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Brewerton TD, Gavidia I, Suro G, Perlman MM. Associations between major depressive and bipolar disorders and eating disorder, PTSD, and comorbid symptom severity in eating disorder patients. EUROPEAN EATING DISORDERS REVIEW 2024; 32:188-200. [PMID: 37788327 DOI: 10.1002/erv.3035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 09/05/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVE Major depressive disorder (MDD) and bipolar disorder (BD) are commonly comorbid with eating disorders (EDs). However, there is limited data about the clinical features of such patients, especially their association with traumatic histories and PTSD, which occur commonly in patients admitted to residential treatment. METHODS Adults (≥18 years, 91% female, n = 2155) admitted to residential ED treatment were evaluated upon admission for DSM-5 defined MDD and BD. Patients were divided into three groups based on an admission diagnosis of no mood disorder (NMD), MDD, and BD (types I and II) and compared on a number of demographic variables, clinical features and assessments. RESULTS Mood disorders occurred in 76.4% of participants. There were statistically significant differences across groups in most measures with the BD group showing higher rates and doses of traumatic events; higher current PTSD; higher BMIs; higher severity of ED, depression and state-trait anxiety symptoms; worse quality of life; and higher rates of substance use disorders. Similarly, the MDD group had higher rates than the NMD group on most measures. CONCLUSIONS These findings have important implications for prevention, treatment and long-term follow-up and highlight the need for early trauma-focused treatment of ED patients with comorbid mood disorders and PTSD.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
- Timothy D. Brewerton, MD, LLC, Mt. Pleasant, South Carolina, USA
- Monte Nido and Affiliates, Miami, Florida, USA
| | | | - Giulia Suro
- Monte Nido and Affiliates, Miami, Florida, USA
| | - Molly M Perlman
- Monte Nido and Affiliates, Miami, Florida, USA
- Department of Psychiatry and Behavioral Health, Florida International University Herbert Wertheim College of Medicine, Miami, Florida, USA
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2
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Aurora P, LoSavio ST, Kimbrel NA, Beckham JC, Calhoun PS, Dillon KH. Examining the daily relationship between guilt, shame, and substance use among veterans with psychiatric disorders. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 8:100174. [PMID: 37753347 PMCID: PMC10518500 DOI: 10.1016/j.dadr.2023.100174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/09/2023] [Accepted: 06/09/2023] [Indexed: 09/28/2023]
Abstract
Background Shame and guilt are key emotions known to amplify trauma-related symptoms in veterans. Maintenance of symptoms is facilitated by avoidance behaviors, such as substance use. However, limited research has examined the associations between shame, guilt, and substance use in daily life. Methods The current study sought to examine the cross-lagged association between shame, guilt, and substance use. Forty veterans completed 28 days of experience sampling reporting on their current emotional experiences and use of substances. Results Results suggest a reciprocal relationship among shame and guilt and substance use, such that shame and guilt separately predicted subsequent substance use, and substance use predicted subsequent shame and guilt. Conclusions These results highlight the dynamic relationship among shame, guilt, and substance use and suggest the potential value of conceptualizing these clinical targets as mutually reinforcing to inform integrative intervention strategies that can interrupt the in-the-moment cascade of negative consequences.
