Parental bonding, childhood maltreatment and eating disorder psychopathology: an investigation of their interactions

  • Alessio Maria MonteleoneEmail author
  • Valeria Ruzzi
  • Giuseppina Patriciello
  • Francesca Pellegrino
  • Giammarco Cascino
  • Giovanni Castellini
  • Luca SteardoJr.
  • Palmiero Monteleone
  • Mario Maj
Original Article



Childhood trauma and parental bonding have been widely recognized as risk factors for eating disorders (EDs). However, their interplay in determining ED psychopathology has been poorly investigated. Consequently, we have assessed their interaction with core ED psychopathological symptoms.


Fifty-seven patients with anorexia nervosa, 43 with bulimia nervosa and 77 healthy women completed the Childhood Trauma Questionnaire, the Parental Bonding Instrument and the Eating Disorder Inventory-2. Chi square test and regression analyses with a moderation model were performed to investigate the interplay between childhood trauma, parental bonding and ED symptoms such as ineffectiveness, social insecurity, drive to thinness, interoceptive awareness, impulsivity and perfectionism.


Compared to controls, patients with EDs showed higher levels of trauma and parental control perception and lower levels of parental care. Childhood maltreatment was more prevalent in patients with the affectionless control parental style. Moderation analyses revealed that higher maternal control significantly predicted the ED symptom of social insecurity only when participants experienced lower levels of emotional abuse.


These findings demonstrate an interplay between deranged problematic parental bonding and childhood trauma in promoting a possible vulnerability to social insecurity, one of the most central dimensions of ED psychopathology. This interaction might have psychotherapeutic implications.

Level of evidence

Level V, cross-sectional descriptive study.


Attachment Parenting style Childhood abuse Eating disorders Social insecurity 



This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Alessio Maria Monteleone
    • 1
    Email author
  • Valeria Ruzzi
    • 1
  • Giuseppina Patriciello
    • 1
  • Francesca Pellegrino
    • 1
  • Giammarco Cascino
    • 2
  • Giovanni Castellini
    • 3
  • Luca SteardoJr.
    • 1
  • Palmiero Monteleone
    • 2
  • Mario Maj
    • 1
  1. 1.Department of PsychiatryUniversity of Campania “Luigi Vanvitelli”NaplesItaly
  2. 2.Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, Section of NeurosciencesUniversity of SalernoSalernoItaly
  3. 3.Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child HealthUniversity of FlorenceFlorenceItaly

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