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Annals of Behavioral Medicine

, Volume 51, Issue 6, pp 822–832 | Cite as

Posttraumatic Stress Disorder Symptoms and Problematic Overeating Behaviors in Young Men and Women

  • Susan M. MasonEmail author
  • Patricia A. Frazier
  • S. Bryn Austin
  • Bernard L. Harlow
  • Benita Jackson
  • Nancy C. Raymond
  • Janet W. Rich-Edwards
Original Article

Abstract

Background

Posttraumatic stress disorder (PTSD) is a risk factor for obesity, but the range of behaviors that contribute to this association are not known.

Purpose

The purpose of this study was to examine associations between self-reported PTSD symptoms in 2007, with and without comorbid depression symptoms, and three problematic overeating behaviors in 2010, and to estimate the associations of PTSD-related overeating behaviors with obesity.

Methods

Cross-sectional and longitudinal analyses included 7438 male (n = 2478) and female (n = 4960) participants from the Growing Up Today Study (mean age 22–29 years in 2010). Three eating behavior outcomes were assessed: binge eating (eating a large amount of food in a short period of time with loss of control), top quartile of coping-motivated eating (from the Motivations to Eat scale), and top quartile of disinhibited eating (from the Three-Factor Eating Questionnaire).

Results

PTSD symptoms were associated with two- to threefold increases in binge eating and top-quartile coping-motivated eating; having ≥4 PTSD symptoms, relative to no PTSD symptoms, was associated with covariate-adjusted RRs of 2.7 (95% CI 2.1, 3.4) for binge eating, 2.1 (95% CI 1.9, 2.4) for the top quartile of coping-motivated eating, and 1.5 (95% CI 1.3, 1.7) for the top quartile of disinhibited eating. There was a trend toward PTSD symptoms in 2007 predicting new onset binge eating in 2010. Having depression symptoms comorbid with PTSD symptoms further increased risk of binge eating and coping-motivated eating. All eating behaviors were associated with obesity.

Conclusion

Clinicians treating patients with PTSD should know of potential comorbid problematic eating behaviors that may contribute to obesity.

Keywords

Posttraumatic stress disorder Depression Obesity Eating behavior Binge eating 

Notes

Compliance with Ethical Standards

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Mason, Frazier, Austin, Harlow, Jackson, Raymond, and Rich-Edwards declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Funding

Dr. Mason is supported by the Building Interdisciplinary Research Careers in Women’s Health Grant (No. K12HD055887) from the Eunice Kennedy Shriver National Institutes of Child Health and Human Development (NICHD), the Office of Research on Women’s Health, and the National Institute on Aging, NIH, administered by the University of Minnesota Deborah E. Powell Center for Women’s Health. The content is solely the responsibility of the authors and does not necessarily represent the office views of the NICHD or NIH. This work was also supported by the National Institutes of Health grants R01 HD066963 and R01 HD049889. Dr. Austin is supported by the US Maternal and Child Health Bureau, Health Resources and Services Administration grants 6T71-MC00009 and T76-MC00001.

