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

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity volume 25, pages 577–589 (2020)Cite this article

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgements

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

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Affiliations

  1. Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie, 80138, Naples, Italy

    Alessio Maria Monteleone, Valeria Ruzzi, Giuseppina Patriciello, Francesca Pellegrino, Luca Steardo Jr. & Mario Maj

  2. Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, Section of Neurosciences, University of Salerno, Salerno, Italy

    Giammarco Cascino & Palmiero Monteleone

  3. Psychiatric Unit, Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy

    Giovanni Castellini

Authors
  1. Alessio Maria Monteleone
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  2. Valeria Ruzzi
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  4. Francesca Pellegrino
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  5. Giammarco Cascino
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Correspondence to Alessio Maria Monteleone.

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Monteleone, A.M., Ruzzi, V., Patriciello, G. et al. Parental bonding, childhood maltreatment and eating disorder psychopathology: an investigation of their interactions. Eat Weight Disord 25, 577–589 (2020). https://doi.org/10.1007/s40519-019-00649-0

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Keywords

  • Attachment
  • Parenting style
  • Childhood abuse
  • Eating disorders
  • Social insecurity