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Affiliation(s)
- Pallavi Aurora
- Durham VA Health Care System, Durham NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Stefanie T. LoSavio
- Durham VA Health Care System, Durham NC, USA
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Nathan A. Kimbrel
- Durham VA Health Care System, Durham NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Jean C. Beckham
- Durham VA Health Care System, Durham NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Patrick S. Calhoun
- Durham VA Health Care System, Durham NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Kirsten H. Dillon
- Durham VA Health Care System, Durham NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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3
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Brewerton TD. Mechanisms by which adverse childhood experiences, other traumas and PTSD influence the health and well-being of individuals with eating disorders throughout the life span. J Eat Disord 2022; 10:162. [PMID: 36372878 PMCID: PMC9661783 DOI: 10.1186/s40337-022-00696-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Multiple published sources from around the world have confirmed an association between an array of adverse childhood experiences (ACEs) and other traumatic events with eating disorders (EDs) and related adverse outcomes, including higher morbidity and mortality. METHODS In keeping with this Special Issue's goals, this narrative review focuses on the ACEs pyramid and its purported mechanisms through which child maltreatment and other forms of violence toward human beings influence the health and well-being of individuals who develop EDs throughout the life span. Relevant literature on posttraumatic stress disorder (PTSD) is highlighted when applicable. RESULTS At every level of the pyramid, it is shown that EDs interact with each of these proclaimed escalating mechanisms in a bidirectional manner that contributes to the predisposition, precipitation and perpetuation of EDs and related medical and psychiatric comorbidities, which then predispose to early death. The levels and their interactions that are discussed include the contribution of generational embodiment (genetics) and historical trauma (epigenetics), social conditions and local context, the ACEs and other traumas themselves, the resultant disrupted neurodevelopment, subsequent social, emotional and cognitive impairment, the adoption of health risk behaviors, and the development of disease, disability and social problems, all resulting in premature mortality by means of fatal complications and/or suicide. CONCLUSIONS The implications of these cascading, evolving, and intertwined perspectives have important implications for the assessment and treatment of EDs using trauma-informed care and trauma-focused integrated treatment approaches. This overview offers multiple opportunities at every level for the palliation and prevention of EDs and other associated trauma-related conditions, including PTSD.
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Affiliation(s)
- Timothy D Brewerton
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
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4
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Liu L, Wang X, Xie Y, Chui WH. Using Illicit Drugs to Lose Weight among Recovering Female Drug Users in China: An Exploratory Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052626. [PMID: 35270314 PMCID: PMC8909896 DOI: 10.3390/ijerph19052626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 11/16/2022]
Abstract
The population of female drug users has been growing in China, and these women have been found to care deeply about their weight. Against this backdrop, this study examines the relationship between Chinese women's illicit drug use and their intentions to lose weight, keep fit, and maintain a slim body shape. The participants of this study were 29 women who all had experience with illicit drug use for weight control. These women were drawn from a female compulsory drug treatment center located in eastern China. Semi-structured interviews with these 29 participants were conducted between 2013 and 2016. Expectations of losing weight and pursuing their ideal slim body shape were found to be an important reason for the study participants' initiation of drug use, its maintenance, and failures to achieve abstinence. These Chinese female drug users were generally satisfied with weight loss outcomes subsequent to drug consumption. A fuller appreciation of Chinese women's weight-loss-related illicit drug use patterns is much needed to help devise strategies and policies to deal with this growing problem. These include changing the dominant aesthetic cultural preference for thinness, paying particular attention to the functional use of illicit drugs in drug treatment programs, and having special interventions for women who interact with drug users within their social networks.
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Affiliation(s)
- Liu Liu
- School of Social and Behavioral Sciences, Nanjing University, Nanjing 210023, China
- Correspondence: ; Tel.: +86-25-8968-0958 (ext. 409)
| | - Xiaotao Wang
- School of Social Development, Nanjing Normal University, Nanjing 210097, China;
| | - Yang Xie
- Faculty of Education, Beijing Normal University, Beijing 100875, China;
| | - Wing-Hong Chui
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China;
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Hien D, Kropp F, Wells EA, Campbell A, Hatch-Maillette M, Hodgkins C, Killeen T, Lopez-Castro T, Morgan-Lopez A, Ruglass LM, Saavedra L, Nunes EV. The "Women and Trauma" study and its national impact on advancing trauma specific approaches in community substance use treatment and research. J Subst Abuse Treat 2021; 112S:12-17. [PMID: 32220405 DOI: 10.1016/j.jsat.2020.02.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/02/2020] [Accepted: 02/08/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The "Women and Trauma" Study (WTS) conducted in the National Drug Abuse Treatment Clinical Trials Network (CTN-0015) resulted in research publications, presentations, and a train-the-trainer workshop to support dissemination efforts for skills-based trauma treatment in substance use community treatment. Twelve years after its completion, this paper aims to examine whether and how the WTS contributed to knowledge in the field of trauma and addictions and inspired community treatment programs (CTPs) to train staff to identify and provide trauma-related services. METHOD We present findings from two different analyses that explored longer term study impacts on treatment and dissemination: (1) a post-study site survey covering 4 domains from 4/7 programs that participated in delivering the WTS to evaluate their perceptions of study impact on their treatment community; and (2) an analysis of citations of its publications to determine impact on the scientific community. RESULTS Surveys from responding sites indicated that participation in the study significantly increased their agencies'' awareness of the need to take a focused approach to treating trauma issues in this population. Specifically, these sites increased their commitment to using skills-based trauma treatment with the study's target population of female patients with SUD and trauma histories, as well as expanding it to other groups affected by trauma. Citation analysis revealed that according to the Web of Science, as of August 2019, the number of citations of 24 CTN-0015 articles, ranged from 1 to 135 (Mean = 20, SD = 33; Median = 6). Four of the most influential are discussed. CONCLUSIONS This manuscript provides original information about the contributions of the WTS study, demonstrating how the study contributed to serving women with trauma in community substance use treatment.