References

  1. 1.
    Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:593–602. doi: 10.1001/archpsyc.62.6.593.CrossRefPubMedGoogle Scholar
  2. 2.
    Roberts AL, Agnew-Blais JC, Spiegelman D, et al. Posttraumatic stress disorder and incidence of type 2 diabetes mellitus in a sample of women: A 22-year longitudinal study. JAMA Psychiatry. 2015Google Scholar
  3. 3.
    Kubzansky LD, Bordelois P, Jun HJ, et al. The weight of traumatic stress: A prospective study of posttraumatic stress disorder symptoms and weight status in women. JAMA Psychiat. 2013 doi: 10.1001/jamapsychiatry.2013.2798.
  4. 4.
    Pagoto SL, Schneider KL, Bodenlos JS, et al. Association of post-traumatic stress disorder and obesity in a nationally representative sample. Obesity (Silver Spring) 2012;20:200–205. doi: 10.1038/oby.2011.318.CrossRefGoogle Scholar
  5. 5.
    Mitchell KS, Aiello AE, Galea S, Uddin M, Wildman D, Koenen KC. PTSD and obesity in the Detroit neighborhood health study. Gen Hosp Psychiatry 2013;35:671–673. doi: 10.1016/j.genhosppsych.2013.07.015.CrossRefPubMedGoogle Scholar
  6. 6.
    Perkonigg A, Owashi T, Stein MB, Kirschbaum C, Wittchen HU. Posttraumatic stress disorder and obesity. Evidence for a risk association. Am J Prev Med 2009;36:1–8. doi: 10.1016/j.amepre.2008.09.026.CrossRefPubMedGoogle Scholar
  7. 7.
    Dedert EA, Becker ME, Fuemmeler BF, Braxton LE, Calhoun PS, Beckham JC. Childhood traumatic stress and obesity in women: The intervening effects of PTSD and MDD. J Trauma Stress 2010;23:785–763. doi: 10.1002/jts.20584.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Brewerton T, O’Neil P, Dansky B, Kilpatrick D. Extreme obesity and its associations with victimization, PTSD, major depression and eating disorders in a national sample of women. J Obes Eat Disord 2015;1(2):2–9.Google Scholar
  9. 9.
    Ahmadi N, Hajsadeghi F, Mirshkarlo HB, Budoff M, Yehuda R, Ebrahimi R. Post-traumatic stress disorder, coronary atherosclerosis, and mortality. Am J Cardiol 2011;108:29–33. doi: 10.1016/j.amjcard.2011.02.340.CrossRefPubMedGoogle Scholar
  10. 10.
    Boyko EJ, Jacobson IG, Smith B, et al. Risk of diabetes in U.S. military service members in relation to combat deployment and mental health. Diabetes Care 2010;33:1771–1777. doi: 10.2337/dc10-0296.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Dedert EA, Calhoun PS, Watkins LL, Sherwood A, Beckham JC. Posttraumatic stress disorder, cardiovascular, and metabolic disease: A review of the evidence. Ann Behav Med 2010;39(1):61–78. doi: 10.1007/s12160-010-9165-9.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Cota D, Tschöp MH, Horvath TL, Levine AS. Cannabinoids, opioids and eating behavior: The molecular face of hedonism? Brain Res Rev 2006;51:85–107. doi: 10.1016/j.brainresrev.2005.10.004.CrossRefPubMedGoogle Scholar
  13. 13.
    Ulrich-Lai YM, Christiansen AM, Ostrander MM, et al. Pleasurable behaviors reduce stress via brain reward pathways. Proc Natl Acad Sci U S A 2010;107:20529–20534. doi: 10.1073/pnas.1007740107.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Striegel-Moore RH, Garvin V, Dohm FA, Rosenheck RA. Eating disorders in a national sample of hospitalized female and male veterans: Detection rates and psychiatric comorbidity. Int J Eat Disord. 1999;25:405–414. doi: 10.1002/(SICI)1098-108X(199905)25:4<405::AID-EAT5>3.0.CO;2-F.CrossRefPubMedGoogle Scholar
  15. 15.
    Swinbourne JM, Touyz SW. The co-morbidity of eating disorders and anxiety disorders: A review. Eur Eat Disord Rev 2007;15:253–274. doi: 10.1002/erv.784.CrossRefPubMedGoogle Scholar
  16. 16.
    Mitchell KS, Mazzeo SE, Schlesinger MR, Brewerton TD, Smith BN. Comorbidity of partial and subthreshold PTSD among men and women with eating disorders in the national comorbidity survey-replication study. Int J Eat Disord. 2012;45:307–315. doi: 10.1002/eat.20965.CrossRefPubMedGoogle Scholar
  17. 17.
    Grilo CM, White M A, Barnes RD, Masheb RM. Posttraumatic stress disorder in women with binge eating disorder in primary care. J Psychiatr Pract 2012;18:408–412. doi: 10.1097/01.pra.0000422738.49377.5e.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Campbell DG, Felker BL, Liu C-F, et al. Prevalence of depression-PTSD comorbidity: Implications for clinical practice guidelines and primary care-based interventions. J Gen Intern Med 2007;22(6):711–718. doi: 10.1007/s11606-006-0101-4.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    de Wit L, Luppino F, van Straten A, Penninx B, Zitman F, Cuijpers P. Depression and obesity: A meta-analysis of community-based studies. Psychiatry Res. 2010;178:230–235. doi: 10.1016/j.psychres.2009.04.015.CrossRefPubMedGoogle Scholar
  20. 20.
    Pan A, Sun Q, Czernichow S, et al. Bidirectional association between depression and obesity in middle-aged and older women. Int J Obes 2012;36:595–602. doi: 10.1038/ijo.2011.111.CrossRefGoogle Scholar
  21. 21.
    Puccio F, Fuller-Tyszkiewicz M, Ong D, Krug I. A systematic review and meta-analysis on the longitudinal relationship between eating pathology and depression. Int J Eat Disord. 2016;49(5):439–454. doi: 10.1002/eat.22506.CrossRefPubMedGoogle Scholar
  22. 22.
    Orzechowska A, Zajączkowska M, Talarowska M, Gałecki P. Depression and ways of coping with stress: A preliminary study. Med Sci Monit. 2013;19:1050–1056. doi: 10.12659/MSM.889778.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Pu S, Nakagome K, Yamada T, et al. The relationship between the prefrontal activation during a verbal fluency task and stress-coping style in major depressive disorder: A near-infrared spectroscopy study. J Psychiatr Res 2012;46(11):1427–1434. doi: 10.1016/j.jpsychires.2012.08.001.CrossRefPubMedGoogle Scholar
  24. 24.
    Talbot LS, Maguen S, Epel ES, Metzler TJ, Neylan TC. Posttraumatic stress disorder is associated with emotional eating. J Trauma Stress 2013;26(4):521–525. doi: 10.1002/jts.21824.CrossRefPubMedGoogle Scholar
  25. 25.
