Trauma exposure and disordered eating: A qualitative study

ABSTRACT

Quantitative studies have demonstrated a positive association between trauma exposure and disordered eating. However, reasons for this relationship are unclear. We used qualitative methods to understand why some individuals exposed to trauma report disordered eating. We conducted five focus groups and two dyadic interviews between spring 2013 and fall 2014 with women at a Veterans Health Administration medical center (N = 20). Most participants were recruited from outpatient mental health clinics. Participants completed demographic and psychological questionnaires. Using thematic analysis of transcripts, we identified trauma and disordered eating-related themes. Most participants were women of color (55%), and many reported psychological symptoms (65%). The mean age was 48 years (SD = 15). Thematic analysis resulted in three themes. First, trauma can be associated with disordered eating, often in relation to negative affect and maladaptive thoughts. Second, disordered eating can provide short-term, but not long-term, relief from trauma-related negative affect. Third, disordered eating can provide a mechanism to avoid unwanted attention from potential and past perpetrators of trauma. Trauma-related disordered eating, particularly in relation to sexual trauma, may have a distinct profile. Querying patients about causes of disordered eating when women report trauma histories may help clinicians ensure patients receive appropriate treatment.

KEYWORDS:

• Disordered eating
• mental health
• psychosocial
• stress

Acknowledgments

The authors would like to thank Dr. Michelle Wang for her help during the data collection process and Drs. Ann Cheney and Andrea Nevedal for consulting on qualitative methods and analysis for this study.

Funding

This research was supported by the Veterans Health and Integration Program (VHIP; PI: Maguen). Dr. Breland was supported by the VA Office of Academic Affiliations and VA Health Services Research and Development Service in conjunction with a VA HSR&D Advanced Fellowship Program. She is currently supported by a VA HSR&D Career Development Award (CDA15-257) in Palo Alto. Sponsors had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. The views expressed in this article are those of the authors and do not necessarily represent those of the Department of Veterans Affairs.

Supplementary Material

A supplemental online appendix (Section of the Semi-Structured Focus Group and Interview Guide Relevant to Trauma Exposure and Disordered Eating) is available for this article at https://doi.org/10.1080/03630242.2017.1282398.

Additional information

Funding

This research was supported by the Veterans Health and Integration Program (VHIP; PI: Maguen). Dr. Breland was supported by the VA Office of Academic Affiliations and VA Health Services Research and Development Service in conjunction with a VA HSR&D Advanced Fellowship Program. She is currently supported by a VA HSR&D Career Development Award (CDA15-257) in Palo Alto. Sponsors had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. The views expressed in this article are those of the authors and do not necessarily represent those of the Department of Veterans Affairs.