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Affiliation(s)
- Denise Hien
- Center of Alcohol & Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, Piscataway, NJ, United States of America.
| | - Frankie Kropp
- Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, College of Medicine, University of Cincinnati, Cincinnati, OH, United States of America
| | - Elizabeth A Wells
- School of Social Work, University of Washington, Seattle, WA, United States of America
| | - Aimee Campbell
- Department of Psychiatry, Columbia University Irving Medical Center and Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, United States of America
| | - Mary Hatch-Maillette
- University of Washington Alcohol & Drug Abuse Institute, Department of Psychiatry & Behavioral Sciences, Seattle, WA, United States of America
| | | | - Therese Killeen
- Medical University of South Carolina, Charleston, SC, United States of America
| | - Teresa Lopez-Castro
- Psychology Department, The City College of New York, New York, NY, United States of America
| | - Antonio Morgan-Lopez
- Behavioral Health Research Division, RTI International, Research Triangle Park, NC, United States of America
| | - Lesia M Ruglass
- Center of Alcohol & Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, Piscataway, NJ, United States of America
| | - Lissette Saavedra
- Behavioral Health Research Division, RTI International, Research Triangle Park, NC, United States of America
| | - Edward V Nunes
- Department of Psychiatry, Columbia University Irving Medical Center and Division on Substance Use Disorders, New York State Psychiatric Institute, New York, NY, United States of America
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Binge eating and alcohol consumption: an integrative review. Eat Weight Disord 2021; 26:759-769. [PMID: 32424561 DOI: 10.1007/s40519-020-00923-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 05/06/2020] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To identify the relationship between binge eating and alcohol consumption. METHODS This is an integrative literature review of publications from 2015 to 2019, using the Pubmed, Cinhahl, Psynet, Lilacs, Embase and Web of Science virtual databases and the descriptors ("Binge-Eating" OR "Bulimia") AND Alcohol* in English, Spanish and Portuguese. RESULTS A total of 964 articles were found. After reading the titles and abstracts and excluding duplicates, 36 articles were included in the final sample (35 in English and one in Portuguese). They were grouped into three thematic categories: "sample profile and characterization", "genetic and environmental factors", and "emotions and behavior". CONCLUSIONS The data indicate the existence of a relationship between binge eating and alcohol use, and some factors were associated with this comorbidity. Still, there were few publications on the theme at the national level, indicating the need for developing more research. These findings may support therapeutic actions and strategies for identification of cases, embracing approaches and more effective treatments to meet the individual's biopsychosocial demands. LEVEL OF EVIDENCE Level V, narrative review.
