ABSTRACT

Posttraumatic stress disorder (PTSD) frequently co-occurs with eating disorders (ED) and is likely to be a powerful ED maintaining factor for a significant subgroup of individuals. The goal of PROJECT RECOVER is to develop and evaluate concurrent integrated treatment approaches for ED-PTSD to enable these individuals to recover from both their ED and PTSD. To date, we have trialed two approaches to concurrent/integrated treatment in PROJECT RECOVER: (1) concurrent delivery of Cognitive Processing Therapy (CPT) for PTSD to individuals receiving intensive ED treatment, and (2) delivery of a manualized individual cognitive-behavioral therapy (CBT) addressing both ED and PTSD (Integrated CBT for ED-PTSD) following a period of initial ED treatment. Interventions from both CBT for ED, and CPT for PTSD can be utilized and adapted to address the functional relationship between ED and PTSD, and promote full recovery from both disorders. Examples include integrating PTSD symptoms into the cognitive-behavioral individualized formulation of ED maintenance; integrating the ED into psychoeducation about PTSD maintenance; and identifying maladaptive beliefs that connect the ED to the trauma and/or PTSD. Emerging evidence suggests that CPT can be successfully integrated with CBT for ED.

摘要

创伤后应激障碍 (PTSD) 经常与饮食失调 (ED) 共同发生，并且可能是重要的个体亚群的强大 ED 维持因素。PROJECT RECOVER 的目标是开发和评估 ED-PTSD 的同步综合治疗方法，使这些人能够从他们的 ED 和 PTSD 中恢复过来。迄今为止，我们已经在 PROJECT RECOVER 中试用了两种同时/综合治疗方法：（1）同时向接受强化 ED 治疗的个体提供针对 PTSD 的认知处理疗法（CPT），以及（2）提供手动化的个体认知行为疗法ED 和 PTSD 的治疗（CBT）（ED-PTSD 的综合 CBT）在初始 ED 治疗一段时间后。CBT 对 ED 的干预，PTSD 和 CPT 可用于解决 ED 和 PTSD 之间的功能关系，并促进两种疾病的完全康复。例子包括将 PTSD 症状整合到 ED 维护的认知行为个体化公式中；将 ED 纳入有关 PTSD 维持的心理教育；并确定将 ED 与创伤和/或 PTSD 联系起来的适应不良信念。新出现的证据表明 CPT 可以成功地与 CBT 结合用于 ED。