Background RCTs indicate that more than half of those who receive standardized treatments for Eating Disorders (EDs) do not reach full remission. ED treatments may not cover all psychopathological factors that maintain the EDs. Comorbidity among EDs with Posttraumatic Stress Disorder (PTSD) have been reported with various prevalence. A functional relationship between these disorders deserves research attention, to identify and address untreated PTSD as a potential maintaining factor. Objective To investigate prevalence of PTSD in Bulimia Nervosa (BN) patients, the different traumatic events experienced and the implications for assessment and treatment. Methods The patients ran an integrated multidisciplinary outpatient treatment composed by Psycho-Nutritional Rehabilitation (PNR), Cognitive and Cognitive-Behavioral Psychotherapy (CT/CBT) including Trauma Therapy if necessary. The sample was composed of 296 females with BN (age 25.24 ± 6.7; BMI 21.28 + 3.7; duration 8.6 ± 6.17 years). The patients were assessed (EDI-3, EAT-40, CBA 2.0, MCQ and SCID-I/II) at the beginning (t0), after 12 sessions of CT/CBT and 12 of PNR (t1) and at the end of treatment (tf). Results 22.3% (n = 66) of the whole sample met DSM-5 criteria for PTSD and 95.6% (62/66) of these reported the first traumatic event before the onset of BN. Mistreating/carelessness (19.69%), domestic violence (12.12%), unexpected death (12.12%) and psychological distress due to childhood obesity (18.18%) are reported as main traumatic events of the PTSD. The BN-PTSD patients show significantly higher ED related symptoms, binging and vomiting, interceptive deficits, affective problems (EDI-3), in body and food concern (EAT), in state anxiety (CBA-STAI) and general negative beliefs (including responsibility, superstition and punishment) (MCQ). The BN without PTSD respond with significantly higher values in autonomy and self-acceptance (PWB). The mean duration of treatment for BN-PTSD was 34 PNR and 37 CT-CBT sessions, including Trauma Therapy (drop-out: 3.8%) (BN: 18 PNR and 24 CT-CBT; drop-out: 12.2%). Conclusion BN and PTSD can co-exist and traumatic events tend to occur prior to onset of BN. It is important to include differential and sequential diagnosis to understand the role of untreated PTSD as a possible maintaining factor for EDs. The inclusion of Trauma Therapy may reduce dropout rate. These hypotheses need further research.
POST TRAUMATIC STRESS DISORDER AND TRAUMA TYPES IN AN ITALIAN SAMPLE OF PATIENTS WITH BULIMIA NERVOSA / Valentina Fasoli; Chiara Mazzoni, Elena Tomba, Marialuisa Rausa, Livia Pozzi, Elena Dapporto, Donatella Ballardini, Romana Schumann. - In: EATING AND WEIGHT DISORDERS. - ISSN 1124-4909. - ELETTRONICO. - 22:3(2017), pp. 563-564.
POST TRAUMATIC STRESS DISORDER AND TRAUMA TYPES IN AN ITALIAN SAMPLE OF PATIENTS WITH BULIMIA NERVOSA
Elena Tomba
;
2017
Abstract
Background RCTs indicate that more than half of those who receive standardized treatments for Eating Disorders (EDs) do not reach full remission. ED treatments may not cover all psychopathological factors that maintain the EDs. Comorbidity among EDs with Posttraumatic Stress Disorder (PTSD) have been reported with various prevalence. A functional relationship between these disorders deserves research attention, to identify and address untreated PTSD as a potential maintaining factor. Objective To investigate prevalence of PTSD in Bulimia Nervosa (BN) patients, the different traumatic events experienced and the implications for assessment and treatment. Methods The patients ran an integrated multidisciplinary outpatient treatment composed by Psycho-Nutritional Rehabilitation (PNR), Cognitive and Cognitive-Behavioral Psychotherapy (CT/CBT) including Trauma Therapy if necessary. The sample was composed of 296 females with BN (age 25.24 ± 6.7; BMI 21.28 + 3.7; duration 8.6 ± 6.17 years). The patients were assessed (EDI-3, EAT-40, CBA 2.0, MCQ and SCID-I/II) at the beginning (t0), after 12 sessions of CT/CBT and 12 of PNR (t1) and at the end of treatment (tf). Results 22.3% (n = 66) of the whole sample met DSM-5 criteria for PTSD and 95.6% (62/66) of these reported the first traumatic event before the onset of BN. Mistreating/carelessness (19.69%), domestic violence (12.12%), unexpected death (12.12%) and psychological distress due to childhood obesity (18.18%) are reported as main traumatic events of the PTSD. The BN-PTSD patients show significantly higher ED related symptoms, binging and vomiting, interceptive deficits, affective problems (EDI-3), in body and food concern (EAT), in state anxiety (CBA-STAI) and general negative beliefs (including responsibility, superstition and punishment) (MCQ). The BN without PTSD respond with significantly higher values in autonomy and self-acceptance (PWB). The mean duration of treatment for BN-PTSD was 34 PNR and 37 CT-CBT sessions, including Trauma Therapy (drop-out: 3.8%) (BN: 18 PNR and 24 CT-CBT; drop-out: 12.2%). Conclusion BN and PTSD can co-exist and traumatic events tend to occur prior to onset of BN. It is important to include differential and sequential diagnosis to understand the role of untreated PTSD as a possible maintaining factor for EDs. The inclusion of Trauma Therapy may reduce dropout rate. These hypotheses need further research.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
