Longitudinal associations among eating disorder and posttraumatic stress disorder symptoms in veteran men and women: A latent difference score modeling approach.

Objective

Cross-sectional studies have established associations between eating disorders (EDs) and posttraumatic stress disorder (PTSD) among both women and men. Although there is evidence that trauma exposure may contribute to the onset of EDs, few longitudinal studies have examined whether there is a reciprocal relationship between ED symptoms and PTSD symptoms resulting from trauma exposure. This issue is particularly relevant for military veterans, who have high rates of PTSD and EDs.

Method

We investigated bidirectional associations among PTSD and ED symptoms in a sample of U.S. veteran men and women. Participants were randomly selected from the national population of veterans and invited to complete the time 1 (T1) survey; respondents were invited to complete the time 2 (T2) survey approximately 12 months later. We estimated latent difference score (LDS) models to determine whether T1 PTSD symptoms were associated with T2 ED symptoms and vice versa.

Results

Bivariate LDS model results indicated that only among the female subsample, T1 PTSD symptoms, particularly negative affect and externalizing behaviors, were positively associated with change in ED symptoms from T1 to T2. T1 ED symptoms were not associated with the PTSD LDS.

Discussion

Among veteran women only, negative affect and externalizing behaviors were associated with later ED symptoms, consistent with the theory that ED symptoms may be used to cope with trauma-related symptoms. Further research is needed to investigate longitudinal associations between PTSD and ED symptoms that may be more relevant to veteran men. Findings have the potential to positively impact future treatment efforts.