Memory reconsolidation therapy for comorbid bulimia nervosa and traumatic memories: a case series study

ABSTRACT

Objective

Individuals with bulimia nervosa (BN) have a high comorbidity with posttraumatic stress disorder (PTSD), complex posttraumatic stress disorder (cPTSD) or borderline personality disorder (BPD). This case series describes the proof of concept of a novel integrative psychotherapy for adults with comorbid BN and psychological trauma. Memory reconsolidation therapy (MRT) was developed as an evolution of classic prolonged exposure therapy. The aim of this study was an initial assessment of MRT for comorbid BN and psychological trauma in a case series study.

Method

MRT was used in this study to reduce trauma symptoms which may maintain disordered eating behaviour. Two women with BN and PTSD, and an additional participant with comorbid BN and BPD/cPTSD, were offered 16 weekly sessions of MRT following baseline measures.

Results

At 3-month follow-up, all participants experienced a decrease in trauma symptoms as measured by the Impact of Event Scale–Revised. All participants also experienced a decrease in the frequency of self-reported BN behaviour.

Conclusions

In this case series patients with BN and PTSD/cPTSD/BPD showed improvement of BN and trauma symptoms. These results offer preliminary support for the inclusion of MRT for the treatment of psychological trauma in adults with BN.

KEY POINTS

What is already known about this topic:

1. There is a high prevalence rate of comorbid bulimia nervosa and posttraumatic stress disorder.

2. Engagement in disordered eating behaviours can be a maladaptive coping strategy in response to traumatic experiences.

3. Preliminary studies support the efficacy of memory reconsolidation therapy in treating traumatic memories.

What this topic adds:

• (1) The results provide preliminary evidence that memory reconsolidation therapy is efficacious in reducing trauma symptoms in adults with bulimia nervosa and comorbid PTSD/cPTSD.

• (2) The reduction in bulimia nervosa symptoms appeared to coincide with the reduction in trauma symptoms.

• (3) Treating posttraumatic stress disorder symptoms in patients with comorbid bulimia nervosa and posttraumatic stress disorder has the potential to reduce both trauma symptoms and the frequency of self-reported disordered eating behaviour.

KEYWORDS:

• Bulimia nervosa
• eating disorder
• memory reconsolidation
• memory reconsolidation therapy posttraumatic stress disorder
• trauma

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data described in this article are openly available in the Open Science Framework at https://osf.io/yc4eg/.

Open Scholarship

This article has earned the Center for Open Science badge for Open Materials. The materials are openly accessible at https://osf.io/yc4eg/.