AccScience Publishing / JCBP / Online First / DOI: 10.36922/jcbp.4662
ORIGINAL RESEARCH ARTICLE

Involvement of adverse life events in body image distortion in a patient with eating disorders

Ester Idini1* Pamela Paredes-Carreño2 Mayte Navarro-Gil3 Alberto Barceló-Soler3,4 Marina Niubó-Cuadras5 Javier Garcia-Campayo6
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1 Department of Psychiatric, University Reina Sofia Hospital, Cordoba, Andalucia, Spain
2 Department of Psychiatric, Reina Sofia Hospital. Tudela, Navarra, Spain
3 Department of Psychology and Sociology, University of Zaragoza, Aragón, Spain
4 Department of Psychology and Sociology, Aragón Institute for Health Research (IIS Aragón), Zaragoza, Aragón, Spain
5 Day Hospital, Psychotherapeutic Center (CPB), Barcelona, Cataluña, Spain
6 Department of Psichiatry, University of Zaragoza, Spain
Submitted: 27 August 2024 | Accepted: 8 October 2024 | Published: 11 November 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Adverse life events (ALEs), particularly interpersonal ALEs and those experienced during childhood are associated with adult psychopathology. Altered eating behaviors and body image distortion (BID) have been reported in maltreated children. This study aimed to evaluate the presence of interpersonal ALEs before the age of 13 years in patients with eating disorders (ED) and clarify its relationship with BID. This observational case–control study comprised the ED group, including 79 outpatients with ED, and two control groups, including 20 outpatients with depressive disorder and 41 participants with no history of mental illness. The presence of ALEs was determined using the Traumatic Events Questionnaire. To assess BID, the contouring drawing rate scale was used, and visual BID was distinguished from non-visual BID. Data were collected and processed using Statistical Package for Social Sciences v28. All tests were two-tailed (significance level of 0.05). Patients with ED had a higher proportion of interpersonal ALEs during childhood (P = 0.065). In the ED group, patients with interpersonal ALEs during childhood overestimated their shape (P = 0.021). The non-visual BID was significantly higher in patients with childhood ALEs. In a logistic regression model, the presence of interpersonal ALEs during childhood as an independent variable predicted visual and non-visual BID in patients with ED. During the estimation of body shape, it appears that the negative emotions experienced during childhood are shifted to the body shape itself. Thus, the BID experienced is attributed more to the unresolved emotions of the maltreated individuals than to the social pressures experienced.

Keywords
Body image
Adverse life events
Childhood abuse
Eating disorders
Perfectionism
Funding
None.
Conflict of interest
The authors declare that they have no competing interests. The authors alone are responsible for the content and writing of the paper.
References
  1. Treasure J, Duarte TA, Schmidt U. Eating disorders. Lancet. 2020;395(10227):899-911. doi: 10.1016/S0140-6736(20)30059-3

 

  1. Keel PK, Brown TA. Update on course and outcome in eating disorders. Int J Eat Disord. 2010;43(3):195-204. doi: 10.1002/eat.20810

 

  1. Guillaume S, Jaussent I, Maimoun L, et al. Associations between adverse childhood experiences and clinical characteristics of eating disorders. Sci Rep. 2016;6:35761. doi: 10.1038/srep35761

 

  1. Kjaersdam Telléus G, Lauritsen MB, Rodrigo-Domingo M. Prevalence of various traumatic events including sexual trauma in a clinical sample of patients with an eating disorder. Front Psychol. 2021;12:687452. doi: 10.3389/fpsyg.2021.687452

 

  1. Backholm K, Isomaa R, Birgegård A. The prevalence and impact of trauma history in eating disorder patients. Eur J Psychotraumatol. 2013;22482-9:4. doi: 10.3402/ejpt.v4i0.22482

 

  1. Lejonclou A, Nilsson D, Holmqvist R. Variants of potentially traumatizing life events in eating disorder patients. Psychol Trauma Theory Res Pract Policy. 2014;6(6):661-667. doi: 10.1037/a0034926

 

  1. Molendijk ML, Hoek HW, Brewerton TD, Elzinga BM. Childhood maltreatment and eating disorder pathology: A systematic review and dose-response meta-analysis. Psychol Med. 2017;47(8):1402-1416. doi: 10.1017/S0033291716003561

