Psychological Treatment of Co-Occurring Trauma History, Posttraumatic Stress Disorder, and Eating Disorders: A Systematic Review of Clinical Outcomes

Objective

The association between eating disorders (EDs) and both trauma exposure and posttraumatic stress disorder (PTSD) is well established. Existing evidence is inconclusive about the impact of trauma exposure and/or comorbid PTSD on ED treatment outcomes and if comorbid ED affects PTSD treatment outcomes. The objective of this systematic review is to consolidate the literature on treatment efficacy and effectiveness for individuals with EDs and trauma histories with and without PTSD, as well as to understand how ED and PTSD symptoms may impact improvement in each other, and how improvements in ED and PTSD symptoms might differ across treatment focus (ED-focused, PTSD-focused or both) and modality (e.g., cognitive behavioural, psychodynamic, transdiagnostic, integrative).

Methods

A systematic search of peer-reviewed publications was conducted across three databases (PsycINFO, PubMed, SCOPUS).

Results

Results indicate that comorbid PTSD symptoms, but not trauma history alone, may negatively affect ED treatment outcomes. Likewise comorbid ED symptoms may negatively affect PTSD treatment outcomes, but data is lacking. ED and/or PTSD symptom improvement was observed across treatment modalities.

Conclusions

Results suggest that individuals may respond to a variety of modalities. Integrated and concurrent treatments show promise as an effective strategy to achieve long-term recovery from this debilitating comorbid condition.