Trauma in relation to psychological characteristics in women with eating disorders
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Institute of Applied Psychology, Jagiellonian University of Cracow, Poland
Submission date: 2016-09-15
Final revision date: 2017-01-09
Acceptance date: 2017-01-30
Online publication date: 2017-05-12
Publication date: 2017-12-01
Current Issues in Personality Psychology 2017;5(4):244-259
The aim of the article was to present the results of the author’s own study that sought relationships between having experienced psychological trauma and the psychological characteristics of people with eating disorders. The basic research question was the following: To what degree are the traumatic events experienced by females with various types of eating disorders related to these females’ psychological characteristics?

Participants and procedure
The sample comprised 120 females with eating disorders: 30 females aged between 20 and 26 diagnosed with bulimia nervosa, 31 females diagnosed with binge-eating disorder and 59 females aged between 20 and 26 diagnosed with anorexia nervosa. The research was carried out in the years 2007-2012 in outpatient clinics treating neuroses and eating disorders and mental health outpatient clinics in Poland. The study employed a clinical and psychometric (i.e., questionnaires for measuring psychological characteristics) approach.

Statistical analysis confirmed the existence of significant differences between the females with eating disorders who have experienced relational trauma(s) in their lives (particularly in their childhood and adolescence) and those who did not reveal such experience. The females with anorexia and bulimia who have also experienced psychological, physical or sexual violence revealed a significantly different, higher level of bulimic thinking and tendencies for excessively uncontrolled, impulsive behaviors towards food and nutrition (i.e., vomit-provoking and other forms of body purgation, e.g. using purgative drugs and others) than did females with no relational trauma experience.

The frequency of relational trauma occurrence was significantly higher for females with bulimia and bulimic anorexia. For females with restrictive anorexia and binge-eating disorder, no significantly frequent occurrence of trauma was observed.
Diagnosing the occurrence of relational trauma in patients’ histories is a key element that should be involved in the process of psychotherapy for people with eating disorders.
Bateman, A. W., & Fonagy, P. (2010). Mentalization-based treatment for borderline personality disorder. World Psychiatry, 9, 11–15.
Bowlby, J. (1982). Attachment and loss: retrospect and prospect. American Journal of Orthopsychiatry, 52, 664–678.
Bowlby, J. A. (1988). Secure base. New York: Basic Books.
Bruch, H. (1973). Eating disorders: Obesity, anorexia nervosa and the person within. New York: Basic Books.
Bulik, C. M., Tozzi, F., Anderson, C., Mazzeo, S. E., Aggen, S., & Sullivan, P. F. (2003). The relation between eating disorders and components of perfectionism. American Journal Psychiatry, 160, 366–368.
Button, E., & Aldridge, S. (2007). Season of birth and eating disorders: patterns across diagnoses in a specialized eating disorders service. International Journal of Eating Disorders, 40, 468–471.
Caslini, M., Bartoli, F, Crocamo, C., Dakanalis, A., Clerici, M., & Carrà, G. (2016). Disentangling the association between child abuse and eating disorders: A systematic review and meta-analysis. Psychosomatic Medicine, 78, 79–90.
Choi-kain, L. W., & Gunderson, J. G. (2008). Mentalization: ontogeny, assessment, and application in the treatment of borderline personality disorder. American Journal of Psychiatry, 165, 1127–1135.
Clarkin, J. F., Fonagy, P., & Gabbard, G. (2013). Psychoterapia psychodynamiczna zaburzeń osobowo­ści [Psychodynamic psychotherapy of personality disorders]. Kraków: Wydawnictwo Uniwersytetu Jagiellońskiego.
Cloninger, C. R., Svarkic, D. M., & Przybeck, T. R. (1993). Psychobiological model of temperament and character. Archives of General Psychiatry, 14, 213–218.
Collins, B., Fischer, S., Stojek, M., & Becker, K. (2014). The relationship of thought suppression and recent rape to disordered eating in emerging adulthood. Journal of Adolescence, 37, 113–121.
Fassino, S., Abbate-Daga, G., Amianto, F., Leombruni, P., Boggio, S., & Rovera, G. G. (2002). Temperament and character profile of eating disorders: a controlled study with the Temperament and Character Inventory. International Journal Eating Disorder, 32, 412–425. DOI: 10.1002/eat.10099.