 

  1. Russotti J, Warmingham JM, Duprey EB, et al. Child maltreatment and the development of psychopathology: The role of developmental timing and chronicity. Child Abuse Negl. 2021;120:105215. doi: 10.1016/j.chiabu.2021.105215

 

  1. World Health Organization. Global Status Report on Preventing Violence Against Children 2020; 2021. Available from: https://apps.who.int/iris/bitstream/han dle/10665/332394/9789240004191-eng.pdf [Last accessed on 2022 May 20]

 

  1. Thomas EA, Owens GP, Keller EM. Relationships among non-interpersonal and interpersonal trauma types, posttraumatic stress, and posttraumatic growth. J Clin Psychol. 2021;77(11):2592-2608. doi: 10.1002/jclp.23190

 

  1. Quick VM, Byrd-Bredbenner C. Disordered eating, socio-cultural media influencers, body image, and psychological factors among a racially/ethnically diverse population of college women. Eat Behav. 2014;15(1):37-41. doi: 10.1016/j.eatbeh.2013.10.005

 

  1. Troisi A, Di Lorenzo G, Alcini S, Nanni RC, Di Pasquale C, Siracusano A. Body dissatisfaction in women with eating disorders: Relationship to early separation anxiety and insecure attachment. Psychosom Med. 2006;68(3):449-453. doi: 10.1097/01.psy.0000204923.09390.5b

 

  1. Tylka TL, Wood-Barcalow NL. What is and what is not positive body image? Conceptual foundations and construct definition. Body Image. 2015;14:118-129. doi: 10.1016/j.bodyim.2015.04.001

 

  1. Katznelson H, Daniel SIF, Poulsen S, Lunn S, Buhl-Nielsen B, Sjögren JM. Disturbances in the experiences of embodiment related to attachment, mentalization and self-objectification in anorexia nervosa. J Eat Disord. 2021;9(1):137. doi: 10.1186/s40337-021-00463-z

 

  1. Rossi E, Cassioli E, Dani C, et al. The maltreated eco- phenotype of eating disorders: A new diagnostic specifier? A systematic review of the evidence and comprehensive description. Neurosci Biobehav Rev. 2024;160:105619. doi: 10.1016/j.neubiorev.2024.105619

 

  1. Teicher MH, Samson JA, Anderson CM, Ohashi K. The effects of childhood maltreatment on brain structure, function and connectivity. Nat Rev Neurosci. 2016;17(10):652-666. doi: 10.1038/nrn.2016.111

 

  1. Jaye Capretto J. Developmental timing of childhood physical and sexual maltreatment predicts adult depression and post-traumatic stress symptoms. J Interpers Violence. 2020;35(13- 14):2558-2582. doi: 10.1177/0886260517704963

 

  1. Donahue JM, Reilly EE, Anderson LM, Scharmer C, Anderson DA. Evaluating associations between perfectionism, emotion regulation, and eating disorder symptoms in a mixed-gender sample. J Nerv Ment Dis. 2018;206(11):900-904. doi: 10.1097/NMD.0000000000000895

 

  1. Quilliot D, Brunaud L, Mathieu J, et al. Links between traumatic experiences in childhood or early adulthood and lifetime binge eating disorder. Psychiatry Res. 2019;276:134-141. doi: 10.1016/j.psychres.2019.05.008

 

  1. Armour C, Műllerová J, Fletcher S, et al. Assessing childhood maltreatment and mental health correlates of disordered eating profiles in a nationally representative sample of English females. Soc Psychiatry Psychiatr Epidemiol. 2016;51(3):383-393. doi: 10.1007/s00127-015-1154-7

 

  1. Paans NPG, Bot M, Brouwer IA, Visser M, Penninx BWJ. Contributions of depression and body mass index to body image. J Psychiatr Res. 2018;103:18-25. doi: 10.1016/j.jpsychires.2018.05.003

 

  1. American Psychiatric Association, editor. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publising Incorporated; 2013.

