{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T02:06:27Z","timestamp":1775095587544,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Mental Health","award":["K23MH131871"],"award-info":[{"award-number":["K23MH131871"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>In the current study, we conducted a preliminary test of whether adding evidence-based PTSD treatment may influence intensive ED treatment outcomes by comparing individuals with co-occurring ED-PTSD diagnoses who received PTSD treatment to those who did not. We hypothesized that receiving PTSD treatment would moderate outcomes, such that individuals who received PTSD treatment throughout their course of ED treatment would demonstrate improved outcomes compared to those with PTSD who did not. The participants were 104 adults with DSM-5 EDs and PTSD admitted to a partial-hospital ED program. The participants either completed a course of evidence-based PTSD treatment within the context of intensive ED treatment or completed ED treatment as usual (n = 58 PTSD treatment, n = 46 TAU). Multilevel modeling was used to examine changes in symptoms as moderated by receipt of PTSD treatment over the course of treatment and at follow-up. Models exploring changes in anxiety, depression, clinical impairment, and ED symptoms suggested no differences across groups. The findings indicated that individuals who received PTSD treatment began with higher body dissatisfaction compared to their peers and experienced a significant decrease over the course of treatment. This investigation provides preliminary support for improved body dissatisfaction outcomes when PTSD treatment is incorporated into intensive ED treatment.<\/jats:p>","DOI":"10.3390\/bs15091173","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T08:01:01Z","timestamp":1756454461000},"page":"1173","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring the Additive Benefit of PTSD Treatment on Eating Disorder Outcomes for Those with Co-Occurring PTSD"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9964-2331","authenticated-orcid":false,"given":"Christina R.","family":"Felonis","sequence":"first","affiliation":[{"name":"Eating Disorders Center for Treatment and Research, Department of Psychiatry, University of California, San Diego, CA 92121, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0073-6053","authenticated-orcid":false,"given":"Alexandra D.","family":"Convertino","sequence":"additional","affiliation":[{"name":"Department of Psychology, California State University, Dominguez Hills, CA 90747, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin E.","family":"Reilly","sequence":"additional","affiliation":[{"name":"Eating Disorders Program, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA 94107, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanvi","family":"Beri","sequence":"additional","affiliation":[{"name":"Eating Disorders Center for Treatment and Research, Department of Psychiatry, University of California, San Diego, CA 92121, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly","family":"Claudat","sequence":"additional","affiliation":[{"name":"Eating Disorders Center for Treatment and Research, Department of Psychiatry, University of California, San Diego, CA 92121, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1037\/met0000195","article-title":"Statistical power in two-level models: A tutorial based on monte carlo simulation","volume":"24","author":"Arend","year":"2019","journal-title":"Psychological Methods"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v067.i01","article-title":"Fitting linear mixed-effects models using lme4","volume":"67","author":"Bates","year":"2015","journal-title":"Journal of Statistical Software"},{"key":"ref_3","unstructured":"Fairburn, C. G. (2008). Clinical impairment assessment questionnaire (CIA 3.0). Cognitive behavior therapy and eating disorders, Guilford Press."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1080\/10926771.2018.1532940","article-title":"An overview of trauma-informed care and practice for eating disorders","volume":"28","author":"Brewerton","year":"2019","journal-title":"Journal of Aggression, Maltreatment, & Trauma"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Brewerton, T. D. (2023). The integrated treatment of eating disorders, posttraumatic stress disorder, and psychiatric comorbidity: A commentary on the evolution of principles and guidelines. Frontiers in Psychiatry, 14.","DOI":"10.3389\/fpsyt.2023.1149433"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1002\/erv.2589","article-title":"Efficacy of a partial hospital programme for adults with eating disorders","volume":"26","author":"Brown","year":"2018","journal-title":"European Eating Disorders Review"},{"key":"ref_7","first-page":"19","article-title":"Trauma-focused interventions: A clinical practice analysis","volume":"7","author":"Carbajal","year":"2018","journal-title":"The Practitioner Scholar: Journal of Counseling and Professional Psychology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1007\/s40519-022-01500-9","article-title":"Integrating evidence-based PTSD treatment into intensive eating disorders treatment: A preliminary investigation","volume":"27","author":"Claudat","year":"2022","journal-title":"Eating and Weight Disorders"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1002\/eat.23933","article-title":"Posttraumatic stress disorder, traumatic events, and longitudinal eating disorder treatment outcomes: A systematic review","volume":"56","author":"Convertino","year":"2023","journal-title":"The International Journal of Eating Disorders"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1002\/jclp.22909","article-title":"Treating posttraumatic stress disorder across cultures: A systematic review of cultural adaptations of trauma-focused cognitive behavioral therapies","volume":"76","author":"Ennis","year":"2020","journal-title":"Journal of Clinical Psychology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/1098-108X(199412)16:4<363::AID-EAT2260160405>3.0.CO;2-#","article-title":"Assessment of eating disorders: Interview or self-report questionnaire?","volume":"16","author":"Fairburn","year":"1994","journal-title":"The International Journal of Eating Disorders"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1080\/10926771.2020.1832168","article-title":"Prevalence estimates of comorbid eating disorders and posttraumatic stress disorder: A quantitative synthesis","volume":"31","author":"Ferrell","year":"2022","journal-title":"Journal of Aggression, Maltreatment & Trauma"},{"key":"ref_13","unstructured":"First, M. B., Williams, J. B., Karg, R. S., and Spitzer, R. L. (2015). Structured clinical interview for DSM-5\u2014Research version (SCID-5 for DSM-5, research version; SCID-5-RV), American Psychiatric Association."