Adverse childhood experiences among adults with eating disorders: comparison to a nationally representative sample and identification of trauma.
Adults
Adverse childhood experiences
Eating disorders
Latent class analysis
Journal
Journal of eating disorders
ISSN: 2050-2974
Titre abrégé: J Eat Disord
Pays: England
ID NLM: 101610672
Informations de publication
Date de publication:
20 May 2022
20 May 2022
Historique:
received:
04
03
2022
accepted:
11
05
2022
entrez:
20
5
2022
pubmed:
21
5
2022
medline:
21
5
2022
Statut:
epublish
Résumé
Adverse childhood experiences (ACEs) are prevalent, impact long-term physical and mental health, and are associated with eating disorders (EDs) in adulthood. The primary objectives of the current study were: (1) to examine and compare ACEs between two samples: treatment-seeking adults, and a nationally representative sample of adults, (2) to characterize ACEs items and total scores across demographic and diagnostic information in adults seeking treatment for an ED, (3) to statistically classify ACEs profiles using latent class analysis, and (4) to examine associations between ACEs profiles and diagnosis. This cross-sectional study assessed patients with a DSM-5 ED receiving treatment between October 2018 and April 2020 at the inpatient, residential, or partial hospitalization levels of care at one of two private ED treatment facilities. ACEs were assessed with the Adverse Childhood Experiences Survey at admission. Generalized linear models and Welch's t-tests were used to compare ACEs in the current sample with national estimates. A latent class analysis was conducted to examine subgroups of ACEs responses, and differences in these classes by ED diagnoses were examined with multinomial logistic regression. Patients with EDs had significantly higher ACEs scores (M = 1.95, SD = 1.90) than the nationally representative sample (M = 1.57, SD = 4.72; t = 6.42, p < .001). Within patients with EDs, four latent classes of ACEs item endorsement were identified. Patients with other specified feeding or eating disorder (OSFED) and binge eating disorder (BED) were more likely to fall into the "Household ACEs" and "Abuse ACEs" groups, respectively, compared to anorexia nervosa-restricting subtype (AN-R). Patients with EDs reported more ACEs than the nationally representative sample, and differences in total ACEs and latent class membership were found across ED diagnoses. The current study can inform the development of trauma-informed care for patients with EDs. Adverse childhood experiences (ACEs), such as abuse, are considered a significant public health crisis and are associated with mental and physical health problems later in life. The current study compared ACEs among a treatment-seeking sample of adults with eating disorders to a nationally representative sample, and found that patients with eating disorders reported higher ACEs scores. Within the eating disorder sample, females were more likely to report a history of sexual abuse than males. Four categories of ACEs emerged, representing four distinct clusters of ACEs item endorsement. Patients with binge eating disorder (BED) reported higher levels of ACEs than patients with anorexia nervosa – restricting subtype (AN-R). In addition, patients with other specified feeding or eating disorder (OSFED) were more likely to be characterized by high levels of household dysfunction than patients with AN-R. Screening for adverse childhood experiences among patients with eating disorders should be part of standard care, and more broadly, providing children with safe environments may lessen the long-term development of several serious illnesses, including eating disorders.
Sections du résumé
BACKGROUND
BACKGROUND
Adverse childhood experiences (ACEs) are prevalent, impact long-term physical and mental health, and are associated with eating disorders (EDs) in adulthood. The primary objectives of the current study were: (1) to examine and compare ACEs between two samples: treatment-seeking adults, and a nationally representative sample of adults, (2) to characterize ACEs items and total scores across demographic and diagnostic information in adults seeking treatment for an ED, (3) to statistically classify ACEs profiles using latent class analysis, and (4) to examine associations between ACEs profiles and diagnosis.
METHODS
METHODS
This cross-sectional study assessed patients with a DSM-5 ED receiving treatment between October 2018 and April 2020 at the inpatient, residential, or partial hospitalization levels of care at one of two private ED treatment facilities. ACEs were assessed with the Adverse Childhood Experiences Survey at admission. Generalized linear models and Welch's t-tests were used to compare ACEs in the current sample with national estimates. A latent class analysis was conducted to examine subgroups of ACEs responses, and differences in these classes by ED diagnoses were examined with multinomial logistic regression.
