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Psychological and clinical associations of adverse childhood experiences in Chinese patients with eating disorders
The relationship between adverse childhood experiences (ACEs) and eating disorders (EDs) is critical, given the severe mental health implications associated with EDs. While ACEs are known risk factors for these conditions, their precise effects across various types of EDs and the psychological mechanisms involved remain underexplored.
This cross-sectional research, conducted between 2008 and 2015, involved 970 outpatients diagnosed with eating disorders (919 of whom were female). Participants were evaluated using the Eating Disorder Questionnaire to assess clinical behaviors and the Eating Disorder Inventory-1 for psychological traits. Advanced statistical techniques such as factorial ANOVA, Lasso regression, and mediation analysis were employed to identify the role of ACEs and different diagnostic subtypes, as well as the mediating effects of psychological characteristics.
Findings revealed that ACEs were nominally linked to various clinical behaviors, with the most significant associations found in binge eating, laxative use, and age at onset, particularly after adjustments were made. Notably, childhood emotional abuse had the greatest influence on psychological traits. The study also established that a higher cumulative number of ACEs was associated with greater severity of psychological traits and higher rates of clinical behaviors. Mediation analyses indicated that specific psychological characteristics played a significant role in mediating the relationship between ACEs and ED behaviors. For instance, the trait of ineffectiveness accounted for a mediation proportion of 0.481, while ‘criticism and blame‘ and ‘abandonment threats‘ had mediation proportions of 0.629 and 0.601, respectively, in relation to binge eating.
In conclusion, childhood emotional abuse and the accumulation of ACEs strongly correlated with exacerbated psychological traits and clinical behaviors associated with eating disorders. The results underscore the importance of incorporating routine assessments of ACEs and adopting trauma-informed strategies aimed at addressing psychological vulnerabilities in the treatment of EDs. [NPID: Eating disorders, psychological traits, emotional abuse, ACE]
Year: 2026
