AN INVESTIGATION INTO THE INFLUENCE OF CHILDHOOD TRAUMA ON THE DEVELOPMENT OF EATING DISORDERS IN ADULTHOOD

CHAPTER ONE

INTRODUCTION

Background of the study

Childhood trauma is widely acknowledged as a critical risk factor for several detrimental psychological consequences, including the onset of eating disorders in adulthood (Smolak & Levine, 2015). Childhood trauma may include several adverse events, such as physical, emotional, or sexual abuse, neglect, and exposure to domestic violence. Experiences throughout crucial developmental phases may significantly impact an individual's mental health, often resulting in maladaptive coping mechanisms that emerge in adulthood (Brewerton, 2019). The association between childhood trauma and eating disorders is intricate, with data indicating that traumatic events may impair emotional regulation, self-concept, and interpersonal interactions, all of which contribute to disordered eating behaviours (Palmer et al., 2016). The incidence of eating disorders, such as anorexia nervosa, bulimia nervosa, and binge-eating disorder, has increased, impacting millions globally. Research indicates that as many as 70% of persons with eating disorders have a history of trauma (Trottier & MacDonald, 2017). These disorders are not solely food-related issues; they are marked by substantial disruptions in eating behaviours and a distorted body image, frequently linked with concurrent mental health conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD) (Mitchell et al., 2017). Eating disorders often emerge throughout adolescence or early adulthood, however their roots frequently stem from adverse childhood experiences (ACEs), indicating a developmental path shaped by early trauma (Kong & Bernstein, 2019). The connection between childhood trauma and eating disorders may be elucidated via many psychological and neurobiological pathways. Trauma may result in increased emotional dysregulation and compromised stress responses, prompting people to engage in maladaptive behaviours such as restricted eating, bingeing, or purging as coping mechanisms (Brewerton, 2019). Childhood trauma is neurobiologically linked to alterations in brain structure and function, especially in regions involved in emotional regulation, including the prefrontal cortex and amygdala (De Bellis & Zisk, 2014). These alterations may predispose people to engage in behaviours intended to regulate food consumption or body weight as a means of restoring a feeling of control diminished by trauma (Monteleone et al., 2018). Attachment theory elucidates the connection between trauma and eating problems. This hypothesis posits that persons with insecure attachments in infancy, resulting from abuse or neglect, may have challenges in emotional regulation and establishing stable relationships (Smolak & Levine, 2015). Eating disorders may arise as a means to cope with anxiety, guilt, and poor self-esteem resulting from altered attachment patterns (Palmer et al., 2016). The sociocultural milieu, which often glorifies thinness and stigmatises bigger body proportions, may intensify the effects of childhood trauma by promoting maladaptive behaviours concerning food and body image (Trottier & MacDonald, 2017). Although much evidence links childhood trauma with the onset of eating problems, current research reveals deficiencies that need attention. The impact of various trauma types (e.g., physical vs emotional abuse) on certain eating disorder subtypes is little investigated (Molendijk et al., 2017). Furthermore, the influence of protective variables, including social support and resilience, in alleviating the impact of trauma on the onset of eating disorders remains less comprehended (Brewerton, 2019). This requires a more detailed examination of how different trauma experiences influence the development of eating disorders in people and the possible therapies that may be used to mitigate their effects. Furthermore, the majority of research has been performed on Western populations, thus failing to capture the perspectives of people from varied cultural backgrounds. The cultural environment may affect the prevalence, manifestation, and coping strategies related to eating disorders, indicating a need for culturally sensitive research (Smolak & Levine, 2015). Comprehending these cultural disparities may provide insights for more effective, personalised therapy methodologies. Untreated eating disorders may lead to serious long-term repercussions, including heightened mortality risk, physical difficulties, and persistent mental health concerns (Mitchell et al., 2017). Therefore, integrating a trauma-informed methodology into eating disorder therapy is essential. Trauma-informed care acknowledges the influence of historical events on present behaviours and prioritises safety, empowerment, and cooperative treatment planning (Substance Abuse and Mental Health Services Administration [SAMHSA], 2015).  therefore, the researcher sought to influence of childhood trauma on the development of eating disorders in adulthood.

