Do broken relationships in childhood relate to bulimic women breaking off psychotherapy in adulthood?

Objective/Method: The case notes of Ill women presenting consecutively to a n outpatient eating disorders clinic with bulimia nervosa or atypical bulim ia nervosa were reviewed for pretreatment factors that predicted dropout in a retrospective study. Dropping out was conceptualized as not just a patie nt characteristic but as a transaction between patient and therapist. Facto rs believed to influence this transaction included experiences of childhood trauma, severity of eating disorder characteristics and comorbid psychiatr ic symptoms, demographic characteristics, waiting times for assessment and therapy, distance traveled to the clinic, previous experience of psychiatri c treatment, and Eating Disorder Inventory (EDI) and Rosenberg Self-Esteem questionnaire results. Results: Witnessing parental breakup, being younger, being employed outside the home, and having previous experience of psychia tric treatment predicted dropping out in logistic regression models. Experi ences of childhood trauma had a dose-effect relationship with dropping out. Having lower overall severity of eating disorder characteristics may also relate to dropping out. Discussion: An impaired ability to trust resulting from disturbed attachments may link childhood trauma and dropping out. (C) 2001 by John Wiley & Sons, Inc.