User:Josephine Sanchez2/Trauma and Eating Disorders

Trauma and Eating Disorders

Eating Disorder Introduction

Eating disorders are part of the DSM-5 category of psychological disorders which vary in their presentation of symptoms as it focuses on the main concept of the role of behaviors related to eating and feeding oneself. The key factor that causes the behaviors to be labeled as disorders is that it hinders the psychological functioning and physical health of an individual. (DSM-5). Examples of impairments common in eating disorder are disruptions to ( school, life, work function, specific examples). Specifically within school and work an eating disorder can cause disruption in form of avoidance of social eating events, isolation from others when eating, and decrease in social engagement due to fear of having to eat in front of others or a large quantity. Eating disorders come about from various reasons such as exercise, bullying, the need to lose weight, or societal expectations. Individuals with eating disorders who have experienced a traumatic event present with symptoms that are more complex than avoidance of food, excessive exercise, and fear of gaining weight such as self-harm, dissociation, and post-traumatic stress disorder. Scharff’s research described how a high percentage (37-90%) of individuals with an eating disorder have a large percentage of trauma history.

Traumatic Events

Traumatic events faced or experienced by an individual are a contributing factor to the display of symptoms an individual with eating disorders may express. Prevalence of post-traumatic stress disorder is higher within individuals with an eating disorder, and in regards to individuals who have experienced a traumatic event such as sexual abuse as a child the rates of developing an eating disorder greatly increase. Developing an eating disorder after experiencing sexual abuse increases the likelihood that the individual will experience post-traumatic stress symptoms. These increases and likelihood demonstrate the comorbid relationship post-traumatic stress disorder and eating disorders can have within each other. Comorbidity of eating disorders and post-traumatic stress disorder have been associated with an increase in symptom severity such as higher dropout rates, poorer-long-term prognosis . Early assessment and intervention of trauma-related disorders are imperative. In comparison to healthy individuals, Carretero-Garcia’s research found how emotional abuse had the highest percentage of traumatic experiences for an individual with an eating disorder. These findings are related to other research literature that discuss how emotional dysregulation is associated with eating disorders as well as post-traumatic stress disorder.

Dissociation and Eating Disorders

Dissociation has been thought to be a coping mechanism for individuals with eating disorders utilized to help handle and manage the traumatic experiences they have experienced within their lifetime.  Dissociative defenses can be life-saving although they can also cause a disruption in the healing process as the traumatic event may present itself as shameful therefore avoidance of processing the event ensues. Avoidance of the traumatic event in the eyes of the individual with an eating disorder can be an indicator of emotional dysregulation utilized in the past due to a traumatic event such as child abuse, sexual abuse, or physical abuse. This emotional dysregulation along with impulsivity within eating disorders is common especially within individuals with comorbidity of post-traumatic stress disorder and eating disorders. Continuation of the use of dissociation as a coping mechanism for individuals with eating disorders can hinder treatment and prolong a client’s recovery process. Examples of how dissociation can hinder treatment and recovery is how it can decrease an individual’s awareness and result in avoidance of thoughts and feelings associated with trauma or even one’s body. In this case of the example provided above the avoidance and decrease of one’s awareness results in prolonging a client’s recovery process towards emotional regulation and recognizing avoidance patterns which in return can help begin process of traumatic events experienced.

Self-harm and Eating Disorders

Self-harm has been tied to dissociation as self-harm has been researched to be utilized as another coping mechanism in which the individual may begin to self-harm in order to cope with the dissociative states they experience. Self-harm is utilized as another coping mechanism as not all coping mechanisms are adaptive for the individual with an eating disorder to use in a moment of distress. When an individual may begin to experience themselves regressing into a dissociative state in order to prevent this the utilization of self-harm behaviors is done as pain can help bring the individual to the present. Self-harm ties back into trauma as previous research has found an association between self-harm and traumatic events experienced by individuals such as physical and sexual abuse. Repeated traumatic experiences such as physical and sexual abuse especially those experienced in childhood have been found to increase the severity of eating disorder symptoms within individuals who are adults. Eating disorders’ symptom severity and presentation can increase and have various mediating risk factors such as traumatic events, self-harm, dissociative states, and post-traumatic stress disorder that can affect an individual’s care and treatment. Individuals with eating disorders and post-traumatic stress disorder could also be more predisposed to retraumatization this aligns with the previous statement of how it is common for individuals with an eating disorder, trauma, and post-traumatic stress disorder to also have higher dropout rates, and less favorable outcomes of staying in treatment.

Recovery and Eating Disorders

Trauma-informed care for individuals with an eating disorder is beneficial as traumatic experiences (sexual abuse, emotional abuse, physical abuse) have been shown to be a risk factor for developing eating disorders and other psychiatric disorders as well. As most individuals with an eating disorder whether it be children, adolescents, or adults have faced at least one traumatic experience whether it be sexual, physical, or verbal abuse the options out there for care are varied and at times minimal. A higher level of care is required for individuals whose eating disorders have greatly impaired their physical health and psychological well-being. The downside of a higher level of care such as residential settings is that trauma-informed care for individuals with an eating disorder is intensive and requires an abundance of time that cannot be provided in a residential setting that is shorter than the treatment. These barriers contribute to recovery for individuals with eating disorders and trauma to stagnate and decrease in improvements.