Treatment of Eating Disorder—Posttraumatic Stress Disorder Patients in Residential Care With and Without Cognitive Processing Therapy
Giulia Suro, Molly M. Perlman, Timothy D. BrewertonABSTRACT
Objective
Posttraumatic stress disorder (PTSD) is a common co‐occurring diagnosis for individuals with eating disorders (EDs) admitted to residential treatment (RT). While cognitive processing therapy (CPT) has shown promise for ED‐PTSD populations, few large‐scale naturalistic studies have evaluated CPT in residential ED treatment settings. This study examined outcomes for ED‐PTSD patients who elected to receive CPT compared to those who did not.
Methods
Participants ( n = 348) (including 247 who received CPT [CPT+] and 101 who did not [CPT–]) completed standardized self‐report measures at admission and discharge: PTSD Checklist for DSM‐5 (PCL‐5), Eating Disorder Examination Questionnaire (EDE‐Q), Eating Disorders Inventory (EDI‐2), and Patient Health Questionnaire (PHQ‐9). Outcomes included changes in PCL‐5, EDE‐Q, and PHQ‐9 scores, and EDI‐2 Ineffectiveness and Interoceptive Awareness subscale scores.
Results
Significant Time × Group interactions indicated that symptom change differed by CPT participation for some outcomes. CPT + participants had greater reductions in EDE‐Q Global, PCL‐5 total, and PHQ‐9 total scores than CPT− participants. Changes in ineffectiveness and interoceptive awareness scores did not differ significantly between groups. Discussion: CPT participation during RT was associated with greater reductions in PTSD, depressive, and ED symptoms through discharge—the nonrandomised design and variation in CPT exposure limit causal interpretation.