Weider Siri, Rø Øyvind, Bjørnelv Sigrid, Danielsen Marit
Department of Psychology, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Eating Disorder Unit, Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
J Eat Disord. 2025 Jun 19;13(1):117. doi: 10.1186/s40337-025-01316-9.
Childhood traumatic events (CTE) are frequently described in patients with eating disorders. However, the understanding of how such events impact eating disorder treatment outcome is limited. The aim of this study was to examine the prevalence of childhood sexual abuse (CSA) or any CTE at baseline in a naturalistic transdiagnostic sample, and to evaluate how such events affect symptom change and rates of remission at follow-up.
The sample comprised 228 adult female former eating disorder inpatients (M = 24.6 years), of which 61.4% (n = 140) had been diagnosed with anorexia nervosa at baseline, 21.1% (n = 48) with bulimia nervosa, and 17.5% (n = 40) with other specified feeding or eating disorder including binge eating. Data on CSA/ CTE exposure were collected from the patients' hospital records and were rated for degree of severity (severe, moderate to low, or no). Analyses of prevalence, group differences, and rates of remission at follow-up were performed.
Findings showed high prevalence of high severity CSA and CTE at admission, respectively 33% (n = 75) and 48.7% (n = 111). Moreover, although all patients showed significant improvement in symptoms from baseline to follow-up, a significant association was found between severity of CTE exposure and remission group affiliation with 24% of those with severe CTE exposure and 40% of those with no CTE exposure being in remission.
Despite considerable heterogeneity in demographic characteristics, treatment and length of follow-up, severity of CTE exposure was associated with remission at follow-up. Thus, patients with the highest CTE severity showed the poorest prognoses. Findings from this study underline the importance of addressing trauma experiences in assessment and therapy and indicate that CTE severity level should be considered when assessing trauma experiences.
饮食失调患者中经常会提及童年创伤事件（CTE）。然而，对于此类事件如何影响饮食失调治疗结果的理解却很有限。本研究的目的是在一个自然主义的跨诊断样本中，检查基线时童年性虐待（CSA）或任何CTE的患病率，并评估这些事件如何影响随访时的症状变化和缓解率。
样本包括228名成年女性前饮食失调住院患者（平均年龄24.6岁），其中61.4%（n = 140）在基线时被诊断为神经性厌食症，21.1%（n = 48）为神经性贪食症，17.5%（n = 40）为其他特定的喂养或饮食失调，包括暴饮暴食。从患者的医院记录中收集了关于CSA/CTE暴露的数据，并对严重程度（严重、中度至低度或无）进行了评分。进行了患病率、组间差异和随访缓解率的分析。
研究结果显示，入院时高严重程度的CSA和CTE患病率分别为33%（n = 75）和48.7%（n = 111）。此外，尽管所有患者从基线到随访时症状都有显著改善，但发现CTE暴露的严重程度与缓解组归属之间存在显著关联，严重CTE暴露患者中有24%处于缓解状态，无CTE暴露患者中有40%处于缓解状态。
尽管在人口统计学特征、治疗和随访时间方面存在相当大的异质性，但CTE暴露的严重程度与随访时的缓解有关。因此，CTE严重程度最高的患者预后最差。本研究结果强调了在评估和治疗中处理创伤经历的重要性，并表明在评估创伤经历时应考虑CTE严重程度水平。
