Eye movement desensitisation and reprocessing as add‐on treatment to enhanced cognitive behaviour therapy for patients with anorexia nervosa reporting childhood maltreatment: A quasi‐experimental multicenter study

Abstract

Objective

This quasi‐experimental study aimed to compare the outcome of patients with Anorexia Nervosa (AN) reporting moderate/severe childhood maltreatment (CM) treated exclusively with Enhanced Cognitive Behaviour Therapy (CBT‐E) or with CBT‐E plus Eye Movement Desensitisation and Reprocessing (EMDR).

Method

A total of 75 patients with AN reporting moderate/severe CM were initially assessed regarding body mass index (BMI), general and eating disorder (ED)‐specific psychopathology, and dissociative symptoms, and re‐evaluated after 40 CBT‐E sessions (T1). Then, 18 patients received EMDR, whereas the others were placed on a waiting list and continued CBT‐E. T2 assessment was performed after 20–25 sessions of EMDR or CBT‐E. A control group of 67 patients without CM was also enroled and treated with CBT‐E.

Results

Contrary to patients without CM, neither of the traumatised groups improved in BMI, general and ED psychopathology, or dissociation at T1. However, at T2, both traumatised groups improved in BMI and ED‐specific psychopathology, with the CBT + EMDR group demonstrating greater improvements. Moreover, only the CBT + EMDR group improved in general psychopathology and dissociative symptoms. The reduction of ED symptoms in traumatised patients was mediated by the amelioration of dissociation.

Discussion

The addition of EMDR to CBT‐E may benefit patients with AN reporting moderate/severe CM.

Highlights

• Patients with Anorexia Nervosa (AN) and a history of Childhood Maltreatment (CM) who were treated with a combination of Enhanced Cognitive Behaviour Therapy (CBT‐E) and Eye Movement Desensitisation and Reprocessing (EMDR) (CBT + EMDR group) achieved significantly greater weight recovery and a more substantial reduction in eating disorder‐specific psychopathology compared to those who received CBT‐E alone.

• Among patients with AN and a history of CM, only those who also received EMDR treatment in addition to CBT‐E achieved a significant reduction in terms of general psychopathology and dissociative symptomatology.

• The reduction of eating disorder symptoms in patients with a history of CM was mediated by the improvement in dissociative symptoms.