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Exploring the Relationship Between Eating Disorder Symptoms and Substance Use Severity in Women with Comorbid PTSD and Substance Use Disorders.

American Journal of Drug and Alcohol Abuse 2015;41(6):547-52. [doi: 10.3109/00952990.2015.1080263]

Therese Killeen, PhD, APRN (Medical University of South Carolina, SC Node), Timothy D. Brewerton, MD (Institute of Psychiatry, South Carolina), Aimee N. C. Campbell, PhD, MSW (Columbia University, NY Node), Lisa R. Cohen, PhD (Columbia University Medical Center, GNY Node), Denise A. Hien, PhD (New York State Psychiatric Institute, GNY Node).

Eating disorders (ED) and substance use disorders (SUD) commonly co-occur, especially in conjunction with posttraumatic stress disorder (PTSD), yet little is known about ED and ED symptoms in women presenting to addiction treatment programs. This study examined the association between ED symptoms and substance use frequency and severity in a sample of women with a DSM IV diagnosis of current SUD and PTSD enrolled in SUD treatment. Participants were 122 women from four substance abuse treatment sites who participated in a multi-site clinical trial through NIDA's Clinical Trials Network (CTN), Survey of Eating Disorder Symptoms Among Women in Treatment for Substance Abuse Disorders (an ancillary investigation of CTN-0015, Women's Treatment for Trauma and Substance Use Disorders). The Eating Disorder Examination-Questionnaire (EDE-Q), the Clinician Administered PTSD Scale (CAPS), and the Addiction Severity Index (ASI) were administered at baseline and correlational analyses were performed. Variables that significantly correlated with EDE-Q total and subscale scores were entered into a linear regression analysis. Results found that scores on the EDE-Q Global scale, as well as the Eating Concern, Weight Concern, and Shape Concern subscales of the EDE-Q were significantly associated with Caucasian race/ethnicity, past 30 day opiate use, higher ASI Psychiatric Subscale score, and lower ASI Employment Subscale score.

Conclusions: Women in recovery from SUD and PTSD reported concerns about weight, shape, and eating at a higher rate than in the general US population of women. The finding that past 30 day opiate use was associated with EDE scores may indicate that opiates also play a substantial role in disordered eating symptoms. Though exploratory, these findings suggest that there may be a relationship between addiction severity, use of certain drugs of abuse, and eating disorder symptoms, particularly those involving weight and shape concerns in women with comorbid PTSD and SUD. Comprehensive and integrated treatment approaches need to be developed to address this complex but common comorbidity. (Article (Peer-Reviewed), PDF, English, 2015)

Keywords: Addiction Severity Index (ASI) | Alcohol | Anxiety disorders | Clinician Administered PTSD Scale (CAPS) | Cocaine | CTN platform/ancillary study | Eating Disorder Examination-Questionnaire (EDE-Q) | Eating disorders | Post-traumatic stress disorder (PTSD) | Prescription-type opiates | Trauma | Women | American Journal of Drug and Alcohol Abuse (journal)

Document No: 1169, PMID: 26366716.

Submitted by CTN Dissemination Librarians, 9/21/2015.


Brewerton, Timothy D.
Campbell, Aimee N. C. mail
Cohen, Lisa R.
Killeen, Therese mail
Hien, Denise A. mail
NIDA-CTN-0015 www
NIDA-CTN-0015-A-1 www

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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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