1.2 Statement of the problem 

Childhood trauma, characterised by negative events such as abuse, neglect, or familial dysfunction throughout developmental years, has been associated with several long-term psychological and physiological consequences, including the onset of eating disorders in adulthood (Dakanalis et al., 2015). Eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorder, are serious mental health problems marked by atypical eating behaviours and a skewed perception of body image. Studies demonstrate that persons with a history of childhood trauma are more susceptible to developing eating disorders, since such traumatic events may affect coping strategies, self-esteem, and emotional regulation (Molendijk, Hoek, Brewerton, & Elzinga, 2017). Despite the expanding literature on this topic, a consensus is lacking regarding the differential effects of specific trauma types on the development of eating disorders, as well as the mechanisms that connect these experiences to disordered eating patterns in later life (Monteleone, Cascino, & Treasure, 2018). It is important to address this problem, since eating disorders are linked to considerable physical and mental health repercussions, including heightened mortality risk, comorbid psychiatric diseases, and worse quality of life (Micali et al., 2017). Hence, the study influence of childhood trauma on the development of eating disorders in adulthood.

1.3 Objective of the study

The broad objective of the study is to investigate the influence of childhood trauma on the development of eating disorders in adulthood. The specific objectives is as follows

To examine the prevalence of childhood trauma among adults diagnosed with eating disorders.

To assess the impact of childhood trauma on the severity of eating disorders in affected individuals.

To explore the psychological mechanisms that mediate between childhood trauma and the onset of eating disorders in adulthood.

To explore the long-term mental health outcomes for adults with eating disorders who experienced childhood trauma

1.4 Research questions

The following questions have been prepared to guide the study

What is the prevalence of childhood trauma among adults diagnosed with eating disorders?

What is the impact of childhood trauma on the severity of eating disorders in affected individuals?

What are the psychological mechanisms that mediate between childhood trauma and the onset of eating disorders in adulthood?

What are the long-term mental health outcomes for adults with eating disorders who experienced childhood trauma?

1.5 Significance of the study

The findings of the study can inform policymakers and mental health advocates on the need for comprehensive support services that address childhood trauma and its long-term effects. This can lead to improved funding for mental health services, the inclusion of trauma-informed care in healthcare policies, and the implementation of programs aimed at preventing abuse and neglect.

 Findings of the study will also be significant to the academic community as it will contribute to existing literature, add to library resources and serve as a guide to future researchers.

1.6 Scope of the study

The study focus on the influence of childhood trauma on the development of eating disorders in adulthood. Empirically, the study will examine the prevalence of childhood trauma among adults diagnosed with eating disorders, assess the impact of childhood trauma on the severity of eating disorders in affected individuals, explore the psychological mechanisms that mediate between childhood trauma and the onset of eating disorders in adulthood and explore the long-term mental health outcomes for adults with eating disorders who experienced childhood trauma.

Geographically, the study will be delimited to students in the University of Ibadan.

1.7 Limitation of the study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint are: 

Time: The researcher encountered time constraint as the researcher had to carry out this research along side other academic activities such as attending lectures and other educational activities required of her.

Finance: The researcher incurred more financial expenses in carrying out this study such as typesetting, printing, sourcing for relevant materials, literature, or information and in the data collection process.

Availability of Materials: The researcher encountered challenges in sourcing for literature in this study. The scarcity of literature on the subject due to the nature of the discourse was a limitation to this study.

1.8 Definition of terms

Childhood Trauma: Refers to adverse experiences during childhood, such as physical, emotional, or sexual abuse, neglect, and household dysfunction, that can cause lasting psychological harm and increase the risk of mental health issues in later life .

Eating Disorders: A group of mental health conditions characterized by abnormal eating behaviors, intense fear of gaining weight, and distorted body image, which include anorexia nervosa, bulimia nervosa, and binge-eating disorder .

Anorexia Nervosa: An eating disorder characterized by a persistent restriction of energy intake, an intense fear of gaining weight, and a distorted perception of body weight or shape, leading to significantly low body weight (American Psychiatric Association.

Bulimia Nervosa: An eating disorder involving recurrent episodes of binge eating followed by inappropriate compensatory behaviors, such as vomiting, fasting, or excessive exercise, to prevent weight gain.

Binge-Eating Disorder: An eating disorder marked by recurrent episodes of eating large quantities of food, often rapidly and to the point of discomfort, without regular compensatory behaviors to counter the eating .

Emotional Regulation: The ability to manage and respond to emotional experiences in a healthy and adaptive way. Impaired emotional regulation is often observed in individuals with a history of trauma, potentially contributing to maladaptive coping mechanisms like disordered eating .

Trauma-Informed Care: An approach to treatment that recognizes the impact of past trauma on an individual's current behavior and emphasizes safety, empowerment, and collaboration in therapeutic interventions.

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