RESULTS
RESULTS
Patients with EDs had significantly higher ACEs scores (M = 1.95, SD = 1.90) than the nationally representative sample (M = 1.57, SD = 4.72; t = 6.42, p < .001). Within patients with EDs, four latent classes of ACEs item endorsement were identified. Patients with other specified feeding or eating disorder (OSFED) and binge eating disorder (BED) were more likely to fall into the "Household ACEs" and "Abuse ACEs" groups, respectively, compared to anorexia nervosa-restricting subtype (AN-R).
CONCLUSIONS
CONCLUSIONS
Patients with EDs reported more ACEs than the nationally representative sample, and differences in total ACEs and latent class membership were found across ED diagnoses. The current study can inform the development of trauma-informed care for patients with EDs.
Adverse childhood experiences (ACEs), such as abuse, are considered a significant public health crisis and are associated with mental and physical health problems later in life. The current study compared ACEs among a treatment-seeking sample of adults with eating disorders to a nationally representative sample, and found that patients with eating disorders reported higher ACEs scores. Within the eating disorder sample, females were more likely to report a history of sexual abuse than males. Four categories of ACEs emerged, representing four distinct clusters of ACEs item endorsement. Patients with binge eating disorder (BED) reported higher levels of ACEs than patients with anorexia nervosa – restricting subtype (AN-R). In addition, patients with other specified feeding or eating disorder (OSFED) were more likely to be characterized by high levels of household dysfunction than patients with AN-R. Screening for adverse childhood experiences among patients with eating disorders should be part of standard care, and more broadly, providing children with safe environments may lessen the long-term development of several serious illnesses, including eating disorders.
Autres résumés
Type: plain-language-summary
(eng)
Adverse childhood experiences (ACEs), such as abuse, are considered a significant public health crisis and are associated with mental and physical health problems later in life. The current study compared ACEs among a treatment-seeking sample of adults with eating disorders to a nationally representative sample, and found that patients with eating disorders reported higher ACEs scores. Within the eating disorder sample, females were more likely to report a history of sexual abuse than males. Four categories of ACEs emerged, representing four distinct clusters of ACEs item endorsement. Patients with binge eating disorder (BED) reported higher levels of ACEs than patients with anorexia nervosa – restricting subtype (AN-R). In addition, patients with other specified feeding or eating disorder (OSFED) were more likely to be characterized by high levels of household dysfunction than patients with AN-R. Screening for adverse childhood experiences among patients with eating disorders should be part of standard care, and more broadly, providing children with safe environments may lessen the long-term development of several serious illnesses, including eating disorders.
Identifiants
pubmed: 35596196
doi: 10.1186/s40337-022-00594-x
pii: 10.1186/s40337-022-00594-x
pmc: PMC9123748
doi:
Types de publication
Journal Article
Langues
eng
Pagination
72Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2022. The Author(s).
Références
Merrick MT, Ford DC, Ports KA, Guinn AS. Prevalence of adverse childhood experiences from the 2011–2014 behavioral risk factor surveillance system in 23 states. JAMA Pediatr. 2018;172:1038–44.
doi: 10.1001/jamapediatrics.2018.2537
Zarse EM, Neff MR, Yoder R, Hulvershorn L, Chambers JE, Chambers RA. The adverse childhood experiences questionnaire: two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases. Cogent Med. 2019. https://doi.org/10.1080/2331205X.2019.1581447 .
doi: 10.1080/2331205X.2019.1581447
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ACE) study. Am J Prev Med. 1998;14:245–58.
doi: 10.1016/S0749-3797(98)00017-8
Jia H, Lubetkin EI. Impact of adverse childhood experiences on quality-adjusted life expectancy in the U.S. population. Child Abuse Negl. 2020. https://doi.org/10.1016/j.chiabu.2020.104418 .
doi: 10.1016/j.chiabu.2020.104418
pubmed: 32088537
Sahle BW, Reavley NJ, Li W, Morgan AJ, Yap MBH, Reupert A, et al. The association between adverse childhood experiences and common mental disorders and suicidality: an umbrella review of systematic reviews and meta-analyses. Eur Child Adoles Psy. 2021. https://doi.org/10.1007/s00787-021-01745-2 .
doi: 10.1007/s00787-021-01745-2
American Academy of Pediatrics. Policy statement: early childhood adversity, toxic stress and the role of the pediatrician: translating developmental science into lifelong health. Pediatrics. 2012;129:e224–31.
doi: 10.1542/peds.2011-2662
van der Feltz-Cornelis CM, Potters EC, van Dam A, Koorndijk RPM, Elfeddali I, van Eck van der Sluijs JF. Adverse childhood experiences (ACE) in outpatients with anxiety and depressive disorders and their association with psychiatric and somatic comorbidity and revictimization cross-sectional observational study. J Affect Disord. 2019;246:458–64.
