There are numerous factors which can contribute to the development of an eating disorder including genetics, co-occurring disorders and upbringing but one of the major influences is the experience of psychological trauma. New research suggests that while anorexia and PTSD are often co-morbidities in adults, traumatic events that can lead to PTSD usually occur before the onset of an eating disorder.
People react to trauma in very individualistic ways and one of the reactions can be a desire to control eating habits as a coping method to suppress painful emotions. While it has been known in the past that anorexia can occur alongside PTSD in a dual disorder, research suggests that assessment of trauma for all anorexia patients may be necessary for improved treatment methods rather than standard anorexia treatment.
Traumatic Events, PTSD and Eating Disorder Symptoms
When individuals experience trauma, it can result from actual or perceived threats of physical and emotional harm including direct harm or witnessing an event happening to someone else. Recent research has shown that among women that have experienced PTSD prior to developing anorexia, the most common traumatic event was a sexually related trauma experienced either in childhood or adulthood.
Those involved in these studies are looking for associations with anorexia that could help determine the factors that contribute to its onset. The authors of the study found that sexually related trauma had a strong association with anorexia but more research needs to be done to determine if this or other types of trauma are a direct causation.
Stressful life events, however, have a definite correlation with anorexia and PTSD as they can trigger certain behaviors to repress the ongoing experience of the event. For someone with PTSD the trauma that they've experienced continues to affect their life long after the actual event and begins to interfere with their life and health. An eating disorder like anorexia may be a way of dealing with the trauma or coping with the difficult emotions that continue to be problematic.
Impulsivity as a Coping Mechanism
Someone with PTSD experiences symptoms that can make it difficult to effectively cope with the trauma that they have been through. They may have anxiety and a feeling of being on edge, angry outbursts, trouble concentrating and insomnia.
They may also have avoidance symptoms such as staying away from places, situations, people or activities that remind them of the traumatic event. When a person is plagued by these symptoms they may develop other issues that help them numb their feelings such as restrictive eating habits.
Focusing on or even obsessing over food intake can help someone block out recurring memories, suppress their more painful emotions or feel that they are regaining a sense of control within the chaos of their life. This recent study focused on specific behaviors associated with an eating disorder and found that impulsivities like binging and purging could be mechanisms to avoid awareness of the trauma.
This study found that a strong majority of women (64%) with PTSD experienced a traumatic event prior to their anorexia symptoms. The most common traumatic event with 40.8% was sexual abuse between the ages of 6 and 17 years and 35% experienced sexual abuse above the age of 18.
Of the women in the survey, 17.5% developed PTSD as a result of the death or serious illness of a loved one. The study also highlighted how important it is to evaluate patients with an eating disorder to determine if they have had a traumatic experience in the past. Those experience eating disorder symptoms as well as PTSD need to be treated for both issues simultaneously in a specialized program in order to recover.