Associations between disordered eating and intimate partner violence mediated by depression and posttraumatic stress disorder symptoms in a female veteran sample.

OBJECTIVE: This study established a link between intimate partner violence (IPV) and eating disorders (EDs) via mediators of depression and posttraumatic stress disorder (PTSD) symptoms in female veterans. METHOD: A nationally representative sample of female veterans (N = 190, Mean age = 48.41 years) completed online surveys assessing IPV and symptoms of depression, PTSD, and EDs, at three time points from 2014 to 2017. RESULTS: Approximately 14.11% of participants met criteria for any ED (7.83% Bulimia Nervosa; 6.28% Binge Eating Disorder), and 49.42% reported lifetime histories of IPV. Eating disorder symptoms were significantly associated with lifetime IPV, PTSD and depression symptoms at the bivariate level. Mediation model results revealed that lifetime IPV was indirectly associated with EDDS scores, via PTSD symptoms and depression symptoms. CONCLUSION: Findings confirmed elevated rates of probable EDs and lifetime IPV among female veterans; significant associations between EDs, lifetime IPV, depression, and PTSD; and mediation of the association between IPV and EDs by PTSD and depression symptoms. Implications for screening, treatment and research are discussed.

Associations between healthcare use and disordered eating among female veterans.

OBJECTIVE: Individuals with eating disorders (EDs) have considerable medical and psychiatric comorbidity as well as increased healthcare use and associated costs. However, EDs remain largely undetected and understudied among veteran populations, and EDs are not routinely screened for or treated in Veterans Affairs (VA) medical settings. Research elucidating the links between disordered eating and VA and non-VA healthcare use is needed to inform policy and practice for ED screening and treatment. METHOD: Data regarding probable EDs and VA and non-VA healthcare use was obtained through a mail survey of 198 female veterans receiving care from VA. RESULTS: A total of 21 participants (10.6%) met probable criteria for subthreshold anorexia nervosa, bulimia nervosa, or binge-eating disorder. Negative binomial regression models revealed that female veterans with EDs reported higher frequency of VA mental healthcare use and substance use disorder treatment, above and beyond the association of comorbid PTSD and depression symptoms. DISCUSSION: These findings confirm the high probability that female veterans with EDs are utilizing significant VA mental health resources. Screening for EDs may be particularly important in VA medical and mental health settings.