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

Objective: The primary goal of this study uas to replicate the finding that experiences of childhood trauma have a dose-effect relationship with dropp ing 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 prese nting to an outpatient eating disorders clinic with bulimia nervosa or atyp ical bulimia nervosa. Data were gathered using a retrospective, case-note a pproach and were analysed using logistic regression (LR). A correlation tec hnique was employed to assess the presence of a dose-effect relationship be tween experiences of trauma in childhood and dropping out. LR models were d ouble cross-validated between this and an earlier cohort. Results: The dose -effect relationship between experiences of childhood trauma and dropping o ut was confirmed. Witnessing parental break-up in childhood again predicted dropping out of treatment in adulthood. Cross-validation of LR equations w as unsuccessful. Discussion: These results strongly suggest that experience s of childhood trauma have a dose-effect relationship with dropping out. Pa rental break-up is a stable predictor of dropping out. It is possible that these experiences influence attachment style, particularly the ability to m ake and maintain a trusting relationship with a psychotherapist. Clinical i mplications are discussed. (C) 2001 by John Wiley & Sons, Inc.