Etiological Role of Childhood Emotional Trauma and Neglect in Adolescent Anorexia Nervosa: A Cross-Sectional Questionnaire Analysis

Abstract

Background: Most studies on the relationship between childhood trauma and anorexia nervosa (AN) have focused on the role of childhood sexual and physical trauma in adult patients. Little is known about the role of emotional trauma and eating disorders. The aim of the present study was to examine childhood sexual, physical, and emotional traumatization in adolescents with anorexia nervosa restricting type (AN-R) in comparison to those with anorexia nervosa binge-eating/purging type (AN-BP) and a healthy control group. Sampling and Methods: The sample included 50 patients with AN-R (mean age = 15.8 ± 1.6 years), 27 with AN-BP (mean age = 16.1 ± 1.1 years), and 44 healthy female control participants (mean age = 15.7 ± 1.3 years). AN diagnosis was confirmed by the Structured Inventory for Anorexic and Bulimic Syndromes (SIAB-EX). Childhood sexual, physical, and emotional traumatization was assessed by a self-report questionnaire (Childhood Trauma Questionnaire; CTQ). Results: The results indicated higher rates of sexual, physical, and emotional abuse and physical and emotional neglect in patients with AN-BP than in patients with AN-R and healthy control participants. No significant differences in childhood traumatization were found between patients with AN-R and control participants. Conclusions: Our results underline the importance of detecting the full range of possible childhood traumatic experiences in adolescents with AN, rather than focusing simply on childhood sexual traumatization. Sexual, physical, and emotional childhood traumatization are particularly important in the history of adolescent patients with AN-BP, in contrast to patients with AN-R, and should be screened for in the diagnosis and therapy of eating disorders.

Disorder‐specific attachment characteristics and experiences of childhood abuse and neglect in adolescents with anorexia nervosa and a major depressive episode

“…Studies showed that patients with ED often report interpersonal trauma and adverse childhood circumstances including emotional abuse, parental mental health problems, or divorce (Lejonclou et al, 2014). In patients with BN, AN binge-eating/purging type, or BED, researchers also found higher rates of sexual trauma, but in line with our findings, this is not reported in patients with AN restrictive type (Brewerton, 2007;Jaite et al, 2012). Yet our findings reveal that, compared with adolescents with MDE, patients with AN reached higher scores on the minimization/denial scale, especially on questions regarding family issues.…”

“…Recently published studies demonstrated that patients with an eating disorder (ED) often report emotional abuse, mental health problems in parents, or parental divorce during their upbringing (Lejonclou, Nilsson, & Holmqvist, ; Maxwell et al, ). It is also suggested that sexual trauma is related more often to bulimia nervosa (BN) or AN binge‐eating/purging type, than to AN, restrictive type (AN‐R; Brewerton, ; Jaite et al, ). Even though theorists propose that sexual and physical traumatization represent non‐specific risk factors (Lejonclou et al, ), clinicians often face histories of various abusive experiences in their patients with ED.…”

“…than to AN, restrictive type (AN-R; Brewerton, 2007;Jaite et al, 2012). Even though theorists propose that sexual and physical traumatization represent non-specific risk factors (Lejonclou et al, 2014), clinicians often face histories of various abusive experiences in their patients with ED.…”

Childhood trauma and cortisol awakening response in symptomatic patients with anorexia nervosa and bulimia nervosa

“…17 We recently reported an increased CAR in adult patients with symptomatic AN but not in patients with BN. 20,21 Therefore, in the present exploratory study, we examined possible associations between childhood traumatic experiences and HPA-axis functioning in adult patients with AN or BN and in healthy adult women. This area seems worthy of investigation, because patients with EDs report childhood trauma experiences more frequently than matched healthy controls.…”

“…This area seems worthy of investigation, because patients with EDs report childhood trauma experiences more frequently than matched healthy controls. 20,21 Therefore, in the present exploratory study, we examined possible associations between childhood traumatic experiences and HPA-axis functioning in adult patients with AN or BN and in healthy adult women. We hypothesized that adult patients with AN and adult patients with BN who were exposed to early traumatic experiences would have a different CAR from adult ED patients without childhood trauma exposure.…”