Survey of eating disorder symptoms among women in treatment for substance abuse.

A strong association between substance use disorders (SUD) and eating disorders (ED) in women has been established. Yet, little is known about the rates and impact of ED symptoms in women presenting to addiction treatment. This ancillary investigation assessed the prevalence of ED symptoms and their affect on treatment outcomes in a sample of substance abusing women with co-occurring posttraumatic stress disorder (PTSD) enrolled in outpatient substance use programs. Participants were 122 women from four of the CTPs participating in a multi-site clinical trial comparing two behavioral treatments for co-occurring SUD and PTSD (protocol CTN-0015, “Women’s Treatment for Trauma and Substance Use Disorders”). The Eating Disorder Examination self-report (EDE-Q) and measures of PTSD and SUD symptoms were administered at baseline, during treatment, and at four follow-up points. Two subgroups emerged; those reporting binge eating in the 28 days prior to baseline (Binge group; n=35) and those who reported no binge eating episodes (No Binge group; n=87). Women in the Binge group endorsed significantly higher ED, PTSD, and depression symptoms at baseline than those in the No Binge group. Though all participants showed significant reductions in PTSD symptoms and improvements in abstinence rates during the study period, the improvements for the Binge group were significantly lower.

These findings suggest that a sub-group of women with co-occurring PTSD and SUDs who endorsed binge ED symptoms responded differently to SUD/PTSD group treatment. Identification of eating disorder symptoms among treatment-seeking women with SUDs may be an important element in tailoring interventions and enhancing treatment outcomes.

Related protocols: CTN-0015-A-1