Fonagy, P. (1991). Thinking about thinking: some clinical and theoretical considerations in the treatment of a borderline patient. International Journal of Psycho-Analysis, 72, 639–656.
Franzoni, E., Gualandi, S., Caretti, V., Schimmenti, A., Di Pietro, E., Pellegrini, G., Craparo, G., Franchi, A., Verrotti, A., & Pellicciari, A. (2013). The relationship between alexithymia, shame, trauma, and body image disorders: Investigation over a large clinical sample. Neuropsychiatric Disease and Treatment, 9, 185–193. DOI: https//
Gabbard, G. O. (2009). Psychiatria psychodynamiczna w praktyce klinicznej [Psychodynamic psychiatry in clinical practice]. Krakow: Wydawnictwo Uniwersytetu Jagiellońskiego.
Garner, D. EDI-3. (2004). Eating disorders inventory-3. Psychological Assessment Resources Inc. USA.
Glickauf-Hughes, Ch., &Wells, M. (1997). Object relations psychotherapy. An individual and integreative approach to diagnosis and treatment. Jason Aronson, Inc., USA.
Grilo, C. M., & Masheb, R. M. (2002). Childhood maltreatment and personality disorders in adult patients with binge eating disorder. Acta Psychiatrica Scandinavica, 106, 183–188.
Grilo, C. M., Sanislow, C. A., Skodol, A. E., Gunderson, J. G., Sout, R. L., Sea, M. T., Zanarini, M. C., Bender, D. S., Morey, L. C., Dyck, I. R., & McGlashan, T. H. (2003). Do eating disorders co-occur with personality disorders? Comparison groups matter. International Journal Eating Disorders, 33, 155–164. DOI: 10.1002/eat.10123.
Greeno, C., Wing, R., & Shiffman, S. (2000). Binge antecedents in obese women with and without binge eating disorder Journal of Consulting and Clinical Psychology, 68, 95‒102.
Hartt, J., & Waller, G. (2002). Child abuse, dissociation and core beliefs in bulimic disorders. Child Abuse & Neglect, 26, 923‒938.
Hewett, J., & Loma, L. U. (2015). The impact of trauma and attachment on eating disorder symptomology. Dissertation Abstracts International: Section B: The Sciences and Engineering, 76(3-B)(E).
Herzog, D. B., & Keller, M. B. (1992). The prevalence of personality disorders in 210 women with eating disorders. Journal Clinical Psychiatry, 53, 147–152.
Izydorczyk, B. (2014). Postawy i zachowania wobec własnego ciała w zaburzeniach odżywiania [Attitudes and behaviors towards one’s own body within eating disorders]. Warsaw: Wydawnictwo Naukowe PWN.
Izydorczyk, B. (2013a). A psychological diagnosis of the structure of the body self in a group. Archives of Psychiatry and Psychotherapy, 2, 21‒306.
Izydorczyk, B. (2013b). Selected psychological traits and body image characteristics in females suffering from binge eating disorder. Archives of Psychiatry and Psychotherapy, 1, 19–33.
Izydorczyk, B. (2011). A psychological profile of the bodily self characteristics in women suffering from bulimia nervosa. In P. Hay (ed.), New insights into the prevention and treatment of bulimia nervosa (pp. 147–167). Croatia: Intech Open Access Publisher.
Jakubczyk, A., Żechowski, C., & Namysłowska, I. (2003). Jadłowstręt psychiczny – różne postacie, różne terapie [Anorexia nervosa—various forms, various therapies]. In J. Bomba & B. Józefik (eds.), Leczenie anoreksji i bulimii psychicznej: co, kiedy, komu [Treating anorexia and bulimia nervosa: What, when and to whom] (pp. 47–55). Krakow: Biblioteka Psychiatrii Polskiej, Wydawnictwo Uniwersytetu Jagiellońskiego.
Józefik, B. (2006). Relacje rodzinne w anoreksji i bulimii psychicznej [Family relationships in anorexia and bulimia nervosa]. Krakow: Wydawnictwo Uniwersytetu Jagiellońskiego.
Józefik, B. (2008). Koncepcja przywiązania a zaburzenia odżywiania – teoria i empiria [Attachment theory and eating disorders – theoretical and empirical issues]. Psychiatria Polska, XLII, 157–166.
