From Childhood Emotional Maltreatment to Disordered Eating: A Path Analysis

Childhood emotional maltreatment (i.e., emotional abuse and emotional neglect), attachment, reflective functioning (RF), defense styles, and disordered eating (DE) are associated with each other. However, no study has yet investigated all these variables simultaneously. The present study aimed to test the mediating role of attachment, RF, and defense styles in the relationship between childhood emotional abuse and neglect and DE. Self-report questionnaires were completed by 769 Italian adults (48.1% females; mean age = 28.89; SD = 7.28). DE, childhood emotional abuse and neglect, attachment (anxiety and avoidance), RF, and defense styles were assessed. Bivariate correlations and path analysis were run separately for males and females. We found significant indirect effects between emotional abuse and neglect and DE via attachment insecurities (anxiety and avoidance), low RF, and neurotic and immature defense styles in females. In addition, neurotic and immature defense styles and RF mediated the relationship between emotional neglect, attachment anxiety, and DE, in males. The findings supported the hypothesized model of risk factors for DE and provided additional insight into mechanisms underlying the relationship between childhood emotional maltreatment and DE. Prevention and intervention programs should be targeted at improving attachment security, defensive functioning maturity, and RF in people with a history of childhood emotional maltreatment. 儿童期的情感虐待(即情感虐待和情感忽视)、依恋、反思功能(RF)、防御方式和进食障碍(DE)是相互关联的。然而,还没有同时调查所有这些变量的研究。本研究旨在测试依恋、RF和防御方式在儿童期情感虐待和忽视与DE之间关系中的调节作用。769名意大利成年人(48.1%为女性;平均年龄=28.89岁; SD = 7.28)完成了自我报告的调查问卷。对DE、儿童期情感虐待和忽视、依恋(焦虑和回避)、低RF和防御方式进行了评估。男性和女性的双变量相关性和路径分析分别进行。我们发现在女性中,情感虐待和忽视与DE之间存在显著的间接影响,通过不安全依恋(焦虑和回避)、低RF以及神经症的和不成熟防御方式。此外,在男性中,神经症的和不成熟的防御方式和RF调解了情感忽视、依恋焦虑和DE之间的关系。研究结果支持了DE危险因素的假设模型,并为儿童期情感虐待与DE之间关系的机制提供了额外的见解。预防和干预计划应旨在改善有儿童期情感虐待史的人的依恋安全性、防御功能的成熟度和RF。