Abstract
Objective
To examine childhood abuse and post‐traumatic stress disorder (PTSD) as predictors and moderators of binge‐eating disorder (BED) treatment outcomes in a randomized controlled trial comparing Integrative Cognitive‐Affective Therapy with cognitive‐behavioural therapy administered using guided self‐help.
Method
In 112 adults with BED, childhood abuse was defined as any moderate/severe abuse as assessed by the Childhood Trauma Questionnaire, lifetime PTSD was assessed via the Structured Clinical Interview for DSM‐IV, and outcomes were assessed via the Eating Disorder Examination (EDE). Covariate‐adjusted regression models predicting binge‐eating frequency and EDE global scores at end of treatment and 6‐month follow‐up were conducted.
Results
Lifetime PTSD predicted greater binge‐eating frequency at end of treatment (B = 1.32, p = 0.009) and childhood abuse predicted greater binge‐eating frequency at follow‐up (B = 1.00, p = 0.001). Lifetime PTSD moderated the association between childhood abuse and binge‐eating frequency at follow‐up (B = 2.98, p = 0.009), such that childhood abuse predicted greater binge‐eating frequency among participants with a history of PTSD (B = 3.30, p = 0.001) but not among those without a PTSD history (B = 0.31, p = 0.42). No associations with EDE global scores or interactions with treatment group were observed.
Conclusions
Results suggest that a traumatic event history may hinder treatment success and that PTSD may be more influential than the trauma exposure itself.