Compulsive features in the eating disorders: a role for trauma?

There is considerable evidence of a link between reported childhood trauma and the current presence of impulsive behaviors in eating-disordered populations. However, there is no research testing the possibility of links with compulsive behaviors in this group, despite evidence that both impulsive and compulsive behaviors can serve to affect regulation functions. This study of 62 eating-disordered women examined potential links between different forms of reported childhood trauma (emotional, physical, sexual) and current compulsive behaviors (cleaning, checking). Each woman was interviewed to establish diagnosis, reported trauma history, and the presence of compulsive checking and cleaning behaviors. Chi-squared analyses demonstrated that there were no associations of either emotional or physical abuse with checking or cleaning behaviors. However, there was a significant association of reported childhood sexual abuse with the presence of cleaning behaviors. Although further research is needed to establish the generalizability of this conclusion across diagnostic group and measures, it implies that treatment of eating-disordered patients with comorbid compulsive cleaning behaviors might need to include a focus on the cognitive and affective consequences of childhood sexual abuse.