    Michopoulos V, Powers A, Moore C, Villarreal S, Ressler KJ, Bradley B. The mediating role of emotion dysregulation and depression on the relationship between childhood trauma exposure and emotional eating. Appetite 2015;91:129–136. doi: 10.1016/j.appet.2015.03.036.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Mason SM, Flint AJ, Roberts AL, Agnew-Blais J, Koenen KC, Rich-Edwards JW. Posttraumatic stress disorder symptoms and food addiction in women by timing and type of trauma exposure. JAMA Psychiat 2014;71(11):1271–1278. doi: 10.1001/jamapsychiatry.2014.1208.CrossRefGoogle Scholar
  27. 27.
    Mitchell KS, Wolf EJ. PTSD, food addiction, and disordered eating in a sample of primarily older veterans: The mediating role of emotion regulation. Psychiatry Res 2016;243:23–29. doi: 10.1016/j.psychres.2016.06.013.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Hirth JM, Rahman M, Berenson AB. The association of posttraumatic stress disorder with fast food and soda consumption and unhealthy weight loss behaviors among young women. J Women’ss Health (Larchmt) 2011;20:1141–1149. doi: 10.1089/jwh.2010.2675.
  29. 29.
    Vilija M, Romualdas M. Unhealthy food in relation to posttraumatic stress symptoms among adolescents. Appetite 2014;74:86–91. doi: 10.1016/j.appet.2013.12.002.CrossRefPubMedGoogle Scholar
  30. 30.
    Godfrey KM, Lindamer LA, Mostoufi S, Afari N. Posttraumatic stress disorder and health: A preliminary study of group differences in health and health behaviors. Ann General Psychiatry 2013;12(1):30. doi: 10.1186/1744-859X-12-30.CrossRefGoogle Scholar
  31. 31.
    Carmassi C, Antonio Bertelloni C, Massimetti G, et al. Impact of DSM-5 PTSD and gender on impaired eating behaviors in 512 Italian earthquake survivors. Psychiatry Res 2015;225(1–2):64–69. doi: 10.1016/j.psychres.2014.10.008.CrossRefPubMedGoogle Scholar
  32. 32.
    Jackson B, Cooper ML, Mintz L, Albino A. Motivations to eat: Scale development and validation. J Res Pers 2003;37:297–318. doi: 10.1016/S0092-6566(02)00574-3.CrossRefGoogle Scholar
  33. 33.
    Stunkard AJ, Messick S. The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res 1985;29(1):71–83.Google Scholar
  34. 34.
    Breslau N, Peterson EL, Kessler RC, Schultz LR. Short screening scale for DSM-IV posttraumatic stress disorder. Am J Psychiatry 1999;156:908–911.CrossRefPubMedGoogle Scholar
  35. 35.
    Roberts AL, Agnew-Blais J, Spiegelman D, et al. Posttraumatic stress disorder and type 2 diabetes incidence in women: An 18-year longitudinal study. Under Rev. 2013.Google Scholar
  36. 36.
    Goodman E, Whitaker RC. A prospective study of the role of depression in the development and persistence of adolescent obesity. Pediatrics 2002;110:497–504. doi: 10.1542/peds.110.3.497.CrossRefPubMedGoogle Scholar
  37. 37.
    Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: Evaluation of a short form of the CES-D. Am J Prev Med 1994;10:77–84.PubMedGoogle Scholar
  38. 38.
    Irwin M, Artin KH, Oxman MN. Screening for depression in the older adult: Criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med. 159(15):1701–1704.Google Scholar
  39. 39.
    Field AE, Taylor CB, Celio A, Colditz GA. Comparison of self-report to interview assessment of bulimic behaviors among preadolescent and adolescent girls and boys. Int J Eat Disord. 2004;35:86–92. doi: 10.1002/eat.10220.CrossRefPubMedGoogle Scholar
  40. 40.
    Bohrer BK, Forbush KT, Hunt TK. Are common measures of dietary restraint and disinhibited eating reliable and valid in obese persons? Appetite 2015;87:344–351. doi: 10.1016/j.appet.2014.12.226.CrossRefPubMedGoogle Scholar
  41. 41.
    Goodman E, Hinden BR, Khandelwal S. Accuracy of teen and parental reports of obesity and body mass index. Pediatrics 2000;106:52–58. doi: 10.1542/peds.106.1.52.CrossRefPubMedGoogle Scholar
  42. 42.
    Strauss RS. Comparison of measured and self-reported weight and height in a cross-sectional sample of young adolescents. Int J Obes Relat Metab Disord 1999;23:904–908. doi: 10.1038/sj.ijo.0800971.CrossRefPubMedGoogle Scholar
  43. 43.
    Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC growth charts for the United States: Methods and development. Vital Health Stat 11. 2002;1–190.Google Scholar
  44. 44.
    Troy LM, Hunter DJ, Manson JE, Colditz GA, Stampfer MJ, Willett WC. The validity of recalled weight among younger women. Int J Obes Relat Metab Disord 1995;19(8):570–572.PubMedGoogle Scholar
  45. 45.
    Zou G. A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol 2004;159(7):702–706. doi: 10.1093/aje/kwh090.CrossRefPubMedGoogle Scholar
  46. 46.
    Berg KC, Crosby RD, Cao L, et al. Facets of negative affect prior to and following binge-only, purge-only, and binge/purge events in women with bulimia nervosa. J Abnorm Psychol 2012. doi: 10.1037/a0029703.PubMedPubMedCentralGoogle Scholar
  47. 47.
    Brewerton TD. Posttraumatic stress disorder and disordered eating: Food addiction as self-medication. J Womens Health (Larchmt). 2011;20:1133–1134. doi: 10.1089/jwh.2011.3050.CrossRefGoogle Scholar
  48. 48.
    Smith BN, Tyzik AL, Neylan TC, Cohen BE. PTSD and obesity in younger and older veterans: Results from the mind your heart study. Psychiatry Res 2015;229(3):895–900. doi: 10.1016/j.psychres.2015.07.044.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    von Lojewski A, Boyd C, Abraham S, Russell J. Lifetime and recent DSM and ICD psychiatric comorbidity of inpatients engaging in different eating disorder behaviours. Eat Weight Disord 2012;17:e185-e193.Google Scholar
  50. 50.
    Hoerster KD, Jakupcak M, Hanson R, et al. PTSD and depression symptoms are associated with binge eating among US Iraq and Afghanistan veterans. Eat Behav 2015;17:115–118. doi: 10.1016/j.eatbeh.2015.01.005.CrossRefPubMedGoogle Scholar
  51. 51.
    Dansky BS, Brewerton TD, Kilpatrick DG, O’Neil PM. The National Women’s Study: Relationship of victimization and posttraumatic stress disorder to bulimia nervosa. Int J Eat Disord 1997;21:213–228. doi: 10.1002/(SICI)1098-108X(199704)21:3<213::AID-EAT2>3.0.CO;2-N.CrossRefPubMedGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 2017

