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Child Abuse Negl. 2013 Nov;37(11):926-33. doi: 10.1016/j.chiabu.2013.03.004. Epub 2013 Apr 25.

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

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  • 1University of Ottawa, Canada; The Ottawa Hospital, Canada; Carleton University, Canada.



Childhood 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.


Treatment seeking adults with eating disorders (N=308) completed questionnaires about childhood maltreatment, eating disorder psychopathology, and adult attachment.


Structural 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.


Attachment 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.

Copyright © 2013 Elsevier Ltd. All rights reserved.


Attachment; Child abuse and trauma scale; Childhood maltreatment; Eating disorders; Structural equation modeling; Trauma

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