Józefik, B., Iniewicz, G., & Ulasińska, R. (2010). Wzory przywiązania, samoocena i płeć psychologiczna w anoreksji i bulimii psychicznej [Attachment patterns, self-esteem, gender schema in anorexia and bulimia nervosa]. Psychiatria Polska, XLIV, 665‒676.
Keel, P. K., Gravener, J. A., Joiner, T. E, & Haedt, A. A. (2010). Twenty-year follow-up of bulimia nervosa and related eating disorders not otherwise specified. International Journal Eating Disorders, 43, 492‒497.
Keel, P. K., Mitchell, J. E., Davis, T. L., & Crow, S. J. (2001). Relationship between depression and body dissatisfaction in women diagnosed with bulimia nervosa. International Journal Eating Disorders, 30, 48‒56.
Kent, A., Waller, G., & Dagnan, D. A. (1999). A greater role of emotional than physical or sexual abuse in predicting disordered eating attitudes: The role of mediating variables. International Journal of Eating Disorders, 25, 159‒167.
Kent, A., & Waller, G. (2000). Childhood emotional abuse and eating psychopathology. Clinical Psychology Review, 20, 887‒903.
Klatkiewicz, A. (2011). Traumatyczne zdarzenia w dzieciństwie a rozwój zaburzeń osobowości borderline [Traumatic events in childhood and the development of borderline personality disorders]. Nowiny Lekarskie, 80, 484–492.
Krueger, D. W. (2000). Psychodynamic perspective on body image. In T. F. Cash & T. Pruzinsky (eds.), Body Image. A Handbook of Theory, Research, and Clinical Practice (pp. 30‒37). New York, London: The Guilford Press.
Krueger, D. W. (2002). Integrating Body Self and Psychological Self. Creating a New Story in Psychoanalysis and Psychotherapy. New York‒London: Bruner-Routledge.
Kubiak, A., & Sakson-Obada, O. (2016). Nawykowe samouszkodzenia a Ja cielesne [Repetetive self-injury and the body self]. Psychiatria Polska, 50, 43–54. DOI:
Krystal, H. (1979). Alexithymia and psychotherapy. American Journal of Psychotherapy, 33, 17‒31.
Lilenfeld, L. R., Kaye, W. H., Greeno, C. G., Merikangas, K. R., Plotnicov, K., Pollice, C., Rao, R., Strober, M., Bulik, C. M., & Nagy, L. (1998). A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity. Archives of General Psychiatry, 55, 603‒610.
Litwack, S. D., Mitchell, K. R., Sloan, D. M., Reardon, A. F., & Miller, M. W. (2014). Eating disorder symptoms and comorbid psychopathology among male and female veterans. General Hospital Psychiatry,36, 406‒410.
Luban-Plozza, B., Pöldinger, W., Kröger, F., & Wasilewski, B. (1995). Zaburzenia psychosomatyczne w praktyce lekarskiej [Psychosomatic disorders in medical practice]. Warszawa: PZWL.
Madowitz, J., Matheson, B. E., & Liang, J. (2015). The relationship between eating disorders and sexual trauma. Eating and Weight Disorders, 20, 281‒293.
McCormack, L., Lewis, V., & Wells, J. R. (2014). Early life loss and trauma: Eating disorder onset in a middle- aged male ‒ a case study. American Journal of Men’s Health, 8, 121‒136.
McDougall, J. (2014). Teatr ciała. Psychoanalityczne podejście do chorób psychosomatycznych [Theaters of the body: a psychoanalytic approach to psychosomatic illness]. Warsaw: Oficyna Ingenium.
Mikołajczyk, E., & Samochowiec, J. (2004a). Cechy psychologiczne pacjentek z zaburzeniami odżywiania w porównaniu ze studentkami wyższych szkół medycznych badanych kwestionariuszem EDI [Psychological characteristics of patients with eating disorders in comparison with students of medical high school who were tested with the EDI questionnaire]. Psychiatria Polska, 38, 170–171.
Mikołajczyk, E., & Samochowiec, J. (2004b). Cechy osobowości u pacjentek z zaburzeniami odżywiania [Personality traits in patients with eating disorders]. Psychiatria, 1, 91–95, 147–167.
