Childhood trauma has dose-effect relationship with dropping out from psychotherapeutic treatment for bulimia nervosa: A replication

Objective The primary goal of this study was to replicate the finding that experiences of childhood trauma have a dose‐effect relationship with dropping out from psychotherapeutic treatment for bulimia nervosa. It also aimed to replicate logistic regression findings that parental break‐up predicts dropping out. Method The cohort consisted of 114 women consecutively presenting to an outpatient eating disorders clinic with bulimia nervosa or atypical bulimia nervosa. Data were gathered using a retrospective, case‐note approach and were analysed using logistic regression (LR). A correlation technique was employed to assess the presence of a dose‐effect relationship between experiences of trauma in childhood and dropping out. LR models were double cross‐validated between this and an earlier cohort. Results The dose‐effect relationship between experiences of childhood trauma and dropping out was confirmed. Witnessing parental break‐up in childhood again predicted dropping out of treatment in adulthood. Cross‐validation of LR equations was unsuccessful. Discussion These results strongly suggest that experiences of childhood trauma have a dose‐effect relationship with dropping out. Parental break‐up is a stable predictor of dropping out. It is possible that these experiences influence attachment style, particularly the ability to make and maintain a trusting relationship with a psychotherapist. Clinical implications are discussed. © 2001 by John Wiley & Sons, Inc. Int J Eat Disord 30: 138–148, 2001.