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Sexual and gender minority individuals report higher rates of lifetime traumas and current PTSD than cisgender heterosexual individuals admitted to residential eating disorder treatment

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity Aims and scope Submit manuscript

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Abstract

Objective

Trauma and posttraumatic stress disorder (PTSD) are associated with eating disorders (EDs), which occur across all sexual orientations and gender identities. Prior traumas and PTSD also are reported to occur significantly more frequently in individuals identifying as lesbian, gay, bisexual, transgender, queer or questioning, non-binary, or other (LGBTQ+), but little is known about rates of PTSD in LGBTQ+ individuals with EDs admitted to residential treatment (RT).

Method

Our sample included 542 adults with DSM-5 EDs admitted to RT at seven sites in the U.S. Rates of current presumptive PTSD (PTSD +) by LGBTQ + status were determined by responses on the Life Events Checklist (LEC-5) and the PTSD Symptom Checklist for DSM-5 (PCL-5).

Results

Nearly 24% of admitting individuals self-reported as LGBTQ+, and these individuals had significantly higher LEC-5 total scores (5.6 v. 4.9), PCL-5 total scores (41.9 v. 34.0), and rates of PTSD+ (63% v. 45%) than non-LGBTQ+ individuals. The LGBTQ+ with PTSD+ group reported (1) significantly more unwanted sexual experiences, sexual assaults, physical assaults, and severe human suffering experiences, and (2) significantly greater ED, depressive and trait-anxiety symptoms than the non-LGBTQ+ group with PTSD+.

Conclusions

LGBTQ+ individuals had significantly higher rates of high impact lifetime traumas and presumptive PTSD+, as well as greater ED and comorbid symptom severity, than non-LGBTQ+ individuals. Development, implementation and assessment of integrated treatment protocols for LGBTQ+ individuals with an ED and PTSD+ is warranted to address the needs of this underserved and often overlooked population.

Level of evidence

Level III: Evidence obtained from cohort or case–control analytic studies.

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Data availability

Data are proprietary and not available.

Code availability

SPSS 25.0.

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Acknowledgements

This study was supported by Monte Nido and Affiliates (MNA).

Funding

None.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA

    Timothy D. Brewerton

  2. Timothy D. Brewerton, MD, LLC, Mount Pleasant, SC, USA

    Timothy D. Brewerton

  3. Monte Nido and Affiliates, Miami, FL, USA

    Timothy D. Brewerton, Giulia Suro, Ismael Gavidia & Molly M. Perlman

  4. Department of Psychiatry and Behavioral Health, Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA

    Molly M. Perlman

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  1. Timothy D. Brewerton
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  2. Giulia Suro
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  4. Molly M. Perlman
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Corresponding author

Correspondence to Timothy D. Brewerton.

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Conflict of interest

Timothy D. Brewerton is a paid, independent consultant for MNA. Giulia Suro, Ismael Gavidia, and Molly Perlman are all employees of MNA.

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This study was approved by the Salus Institutional Review Board.

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All participants provided informed consent prior to their participation.

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All participants gave written informed consent and were deidentified prior to analysis of data.

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Brewerton, T.D., Suro, G., Gavidia, I. et al. Sexual and gender minority individuals report higher rates of lifetime traumas and current PTSD than cisgender heterosexual individuals admitted to residential eating disorder treatment. Eat Weight Disord 27, 813–820 (2022). https://doi.org/10.1007/s40519-021-01222-4

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