An updated report on trauma in Anorexia Nervosa: Confirmation and novel data

Abstract

Objective

Literature reported a great occurrence of Traumatic Events (TEs) and post-traumatic symptoms in anorexia nervosa (AN). The present study aims to: a) describe the prevalence and the characteristics of TEs in AN, also comparing TEs related to Post-traumatic Stress Disorder (PTSD) to those without this link; b) compare patients with and without TEs and with and without PTSD in terms of clinical picture; c) compare patients who suffered the TE before AN onset to those with TE after AN onset.

Methods

The sample consisted of 126 patients with AN who were interviewed with the Structured and Clinical Interview for DSM 5 (SCID-5), and completed self-reported questionnaires to investigate the general and eating-related psychopathology.

Results

The results showed that the majority of the patients with AN reported a TE, and TEs related to PTSD were more relational and sexual-related compared to TEs not leading to PTSD. Moreover, after Bonferroni correction was applied to the results, no significant differences emerged between patients with and without TEs, and between individuals with TEs before and after AN onset; differently, patients with PTSD presented a more severe global clinical picture than those without PTSD, partially independent of diagnostic AN subtype.

Conclusion

The study highlights that, despite TEs are risk factors for AN, the diagnosis of PTSD makes the difference in terms of clinical presentation and severity, impacting not only eating-related symptoms but also general psychopathology. A careful screening for PTSD in patients with AN is suggestable, especially when relational trauma and sexual violence are reported.