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PTSD and eatingdisorders:

It has been suggested that the development of PTSD may fully or partially mediate the relation between trauma and disordered eating (2). Among participants in the population-based National Women’s Study, 36.9% of participants with bulimia nervosa (BN), 21% with binge eating disorder (BED), and 11.8% of non-BN/non-BED women met criteria for lifetime PTSD (9). Despite these high rates, the comorbidity of EDs and PTSD remains understudied, possibly because these disorders have very different clinical presentations. Although they do not share core criteria, many of the associated features of PTSD and EDs overlap (10). High rates of dissociation, as well as alexithymia, have been described among individuals with EDs as well as PTSD (3, 11-14). Bingeating or purging might serve as a means of dissociation to “escape from” PTSD symptoms (4, 15-17). Further, it has been suggested that emotion dysregulation is a key developmental factor in both disorders (18-21), and subsets of individuals with both EDs and PTSD are characterized by impulsivity (22-28).

These shared features may explain why anorexia nervosa (AN) binge/purge type, BN, and BED are more frequently comorbid with PTSD compared with AN- restricting type (2, 15, 17, 29-31). However, it is difficult to determine whether the impulsivity associated with these self-harming behaviors was evident prior to the trauma experience or whether it was triggered by the trauma exposure (9, 32). EDs and PTSD also may share common genetic and biological vulnerabilities. Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has been described in both disorders (33, 34). In addition, genetic variation in the serotonin, dopamine, glucocorticoid, and neuropeptide Y (NPY) systems may predispose some individuals to both PTSD (35-39) and disordered eating (40-44). Thus, PTSD and EDs may be comorbid because of shared biological, genetic, and psychosocial vulnerabilities.


Source: US National Library of Medicine