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Updated: Jun 11, 2025

A Computer-Based Platform for Aiding Clinicians in Eating Disorder Analysis and Diagnosis
Published on: May 10, 2022
Alliance processes in eating disorders with childhood maltreatment sequelae: Preliminary implications
Malin E Olofsson1,2, KariAnne R Vrabel2,3, Maren C Kopland3
1Department of Psychiatry, Lovisenberg Diaconal Hospital, Oslo, Norway.
Background:
Effective eating disorder (ED) treatments are drastically needed for patients with experiences of sustained and prolonged emotional, physical and sexual childhood maltreatment (CM) that often results in post-traumatic sequelae such as severe, complex posttraumatic stress disorder (cPTSD). EDs with comorbid cPTSD (cPTSD-ED) have protracted treatment courses and poorer prognoses.
Aim:
To summarise the knowledge base on cPTSD-ED with specific emphasis on disturbances in self-organisation (DSO) in relation to therapeutic alliance (TA) processes.
Method:
Expert opinions based on current relevant literature are critically examined.
Results:
Preliminary insights on change and alliance processes suggest that neglecting to address emotional-relational processes in the conceptualisation and treatment of cPTSD-ED impedes treatment progress.
Conclusion:
We hypothesise that the DSO construct inherent in cPTSD-ED calls for a focus on TA processes in addition to traditional ED treatment elements such as nutritional rehabilitation and behaviour change, and regardless of ED treatment provided. More process research on a larger scale is urgently called for.
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