The interplay between childhood maltreatment and eating disorder psychopathology: an hybryd model combining network and mediation analyses.

Introduction: Childhood maltreatment (CM) is identified as a non-specific risk factor for Eating Disorders (EDs), although the mechanisms underlying this relationship have not been completely explored. Objectives: We aim to investigate the psychological pathways involved in the association between CM experiences and ED core symptoms. Methods: We recruited 228 people with EDs, 94 with anorexia nervosa restricting (ANR) type and 134 with binge-purging (BP) symptoms. Each participant filled in the Eating Disorder Inventory-2, the State-Trait Anxiety Inventory and the Childhood Trauma Questionnaire. These variables were included in a network analysis to define the shortest pathways betweenCMnodes and ED core symptoms. Mediation analyses were conducted to confirm the mediation role of the nodes included in the shortest pathways between CM and ED core symptoms. Results: Each CM experience was connected to the ED psychopathology via emotional abuse. In the ANR group, interoceptive awareness was in the shortest route between emotional abuse and drive to thinness and mediated this association. In the BP group, the same role was identified for ineffectiveness and interoceptive awareness. Conclusions: We built a possible hybrid model which suggests that each CM type may promote ED psychopathology through the mediation effect of emotional abuse, interoceptive awareness and ineffectiveness. These variables may represent clinical target to pursue in treatments for people with EDs and early adverse experience exposure. [ABSTRACT FROM AUTHOR]