Trauma and multi-impulsivity in the eating disorders

Eating Disorders Service, South West London and St. George's Mental Health NHS Trust, United Kingdom.
Eating Behaviors (Impact Factor: 1.58). 02/2007; 8(1):23-30. DOI: 10.1016/j.eatbeh.2004.08.009
Source: PubMed

ABSTRACT Multiple impulsive behaviours are common in the eating disorders, and multi-impulsive patients appear to do more poorly in treatment. However, comparatively little is known about the origins of multi-impulsivity in such cases. This study addresses the links between reported childhood trauma and multi-impulsivity in the eating disorders, examining whether specific types of trauma are predictive of specific impulsive behaviours in this population.
The sample consisted of 102 individuals who met strict criteria for an eating disorder, and who were interviewed regarding trauma history and comorbid impulsive behaviours.
Any reported history of childhood trauma was associated with a higher number of impulsive behaviours and with the presence of multi-impulsivity. Childhood sexual abuse was particularly important, and was associated with self-cutting, alcohol abuse, and substance abuse (amphetamines, cocaine, cannabis and 'other substances', including ketamine and benzodiazepines).
These findings indicate the importance of considering the psychological consequences of trauma during both assessment and treatment of the eating disorders. In particular, eating-disordered women who report a history of childhood sexual abuse should be examined for a pattern of comorbid impulsive behaviours.

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    • "Piran and Robinson [16] showed high rates of stimulant use among women with eating disorders. Corstorphine et al [17] showed that women with eating disorders who were victims of childhood sexual assault were more likely to use alcohol, cocaine or amphetamines. Gender roles stressing the thin-ideal body image may exacerbate the problem, especially among white, Native American and Pacific Island women [18]. "
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    • "Escape theory states that binge eating is used as a management strategy employed to enable the individual to escape from emotional distress (Heatherton & Baumeister, 1991). Waller, Corstorphine and Mountford (2007) present an analysis of the emotional regulation of people with an ED who have experienced emotional abuse. Corstorphine, Waller, Lawson and Ganis (2007) state that in ED patients with childhood emotional abuse, impulsive behaviours are used to regulate affect. "
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