The role of depression and dissociation in the relationship between childhood trauma and bulimic symptoms among ethnically diverse female undergraduates.

OBJECTIVE: The goals of this study were to examine the role of dissociation and depression as possible mediators of the relationship between several forms of childhood trauma and bulimic symptomatology and to explore potential ethnic differences in these relationships.

METHOD: Four hundred seventeen female undergraduates participated in this cross-sectional study. They completed measures of dissociative, depressive, and bulimic symptoms, and childhood trauma. Experiences of multiple forms of childhood trauma were measured, including physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect. However, only emotional abuse was correlated with bulimic symptoms at p<.01. Therefore, other forms of trauma were excluded from the analyses to control for Type I error.

RESULTS: Dissociation was not associated with emotional abuse after controlling for depression; therefore, tests of dissociation as a mediator were discontinued. Depression was significantly associated with emotional abuse after controlling for dissociation. Emotional abuse was significantly associated with bulimia. Finally, emotional abuse and depression together were significantly associated with bulimia after controlling for dissociation. However, emotional abuse became nonsignificant when entered with depression, indicating that depression mediated the relationship between emotional abuse and bulimic symptoms. There were no ethnic differences in this relationship.

CONCLUSIONS: It appears that among women who have experienced childhood emotional abuse, depression is more strongly associated with unhealthy eating behaviors than is dissociation. Results also suggest that emotional abuse is a form of childhood trauma particularly relevant to bulimia.