Childhood Maltreatment and Eating Disorders: A meta-analysis update

Childhood maltreatment (CM) is a public health issue affecting mental and physical well-being of individuals across the lifespan. The literature so far suggests that CM is a risk factor for the development and severity of EDs in adulthood. This study aims to build upon and update the findings of Molendijk et al. (2017) by integrating both pre-2016 and post-2016 literature on the relationship between all types of CM (physical, sexual, and emotional) and all types of EDs. A random-effects meta-analysis with moderator analyses was performed to assess the associations between all types of CM and all types of ED, focusing on their prevalence, severity, and related comorbid conditions. The prevalence of CM was consistently and significantly higher in ED patients (18.4- 57.7%) than in healthy controls (7.2-29.2%) and mostly higher compared to psychiatric controls (21.2 - 31.1%). The odds of developing EDs were significantly elevated in individuals exposed to CM, with ORs ranging from 2.81...Show moreChildhood maltreatment (CM) is a public health issue affecting mental and physical well-being of individuals across the lifespan. The literature so far suggests that CM is a risk factor for the development and severity of EDs in adulthood. This study aims to build upon and update the findings of Molendijk et al. (2017) by integrating both pre-2016 and post-2016 literature on the relationship between all types of CM (physical, sexual, and emotional) and all types of EDs. A random-effects meta-analysis with moderator analyses was performed to assess the associations between all types of CM and all types of ED, focusing on their prevalence, severity, and related comorbid conditions. The prevalence of CM was consistently and significantly higher in ED patients (18.4- 57.7%) than in healthy controls (7.2-29.2%) and mostly higher compared to psychiatric controls (21.2 - 31.1%). The odds of developing EDs were significantly elevated in individuals exposed to CM, with ORs ranging from 2.81 to 4.60. CM exposure was associated with greater severity of EDs (r = .21, 95% CI [0.10, 0.32], p < .001) and was also associated with higher levels of depression and anxiety (r = .19, 95% CI [0.11, 0.26], p < .001). Additionally, we found that CM exposure significantly increased the likelihood of comorbid mental health disorders in patients with EDs compared to non-exposed counterparts (ORs 1.15 to 3.96), with the strongest associations observed for Axis I disorders, especially depression and anxiety. Moderator analyses revealed that recent studies reported slightly higher CM prevalence in AN samples. Sample size influenced the sexual CM-BED relationship (R2 =0.42, p =.04), and higher study quality was linked to lower prevalence rates (R2 = 0.07, p < .001), though these factors explained only a small part of the heterogeneity. Our findings highlight that all types of childhood maltreatment (physical, sexual, and emotional) are associated with a range of EDs in adulthood and influence both the severity and course of EDs.Show less

Leiden University Student Repository

Documents

In Collections

Childhood Maltreatment and Eating Disorders: A meta-analysis update