- Revisiting previously disclosed childhood sexual abuse during psychotherapy precipitated severe emotional distress and a major relapse requiring hospitalisation in a 16-year-old with restrictive anorexia nervosa.
- Clinical assessment must evaluate emotional regulation capacity and medical stability before exploring traumatic experiences in severely underweight adolescents with anorexia nervosa.
- A phase based trauma informed multidisciplinary approach is recommended as trauma may maintain restrictive symptoms via avoidance, control and affect regulation mechanisms.
Front Pediatr. 2026 Oct 14;14:1958194. doi: 10.3389/fped.2026.1958194. eCollection 2026.
ABSTRACT
INTRODUCTION: Childhood traumatic experiences are increasingly recognized as important contributors to the development and maintenance of eating disorders. In adolescents with anorexia nervosa (AN), traumatic experiences may interact with restrictive symptoms through mechanisms involving emotional dysregulation, avoidance, and maladaptive control strategies. However, the optimal timing and approach for addressing traumatic experiences in severely underweight adolescents with AN remain unclear.
CASE PRESENTATION: We describe the case of a 16-year-old girl with restrictive AN who experienced a severe clinical relapse requiring hospitalization after a previously disclosed but unprocessed experience of childhood sexual abuse was revisited in greater detail during routine outpatient psychotherapy for AN. Although the psychotherapy was not trauma-focused, it aimed to reconstruct the patient’s developmental history and identify the maintaining mechanisms of the eating disorder within a specialist multidisciplinary eating-disorder service. Revisiting the traumatic experience was followed by marked emotional distress and a severe exacerbation of restrictive symptoms.
CONCLUSIONS: This case highlights the complex relationship between trauma and AN during adolescence and underscores the clinical importance of carefully assessing emotional regulation capacities and medical stability when traumatic experiences are revisited in severely vulnerable patients. A phase-based, trauma-informed multidisciplinary approach may be particularly important for adolescents whose restrictive symptoms continue to function as primary defensive and affect-regulatory mechanisms.
PMID:42952856 | PMC:PMC13713520 | DOI:10.3389/fped.2026.1958194
Share Evidence Blueprint
Save to Google Notes
Search Google Scholar
Save as PDF
⭐ My Revision List
