title: Posttraumatic stress disorder in anorexia nervosa.
abstract: OBJECTIVE
  Comorbidity among eating disorders, traumatic events, and posttraumatic stress disorder (PTSD) has been reported in several studies. The main objectives of this study were to describe the nature of traumatic events experienced and to explore the relationship between PTSD and anorexia nervosa (AN) in a sample of women.
  
  
  METHODS
  Eight hundred twenty-four participants from the National Institutes of Health-funded Genetics of Anorexia Nervosa Collaborative Study were assessed for eating disorders, PTSD, and personality characteristics.
  
  
  RESULTS
  From a final sample of 753 women with AN, 13.7% (n = 103) met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for PTSD. The sample mean age was 29.5 (standard deviation = 11.1) years. In pairwise comparisons across AN subtypes, the odds of having a PTSD diagnosis were significantly lower in individuals with restricting AN than individuals with purging AN without binge eating (odds ratio = 0.49, 95% confidence interval = 0.30-0.80). Most participants with PTSD reported the first traumatic event before the onset of AN (64.1%, n = 66). The most common traumatic events reported by those with a PTSD diagnosis were sexually related traumas during childhood (40.8%) and during adulthood (35.0%).
  
  
  CONCLUSIONS
  AN and PTSD do co-occur, and traumatic events tend to occur before the onset of AN. Clinically, these results underscore the importance of assessing trauma history and PTSD in individuals with AN and raise the question of whether specific modifications or augmentations to standard treatment for AN should be considered in a subgroup to address PTSD-related psychopathology.
authors.affiliation: Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, CB #7160, Chapel Hill, NC 27599-7160, USA.
authors.forename: Mae Lynn
authors.initials: ML
authors.lastname: Reyes-Rodríguez
authors.forename: Ann
authors.initials: A
authors.lastname: Von Holle
authors.forename: Teresa Frances
authors.initials: TF
authors.lastname: Ulman
authors.forename: Laura M
authors.initials: LM
authors.lastname: Thornton
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Klump
authors.forename: Harry
authors.initials: H
authors.lastname: Brandt
authors.forename: Steve
authors.initials: S
authors.lastname: Crawford
authors.forename: Manfred M
authors.initials: MM
authors.lastname: Fichter
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Halmi
authors.forename: Thomas
authors.initials: T
authors.lastname: Huber
authors.forename: Craig
authors.initials: C
authors.lastname: Johnson
authors.forename: Ian
authors.initials: I
authors.lastname: Jones
authors.forename: Allan S
authors.initials: AS
authors.lastname: Kaplan
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: Michael
authors.initials: M
authors.lastname: Strober
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
authors.forename: D Blake
authors.initials: DB
authors.lastname: Woodside
authors.forename: Wade H
authors.initials: WH
authors.lastname: Berrettini
authors.forename: Walter H
authors.initials: WH
authors.lastname: Kaye
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000856:Anorexia Nervosa / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D015992:Body Mass Index; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D057890:Epigenomics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008016:Life Change Events; D008297:Male; D008572:Menarche; D008875:Middle Aged; D010552:Personality Assessment; D015995:Prevalence; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology