Dataset Information

Trauma exposure and disordered eating: A qualitative study.

ABSTRACT: Quantitative studies have demonstrated a positive association between trauma exposure and disordered eating. However, reasons for this relationship are unclear. We used qualitative methods to understand why some individuals exposed to trauma report disordered eating. We conducted five focus groups and two dyadic interviews between spring 2013 and fall 2014 with women at a Veterans Health Administration medical center (N = 20). Most participants were recruited from outpatient mental health clinics. Participants completed demographic and psychological questionnaires. Using thematic analysis of transcripts, we identified trauma and disordered eating-related themes. Most participants were women of color (55%), and many reported psychological symptoms (65%). The mean age was 48 years (SD = 15). Thematic analysis resulted in three themes. First, trauma can be associated with disordered eating, often in relation to negative affect and maladaptive thoughts. Second, disordered eating can provide short-term, but not long-term, relief from trauma-related negative affect. Third, disordered eating can provide a mechanism to avoid unwanted attention from potential and past perpetrators of trauma. Trauma-related disordered eating, particularly in relation to sexual trauma, may have a distinct profile. Querying patients about causes of disordered eating when women report trauma histories may help clinicians ensure patients receive appropriate treatment.

SUBMITTER: Breland JY

PROVIDER: S-EPMC6192417 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Trauma exposure and disordered eating: A qualitative study.

Breland Jessica Y JY Donalson Rosemary R Dinh Julie V JV Maguen Shira S

Women & health 20170208 2

Quantitative studies have demonstrated a positive association between trauma exposure and disordered eating. However, reasons for this relationship are unclear. We used qualitative methods to understand why some individuals exposed to trauma report disordered eating. We conducted five focus groups and two dyadic interviews between spring 2013 and fall 2014 with women at a Veterans Health Administration medical center (N = 20). Most participants were recruited from outpatient mental health clinic ...[more]

PMID: 28095133

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Project description:Background:Many children in low and middle income countries (LMIC) are exposed to trauma. Contact with public services are a potential influence on parent-child reactions and coping post-trauma. Little is known about how caregivers perceive these interactions. Methods:The aim of this study was to explore caregivers' experiences of accessing and interacting with public services post-trauma and perceptions of needed improvements to public services in a LMIC context. Qualitative interviews were conducted with 20 female caregivers from a high-risk settlement in South Africa after child trauma exposure. Results:Three themes and seven sub-themes were identified regarding caregivers' perceptions of interactions with public services post-trauma. The key themes identified related to (1) communication and exchanges with law enforcement, (2) consequences of an under-resourced justice system and (3) importance of communication and empathy in the healthcare system. Interactions with police were often positive. However, caregivers explained that police-family communication post-trauma could be improved and may help to lessen caregiver anxiety and concerns for the child's safety post-trauma. Caregivers perceived the judicial system to be under-resourced as contact with the judicial system was often protracted and caused child anxiety and distress. Medical treatment was reportedly rushed, with extensive waiting times and little information provided to caregivers regarding the child's injuries or treatment. Some medical staff were perceived as unsympathetic during the child's treatment which was found to exacerbate caregiver and child distress post-trauma. Conclusions:This study provides insight into caregiver experiences of accessing public services following child trauma exposure in a high-risk LMIC context. Public services were perceived as oversubscribed and under-resourced and negative interactions often influenced caregiver responses and appraisals of child safety. Given the impact of poor interactions with public services on families post-trauma, additional research is needed to investigate feasible improvements to public services in LMIC.

Project description:BackgroundThe prognosis for underweight individuals with an eating disorder (ED) and posttraumatic stress disorder (PTSD) is worse than for their peers without these comorbid symptoms. This qualitative study explores the experiences of trauma-focused Imagery Rescripting (ImRs) therapy of underweight inpatients being treated for an ED.ObjectiveTo test the feasibility and to improve ImRs by understanding the experiences and perspectives of people with an ED and PTSD who, when underweight, received ImRs as an adjunct to their inpatient ED treatment.MethodTo explore how underweight people with an ED experience and perceive ImRs, we used a qualitative study design involving semi-structured interviews with 12 participants. After analysis, the data were summarized and classified within a thematic framework that focused on experiences and improving the ImRs method.ResultsThe thematic analysis resulted in the following 6 main themes; (1) Expectations of ImRs; (2) Ability to participate in ImRs; (3) Effect of ImRs; (4) Experience of ImRs technique; (5) Conditions under which ImRs is given; (6) In depth-analysis. The results show that despite the fear of disappointment the participants appreciate addressing the PTSD and ED symptoms simultaneously. Further, results showed that it had been possible for them to attend ImRs but that the effects of ImRs were not uniformly perceived. Also, participants indicated that a caring context is important and that ImRs should not be scheduled immediately before a meal. Finally, the treatment generated hope.ConclusionsThe findings of this study demonstrated the feasibility of the integration of ImRs trauma treatment for individuals who are being treated in an ED inpatient treatment setting, and are in contrast to standard practice where the focus of inpatient treatment has been ED-symptom improvement without comprehensively addressing past traumatic experiences during an underweight phase. Trial registration International Clinical Trials Registry Platform (ICTRP) (NTR6094). Date of registration 09/23/2016. https://trialsearch.who.int/Trial2.aspx?TrialID=NTR6094.

