Childhood emotional abuse and disordered eating among undergraduate females: mediating influence of alexithymia and distress

Child Abuse Negl. 2006 Apr;30(4):393-407. doi: 10.1016/j.chiabu.2005.11.003. Epub 2006 Apr 5.


Objective: Drawing from stress-vulnerability and trauma theory (e.g., Rorty & Yager, 1996), this paper presents a model of associations among child emotional abuse (CEA), alexithymia, general distress (GD), and disordered eating (DE). This study extended previous research on psychological outcomes of child physical and sexual abuse to explore those of CEA using measures of specific emotionally abusive acts.

Method: Five hundred and eighty-eight female university students completed self-report surveys consisting of measures of CEA, alexithymia, depression, anxiety, and DE. Structural equation modeling was used to test this conceptual model.

Results: Comparison between measurement models suggested that bulimic behavior is a separate construct from restrictive eating behaviors and body dissatisfaction. In the structural model with the best fit, the association between CEA and DE was mediated by alexithymia and GD (i.e., a component of depression and anxiety). Specifically, CEA was associated with alexithymia, which was further related to GD. Then, restrictive eating behaviors and attitudes mediated the relation between GD and bulimic behaviors. By analyzing a second, nested model, this latter pathway was shown to be important.

Conclusion: While the best-fitting model is only one of many possibilities, these results point to a weak-but significant-complex relation between CEA and DE. They are associated through a series of mediating relations in a multivariate model including alexithymia and GD. The current study supports research suggesting that child emotional abuse can have a negative impact on its survivors. Treatment of those survivors manifesting disordered eating should be holistic, as opposed to targeted towards specific symptoms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affective Symptoms / diagnosis
  • Affective Symptoms / epidemiology*
  • Affective Symptoms / psychology
  • Body Mass Index
  • Child
  • Child Abuse / psychology
  • Child Abuse / statistics & numerical data*
  • Demography
  • Depression / diagnosis
  • Depression / epidemiology*
  • Depression / psychology
  • Feeding and Eating Disorders / epidemiology*
  • Female
  • Humans
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / etiology
  • Surveys and Questionnaires