Clinical deterioration after revisiting childhood sexual abuse during psychotherapy for restrictive anorexia nervosa: a case report.
- 1Pediatric Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
Abstract
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. 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. 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.
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BibTeX
@article{cirillo2026clinical,
title = {{Clinical deterioration after revisiting childhood sexual abuse during psychotherapy for restrictive anorexia nervosa: a case report.}},
author = {Flavia Cirillo and Elena Bozzola and Giulia Spina and Mariangela Irrera and Alessandra Marchesi and Rosaria Marotta and Maria Rosaria Marchili},
journal = {Frontiers in pediatrics},
year = {2026},
month = oct,
doi = {10.3389/fped.2026.1958194},
url = {https://europepmc.org/article/MED/42952856},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical deterioration after revisiting childhood sexual abuse during psychotherapy for restrictive anorexia nervosa: a case report.
AU - Flavia Cirillo
AU - Elena Bozzola
AU - Giulia Spina
AU - Mariangela Irrera
AU - Alessandra Marchesi
AU - Rosaria Marotta
AU - Maria Rosaria Marchili
PY - 2026
DA - 2026/10/14
JO - Frontiers in pediatrics
DO - 10.3389/fped.2026.1958194
UR - https://europepmc.org/article/MED/42952856
AB - 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. 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. 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.
SN - 2296-2360
ER -