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Foa, E. B., Hembree, E. A., Rothbaum, B. O., and Rauch, S. A. M. (2019). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences\u2014Therapist guide, Oxford University Press. [2nd ed.].","DOI":"10.1093\/med-psych\/9780190926939.001.0001"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1037\/a0032639","article-title":"Development and validation of the Eating Pathology Symptoms Inventory (EPSI)","volume":"25","author":"Forbush","year":"2013","journal-title":"Psychological Assessment"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"101771","DOI":"10.1016\/j.cpr.2019.101771","article-title":"The role of body image disturbance in the onset, maintenance, and relapse of anorexia nervosa: A systematic review","volume":"74","author":"Glashouwer","year":"2019","journal-title":"Clinical Psychology Review"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1002\/(SICI)1098-108X(199809)24:2<147::AID-EAT4>3.0.CO;2-E","article-title":"Scope and significance of posttraumatic symptomatology among women hospitalized for an eating disorder","volume":"24","author":"Gleaves","year":"1998","journal-title":"The International Journal of Eating Disorders"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/2041-210X.12504","article-title":"SIMR: An R package for power analysis of generalized linear mixed models by simulation","volume":"7","author":"Green","year":"2016","journal-title":"Methods in Ecology and Evolution"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.brat.2012.02.011","article-title":"Treating PTSD in suicidal and self-injuring women with borderline personality disorder: Development and preliminary evaluation of a dialectical behavior therapy prolonged exposure protocol","volume":"50","author":"Harned","year":"2012","journal-title":"Behaviour Research and Therapy"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1017\/S0033291701004640","article-title":"Health problems, impairment and illnesses associated with bulimia nervosa and binge eating disorder among primary care and obstetric gynaecology patients","volume":"31","author":"Johnson","year":"2001","journal-title":"Psychological Medicine"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"509","DOI":"10.3928\/0048-5713-20020901-06","article-title":"The PHQ-9: A New depression diagnostic and severity measure","volume":"32","author":"Kroenke","year":"2002","journal-title":"Psychiatric Annals"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1037\/ccp0000245","article-title":"The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis","volume":"85","author":"Linardon","year":"2017","journal-title":"Journal of Consulting and Clinical Psychology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1080\/10640266.2020.1869369","article-title":"Posttraumatic stress disorder and eating disorders: Maintaining mechanisms and treatment targets","volume":"29","author":"Mitchell","year":"2021","journal-title":"Eating Disorders"},{"key":"ref_24","unstructured":"R Core Team (2025, May 30). R: A language and environment for statistical computing (Version 4.5.0) [Computer Software], Available online: https:\/\/www.R-project.org\/."},{"key":"ref_25","unstructured":"Resick, P. A., Monson, C. M., and Chard, K. M. (2017). Cognitive processing therapy for PTSD: A comprehensive manual, Guilford Press."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e32270","DOI":"10.2196\/32270","article-title":"Treatment outcome for adults in a residential program for binge eating spectrum disorders: Protocol for a prospective pragmatic single-arm trial","volume":"11","author":"Rienecke","year":"2022","journal-title":"JMIR Research Protocols"},{"key":"ref_27","first-page":"22","article-title":"The mini-international neuropsychiatric interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10","volume":"59","author":"Sheehan","year":"1998","journal-title":"The Journal of Clinical Psychiatry"},{"key":"ref_28","unstructured":"Speilberger, C. D., Gorsuch, R., Lushene, R., Vagg, P., and Jacobs, G. (1983). Manual for the state-trait anxiety inventory (form Y1\u2013Y2), Consulting Psychologists, IV."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1016\/S0022-3999(02)00488-9","article-title":"Role of body dissatisfaction in the onset and maintenance of eating pathology: A synthesis of research findings","volume":"53","author":"Stice","year":"2002","journal-title":"Journal of Psychosomatic Research"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s40337-022-00725-4","article-title":"The association between eating disorders and mental health: An umbrella review","volume":"11","author":"Tan","year":"2023","journal-title":"Journal of Eating Disorders"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1017\/S0033291721004967","article-title":"Results of the first randomized controlled trial of integrated cognitive-behavioral therapy for eating disorders and posttraumatic stress disorder","volume":"52","author":"Trottier","year":"2022","journal-title":"Psychological Medicine"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1002\/jts.22176","article-title":"Initial findings from Project Recover: Overcoming co-occurring eating disorders and posttraumatic stress disorder through integrated treatment","volume":"30","author":"Trottier","year":"2017","journal-title":"Journal of Traumatic Stress"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1002\/eat.22516","article-title":"Investigating posttraumatic stress disorder as a psychological maintaining factor of eating disorders","volume":"49","author":"Trottier","year":"2016","journal-title":"The International Journal of Eating Disorders"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1002\/erv.2634","article-title":"Illness pathways between eating disorder and post-traumatic stress disorder symptoms: Understanding comorbidity with network analysis","volume":"27","author":"Vanzhula","year":"2019","journal-title":"European Eating Disorders Review"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/9\/1173\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:34:57Z","timestamp":1760034897000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/9\/1173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,29]]},"references-count":34,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["bs15091173"],"URL":"https:\/\/doi.org\/10.3390\/bs15091173","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,29]]}}}