The Correlation Between Anorexia Nervosa and Childhood Traumatic Experience: the Mediating Role of Impulsivity

Background The pathogenesis of anorexia nervosa (AN) involves multiple factors, among which childhood traumatic experience has attracted attention. It may affect AN by influencing emotional regulation and impulsivity. However, relevant research has rarely been conducted in China. The purpose of this study is to compare differences in childhood traumatic experience of patients with different subtypes of AN, and explore the correlation between AN and childhood traumatic experience, as well as elucidating the mediating role of impulsivity between emotional abuse in childhood traumatic experience and disease severity. Methods This study included 164 patients with AN, including 76 with the restricting type (AN-R) and 81 with the binge-eating/purging type (AN-BP), as well as 124 matched healthy controls (HC). Childhood traumatic experience was evaluated using Early Trauma Inventory-short form (ETI-SF), impulsivity assessed by Barratt Impulsiveness Scale 11th Version (BIS-11), and clinical symptoms via Eating Disorder Examination-questionnaire (EDE-Q 6.0), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Furthermore, inter-group differences in childhood traumatic experience were determined by one-way analysis of variance, the correlation between childhood traumatic experience and AN by Pearson correlation analysis, and the mediating role of impulsivity between emotional abuse and disease severity was clarified by the Bootstrap method. Results Cases in the AN-BP group had significantly higher exposure to childhood traumatic experience compared with the AN-R and HC groups (both p  < 0.05). Childhood traumatic experience was positively correlated with AN impulsivity and disease severity (both p  < 0.05), and emotional abuse in childhood traumatic experience was obviously positively correlated with AN impulsivity and disease severity (both p  < 0.05). In addition, the mediation effect of impulsivity between emotional abuse and disease severity was 0.073 (95% CI 0.013 ~ 0.153), with an effect proportion of 19.363%. Conclusion AN-BP patients have more significant childhood traumatic experience than AN-R patients. Childhood traumatic experience, especially emotional abuse, has established correlation with impulsivity and disease severity in AN, with impulsivity playing a mediating role between emotional abuse and disease severity.