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Bogusz K, Kopera M, Jakubczyk A, Trucco EM, Kucharska K, Walenda A, Wojnar M. Prevalence of alcohol use disorder among individuals who binge eat: a systematic review and meta-analysis. Addiction 2021; 116:18-31. [PMID: 32533728 PMCID: PMC7736190 DOI: 10.1111/add.15155] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/02/2020] [Accepted: 06/05/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Binge eating disorder (BED) is correlated with substance use. This study aimed to estimate the life-time prevalence of alcohol use disorder (AUD) among individuals with non-compensatory binge eating and determine whether their life-time prevalence of AUD is higher than in non-bingeing controls. DESIGN A systematic search of databases (PubMed, Embase and Web of Science) for studies of adults diagnosed with BED or a related behavior that also reported the life-time prevalence of AUD was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was followed. The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO). SETTING Studies originating in Canada, Sweden, the United Kingdom and the United States. PARTICIPANTS Eighteen studies meeting the inclusion criteria were found, representing 69 233 individuals. MEASUREMENTS Life-time prevalence of AUD among individuals with binge eating disorder and their life-time relative risk of AUD compared with individuals without this disorder. RESULTS The pooled life-time prevalence of AUD in individuals with binge eating disorder was 19.9% [95% confidence interval (CI) = 13.7-27.9]. The risk of life-time AUD incidence among individuals with binge eating disorder was more than 1.5 times higher than controls (relative risk = 1.59, 95% CI = 1.41-1.79). Life-time AUD prevalence was higher in community samples than in clinical samples (27.45 versus 14.45%, P = 0.041) and in studies with a lower proportion of women (β = -2.2773, P = 0.044). CONCLUSIONS Life-time alcohol use disorder appears to be more prevalent with binge eating disorder than among those without.
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Affiliation(s)
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Elisa M Trucco
- Department of Psychology, Florida International University, Miami, Florida, USA
- Center for Children and Families, Florida International University, Miami, Florida, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Katarzyna Kucharska
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Anna Walenda
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
- Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, USA
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Scharff A, Ortiz SN, Forrest LN, Smith AR. Comparing the clinical presentation of eating disorder patients with and without trauma history and/or comorbid PTSD. Eat Disord 2021; 29:88-102. [PMID: 31348724 DOI: 10.1080/10640266.2019.1642035] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study examined whether clinical characteristics among patients presenting to residential eating disorder (ED) treatment differed according to patients' trauma history and current PTSD diagnostic status. Participants (699 girls and women) completed surveys at treatment onset. One-way analysis of covariance (ANCOVA) tests assessed cross-sectional differences between three groups of patients: those reporting no trauma history (No Trauma, n = 185), those with trauma history but without PTSD (Trauma, n = 263), and those with current PTSD (PTSD, n = 251). Relative to the No Trauma group, the combined Trauma and PTSD groups reported greater ED symptoms, anxiety and depressive symptoms, experiential avoidance, anxiety sensitivity, and lower mindfulness. The PTSD group reported greater ED, anxiety, and depressive symptoms, greater anxiety sensitivity, and lower mindfulness, relative to the Trauma group. In sum, ED patients with any history of trauma experienced more symptoms and other psychopathology relative to patients who did not report trauma history. Among patients reporting trauma, those with current PTSD experienced even greater symptom severity. Interventions focused on improving emotional functioning could be especially beneficial for ED patients with trauma histories.