Project description:BackgroundGendered inequities in disordered eating are well-documented, yet few studies have examined their structural drivers. To help fill this gap, we investigated whether cumulative exposure to state-level structural sexism from childhood through young adulthood potentiates differences in disordered eating risk between cisgender girls/women and boys/men.MethodsParticipants came from the Growing Up Today Study (N = 16,875), a cohort of children aged 9-14 years in 1996 who we followed through 2016. Using a composite index of relevant state policies and social inequalities from the Institute for Women's Policy Research, we categorized states as having high or low levels of structural sexism and summed the number of years participants had lived in a high structural sexism state during the study period to quantify their cumulative exposure. We fit sequential conditional mean models to estimate the effect of cumulative exposure on risk of four outcomes (chronic dieting, purging, binge eating, and overeating), controlling for individual- and state-level confounders via propensity scores. We then tested whether effects differed between girls/women and boys/men by including cumulative-exposure-by-gender-identity interaction terms and calculating the relative excess risk due to interaction (RERI).ResultsIn the full sample, each additional year of living in a high structural sexism state was associated with a 5% increased risk of purging (95% confidence interval (CI): 3%, 7%), an 8% increased risk of binge eating (95% CI: 6%, 10%), and a 9% increased risk of overeating (95% CI: 8%, 11%). Risk increases were larger on average for girls/women than for boys/men, and girls/women who had lived in a high structural sexism state for four or more years had excess risk of chronic dieting (RERI: 0.64, 95% CI: 0.18, 1.10), purging (RERI: 2.64, 95% CI: 1.24, 4.30), and binge eating (RERI: 2.21, 95% CI: 0.93, 3.50).ConclusionsStructural sexism may contribute to inequities in disordered eating between cisgender girls/women and boys/men. Future research should include transgender and gender diverse participants, explore intersectional effects, and identify underlying mechanisms to inform policy-oriented interventions.

Project description:BackgroundA growing body of evidence is suggesting a significant association between the COVID-19 pandemic and population-level mental health. Study findings suggest that individuals with a lifetime history of disordered eating behavior may be negatively affected by COVID-19-related anxiety, and prevention measures may disrupt daily functioning and limit access to treatment. However, data describing the influence of the COVID-19 pandemic on disordered eating behaviors are limited, and most findings focus on individuals in treatment settings.ObjectiveThe aim of this study is to characterize the experiences of Reddit users worldwide who post in eating disorder (ED)-related discussion forums describing the influence of the COVID-19 pandemic on their overall mental health and disordered eating behavior.MethodsData were collected from popular subreddits acknowledging EDs as their primary discussion topic. Unique discussion posts dated from January 1 to May 31, 2020 that referenced the COVID-19 pandemic were extracted and evaluated using inductive, thematic data analysis.ResultsSix primary themes were identified: change in ED symptoms, change in exercise routine, impact of quarantine on daily life, emotional well-being, help-seeking behavior, and associated risks and health outcomes. The majority of users reported that the COVID-19 pandemic and associated public health prevention measures negatively impacted their psychiatric health and contributed to increased disordered eating behaviors. Feelings of isolation, frustration, and anxiety were common. Many individuals used Reddit forums to share personal experiences, seek advice, and offer shared accountability.ConclusionsReddit discussion forums have provided a therapeutic community for individuals to share experiences and provide support for peers with ED during a period of increased psychiatric distress. Future research is needed to assess the impact of the COVID-19 pandemic on disordered eating behavior and to evaluate the role of social media discussion forums in mental health treatment, especially during periods of limited treatment access.

Dataset Information

Trauma exposure and disordered eating: A qualitative study.

Publications

Trauma exposure and disordered eating: A qualitative study.

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