Ziobrowski, H. N., Buka, S. L., Austin, S. B., Duncan, A. E., Simone, M., Sullivan, A. J., Horton, N. J. & Field, A. E. (2021). Child and adolescent maltreatment patterns and risk of eating disorder behaviors developing in young adulthood. Child Abuse & Neglect, 120, 105225.
What we know
Eating disorders usually develop in adolescence and young adulthood. Disordered eating or unhealthy methods of controlling weight are common experiences in this age group and may involve binge eating or purging. People who engage in disordered eating are more likely to experience poor mental and physical health later in life. Experiencing child abuse or neglect may be a risk factor for later disordered eating to cope with trauma. Alternatively, chronic stress may have an impact on an individual’s emotion regulation or stress response, leading to more disordered eating. Previous research has been limited to studying individuals–almost all female–in a treatment setting, and not at a wider population level.
What this study adds
Using a series of national surveys, the study measured the likelihood of eating disordered behaviors for adults with a history of child maltreatment. People who had reported abuse in childhood or adolescence had a greater risk of later disordered eating, especially purging. The risk was even higher for those who had experienced multiple forms of abuse or long-term abuse. The results were true for men and women. Women who had gone through sexual abuse had even higher risks, while men with physical or emotional abuse during their childhood and adolescence had higher risks.
What this means for practice or policy
Clinicians working with adults with a history of child maltreatment, particularly those who experienced multiple forms of abuse or over a long period of time, may want to screen disordered eating behaviors. This population may also benefit from efforts to prevent eating disorders and disordered eating. Adults with disordered eating and a history of child maltreatment may also benefit from trauma-informed care.
How we know this is a good study
The authors used data from the Growing Up Today Study (GUTS), a national survey that included 7,010 participants. GUTS is a longitudinal study, which means that children who first took the survey in 1996 have taken similar surveys almost every year since. The benefit of a longitudinal study is that researchers can see how individuals with certain characteristics in childhood (such as a history of abuse) may later experience certain health outcomes (like disordered eating). The authors divided participants into groups based on their responses about maltreatment in childhood and adolescence. They then examined the risk for disordered eating in young adulthood for each group.
The GUTS survey had certain limitations. It did not ask about neglect as a form of maltreatment, or about any other eating behaviors beyond binging and purging. Additionally, 95% of the participants were white, meaning the results may not be generalizable to a non-White population.