Work

Clinical deterioration after revisiting childhood sexual abuse during psychotherapy for restrictive anorexia nervosa: a case report

Year: 2026

Type: article

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.

Source: Frontiers in Pediatrics

DOI: 10.3389/fped.2026.1958194