Moulton, S. J., Newman, E., Power, K., Swanson, V., & Day, K. (2015). Childhood trauma and eating psychopathology: A mediating role for dissociation and emotion dysregulation? Child Abuse & Neglect, 39, 167–174.
Pinheiro, A. P., Raney, T. J., Thornton, L. M., Fichter, M. M., Berrettini, W. H., Goldman, D., Halmi, K. A., Kaplan, A. S., Strober, M., Treasure, J., Woodside, D. B., Kaye, W. H., & Bulik, C. M. (2010). Sexual functioning in women with eating disorders. International Journal of Eating Disorders, 43, 123–129.
Racine, S. E., & Wildes, J. E. (2015). Emotion dysregulation and anorexia nervosa: An exploration of the role of childhood abuse. International Journal of Eating Disorders, 48, 55–58.
Ranson, K. M., Welzin, T. E., Rao, R., & Matsunaga, H. (1999). Obssesive-compulsive disorder symptoms before and after recovery from bulimia nervosa. American Journal Psychiatry, 156, 1703–1708.
Sakson-Obada, O. (2009a). Pamięć ciała. Ja cielesne w relacji przywiązania i w traumie [The memory of the body. I am a corporal in the relationship of attachment and trauma]. Warsaw: Wydawnictwo Difin.
Sakson-Obada, O. (2009b). Trauma jako czynnik ryzyka dla zaburzeń Ja cielesnego [Trauma as a risk factor for the disorders of the bodily ego]. Przegląd Psychologiczny, 52, 309–326.
Sakson-Obada, O. (2008). Rozwój Ja cielesnego w kontekście wczesnej relacji z opiekunem [Development of the body ego in the context of the early relationship with a caregiver]. Roczniki Psychologiczne, 11, 27–44.
Schier, K. (2005). Bez tchu i bez słowa. Więź psychiczna i regulacja emocji u osób chorych na astmę oskrzelową [Breathless and without a word. Psychological and emotional control in patients with bronchial asthma]. Gdańsk: GWP.
Skrzypska, N., & Suchańska, A. (2011). Uraz seksualny jako czynnik ryzyka zaburzeń doświadczania własnej cielesności [Sexual trauma as a risk factor for dysfunction of experiencing one’s own body]. Seksuologia Polska, 9, 51–56.
Striegel-Moore, R. H., Fairburn, C. G., Wilfley, D. E., Pike, K. M., Dohm, F. A., & Kraemer, H. C. (2005). Toward an Understanding of risk factors for binge-eating disorder in black and white women: a community base case-control study. Psychological Medicine, 35, 907–917.
Strober, M. (1981). The relation of personality characteristics to body image disturbances in juvenile anorexia nervosa: A multivariate analysis. Psychosomatic Medicine, 43, 323‒330.
Tahilani, K. (2015). Impact of self-efficacy and emotion dysregulation as mediators between trauma history and disordered eating. Dissertation Abstracts International: Section B: The Sciences and Engineering, Vol. 75 (11-B)(E).
Tasca, G., Ritchie, K., Zachariades, F., Trinneer, A., Balfour, L., Demidenko, N., Hayden, G., Wong, A., & Bissada, H. (2013). Attachment insecurity mediates the relationship between childhood trauma and eating disorder psychopathology in a clinical sample: A structural equation model. Child Abuse & Neglect, 37, 926–933.
Tryjarska, B. (2010). Bliskość w rodzinie. Więzi w dzieciństwie a zaburzenia w dorosłości [Closeness in a family. Bonds in childhood and disorders in adulthood]. Warsaw: Wydawnictwo Naukowe Scholar.
Wardle, J., Waller, J., & Rapoport, L. (2001). Body dissatisfaction and binge eating in obese women: the role of restraint and depressoin. Obesity Research, 9, 778–787.
Williams, G. (1997). Internal land and scapes foreign bodies. Eating disorders and other pathologies. London, Karnac: Cerald Duckworth & Co. Ltd. (Books) Ltd 6.
Żechowski, C. (2008). Polska wersja Kwestionariusza Zaburzeń Odżywiania (EDI) – adaptacja i normalizacja [Polish Version of Eating Disorder Inventory – adaptation and normalization]. Psychiatria Polska, 2, 179–193.
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