Trauma and Adverse Events: A Pathway to Disturbed Eating

A childhood filled with adversity can lead to increased risk for smoking, alcoholism, use of illegal drugs, risky sexual behavior, obesity, depressed mood, and suicide. Sexual abuse during childhood is also a risk factor for developing eating disturbances later in life. But, can a history of adverse life events help predict disordered eating patterns?

To find the answer, Joshua M. Smyth, PhD and co-workers at Syracuse University, Syracuse, NY, and the Neuro-psychiatric Institute, North Dakota State University and the University of North Dakota, Fargo, studied a group of first-semester college students. The students completed disordered eating questionnaires about restricting eating and binge eating/purging at the beginning and end of their first semester in college. The 249 students in the study were selected from a larger group of about 1000 students asked to complete a short trauma history survey after giving informed consent. The students selected were 18 to 19 years of age; 55% were female; and 96% were Caucasian.

The students gave self-report histories of trauma and adverse life events and also answered items taken from the Eating Disorder Questionnaire, which assesses eating behaviors over the previous month.

History of trauma tied to disordered eating

At baseline, the researchers found that student reports of trauma prior to entering college were associated with reported disordered eating behaviors at the start of college. Restrictive eating was significantly more common when a greater number of traumas were reported, degree of severity of trauma was rated higher, and more severe violent trauma was reported. Individuals who reported binge eating/purging more often had a greater number of traumatic experiences, greater total trauma severity, and a higher severity rating of the death of a loved one, divorce or separation of their parents, and a history of violent trauma.

In this study, the researchers did not attempt to relate sexual events to self-reported disordered eating symptoms at the beginning or the end of the first semester of college. This was due to the fact that previous studies showing a relationship between childhood sexual abuse and psychological distress and risky behaviors relied more on samples of individuals with more frequent and more severe sexual abuse than was shown in this group.

The current study’s findings have implications for screening and intervention programs. Rates of clinically disordered eating among college students in general range from 2% to 4%, and subclinical levels have been reported from 7% to 61% of students. The attitudes, behaviors and thoughts associated with disordered eating (for example, restriction, binge eating/purging) have also been tied to lower grade-point averages.

The authors did point to limitations of their study: use of self-reports of trauma and disordered eating and the fact that the study was done among undergraduates taking a first-year psychology course. Another consideration is that these students may not be typical of individuals with more extreme cases of trauma, who may not enroll in college or stay through the first semester.