Traditionally, the consensus in the eating disorder field had been to avoid trauma work during intensive treatment, opting to address it later in outpatient settings. This approach stems from a concern of making the eating disorder worse, along with a lack of trauma-informed treatment options.
However, recent research conducted by Monte Nido & Affiliates and published in the Journal of Eating Disorders suggests that parallel and interwoven treatment for both the eating disorder and PTSD can be effectively delivered in the residential level of care by the same providers and therapists.
Furthermore, eating disorder residential treatment that addresses PTSD shows lasting improvements in clients six months post discharge, which indicates that this type of care works.
A Groundbreaking Study on PTSD and Eating Disorders
Our study was conducted across seven residential treatment sites in the U.S. and has unveiled significant insights into the relationship between traumatic experiences, post-traumatic stress disorder (PTSD), and the severity of eating disorder symptoms. The study, involving 609 adult participants (96% female) who received residential treatment for an eating disorder, utilized validated self-report measures to gauge the extent of eating disorder symptoms, PTSD, major depression, state-trait anxiety, and overall quality of life.
Nearly Half of Eating Disorder Clients Have PTSD
One of the striking findings of the study is the prevalence of PTSD in the residential eating disorder treatment setting. Nearly half (49.3%) of the clients admitted for eating disorder treatment exhibited symptoms compatible with PTSD, highlighting how common these comorbid conditions are in this demographic.
Trauma and Severity of Symptoms
The study also found that clients with both an eating disorder and PTSD (ED-PTSD+) experienced a significantly higher number of traumatic life events compared to eating disorder clients without PTSD. This group also showed higher rates of almost all types of lifetime traumatic events, particularly those associated with greater trauma exposure, such as sexual and physical assaults. These findings underline the critical role of trauma exposure in the development and maintenance of eating disorders, particularly those with binge-purge features.
Furthermore, clients with both an eating disorder and PTSD had notably more severe symptoms across all measures. These included not only eating disorder symptoms but also depression, state-trait anxiety, and a notably diminished quality of life. These findings suggest that the impact of PTSD on these individuals extends far beyond the eating disorder and to overall mental health and day-to-day functioning.
Integrated Treatment for Trauma
In summary, this study sheds light on the intricate relationships between trauma, PTSD, and eating disorders, highlighting the need for a nuanced approach to treatment that addresses both the psychological trauma and the symptoms of the eating disorder. The high prevalence of PTSD among individuals with eating disorders underscores the importance of considering trauma in the assessment and treatment of these complex conditions.
How does Monte Nido & Affiliates Treat Trauma?
At Monte Nido & Affiliates, we go beyond trauma-informed care by being the first to provide evidence-based trauma treatments concurrently with ED treatment at higher levels of care. We integrate cognitive processing therapy (CPT), one of the three gold standard trauma treatments, in tandem with eating disorder treatment that complements cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). 81% of patients with PTSD at admission had reductions in trauma symptom scores from admission to discharge and 73% from admission to follow-up (6 months later).
“We support clients recovering from eating disorders by enhancing motivation and insight, developing healthy coping strategies, repairing and growing relationships, and changing the way clients understand themselves in their world,” said Molly Perlman, MD, MPH, CEDS, Chief Medical Officer of Monte Nido & Affiliates. “Our comprehensive system of care ensures we treat clients with a multidimensional approach and includes relational focus, trusted outcomes, cultural awareness and building resilience through a trauma-informed approach.”