Childhood trauma as a predictor of eating psychopathology and its mediating variables in patients with eating disorders.

AIM: The aims of this study were to determine whether specific forms of childhood trauma predict eating psychopathologies and to investigate the mediating effects of the psychological symptoms of depression and obsessive-compulsion between childhood trauma and eating psychopathologies in patients with eating disorders.

BACKGROUND: The highest probability of poor treatment outcomes in patients with eating disorders has been observed in those who experienced childhood trauma. Therefore, researchers are now examining whether childhood trauma should be considered a risk factor for eating psychopathology, but childhood traumatic experiences as predictors of eating psychopathology and their mediating variables has not been investigated sufficiently with this clinical population.

DESIGN: Survey.

METHODS: The subjects were 73 Korean patients with eating disorders. The Childhood Trauma Questionnaire, Eating Disorder Inventory-2, Beck Depression Inventory and Maudsley Obsessional-Compulsive Inventory were used to assess self-reported childhood trauma in five domains (emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect), eating psychopathology, depression and obsessive-compulsion. Stepwise multiple regression analyses were used to explore whether these childhood traumatic experiences predict eating psychopathology and mediation analyses were conducted according to Baron and Kenny's guidelines.

RESULTS: Emotional abuse, physical neglect and sexual abuse were found to be significant predictors of eating psychopathology. We also found that depression fully mediated the association between some forms of childhood trauma and eating psychopathology, while obsessive-compulsion did not mediate this association.

CONCLUSIONS: Future interventions for patients with eating disorders should focus on assessing the possibility of childhood trauma, especially in those patients with poor treatment outcomes. In addition, whether or not traumatised individuals exhibit depression is a more important predictor of eating psychopathology than the traumatic experience itself.

RELEVANCE TO CLINICAL PRACTICE: Early intervention for childhood trauma and depression might contribute to preventing eating disorders in traumatised individuals.