title: Emotion dysregulation and anorexia nervosa: an exploration of the role of childhood abuse.
abstract: OBJECTIVE
  Theoretical models of emotion regulation difficulties in anorexia nervosa (AN) specify a role for factors that predispose to or precipitate emotion dysregulation. The current study considered whether childhood abuse (i.e., emotional, sexual, physical) might be related to emotion regulation difficulties and eating disorder symptom severity in patients with AN. Childhood abuse was hypothesized to relate to AN symptoms indirectly via emotion dysregulation.
  
  
  METHODS
  Participants were 188 patients with AN presenting to an intensive treatment facility. The Childhood Trauma Questionnaire, Difficulties in Emotion Regulation Scale, and Eating Disorder Examination were used to assess childhood abuse, emotion dysregulation, and AN symptom severity, respectively.
  
  
  RESULTS
  Of the three forms of childhood abuse, reports of emotional abuse were most strongly related to emotion regulation difficulties and AN symptom severity. Mediation analyses revealed that emotion dysregulation significantly explained the relationship between childhood emotional abuse and AN symptomatology, and mediation effects did not differ by AN subtype (i.e., restricting vs. binge-eating/purging).
  
  
  CONCLUSIONS
  Findings provide initial support for a model in which childhood emotional abuse precipitates emotion dysregulation and the development of AN. Future studies with longitudinal designs and control groups are necessary to examine the direction and specificity of these cross-sectional associations
authors.affiliation: Department of Psychology, Ohio University, Athens, Ohio; Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Racine
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Wildes
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000209:etiology / Q000523:psychology*; D002032:Bulimia / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000523:psychology*; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: anorexia nervosa; childhood abuse; emotion dysregulation; emotional abuse; mediation