The role of stress, trauma, and PTSD in the etiology and treatment of eating disorders, addictions, and substance use disorders

Abstract

Stress, adversity, and trauma often play important roles in the etiology and treatment of substance use disorders, behavioral addictions, and eating disorders. At the outset, the term trauma is defined in terms of events, experiences, and effects, which often include the development of posttraumatic stress disorder (PTSD) and its symptoms. Much has been learned about the psychoneurobiology of stress response, trauma, and PTSD and associated comorbidity over the last several years. Literature illustrating how trauma and in particular PTSD predispose toward both addictions and eating disorders, particularly bulimic-spectrum disorders, is appraised. The emerging field of epigenetics and its relationship to understanding the role of trauma in the development of addictions and eating disorders is also examined. In addition, treatment implications and strategies for traumatized patients who are comorbid with PTSD and addictions and/or eating disorders are reviewed.