Attachment insecurity mediates the relationship between childhood trauma and eating disorder psychopathology in a clinical sample: A structural equation model

ObjectivesChildhood maltreatment occurs often among those with an eating disorder and is considered a nonspecific risk factor. However, the mechanisms by which childhood maltreatment may lead to an eating disorder are not well understood. The current study tests a model in which attachment insecurity is hypothesized to mediate the relationship between childhood maltreatment and eating disorder psychopathology.MethodTreatment seeking adults with eating disorders (N = 308) completed questionnaires about childhood maltreatment, eating disorder psychopathology, and adult attachment.ResultsStructural equation models indicated that childhood trauma had a direct effect on eating disorder symptoms. Also, attachment anxiety and avoidance each equally mediated the childhood maltreatment to eating disorder psychopathology relationship.ConclusionsAttachment insecurity, characterized by affect dysregulation and interpersonal sensitivities may help to explain why eating disorder symptoms may be one consequence of childhood maltreatment in a clinical sample. Clinicians treating primarily those with trauma might assess for disordered eating as a potential manifestation of the sequelae of trauma and attachment insecurity.