Substance use disorder, disordered eating and post-traumatic stress disorder in young people: Unravelling this common comorbidity

Abstract

Substance use disorders (SUDs), eating disorders (EDs), and post-traumatic stress disorder (PTSD) are highly prevalent. While there is an abundance of evidence demonstrating the substantial comorbidity between each of the dyads, especially among adults, the literature contains three very important evidence gaps: the scarcity of studies that i) concentrate on young people; ii) examine disordered eating in addition to EDs; and iii) examine co-morbidity of all three disorders (i.e., SUD, ED, and PTSD).

Study 1 presents a systematic review of 58 studies examining the prevalence and patterns of comorbid substance use and disordered eating among young people. The review identifies prevalence rates and patterns of comorbidity, as well as a number of methodological flaws and gaps in previous research. In particular, an absence of research examining the role of trauma. Study 2 examines substance use, SUDs, trauma, and PTSD among a large community cohort of young people, highlighting the prevalence rates and associations between trauma exposure, PTSD, and the development of problematic substance use. Studies 3-4 examine cross-sectional and longitudinal associations between substance use, SUD symptom severity, PTSD symptom severity, post-traumatic cognitions, and disordered eating, highlighting a possible underlying mechanism driving this comorbidity.

These four novel empirical studies significantly advance our understanding of the prevalence and patterns of comorbidity between SUD, ED, and PTSD, and lay the foundations for targeted and effective prevention and intervention strategies that will lessen the significant burden, harms, and costs associated with these disorders.