Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA.
Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA.
Eur Eat Disord Rev. 2021 Jul;29(4):611-621. doi: 10.1002/erv.2823. Epub 2021 Mar 4.
To examine childhood abuse and post-traumatic stress disorder (PTSD) as predictors and moderators of binge-eating disorder (BED) treatment outcomes in a randomized controlled trial comparing Integrative Cognitive-Affective Therapy with cognitive-behavioural therapy administered using guided self-help.
In 112 adults with BED, childhood abuse was defined as any moderate/severe abuse as assessed by the Childhood Trauma Questionnaire, lifetime PTSD was assessed via the Structured Clinical Interview for DSM-IV, and outcomes were assessed via the Eating Disorder Examination (EDE). Covariate-adjusted regression models predicting binge-eating frequency and EDE global scores at end of treatment and 6-month follow-up were conducted.
Lifetime PTSD predicted greater binge-eating frequency at end of treatment (B = 1.32, p = 0.009) and childhood abuse predicted greater binge-eating frequency at follow-up (B = 1.00, p = 0.001). Lifetime PTSD moderated the association between childhood abuse and binge-eating frequency at follow-up (B = 2.98, p = 0.009), such that childhood abuse predicted greater binge-eating frequency among participants with a history of PTSD (B = 3.30, p = 0.001) but not among those without a PTSD history (B = 0.31, p = 0.42). No associations with EDE global scores or interactions with treatment group were observed.
Results suggest that a traumatic event history may hinder treatment success and that PTSD may be more influential than the trauma exposure itself.
在一项比较整合认知-情感治疗与认知行为治疗的随机对照试验中，以指导自助的形式进行，研究儿童期虐待和创伤后应激障碍（PTSD）作为暴食症（BED）治疗结果的预测因子和调节因素。
在 112 名 BED 成年人中，儿童期虐待被定义为童年创伤问卷评估的任何中度/重度虐待，通过 DSM-IV 结构化临床访谈评估终身 PTSD，通过饮食失调检查（EDE）评估结果。进行了协变量调整的回归模型，以预测治疗结束时和 6 个月随访时的暴食频率和 EDE 总分。
终身 PTSD 预测治疗结束时暴食频率更高（B=1.32，p=0.009），儿童期虐待预测随访时暴食频率更高（B=1.00，p=0.001）。终身 PTSD 调节了儿童期虐待与随访时暴食频率之间的关联（B=2.98，p=0.009），即儿童期虐待预测 PTSD 病史参与者的暴食频率更高（B=3.30，p=0.001），而无 PTSD 病史参与者的暴食频率更高（B=0.31，p=0.42）。未观察到与 EDE 总分的关联或与治疗组的相互作用。
结果表明，创伤事件史可能会阻碍治疗成功，而 PTSD 的影响可能比创伤暴露本身更大。
