Treatment outcomes of psychotherapy for binge-eating disorder in a randomized controlled trial: Examining the roles of childhood abuse and post-traumatic stress disorder

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.

Automated summary

The study examined childhood abuse and PTSD as predictors and moderators of BED treatment outcomes. Results indicate that PTSD predicted binge-eating frequency at the end of treatment, while childhood abuse predicted binge-eating frequency at follow-up. PTSD moderated the association between childhood abuse and binge-eating frequency at follow-up.