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Affiliation(s)
- Adela Scharff
- Department of Psychology, University at Albany - State University of New York , Albany, USA
| | - Shelby N Ortiz
- Department of Psychology, Miami University , Oxford, OH, USA
| | | | - April R Smith
- Department of Psychology, Miami University , Oxford, OH, USA
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9
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Killeen TK, Wolf B, Greer TL, Carmody T, Rethorst CD, Trivedi MH. Gender and racial/ethnic differences in physiologic responses in the Stimulant Reduction Intervention using Dosed Exercise Study. Addict Behav 2020; 110:106546. [PMID: 32688225 PMCID: PMC7416606 DOI: 10.1016/j.addbeh.2020.106546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/31/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
Exercise may be beneficial for individuals in substance use disorder (SUD) treatment given the higher rates of both medical and psychiatric comorbidity, namely mood and anxiety disorders, compared to the general population. Gender and/or racial/ethnic differences in health benefits and response to prescribed exercise have been reported and may have implications for designing exercise interventions in SUD programs. METHOD Data are from the National Drug Abuse Treatment Clinical Trials Network (NIDA/CTN) Stimulant Reduction Intervention using Dosed Exercise (STRIDE) trial. Gender differences across racial/ethnic groups in physiological responses and stimulant withdrawal severity across time were analyzed using linear mixed effects models. RESULTS Males completed significantly more exercise sessions than females and were more adherent to the prescribed exercise dose of 12 Kcal/Kg/Week. Controlling for age, race/ethnicity, treatment group and stimulant withdrawal severity, there was a significant gender by time interaction for body mass index (BMI) (p < 0.001), waist circumference (p < 0.001) and heart rate measured prior to exercise sessions (p < 0.01). For females, body mass index (BMI) and waist circumference increased over time while for males BMI and waist circumference stayed unchanged or slightly decreased with time. Heart rate over time significantly increased for females at a higher rate than in males. Stimulant withdrawal severity was similar in males and females at baseline but males exhibited a significant decrease over time while females did not. Although baseline differences were observed, there were no time by race/ethnicity differences in physiologic responses. DISCUSSION Gender differences in response to exercise may have implications for developing gender specific exercise interventions in SUD programs.
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Affiliation(s)
- T K Killeen
- Medical University of South Carolina, Charleston, SC, USA.
| | - B Wolf
- Medical University of South Carolina, Charleston, SC, USA
| | - T L Greer
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - T Carmody
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C D Rethorst
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - M H Trivedi
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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10
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Eskander N, Chakrapani S, Ghani MR. The Risk of Substance Use Among Adolescents and Adults With Eating Disorders. Cureus 2020; 12:e10309. [PMID: 33052271 PMCID: PMC7544549 DOI: 10.7759/cureus.10309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Eating disorders (EDs) are negative eating habits that have harmful mental and physical effects. EDs primarily affect young women. Most cases are diagnosed in adolescence. The most common EDs are bulimia nervosa (BN), anorexia nervosa (AN), and binge eating disorder (BED). There is a strong association between EDs and substance use disorder (SUD) in adolescence. Bulimia nervosa and alcohol use disorder (AUD) are the most common co-occurrence. There is a high behavioral association between EDs and AUD. Alcohol consumption could be a primary trigger for binge eating in women with BN. Alcohol can be used as an appetite suppressor and as a compensatory behavior to avoid food. The objective of this literature review was to explore the relation between EDs and SUD. The results of the study showed SUD is common with EDs. There are many reasons for this association such as shared neurobiological mechanisms, personality features, environmental and genetic factors.
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Affiliation(s)
- Noha Eskander
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Sumita Chakrapani
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mohammad R Ghani
- Neurology, California Institute of Behavioral Neuroscience & Psychology, California, USA
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11
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Robinson LD, Kelly PJ, Deane FP, Reis SL. Exploring the Relationships Between Eating Disorders and Mental Health in Women Attending Residential Substance Use Treatment. J Dual Diagn 2019; 15:270-280. [PMID: 31519142 DOI: 10.1080/15504263.2019.1660019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Comorbid eating disorders (EDs) and ED symptoms are highly prevalent among women with substance use disorders and may be a barrier to recovery. Higher rates of psychiatric illness are common when more than one disorder is present. Yet little is known about the rates and risk factors for EDs/ED symptoms in women attending treatment centers in Australia. The primary aim is to examine the prevalence of ED symptoms among women attending treatment centers. This study also examines past physical and sexual abuse and mental health as specific predictors of EDs/ED symptoms. Methods: Participants were 1,444 women attending residential treatment for substance use issues provided by the Salvation Army in Australia. Measures included the Addiction Severity Index, the Eating Disorder Screen for Primary Care, medication use, hospitalization, mental health, and past abuse. Results: Alcohol was the primary substance of concern for 53.3% of the women, followed by amphetamines (17.5%), and the mean age was 37.83 years (SD = 10.8). Nearly 60% of women screened positive for ED symptoms and 32% reported a previous or current ED. Women with a history of sexual abuse had significantly greater odds (1.96) of positive screening for an ED compared to those without a history of sexual abuse. Similarly, compared to women without a history of physical abuse, those who did have a history had significantly higher odds (1.59) of a positive screen for an ED. These women were also significantly more likely to have had a health care provider recommend they take medications for psychological or emotional problems in the past 30 days, χ2(1) = 8.42, p = .004, and during their lifetime, χ2(1) = 17.89, p < .001. They also had a significantly greater number of overnight hospitalizations for medical problems compared to those who screened negative, t(137) = -2.19, p = .03. Conclusions: Women with comorbid substance use issues and EDs are highly likely to have a history of past abuse. This combination of comorbidities makes treatment and recovery difficult. Increased awareness and research are required to explore integrated approaches to treatment that accommodate these vulnerabilities and improve long-term outcomes.
