(PS7-45) Exploring the Additive Benefit of PTSD Treatment on Eating Disorder Treatment Outcome for Those with Co-occurring PTSD

Background: Given high levels of cooccurrence, there is increasing empirical and clinical interest in the integration of evidence-based treatments for both eating disorders (EDs) and post-traumatic stress disorder (PTSD). However, this work remains limited in scope, and while clinically intuitive, few studies have explored whether integration of PTSD treatment improves outcomes in for those with EDs. In the current study, we conducted a preliminary test of whether addition of evidence based PTSD treatment may influence intensive ED treatment outcomes by comparing individuals with co-occurring PTSD-ED diagnoses who received PTSD treatment to those who did not.

Hypotheses: We hypothesized that receiving PTSD treatment would moderate outcomes, such that individuals with PTSD who received PTSD treatment throughout their course of intensive ED treatment would demonstrate improved treatment outcomes compared to those with PTSD who did not receive PTSD treatment.

Method: Participants were 105 adult men and women with DSM-5 EDs and PTSD admitted to a partial-hospital ED program. Participants either completed a course of evidence-based treatment for PTSD (i.e., Prolonged Exposure, Written Exposure Therapy, or Cognitive Processing Therapy) within the context of intensive ED treatment or completed ED treatment-as-usual (n = 58 PTSD treatment, n = 47 TAU). Participants completed well-validated symptom self-report assessments gauging ED symptoms, mood and anxiety, and overall functioning at admit, discharge, 6-month follow up, and 1-year follow up. Multilevel modeling was used to examine change in symptom outcomes as moderated by receipt of PTSD treatment.

Results: Models exploring changes in anxiety, depression, overall functioning, and ED symptoms suggested no differences across PTSD treatment groups. Findings indicated that the association between time and body dissatisfaction was moderated by PTSD treatment, such that participants who completed PTSD treatment demonstrated a significant decline in body dissatisfaction (b = -0.99, 95% CI = [-1.77, -0.22], p = .014), unlike those who received TAU (b = -0.24, 95% CI = [-0.84, 0.35], p = .423).

Conclusions: Our preliminary investigation provides support for improved treatment outcomes for body dissatisfaction when incorporating PTSD treatment into intensive ED treatment. It is important for future work to perform randomized tests of this integrated approach using large, heterogeneous samples to further our understanding of the potential benefit to ED treatment outcomes.