Childhood trauma has dose-effect relationship with dropping out from psychotherapeutic treatment for bulimia nervosa: a replication.
OBJECTIVE
The primary goal of this study was to replicate the finding that experiences of childhood trauma have a dose-effect relationship with dropping out from psychotherapeutic treatment for bulimia nervosa. It also aimed to replicate logistic regression findings that parental break-up predicts dropping out.


METHODS
The cohort consisted of 114 women consecutively presenting to an outpatient eating disorders clinic with bulimia nervosa or atypical bulimia nervosa. Data were gathered using a retrospective, case-note approach and were analysed using logistic regression (LR). A correlation technique was employed to assess the presence of a dose-effect relationship between experiences of trauma in childhood and dropping out. LR models were double cross-validated between this and an earlier cohort.


RESULTS
The dose-effect relationship between experiences of childhood trauma and dropping out was confirmed. Witnessing parental break-up in childhood again predicted dropping out of treatment in adulthood. Cross-validation of LR equations was unsuccessful.


CONCLUSIONS
These results strongly suggest that experiences of childhood trauma have a dose-effect relationship with dropping out. Parental break-up is a stable predictor of dropping out. It is possible that these experiences influence attachment style, particularly the ability to make and maintain a trusting relationship with a psychotherapist. Clinical implications are discussed.
Mahon
J
J
Department of Psychiatry, University of Leicester, Leicester, United Kingdom.
Bradley
S N
SN
Harvey
P K
PK
Winston
A P
AP
Palmer
R L
RL
D000328:Adult; D002032:Bulimia / Q000523:psychology* / Q000628:therapy*; D002648:Child; D015331:Cohort Studies; D004243:Divorce / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D010352:Patient Dropouts / Q000523:psychology*; D011613:Psychotherapy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013315:Stress, Psychological; D014947:Wounds and Injuries / Q000523:psychology*