Rienecke Renee D, Johnson Craig, Le Grange Daniel, Manwaring Jamie, Mehler Philip S, Duffy Alan, McClanahan Susan, Blalock Dan V
Eating Recovery Center and Pathlight Mood & Anxiety Centers, Denver, USA.
Department of Psychiatry and Behavioral Sciences, Northwestern University, 333 N. Michigan Avenue, Ste. 1900, Denver, IL, 60601, USA.
J Eat Disord. 2022 May 20;10(1):72. doi: 10.1186/s40337-022-00594-x.
Adverse childhood experiences (ACEs) are prevalent, impact long-term physical and mental health, and are associated with eating disorders (EDs) in adulthood. The primary objectives of the current study were: (1) to examine and compare ACEs between two samples: treatment-seeking adults, and a nationally representative sample of adults, (2) to characterize ACEs items and total scores across demographic and diagnostic information in adults seeking treatment for an ED, (3) to statistically classify ACEs profiles using latent class analysis, and (4) to examine associations between ACEs profiles and diagnosis.
This cross-sectional study assessed patients with a DSM-5 ED receiving treatment between October 2018 and April 2020 at the inpatient, residential, or partial hospitalization levels of care at one of two private ED treatment facilities. ACEs were assessed with the Adverse Childhood Experiences Survey at admission. Generalized linear models and Welch's t-tests were used to compare ACEs in the current sample with national estimates. A latent class analysis was conducted to examine subgroups of ACEs responses, and differences in these classes by ED diagnoses were examined with multinomial logistic regression.
Patients with EDs had significantly higher ACEs scores (M = 1.95, SD = 1.90) than the nationally representative sample (M = 1.57, SD = 4.72; t = 6.42, p < .001). Within patients with EDs, four latent classes of ACEs item endorsement were identified. Patients with other specified feeding or eating disorder (OSFED) and binge eating disorder (BED) were more likely to fall into the "Household ACEs" and "Abuse ACEs" groups, respectively, compared to anorexia nervosa-restricting subtype (AN-R).
Patients with EDs reported more ACEs than the nationally representative sample, and differences in total ACEs and latent class membership were found across ED diagnoses. The current study can inform the development of trauma-informed care for patients with EDs.
童年不良经历（ACEs）普遍存在，会影响长期身心健康，并与成年期饮食失调（EDs）相关。本研究的主要目的是：（1）检查并比较两个样本中的ACEs：寻求治疗的成年人以及全国代表性的成年人样本；（2）描述寻求ED治疗的成年人中ACEs项目及总分在人口统计学和诊断信息方面的特征；（3）使用潜在类别分析对ACEs概况进行统计分类；（4）检查ACEs概况与诊断之间的关联。
这项横断面研究评估了2018年10月至2020年4月期间在两家私立ED治疗机构之一接受住院、住院或部分住院治疗水平护理的DSM-5 ED患者。入院时通过童年不良经历调查评估ACEs。使用广义线性模型和韦尔奇t检验将当前样本中的ACEs与全国估计值进行比较。进行潜在类别分析以检查ACEs反应的亚组，并通过多项逻辑回归检查这些类别在ED诊断方面的差异。
ED患者的ACEs得分（M = 1.95，SD = 1.90）显著高于全国代表性样本（M = 1.57，SD = 4.72；t = 6.42，p <.001）。在ED患者中，确定了四类ACEs项目认可情况。与神经性厌食症限制型亚型（AN-R）相比，患有其他特定喂养或进食障碍（OSFED）和暴饮暴食障碍（BED）的患者分别更有可能属于“家庭ACEs”和“虐待ACEs”组。
ED患者报告的ACEs比全国代表性样本更多，并且在不同的ED诊断中发现了总ACEs和潜在类别成员的差异。本研究可为ED患者的创伤知情护理的发展提供参考。