doi: 10.1016/j.jad.2018.12.096
Armour C, Műllerová J, Fletcher S, Lagdon S, Burns CR, Robinson M, et al. Assessing childhood maltreatment and mental health correlates of disordered eating profiles in a nationally representative sample of English females. Soc Psych Psych Epidemiol. 2016;51:383–93.
doi: 10.1007/s00127-015-1154-7
Brewerton TD. Eating disorders, trauma, and comorbidity: focus on PTSD. Eat Disord. 2007;15:285–304.
doi: 10.1080/10640260701454311
Hazzard VM, Bauer KW, Mukherjee B, Miller AL, Sonneville KR. Associations between childhood maltreatment latent classes and eating disorder symptoms in a nationally representative sample of young adults in the United States. Child Abuse Negl. 2019. https://doi.org/10.1016/j.chiabu.2019.104171 .
doi: 10.1016/j.chiabu.2019.104171
pubmed: 31546098
pmcid: 6885127
Ziobrowski HN, Buka SL, Austin SB, Duncan AE, Simone M, Sullivan AJ, et al. Child and adolescent maltreatment patterns and risk of eating disorder behaviors developing in young adulthood. Child Abuse Negl. 2021. https://doi.org/10.1016/j.chiabu.2021.105225 .
doi: 10.1016/j.chiabu.2021.105225
pubmed: 34352683
Smink FRE, van Hoeken D, Hoek HW. Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Curr Psychiatry Rep. 2012;14:406–14.
doi: 10.1007/s11920-012-0282-y
Hudson JI, Hiripi E, Pope HG Jr, Kessler RC. The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biol Psychiatry. 2007;61:348–58.
doi: 10.1016/j.biopsych.2006.03.040
Chesney E, Goodwin GM, Fazel S. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry. 2014;13:153–60.
doi: 10.1002/wps.20128
Jenkins PE, Hoste RR, Meyer C, Blissett JM. Eating disorders and quality of life: a review of the literature. Clin Psychol Rev. 2011;31:113–21.
doi: 10.1016/j.cpr.2010.08.003
Caslini M, Bartoli F, Crocamo C, Dakanalis A, Clerici M, Carrá G. Disentangling the association between child abuse and eating disorders: a systematic review and meta-analysis. Psychosom Med. 2016;78:79–90.
doi: 10.1097/PSY.0000000000000233
Molendijk ML, Hoek HW, Brewerton TD, Elzinga BM. Childhood maltreatment and eating disorder pathology: a systematic review and dose-response meta-analysis. Psychol Med. 2017;47:1402–16.
doi: 10.1017/S0033291716003561
Guillaume S, Jaussent I, Maimoun L, Ryst A, Seneque M, Villain L, et al. Associations between adverse childhood experiences and clinical characteristics of eating disorders. Sci Rep – UK. 2016. https://doi.org/10.1038/srep35761 .
doi: 10.1038/srep35761
Finkelhor D, Turner HA, Shattuck A, Hamby SL. Prevalence of childhood exposure to violence, crime, and abuse: results from the national survey of children’s exposure to violence. JAMA Pediatr. 2015;169:746–54.
doi: 10.1001/jamapediatrics.2015.0676
Brewerton TD. An overview of trauma-informed care and practice for eating disorders. J Aggress Maltreat T. 2019;28:445–62.
doi: 10.1080/10926771.2018.1532940
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.
R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2020. Accessed 1 June 2021.
Linzer DA, Lewis JB. poLCA: An R package for polytomous variable latent class analysis. J Stat Softw. 2011;42:1–29.
doi: 10.18637/jss.v042.i10
Yang CC. Evaluating latent class analysis models in qualitative phenotype identification. Comput Stat Data Anal. 2006;50:1090–104.
doi: 10.1016/j.csda.2004.11.004
Dancyger I, Narayan GA, Fornari V. Eating disorders and abuse. Adolesc Psychiatry. 2017;7:236–52.
doi: 10.2174/2210676608666180112123154
Bolck A, Croon M, Hagenaars J. Estimating latent structure models with categorical variables: one-step versus three-step estimators. Polit Anal. 2004;12:3–27.
doi: 10.1093/pan/mph001
Udo T, Grilo GM. Prevalence and correlates of DSM-5-defined eating disorders in a nationally representative sample of U.S. adults. Biol Psychiatry. 2018;84:345–64.