Authors and Affiliations

  • Susan M. Mason
    • 1
    • 2
    Email author
  • Patricia A. Frazier
    • 3
  • S. Bryn Austin
    • 2
    • 4
    • 5
  • Bernard L. Harlow
    • 6
  • Benita Jackson
    • 7
  • Nancy C. Raymond
    • 8
    • 9
  • Janet W. Rich-Edwards
    • 10
    • 11
  1. 1.Division of Epidemiology and Community HealthUniversity of Minnesota School of Public HealthMinneapolisUSA
  2. 2.Channing Division of Network MedicineBrigham and Women’s Hospital and Harvard Medical SchoolBostonUSA
  3. 3.Department of PsychologyUniversity of MinnesotaMinneapolisUSA
  4. 4.Division of Adolescent and Young Adult MedicineBoston Children’s Hospital/Harvard Medical SchoolBostonUSA
  5. 5.Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonUSA
  6. 6.Department of EpidemiologyBoston University School of Public HealthBostonUSA
  7. 7.Department of PsychologySmith CollegeNorthamptonUSA
  8. 8.Department of PsychiatryUniversity of Minnesota Medical SchoolMinneapolisUSA
  9. 9.Powell Center for Women’s HealthUniversity of Minnesota Medical SchoolMinneapolisUSA
  10. 10.Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonUSA
  11. 11.Connors Center for Women’s Health and Gender BiologyBrigham and Women’s Hospital/Harvard Medical SchoolBostonUSA

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