ABSTRACT

Objective

Individuals with bulimia nervosa (BN) have a high comorbidity with posttraumatic stress disorder (PTSD), complex posttraumatic stress disorder (cPTSD) or borderline personality disorder (BPD). This case series describes the proof of concept of a novel integrative psychotherapy for adults with comorbid BN and psychological trauma. Memory reconsolidation therapy (MRT) was developed as an evolution of classic prolonged exposure therapy. The aim of this study was an initial assessment of MRT for comorbid BN and psychological trauma in a case series study.

Method

MRT was used in this study to reduce trauma symptoms which may maintain disordered eating behaviour. Two women with BN and PTSD, and an additional participant with comorbid BN and BPD/cPTSD, were offered 16 weekly sessions of MRT following baseline measures.

Results

At 3-month follow-up, all participants experienced a decrease in trauma symptoms as measured by the Impact of Event Scale–Revised. All participants also experienced a decrease in the frequency of self-reported BN behaviour.

Conclusions

In this case series patients with BN and PTSD/cPTSD/BPD showed improvement of BN and trauma symptoms. These results offer preliminary support for the inclusion of MRT for the treatment of psychological trauma in adults with BN.

KEY POINTS

What is already known about this topic:

1. There is a high prevalence rate of comorbid bulimia nervosa and posttraumatic stress disorder.

2. Engagement in disordered eating behaviours can be a maladaptive coping strategy in response to traumatic experiences.

3. Preliminary studies support the efficacy of memory reconsolidation therapy in treating traumatic memories.

What this topic adds:

• (1) The results provide preliminary evidence that memory reconsolidation therapy is efficacious in reducing trauma symptoms in adults with bulimia nervosa and comorbid PTSD/cPTSD.

• (2) The reduction in bulimia nervosa symptoms appeared to coincide with the reduction in trauma symptoms.

• (3) Treating posttraumatic stress disorder symptoms in patients with comorbid bulimia nervosa and posttraumatic stress disorder has the potential to reduce both trauma symptoms and the frequency of self-reported disordered eating behaviour.

中文翻译：

---

共病神经性贪食症和创伤性记忆的记忆重建治疗：病例系列研究

摘要

客观的

患有神经性贪食症 (BN) 的个体与创伤后应激障碍 (PTSD)、复杂的创伤后应激障碍 (cPTSD) 或边缘型人格障碍 (BPD) 的共病率很高。这个案例系列描述了一种新的综合心理治疗的概念证明，适用于患有共病 BN 和心理创伤的成年人。记忆再巩固疗法 (MRT) 是作为经典长期暴露疗法的演变而发展起来的。本研究的目的是在案例系列研究中对 MRT 对 BN 和心理创伤共病进行初步评估。

方法

本研究使用 MRT 来减少可能维持饮食失调的创伤症状。两名患有 BN 和 PTSD 的女性，以及一名患有 BN 和 BPD/cPTSD 共病的参与者，在基线测量后每周接受 16 次 MRT。

结果

在 3 个月的随访中，所有参与者都经历了创伤症状的减少，这通过事件量表的影响进行了修订。所有参与者的自我报告 BN 行为的频率也有所下降。

结论

在这个案例系列中，患有 BN 和 PTSD/cPTSD/BPD 的患者表现出 BN 和创伤症状的改善。这些结果为将 MRT 纳入 BN 成人心理创伤的治疗提供了初步支持。

关键点

关于这个主题的已知信息：

1. 合并神经性贪食症和创伤后应激障碍的患病率很高。

2. 参与无序饮食行为可能是应对创伤经历的一种适应不良的应对策略。

3. 初步研究支持记忆重建疗法在治疗创伤性记忆中的功效。

本主题添加的内容：

• (1) 结果提供了初步证据，表明记忆再巩固疗法可有效减轻患有神经性贪食症和合并 PTSD/cPTSD 的成年人的创伤症状。

• (2) 神经性贪食症状的减轻似乎与创伤症状的减轻一致。

• (3) 治疗同时患有神经性贪食症和创伤后应激障碍的患者的创伤后应激障碍症状有可能减少创伤症状和自我报告的饮食失调行为的频率。