Complex posttraumatic stress disorder symptoms and anorexia nervosa manifestations. Dissociative symptoms and emotion dysregulation as explanatory mechanisms

People who have experienced trauma are at higher risk of developing an eating disorder than those who have not suffered a traumatic event. While the association between posttraumatic stress disorder (PTSD) symptoms and anorexia nervosa (AN) symptomatology is widely discussed, research on complex PTSD (CPTSD) in relation to AN symptoms is scarce. In this context, we investigated the specific relationship between CPTSD symptoms (defined by ICD-11 criteria) and restrictive and binge-purging AN, in a clinical sample. We also tested, as possible explanatory mechanisms of these relationships, dissociative symptoms and emotion dysregulation. The questionnaire was completed by 91 participants, all patients in Austrian and German hospitals and clinics in departments for eating disorders, all with a diagnosis of AN. The sample comprised predominantly of women (80%) with a mean age of 20.84. Participants completed scales assessing CPTSD, restrictive AN, binge-purging AN, and dissociative symptoms, and emotion dysregulation. Our findings show that CPTSD symptoms are more strongly associated than PTSD symptoms with restrictive and binge-purging AN. Moreover, CPTSD symptoms are a significant predictor of both AN manifestations. Further findings indicate that dissociative experiences fully mediate the link between CPTSD symptoms and restrictive and binge-purging AN. However, emotion dysregulation did not mediate these relationships, as expected. Therefore, for patients diagnosed with anorexia nervosa, regardless of its type, screening and interventions for CPTSD symptomatology and dissociative experiences can contribute to treatment and recovery.