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. 2025 Jun 19;13(1):117.
doi: 10.1186/s40337-025-01316-9.

The impact of childhood sexual abuse and childhood traumatic events on outcome in adult inpatients with eating disorders

Siri Weider  1   2 , Øyvind Rø  3   4 , Sigrid Bjørnelv  5 , Marit Danielsen  5
Affiliations

The impact of childhood sexual abuse and childhood traumatic events on outcome in adult inpatients with eating disorders

Siri Weider et al. J Eat Disord. .

Abstract

Background: Childhood traumatic events (CTE) are frequently described in patients with eating disorders. However, the understanding of how such events impact eating disorder treatment outcome is limited. The aim of this study was to examine the prevalence of childhood sexual abuse (CSA) or any CTE at baseline in a naturalistic transdiagnostic sample, and to evaluate how such events affect symptom change and rates of remission at follow-up.

Methods: The sample comprised 228 adult female former eating disorder inpatients (Mage = 24.6 years), of which 61.4% (n = 140) had been diagnosed with anorexia nervosa at baseline, 21.1% (n = 48) with bulimia nervosa, and 17.5% (n = 40) with other specified feeding or eating disorder including binge eating. Data on CSA/ CTE exposure were collected from the patients' hospital records and were rated for degree of severity (severe, moderate to low, or no). Analyses of prevalence, group differences, and rates of remission at follow-up were performed.

Results: Findings showed high prevalence of high severity CSA and CTE at admission, respectively 33% (n = 75) and 48.7% (n = 111). Moreover, although all patients showed significant improvement in symptoms from baseline to follow-up, a significant association was found between severity of CTE exposure and remission group affiliation with 24% of those with severe CTE exposure and 40% of those with no CTE exposure being in remission.

Conclusions: Despite considerable heterogeneity in demographic characteristics, treatment and length of follow-up, severity of CTE exposure was associated with remission at follow-up. Thus, patients with the highest CTE severity showed the poorest prognoses. Findings from this study underline the importance of addressing trauma experiences in assessment and therapy and indicate that CTE severity level should be considered when assessing trauma experiences.

Keywords: Anorexia nervosa; Binge eating disorder; Bulimia nervosa; Childhood sexual abuse; Childhood trauma events; Other specified feeding and eating disorders; Remission rates.

Plain language summary

In a group of patients with different types of eating disorder, high prevalences of childhood traumatic events were found. Patients that had experienced severe childhood sexual abuse had more eating disorder- and depressive symptoms at baseline than patients without such events. In addition, patients that had experienced any severe childhood traumatic event had slightly higher eating disorder symptoms than those without such events and than those that had experienced less severe trauamtic events. Although patients with eating disorders and childhood traumatic events had significantly less symptoms at follow-up than at baseline, those with more severe traumatic events had lower levels of remission than patients without traumatic experiences. This underlines the importance of addressing trauma events in eating disorder treatment.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The participants’ written informed consent forms were provided in accordance with the Declaration of Helsinki. The study was approved by the Regional Committee for Medical and Health Ethics for Central Norway (ID: 2009/1864) and the Data Access Committee at Health Trust Nord-Trøndelag (ID: 2023/4505). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the study sample
See this image and copyright information in PMC

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