TY - JOUR
T1 - Treatment outcomes of psychotherapy for binge-eating disorder in a randomized controlled trial
T2 - Examining the roles of childhood abuse and post-traumatic stress disorder
AU - Hazzard, Vivienne M.
AU - Crosby, Ross D.
AU - Crow, Scott J.
AU - Engel, Scott G.
AU - Schaefer, Lauren M.
AU - Brewerton, Timothy D.
AU - Castellini, Giovanni
AU - Trottier, Kathryn
AU - Peterson, Carol B.
AU - Wonderlich, Stephen A.
N1 - Publisher Copyright:
© 2021 Eating Disorders Association and John Wiley & Sons Ltd.
PY - 2021/7
Y1 - 2021/7
N2 - 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.
AB - 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.
KW - binge-eating disorder
KW - childhood abuse
KW - eating disorders
KW - post-traumatic stress disorder
KW - psychotherapy
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U2 - 10.1002/erv.2823
DO - 10.1002/erv.2823
M3 - Article
C2 - 33660906
AN - SCOPUS:85101920863
SN - 1072-4133
VL - 29
SP - 611
EP - 621
JO - European Eating Disorders Review
JF - European Eating Disorders Review
IS - 4
ER -