Female survivors of childhood trauma more likely to suffer from eating disorders as young adults

A study in Italy reported that female survivors of childhood trauma were more likely to experience failures in mentalizing and had a higher risk of developing eating disorders. Failures in mentalizing may mediate the association between childhood trauma and eating disorders. The research was published in Development and Psychopathology.

Childhood trauma refers to deeply distressing or disturbing experiences that occur during childhood and overwhelm a child’s ability to cope. These experiences can include physical, emotional, or sexual abuse, neglect, witnessing violence, or losing a caregiver. Trauma during critical developmental periods can have lasting effects on brain development, emotional regulation, and stress response systems.

Children who experience trauma may develop anxiety, depression, posttraumatic stress disorder, or behavioral issues. Psychological trauma can also impair cognitive functions such as attention, memory, and executive functioning. Early trauma increases the risk of health problems later in life, including substance abuse, chronic illness, and relationship difficulties. The effects vary depending on the severity and duration of the trauma and the support the child receives. Protective factors, such as strong caregiver relationships and early intervention, can buffer some of the negative impacts.

Study author Gianluca Santoro sought to investigate the relationship between childhood trauma, failures in mentalizing (observed as uncertainty about mental states), and the risk of eating disorders among young adult females. The researchers hypothesized that childhood trauma is positively associated with uncertainty about mental states and the risk of eating disorders. They also proposed that uncertainty about mental states mediates the relationship between childhood trauma and the risk of eating disorders.

The study included 409 Caucasian young adult females, with an average age of 23 years. Most participants had either a middle school or high school diploma. All were unmarried, but 91% reported being in a romantic relationship.

Participants completed assessments of childhood trauma (the Childhood Trauma Questionnaire – Short Form), difficulties in mentalizing abilities (the Reflective Functioning Questionnaire), and symptoms and psychological features related to eating disorders (the Eating Disorder Inventory-3). Difficulties in mentalizing refer to challenges in understanding and interpreting one’s own and others’ mental states. This can manifest as uncertainty about thoughts and feelings or excessive certainty that oversimplifies complex mental processes.

Results indicated that participants with a higher body mass index tended to report more symptoms of eating disorders. Greater severity of eating disorder symptoms was also linked to increased uncertainty about mental states.

The researchers tested a statistical model proposing that childhood trauma increases uncertainty about mental states (i.e., difficulties in mentalizing), which in turn increases the risk of eating disorders (i.e., eating disorder symptoms). The findings indicated that such a mediation pathway is possible, but it does not fully explain the link between childhood trauma and eating disorder risk.

“These findings suggest that ED [eating disorder] symptoms might result from unprocessed and painful feelings embedded in child abuse and neglect. Clinical interventions focused at improving mentalizing abilities might reduce the ED risk among young adult females who have been exposed to childhood trauma,” the study authors concluded.

The study sheds light on the links between childhood trauma and eating disorders. However, it should be noted that all data in this study came from self-reports leaving room for reporting bias to have affected the results. Additionally, the design of the study does not allow any causal inferences to be derived from the results.

The paper, “Childhood trauma and eating disorder risk among young adult females: The mediating role of mentalization,” was authored by Gianluca Santoro, Marco Cannavò, Adriano Schimmenti, and Nadia Barberis.