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Affiliation(s)
- Laura D Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
| | - Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Institute for Mental Health, University of Wollongong, Wollongong, Australia
| | - Samantha L Reis
- School of Psychology, University of Wollongong, Wollongong, Australia
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12
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Update on Psychological Trauma, Other Severe Adverse Experiences and Eating Disorders: State of the Research and Future Research Directions. Curr Psychiatry Rep 2017. [PMID: 28624866 DOI: 10.1007/s11920-017-0806-6] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW This paper provides an updated review of the literature on the relationship between psychological trauma exposure, other severe adverse experiences, and eating disorders. RECENT FINDINGS Trauma exposure and other severe adverse experiences (e.g., emotional abuse) in both childhood and adulthood are associated with eating disorders. The relationship between traumatic and other adverse experiences and eating disorders appears to be mediated by emotional and behavioral dysregulation, as well as by cognitive factors such as self-criticism. Biological vulnerabilities may also be relevant to this relationship. Overall, the literature is limited by predominantly cross-sectional designs. There is clear evidence of a correlational relationship between trauma exposure and other severe adverse events, and eating disorders. Both risk and maintenance factor hypotheses have been put forth; however, prospective research testing these hypotheses remains limited. Future research should use prospective designs and focus on trauma-related symptoms (rather than trauma exposure) in order to advance research on risk and maintaining factors for eating disorders and inform treatment directions.
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13
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Exploring Relationships between Recurrent Binge Eating and Illicit Substance Use in a Non-Clinical Sample of Women over Two Years. Behav Sci (Basel) 2017; 7:bs7030046. [PMID: 28718830 PMCID: PMC5618054 DOI: 10.3390/bs7030046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 07/03/2017] [Indexed: 01/19/2023] Open
Abstract
(1) Background: With the new edition of the Diagnostic and Statistical Manual of Mental disorders, 5th Edition (DSM-5), numerous parallels have been drawn between recurrent binge eating (RBE) and substance use disorders, with many authors examining RBE or binge eating disorder (BED) as a “food addiction”. The present study aims to clarify the relationship between recurrent binge eating (RBE) and illicit substance use (ISU) through investigating the temporal association between the two problems. (2) Methods: This study was embedded within a larger longitudinal study of non-clinical adult women recruited from Australian tertiary institutions. Participants responded at year 2 and year 4 of follow-up to the Eating Disorder Examination—Questionnaire. ISU was measured using a modified questionnaire taken from the Australian Longitudinal Study on Women’s Health. (3) Results: RBE and ISU co-morbidity was 5.88% in this non-clinical sample, and having one condition increased the likelihood of the other. The two conditions had a different trajectory over two years whereby ISU participants had significant risk of developing RBE in addition to or in place of their ISU but the reverse was not found for RBE participants. (4) Conclusion: This unidirectional relationship suggests that in spite of the similarities of RBE and ISU they may be distinct with respect to their co-morbidity over time.
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Messman-Moore TL, Bhuptani PH. A review of the long‐term impact of child maltreatment on posttraumatic stress disorder and its comorbidities: An emotion dysregulation perspective. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/cpsp.12193] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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