Posttraumatic stress disorder symptoms and trauma-informed care in higher levels of care for eating disorders

International Journal of Eating Disorders
By Jamie Manwaring, PhD Philip S. Mehler, MD, FACP, FAED, CEDS

Abstract

Objective: The purpose of the current study was to examine the prevalence and trajectory of posttraumatic stress disorder (PTSD) symptoms among patients with eating disorders (EDs) in higher level of ED care with trauma-informed components, but without a formal evidence-based trauma intervention.

Method: Participants were 613 adults diagnosed with EDs receiving treatment at inpatient, residential, or partial hospitalization levels of care. Participants completed the PTSD Checklist-5 (PCL-5) at admission and discharge.

Results: Over half of patients scored above the cutoff of 33 on the PCL-5 at admission, suggestive of PTSD symptoms characteristic of a formal PTSD diagnosis. The average PCL-5 score significantly decreased for every ED diagnostic category, and there was a significant reduction in the proportion of patients above the PCL-5 cutoff score at discharge. PCL-5 subscales measuring PTSD criteria B (intrusions) and C (avoidance) improved with modest effect sizes, whereas PCL-5 subscales D (negative alterations in cognitions and mood) and E (alterations in arousal and reactivity) improved with larger effect sizes.

Discussion: PTSD symptoms are prevalent among patients with EDs seeking higher levels of care. Despite not offering evidence-based trauma-specific interventions, PTSD symptoms decreased over the course of treatment. However, improvements cannot definitely be attributed to trauma-informed care.

Written by

Jamie Manwaring, PhD

Dr. Jamie Manwaring began clinical research in eating and weight disorders after graduating with her degree in psychology from UCLA. This clinical research continued in graduate school at Washington…
Written by

Philip S. Mehler, MD, FACP, FAED, CEDS

Dr. Philip Mehler, MD, FACP, FAED, CEDS founded the ACUTE Center for Eating Disorders and Severe Malnutrition in 2001 and serves as its Executive Medical Director. He began his career at Denver Health…

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

Center of Excellence Logo