The present study examined the relationship of child maltreatment to both emotion dysregulation and subsequent eating pathology. In an effort to extend previous research, the authors examined the unique impact of childhood emotional abuse (CEA) on emotion dysregulation and eating disorder (ED) symptoms while controlling for the effects of sexual and physical abuse. Structural equation modeling was utilized to simultaneously examine the effects of all three abuse types on multiple dependent variables as well as examine whether deficits in emotion regulation mediated the relationship between abuse and eating pathology. Results from a survey of 1,254 female college students revealed significant paths from abuse subtypes to specific eating disorder symptoms, with CEA evidencing the strongest association with ED symptoms. Additionally, emotion dysregulation was positively associated with ED symptoms, and mediated the effects of emotional abuse on symptoms. Findings support previous research on the enduring effects of emotional abuse as well as highlight the importance of the assessment of CEA in the treatment of ED symptoms.
Child abuse, specifically child sexual abuse (CSA), has been identified as a non-specific risk factor for the development of eating disorder (ED) symptoms. Elevated rates of child abuse have consistently been identified in ED samples (Jacobi et al., 2004, Romans et al., 2001, Thompson and Wonderlich, 2004 and Wonderlich et al., 2000), particularly in individuals with Bulimia Nervosa according to a recent meta-analysis (Smolak & Murnen, 2002). Although a recent study found that childhood physical abuse (CPA) in addition to CSA independently contributed to increased risk for ED among women (Gentile, Raghavan, Rajah, & Gates, 2007), few studies have considered the contribution of childhood emotional abuse (CEA), also referred to as psychological abuse, on the development of ED behavior among young adults.
The exclusion of CEA from ED research is likely a direct result of the larger child maltreatment literature's historical practice of focusing almost exclusively on the consequences of sexual and physical abuse. Still, recent research has provided compelling evidence that emotional abuse is associated with negative developmental outcomes in early childhood (Engeland, 2009, Shaffer et al., 2009 and Yates and Wekerle, 2009) in addition to having an enduring impact on psychopathology in adulthood (Briere and Runtz, 1990, Grilo and Masheb, 2001, Hankin, 2005 and Spertus et al., 2003). More recently, preliminary evidence suggests that CEA is linked to ED behavior, with an initial study reporting that a sample of bulimic women endorsed higher rates of emotional (termed psychological), physical, and multiple abuse than the control group (Rorty, Yager, & Rossotto, 1994). Elevated rates of emotional abuse have also been found in samples of women with obesity and binge eating symptoms (Grilo and Masheb, 2001 and Grilo et al., 2005). Although there is preliminary support for the association between emotional abuse and later eating pathology, this research has primarily been descriptive in nature. Further, possible mechanisms by which CEA may elicit subsequent ED symptoms have not been articulated.
