Treatment outcomes of psychotherapy for binge-eating disorder in a randomized controlled trial: Examining the roles of childhood abuse and post-traumatic stress disorder

Vivienne M. Hazzard, Ross D. Crosby, Scott J. Crow, Scott G. Engel, Lauren M. Schaefer, Timothy D. Brewerton, Giovanni Castellini, Kathryn Trottier, Carol B. Peterson, Stephen A. Wonderlich

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: 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. Method: 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. Results: 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. Conclusions: Results suggest that a traumatic event history may hinder treatment success and that PTSD may be more influential than the trauma exposure itself.

Original languageEnglish (US)
JournalEuropean Eating Disorders Review
DOIs
StateAccepted/In press - 2021

Bibliographical note

Funding Information:
This study was supported by grants from the National Institutes of Health (R34MH098995, R34MH099040, P30DK60456, T32MH082761) and the Neuropsychiatric Research Institute.

Publisher Copyright:
© 2021 Eating Disorders Association and John Wiley & Sons Ltd.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

Keywords

  • binge-eating disorder
  • childhood abuse
  • eating disorders
  • post-traumatic stress disorder
  • psychotherapy

PubMed: MeSH publication types

  • Journal Article

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