 

  1. Kubany ES, Haynes SN, Leisen MB, et al. Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: The traumatic life events questionnaire. Psychol Assess. 2000;12(2):210-224. doi: 10.1037//1040-3590.12.2.210

 

  1. Thompson MA, Gray JJ. Development and validation of a new body-image assessment scale. J Pers Assess. 1995;64(2):258-269. doi: 10.1207/s15327752jpa6402_6

 

  1. Garner D. Eating Disorder Inventory-2 Professional Manual. Odessa: Psychological Assessment Resources; 1993.

 

  1. Statistics IS. Software de Computación. 24th ed. Chicago, Illinois: EEUU; 2016.

 

  1. Grunwald M, Ettrich C, Busse F, Assmann B, Dähne A, Gertz HJ. Angle paradigm: A new method to measure right parietal dysfunctions in anorexia nervosa. Arch Clin Neuropsychol. 2002;17(5):485-496.

 

  1. Chemisquy S, Helguera GP. Impacto de la autopresentación perfeccionista en la salud infantil y adolescente: Una revisión sistemática [Impact of perfectionistic self-presentation on children and adolescents’ health: A systematic review]. Rev Psicopatol Psicol Clín. 2018;23(2):149-161. doi: 10.5944/rppc.vol.23.num.2.2018.20095

 

  1. Fonagy P, Gergely G, Target M. The parent-infant dyad and the construction of the subjective self. J Child Psychol Psychiatry. 2007;48(3-4):288-328. doi: 10.1111/j.1469-7610.2007.01727.x

 

  1. Tasca GA, Ritchie K, Zachariades F, et al. Attachment insecurity mediates the relationship between childhood trauma and eating disorder psychopathology in a clinical sample: A structural equation model. Child Abuse Negl. 2013;37(11):926-933. doi: 10.1016/j.chiabu.2013.03.004

 

  1. Meneguzzo P, Behrens SC, Pavan C, et al. Exploring weight bias and negative self-evaluation in patients with mood disorders: Insights from the BodyTalk project. Front Psychiatry. 2024;15:1407474. doi: 10.3389/fpsyt.2024.1407474

 

  1. Pellegrini RA, Finzi S, Veglia F, Di Fini G. Narrative and bodily identity in eating disorders: Toward an integrated theoretical-clinical approach. Front Psychol. 2021;12:785004. doi: 10.3389/fpsyg.2021.785004

 

  1. Gois AC, Ferreira C, Mendes AL. Steps toward understanding the impact of early emotional experiences on disordered eating: The role of self-criticism, shame, and body image shame. Appetite. 2018;125:10-17. doi: 10.1016/j.appet.2018.01.025

 

  1. Dunn EC, Nishimi K, Gomez SH, Powers A, Bradley B. Developmental timing of trauma exposure and emotion dysregulation in adulthood: Are there sensitive periods when trauma is most harmful? J Affect Disord. 2018;227:869-877. doi: 10.1016/j.jad.2017.10.045

 

  1. Kaplow JB, Widom CS. Age of onset of child maltreatment predicts long-term mental health outcomes. J Abnorm Psychol. 2007;116(1):176-187. doi: 10.1037/0021-843X.116.1.176

 

  1. Stice E, Gau JM, Rohde P, Shaw H. Risk factors that predict future onset of each DSM-5 eating disorder: Predictive specificity in high-risk adolescent females. J Abnorm Psychol. 2017;126(1):38-51.doi: 10.1037/abn0000219

 

  1. Fernández-Aranda F, Pinheiro AP, Thornton LM, et al. Impulse control disorders in women with eating disorders. Psychiatry Res. 2008;157(1-3):147-157. doi: 10.1016/j.psychres.2007.02.011

 

  1. Prnjak K, Jukic I, Mitchison D, Griffiths S, Hay P. Body image as a multidimensional concept: A systematic review of body image facets in eating disorders and muscle dysmorphia. Body Image. 2022;42:347-360. doi: 10.1016/j.bodyim.2022.07.006

 

  1. Fairburn CG, Cooper Z, Shafran R. Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behav Res Ther. 2003;41(5):509-528. doi: 10.1016/s0005-7967(02)00088-8

 

  1. Pinto RJ, Maia ÂC. A comparison study between official records and self-reports of childhood adversity. Child Abuse Rev. 2013;22:354-366. doi: 10.1002/car.2232
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Journal of Clinical and Basic Psychosomatics, Electronic ISSN: 2972-4414 Print ISSN: 3060-8562, Published by AccScience Publishing