Childhood maltreatment, posttraumatic  stress disorder symptomatology and eating disorder symptomatology: The mediating effects of inhibitory and prospective intolerance of uncertainty

Background: Childhood maltreatment is a serious issue, leading to posttraumatic stress disorder (PTSD) and eating disorder (ED) symptoms. A proposed mediator is intolerance of uncertainty (IU), composed of inhibitory and prospective IU, which are differentially related to different symptom profiles. Preliminary research shows that inhibitory IU is associated with PTSD symptoms, while prospective IU with ED symptoms. However, these mechanisms have been scarcely studied, and even less so in relation to childhood maltreatment, which the current study aims to do. Methods: This cross-sectional, self-report study used a non-clinical community sample (N = 413), to assess whether inhibitory and prospective IU differentially mediate childhood maltreatment, PTSD and ED symptoms using scores on IUS-12, CTQ-SF, PCL-5, and EDEQ-SF. Two mediation analyses were done with childhood maltreatment as predictor, inhibitory and prospective IU as parallel mediators and PTSD, respectively ED symptoms as...Show moreBackground: Childhood maltreatment is a serious issue, leading to posttraumatic stress disorder (PTSD) and eating disorder (ED) symptoms. A proposed mediator is intolerance of uncertainty (IU), composed of inhibitory and prospective IU, which are differentially related to different symptom profiles. Preliminary research shows that inhibitory IU is associated with PTSD symptoms, while prospective IU with ED symptoms. However, these mechanisms have been scarcely studied, and even less so in relation to childhood maltreatment, which the current study aims to do. Methods: This cross-sectional, self-report study used a non-clinical community sample (N = 413), to assess whether inhibitory and prospective IU differentially mediate childhood maltreatment, PTSD and ED symptoms using scores on IUS-12, CTQ-SF, PCL-5, and EDEQ-SF. Two mediation analyses were done with childhood maltreatment as predictor, inhibitory and prospective IU as parallel mediators and PTSD, respectively ED symptoms as outcomes. Results: Childhood maltreatment was significantly positively associated with PTSD and ED symptoms, and both inhibitory and prospective IU. Only inhibitory IU was further significantly positively associated with PTSD and ED symptoms. Thus, inhibitory IU is a partial mediator between childhood maltreatment and both PTSD and ED symptoms, while prospective IU is not, partly supporting our hypotheses. Conclusion: Histories of childhood maltreatment facilitate an attentional bias to threat and fear of uncertainty. Trauma-related symptoms are alleviated through cognitive avoidance and the fear of uncertainty leads to action paralysis. PTSD and ED symptoms therefore develop and are maintained through inhibitory IU. Clinical interventions should tackle this aspect of IU in maltreated populations.Show less

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Childhood maltreatment, posttraumatic stress disorder symptomatology and eating disorder symptomatology: The mediating effects of inhibitory and prospective intolerance of uncertainty