaptive eating typologies and medical conditions. Results revealed that over 40% of individuals with PTSD endorsed indicators of maladaptive eating. In addition, each maladaptive eating typology among PTSD was significantly associated with unique sociodemographic characteristics and increased odds of medical conditions relative to no PTSD and no eating disorder, adjusted odds ratios (AORs) = 1.34-6.55, and PTSD with no eating psychopathology, AORs = 1.43-5.11. Results of this study provide a better understanding of maladaptive eating in adults with PTSD and potential medical sequelae. Results indicate maladaptive eating may be an important mechanism in the association between PTSD and medical conditions, which may inform targeted interventions among individuals with these comorbidities.
创伤后应激障碍（PTSD）和进食障碍常常同时存在，且两者都是多种疾病的独立风险因素。本研究使用作为 2012-2013 年全国酒精相关状况流行病学调查（NESARC-III；N=36309）的一部分收集的基于人群的数据，主要目的是：(a) 在 PTSD 患者中确定进食障碍类型；(b) 研究 PTSD 患者中适应不良的进食行为与各种医疗状况之间的关系。我们根据 DSM-5 使用酒精使用障碍和相关障碍访谈表（AUDADIS-5）评估 PTSD 和适应不良的进食症状。我们使用潜在类别分析确定了一生中患有 PTSD（n=2339；6.1%）的成年人中的适应不良进食类型，并使用多变量逻辑回归模型来检查 6 种新兴的适应不良进食类型中的每一种与医疗状况之间的关系。结果显示，超过 40%的 PTSD 患者存在适应不良的进食迹象。此外，在 PTSD 患者中，每种适应不良的进食类型都与独特的社会人口特征显著相关，并与没有 PTSD 和没有进食障碍的患者相比，增加了出现医疗状况的几率，调整后的比值比（AOR）为 1.34-6.55，与 PTSD 但没有进食心理障碍的患者相比，AOR 为 1.43-5.11。本研究的结果提供了对 PTSD 成人中适应不良进食行为及其潜在医疗后果的更好理解。结果表明，适应不良的进食行为可能是 PTSD 与医疗状况之间关联的一个重要机制，这可能为这些共病患者的针对性干预提供信息。
