Abstract
The associations between lifetime traumatic events (TEs), posttraumatic stress (PTS) symptoms, and disordered eating (DE) were studied in a sample of 614 university students (mean age 20 years). An anonymous questionnaire included 32 lifetime TEs, IES-revised measured PTS symptoms, and EAT-26 evaluated DE symptoms. Statistical analyses included Pearson correlations and structural equation models (SEM) with bootstrapping method. Findings reveal the prevalence of DE in 8.1% of participants, while 73.9% of students experienced at least one lifetime TE. 52.0% of students with DE had PTS symptoms (p < 0.0001) and 30.8% of students with lifetime TEs had PTS symptoms (p < 0.001). In SEM, direct paths from lifetime TEs to PTS symptoms (0.38, p < 0.0001) and from PTS symptoms to DE (0.40, p < 0.0001) were observed. The final SEM confirmed the mediating role of PTS symptoms in the path between some TEs (traffic accident and seriously injured) and DE among the university students. If PTS symptoms are associated with DE, then addressing PTS symptoms in the context of DE treatment may improve treatment efficacy.
Highlights
Disordered eating (DE) refers to troublesome eating behaviors, such as restrictive dieting and bingeing, which occur less frequently or are less severe than those to meet the full criteria for the diagnosis of eating disorder, and is considered as an early warning sign of an eating disorder [1]
At least one lifetime trauma had been experienced by 73.9% of students; the prevalence of posttraumatic stress (PTS) symptoms was 27.4% and DE 8.1% (Table 1)
The most common traumatic events (TEs) were involved in traffic accident (126, 20.5%), death of some close (132, 21.5%), divorce (76, 12.4%), near drowning (84, 13.7%), seriously injured (48, 7.8%) serious illness (80, 13.0%), other serious accident (76, 12.4%), and childhood emotional abuse (84, 13.7%)
Summary
Disordered eating (DE) refers to troublesome eating behaviors, such as restrictive dieting and bingeing, which occur less frequently or are less severe than those to meet the full criteria for the diagnosis of eating disorder, and is considered as an early warning sign of an eating disorder [1]. Studies investigating patients with anorexia or bulimia nervosa found high prevalence of posttraumatic stress (PTS) symptoms among them [5]. Severe long-term impairment related to the trauma in the form of posttraumatic stress disorder (PTSD) has been suggested as a possible mediator between the TEs and DE [6, 7]. Research focused on psychological state demonstrated that pathological response to trauma through PTSD or depression could be associated with DE rather than trauma exposure per se [8, 9]. In individuals with PTSD, eating disorder symptoms may be used as a means to distract from or to cope with reminders of the trauma [6]
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