Trauma Exposure, DSM-5 Posttraumatic Stress, and Binge Eating Symptoms: Results From a Nationally Representative Sample

Objective: To evaluate the association between trauma exposure type, number and type of DSM-5 posttraumatic stress disorder (PTSD) symptoms, and binge eating symptoms. Methods: Data were analyzed from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III: 2012-2013), which surveyed a nationally representative sample of 36,309 non-institutionalized US civilians aged 18 years and older. Trauma exposure, PTSD, and binge eating symptoms were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule, DSM-5 Version (AUDADIS-5).Three groups were compared: trauma-exposed individuals with no/low PTSD symptoms, those with subthreshold PTSD, and those with threshold PTSD. Results: Among both men and women, zero-inflated negative binomial regression analyses demonstrated that individuals with subthreshold and threshold PTSD endorsed a greater number of binge eating symptoms than trauma-exposed individuals with no/low PTSD symptoms (unstandardized coefficient [B] range, 0.33-0.92). Relative to witnessing trauma, combat-related trauma was associated with fewer binge eating symptoms in men (B =-0.62, SE =0.17), while child maltreatment was associated with a greater number of binge eating symptoms in women (B=0.28, SE =0.12). Negative cognitions and mood symptoms in particular were associated with a greater number of binge eating symptoms (B range, 0.09-0.10). Conclusions: Subthreshold and threshold PTSD are associated with binge eating symptoms in both men and women. Similar to drugs and alcohol, binge eating may be used as a strategy to alleviate distressing symptoms of PTSD.