ABSTRACT

Disordered eating is prevalent among trauma survivors, yet little is known about mechanisms underlying this relation. We explored cross-sectional and longitudinal associations of trauma exposure and posttraumatic stress disorder symptoms (PTSD) with disordered eating among 1,420 community-based youth participating in the Great Smoky Mountain Study. Participants were interviewed about trauma exposure, PTSD symptoms, and disordered eating at regular intervals throughout childhood, adolescence, and early adulthood. Our findings confirmed associations of all forms of trauma exposure (violent, sexual, and other) with disordered eating symptoms in childhood and adulthood, although the pattern of results varied by disordered eating symptom and trauma exposure type. Only non-sexual, non-violent trauma exposure in childhood had significant associations with any disordered eating symptoms in adulthood. Within childhood, trauma exposures but not PTSD symptoms showed significant longitudinal associations with bulimia nervosa symptoms and sustained appetite changes and preoccupation with eating. In adulthood, PTSD symptoms but not trauma exposures showed significant longitudinal associations only with bulimia nervosa symptoms. The association of specific PTSD clusters on bulimia nervosa symptoms was significant for reexperiencing, whereas hyperarousal symptoms trended toward significance. The impact of trauma exposures on disordered eating may vary by developmental period.

摘要

饮食失调在创伤幸存者中很普遍，但对这种关系背后的机制知之甚少。我们在参与大烟山研究的 1,420 名社区青年中探讨了创伤暴露和创伤后应激障碍症状 (PTSD) 与饮食失调之间的横断面和纵向关联。参与者在整个童年、青春期和成年早期定期接受关于创伤暴露、创伤后应激障碍症状和饮食失调的采访。我们的研究结果证实了所有形式的创伤暴露（暴力、性和其他）与儿童和成年期饮食失调症状的关联，尽管结果模式因饮食失调症状和创伤暴露类型而异。只有无性，儿童时期的非暴力创伤暴露与成年期的任何饮食失调症状有显着关联。在儿童时期，创伤暴露而非 PTSD 症状与神经性贪食症症状、持续的食欲变化和对进食的专注有显着的纵向关联。在成年期，PTSD 症状而非创伤暴露仅与神经性贪食症症状显示出显着的纵向关联。特定的 PTSD 集群与神经性贪食症症状的关联对于重新体验是显着的，而过度觉醒症状则趋于显着。创伤暴露对饮食失调的影响可能因发育时期而异。创伤暴露而非 PTSD 症状与神经性贪食症症状、持续的食欲变化和对进食的专注有显着的纵向关联。在成年期，PTSD 症状而非创伤暴露仅与神经性贪食症症状显示出显着的纵向关联。特定的 PTSD 集群与神经性贪食症症状的关联对于重新体验是显着的，而过度觉醒症状则趋于显着。创伤暴露对饮食失调的影响可能因发育时期而异。创伤暴露而非 PTSD 症状与神经性贪食症症状、持续的食欲变化和对进食的专注有显着的纵向关联。在成年期，PTSD 症状而非创伤暴露仅与神经性贪食症症状显示出显着的纵向关联。特定的 PTSD 集群与神经性贪食症症状的关联对于重新体验是显着的，而过度觉醒症状则趋于显着。创伤暴露对饮食失调的影响可能因发育时期而异。特定的 PTSD 集群与神经性贪食症症状的关联对于重新体验是显着的，而过度觉醒症状则趋于显着。创伤暴露对饮食失调的影响可能因发育时期而异。特定的 PTSD 集群与神经性贪食症症状的关联对于重新体验是显着的，而过度觉醒症状则趋于显着。创伤暴露对饮食失调的影响可能因发育时期而异。