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

7 Scopus citations

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)
Pages (from-to)611-621
Number of pages11
JournalEuropean Eating Disorders Review
Volume29
Issue number4
Early online dateMar 4 2021
DOIs
StatePublished - Jul 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.

Keywords

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

PubMed: MeSH publication types

  • Journal Article
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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