Trauma subgroups among individuals with eating disorders: a latent profile analysis

Trauma-related symptoms are known to be highly prevalent in eating disorder (ED) populations but there has been limited research on complex post-traumatic stress disorder (CPTSD). The current study used latent profile analysis to examine trauma-related subgroups among clients with EDs and associations with ED severity and other outcomes.

Participants (N = 378) attending residential, day program, and outpatient ED services completed measures of ED symptoms, body mass index (BMI), ED-related impairment, depression, anxiety, and trauma-related symptoms (based on ICD-11 PTSD and CPTSD criteria, and dissociation) at admission.

Latent profile analysis identified four trauma profiles: 1) high disturbances in self-organisation (DSO), 2) CPTSD (high on both PTSD and DSO symptoms, and severe dissociation), 3) general distress (moderate outcomes across all domains), and 4) no/mild trauma-related symptoms. After adjusting for level of care, profiles significantly differed on all outcomes except BMI, ED diagnosis, and objective binges. Groups 1 and 2 reported more severe ED and comorbid symptoms than groups 3 and 4, with group 2 also being more severe than group 1 on total ED psychopathology, eating concerns, purging, and anxiety.

Findings support previous research on the high prevalence of trauma-related symptoms in EDs, with DSO symptoms (unique to CPTSD) appearing to drive much of the association with ED symptom severity. ED services may benefit from targeted use of trauma-focused therapies for individuals presenting with high DSO symptoms, both in the presence and absence of severe PTSD symptomatology.