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. 2024 Jan 11;12(1):6.
doi: 10.1186/s40337-024-00965-6.

Longitudinal associations between community violence exposure, posttraumatic stress symptoms, and eating disorder symptoms

Martina Isaksson  1 , Johan Isaksson  1   2 , Mary Schwab-Stone  3 , Vladislav Ruchkin  4   5   6
Affiliations

Longitudinal associations between community violence exposure, posttraumatic stress symptoms, and eating disorder symptoms

Martina Isaksson et al. J Eat Disord. .

Abstract

Background: Eating disorder (ED) symptoms have been associated with different types of traumatic events, such as exposure to sexual and physical violence, and emotional abuse. However, the relation between ED symptoms and community violence exposure (CVE) is underexplored, despite the latter's adverse effects on many aspects of adolescent functioning. The primary aim of this study was to evaluate the relation between CVE and ED symptoms in adolescents, while also investigating the potential mediating and moderating roles of posttraumatic stress (PTS) symptoms, gender, and ethnicity.

Methods: Data were collected longitudinally over two consecutive years in the city of New Haven, CT, in the United States. Participants were 2612 adolescent students from the public school system (1397 girls and 1215 boys) with an average age of 12.8 years (SD = 1.29). The students were comprised of several different ethnic groups, including Caucasians, African Americans and Hispanic Americans. Associations between CVE (no exposure, witnessing, and victimization) and PTS symptoms at year one, and ED symptoms (thoughts and compensatory behaviors) at year two, were assessed with self-rating instruments. Moderation and mediation analyses were conducted using a variant of linear regression (Hayes PROCESS macro).

Results: ED symptoms at year two were significantly associated with both witnessing and being a victim of community violence at year one, with most or all of the relations being explained by PTS symptoms. Overall, neither gender nor ethnicity had a meaningful moderating effect in the observed relations.

Conclusions: The findings support the notion that assessing and addressing PTS symptoms might be beneficial when treating individuals with ED symptoms who have experienced community violence, irrespective of gender or ethnicity.

Keywords: Community violence; Eating disorders; Ethnicity; Gender; Longitudinal studies; Mediation analysis; Moderation analysis; Posttraumatic stress disorders.

Plain language summary

In this study we wanted to see if there was a relation between adolescents experiencing violence in their community and showing signs of eating disorders. We also looked at the role of gender, ethnicity, and post-traumatic stress symptoms in this relation. We collected data from 2612 students in New Haven, in the United States, over 2 years. The participants were from various ethnic backgrounds. We used surveys to measure their exposure to community violence and their post-traumatic stress symptoms in the first year, and in the second year, we measured their eating disorder symptoms. We found that adolescents who witnessed or were victims of community violence in the first year were more likely to have eating disorder symptoms in the second year. Post-traumatic stress symptoms seemed to explain most of this relation. Gender and ethnicity did not appear to change these findings in any meaningful way. Thus, It is likely important to assess and address post-traumatic stress symptoms when helping adolescents with eating disorders who have experienced community violence, regardless of their gender or ethnicity.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Mediation analysis examining the association between CVE and eating disorder thoughts, with posttraumatic stress symptoms as mediator. Note X1 represents the pairwise comparison between no exposure and witnessing, while X2 represents the pairwise comparison between no exposure and victimization
Fig. 2
Fig. 2
Mediation analysis examining the association between CVE and eating disorder compensatory behaviors, with posttraumatic stress symptoms as mediator. Note Z1 represents the pairwise comparison between no exposure and witnessing, while Z2 represents the pairwise comparison between no exposure and victimization
Fig. 3
Fig. 3
Visualization of the relation between CVE and eating disorder thoughts and compensatory behaviors respectively, moderated by gender
Fig. 4
Fig. 4
Visualization of the relation between CVE and eating disorder thoughts and compensatory behaviors respectively, moderated by ethnicity
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