Objective: The aim of this study was to determine whether posttraumatic stress disorder (PTSD) predicts non-completion of CBT-based day hospital treatment for bulimia nervosa (BN) and other specified feeding and eating disorder (OSFED).
Method: Participants were 151 day hospital patients with BN or OSFED. Participants were assessed at pretreatment via interview and self-report measures. Cox regression was used to model the rate and timing of treatment termination; pretreatment binge and vomit frequencies, eating disorder-related clinical impairment, depression, and ED psychopathology were entered as covariates.
Results: Participants who screened positive for PTSD (n = 64) had more severe ED psychopathology, ED-related impairment, negative schemas, and depression relative to those who did not screen positive. Cox regression indicated that PTSD significantly predicted premature termination and was associated with a 2.32 times greater risk. Individuals with BN or OSFED and co-occurring PTSD were particularly likely to terminate in the early phase of treatment compared with later in treatment.
Conclusion: PTSD appears to affect some individuals' ability to complete intensive ED treatment. Future research should examine whether PTSD predicts premature termination from less intensive ED treatments, as well as in other intensive treatment settings, and whether PTSD predicts poorer outcomes from ED treatment.
Keywords: bulimia nervosa; dropout; eating disorders; posttraumatic stress disorder; trauma.
© 2020 John Wiley & Sons, Ltd and Eating Disorders Association.