The impact of childhood sexual abuse and childhood traumatic events on outcome in adult inpatients with eating disorders

Abstract

Abstract Background 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. Methods The sample comprised 228 adult female former eating disorder inpatients (Mage = 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. Results 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. Conclusions 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.

Keywords

• Anorexia nervosa
• Bulimia nervosa
• Binge eating disorder
• Other specified feeding and eating disorders
• Childhood sexual abuse
• Childhood trauma events