doi: 10.1016/j.biopsych.2018.03.014
Chiu GR, Lutfey KE, Litman HJ, Link CL, Hall SA, McKinlay JB. Prevalence and overlap of childhood and adult physical, sexual, and emotional abuse: a descriptive analysis of results from the boston area community health (BACH) survey. Violence Vict. 2013;28:381–402.
doi: 10.1891/0886-6708.11-043
Mersky JP, Choi C, Plummer Lee C, Janczewski CE. Disparities in adverse childhood experiences by race/ethnicity, gender, and economic status: intersectional analysis of a nationally representative sample. Child Abuse Negl. 2021. https://doi.org/10.1016/j.chiabu.2021.105066 .
doi: 10.1016/j.chiabu.2021.105066
pubmed: 33845239
Sieben A, Lust K, Crose A, Renner LM, Nguyen RHN. Race and sex differences in adverse childhood experiences among Asian/Pacific Islander college students. J Am Coll Health. 2021;69:353–60.
doi: 10.1080/07448481.2019.1677671
Trottier K. Posttraumatic stress disorder predicts non-completion of day hospital treatment for bulimia nervosa and other specified feeding/eating disorder. Eur Eat Disord Rev. 2020;28:343–50.
doi: 10.1002/erv.2723
Afifi TO, Sareen J, Fortier J, Taillieu T, Turner S, Cheung K, et al. Child maltreatment and eating disorders among men and women in adulthood: Results from a nationally representative United States sample. Int J Eat Disorder. 2017;50:1281–96.
doi: 10.1002/eat.22783
Allison KC, Grilo CM, Masheb RM, Stunkard AJ. High self-reported rates of neglect and emotional abuse, by persons with binge eating disorder and night eating syndrome. Behav Res Ther. 2007;45:2874–83.
doi: 10.1016/j.brat.2007.05.007
Quilliot D, Brunaud L, Mathieu J, Quenot C, Sirveaux M-A, Kahn J-P, et al. Links between traumatic experiences in childhood or early adulthood and lifetime binge eating disorder. Psychiatry Res. 2019;276:134–41.
doi: 10.1016/j.psychres.2019.05.008
Serra R, Kiekens G, Tarsitani L, Vrieze E, Bruffaerts R, Loriedo C, et al. The effect of trauma and dissociation on the outcome of cognitive behavioural therapy for binge eating disorder: a 6-month prospective study. Eur Eat Disord Rev. 2020;28:309–17.
doi: 10.1002/erv.2722
Hazzard VM, Crosby RD, Crow SJ, Engel SG, Schaefer LM, Brewerton TD, et al. Treatment outcomes of psychotherapy for binge-eating disorder in a randomized controlled trial: examining the roles of childhood abuse and post-traumatic stress disorder. Eur Eat Disord Rev. 2021;29:611–21.
doi: 10.1002/erv.2823
Evans-Lacko S, Takizawa R, Brimblecombe N, King D, Knapp M, Maughan B, et al. Childhood bullying victimization is associated with use of mental health services over five decades: a longitudinal nationally representative cohort study. Psychol Med. 2017;47:127–35.
doi: 10.1017/S0033291716001719
Menzel JE, Schaefer LM, Burke NL, Mayhew LL, Brannick MT, Thompson JK. Appearance-related teasing, body dissatisfaction, and disordered eating: a meta-analysis. Body Image. 2010;7:261–70.
doi: 10.1016/j.bodyim.2010.05.004
Lie SO, Rø Ø, Bang L. Is bullying and teasing associated with eating disorders? A systematic review and meta-analysis. Int J Eat Disorder. 2019;52:497–514.
doi: 10.1002/eat.23035
Pennebaker JW, Susman JR. Disclosure of traumas and psychosomatic processes. Soc Sci Med. 1988;26:327–32.
doi: 10.1016/0277-9536(88)90397-8
Imperatori C, Innamorati M, Lamis DA, Farina B, Pompili M, Contardi A, et al. Childhood trauma in obese and overweight women with food addiction and clinical-level of binge eating. Child Abuse Negl. 2016;58:180–90.
doi: 10.1016/j.chiabu.2016.06.023
Waldrop AE, Santa Ana EJ, Saladin ME, McRae AL, Brady KT. Differences in early onset alcohol use and heavy drinking among persons with childhood and adulthood trauma. Am J Addict. 2007;16:439–42.
doi: 10.1080/10550490701643484