AN INVESTIGATION INTO HOW CHILDHOOD TRAUMA AFFECTS THE EMERGENCE OF EATING DISORDERS IN ADULT LIFE

CHAPTER ONE INTRODUCTION 1.1 Background of the Study Childhood trauma is increasingly recognized as a significant contributing factor to a range of long-term psychological issues, one of which includes the development of eating disorders in adulthood (Smolak & Levine, 2015). Such trauma may involve various negative experiences, including physical, emotional, or sexual abuse, neglect, and exposure to domestic violence. When these adverse events occur during critical stages of childhood development, they can leave lasting impacts on mental well-being, often leading to unhealthy coping mechanisms that carry into later life (Brewerton, 2019). The relationship between childhood trauma and eating disorders is complex, with research showing that early traumatic experiences can impair emotional regulation, distort self-image, and disrupt interpersonal relationships—all of which can contribute to disordered eating behaviours (Palmer et al., 2016). Eating disorders such as anorexia nervosa, bulimia nervosa, and binge-eating disorder have become increasingly prevalent and now affect millions of people around the world. Studies suggest that up to 70% of individuals with eating disorders have a history of trauma (Trottier & MacDonald, 2017). These disorders are not merely about food; they involve significant disruptions in eating patterns, along with a distorted perception of body image, and are often accompanied by other mental health issues such as anxiety, depression, and post-traumatic stress disorder (PTSD) (Mitchell et al., 2017). While eating disorders often emerge during adolescence or early adulthood, their origins frequently lie in early adverse childhood experiences (Kong & Bernstein, 2019). Various psychological and neurobiological mechanisms have been proposed to explain how childhood trauma can lead to eating disorders. Trauma can result in poor emotional control and maladaptive stress responses, prompting individuals to develop unhealthy eating behaviours such as food restriction, bingeing, or purging as coping strategies (Brewerton, 2019). From a neurobiological perspective, early trauma has been linked to changes in brain structures responsible for emotion regulation—particularly the prefrontal cortex and amygdala (De Bellis & Zisk, 2014). These changes can increase vulnerability to disordered eating, as individuals may attempt to regain a sense of control through managing their food intake or body weight (Monteleone et al., 2018). Attachment theory also helps explain this connection. It suggests that children who experience insecure attachments due to abuse or neglect may struggle with emotional regulation and forming healthy relationships (Smolak & Levine, 2015). In such cases, eating disorders can become a way to manage feelings of anxiety, guilt, and low self-worth that stem from these disrupted attachments (Palmer et al., 2016). Additionally, sociocultural influences—especially societal ideals that glorify thinness and stigmatize larger bodies—can further exacerbate the impact of childhood trauma, encouraging harmful attitudes and behaviours toward food and body image (Trottier & MacDonald, 2017). Despite growing evidence that links childhood trauma to eating disorders, there are still gaps in current research. For example, there is limited knowledge about how different types of trauma—such as emotional versus physical abuse—specifically relate to different forms of eating disorders (Molendijk et al., 2017). There is also a lack of understanding regarding the protective factors, like resilience and social support, that might reduce the risk of developing these disorders in trauma-exposed individuals (Brewerton, 2019). These knowledge gaps highlight the need for further research into how specific trauma experiences influence the onset and progression of eating disorders, as well as the development of effective interventions. Furthermore, most of the existing research has been conducted in Western societies, often overlooking the cultural factors that might shape how eating disorders are experienced and coped with in different populations. Cultural background can significantly influence the way individuals understand, experience, and respond to trauma and eating disorders, underlining the need for more inclusive and culturally relevant research (Smolak & Levine, 2015). A better understanding of these cultural dimensions could lead to more tailored and effective treatment approaches. If left untreated, eating disorders can result in severe long-term consequences, including an increased risk of mortality, chronic physical health issues, and ongoing psychological problems (Mitchell et al., 2017). This makes the integration of trauma-informed care into treatment practices especially crucial. Trauma-informed care recognizes how past trauma influences current behaviours and prioritizes creating safe, empowering, and collaborative therapeutic environments (Substance Abuse and Mental Health Services Administration [SAMHSA], 2015). Therefore, this study aims to examine how childhood trauma influences the development of eating disorders later in life. 1.2 Statement of the Problem Experiencing trauma in childhood—such as abuse, neglect, or dysfunction within the family—has been linked to numerous long-term mental and physical health issues, including eating disorders in adulthood (Dakanalis et al., 2015). These disorders, which include anorexia nervosa, bulimia nervosa, and binge-eating disorder, are serious psychological conditions characterized by abnormal eating patterns and distorted body image. Research has shown that individuals who have experienced trauma in childhood are more likely to develop these disorders, as such events often compromise their ability to manage emotions, maintain self-esteem, and develop healthy coping mechanisms (Molendijk, Hoek, Brewerton, & Elzinga, 2017). Although studies in this area are growing, there remains no clear consensus on how different types of trauma specifically affect the development of different types of eating disorders. Likewise, the psychological pathways that link early trauma to eating disorders in adulthood are still not fully understood (Monteleone, Cascino, & Treasure, 2018). Addressing this knowledge gap is essential, especially considering the severe physical and mental health consequences that come with eating disorders—including increased mortality rates, psychiatric comorbidities, and reduced quality of life (Micali et al., 2017). As a result, this study seeks to explore the influence of childhood trauma on the development of eating disorders in adult life. 1.3 Objectives of the Study The general objective of this study is to explore how childhood trauma contributes to the development of eating disorders in adulthood. The specific objectives are: i. To determine the prevalence of childhood trauma among adults diagnosed with eating disorders. ii. To evaluate how childhood trauma affects the severity of eating disorders in affected individuals. iii. To investigate the psychological processes that mediate the relationship between childhood trauma and eating disorders in adulthood. iv. To examine the long-term mental health outcomes for adults with eating disorders who experienced trauma in childhood. 1.4 Research Questions This study is guided by the following research questions: i. What is the prevalence of childhood trauma among adults diagnosed with eating disorders? ii. How does childhood trauma affect the severity of eating disorders in individuals? iii. What psychological mechanisms link childhood trauma to the onset of eating disorders in adulthood? iv. What long-term mental health outcomes are observed in adults with eating disorders who experienced childhood trauma? 1.5 Significance of the Study The results of this study have the potential to inform policymakers and mental health professionals about the urgent need for support services that address the lingering effects of childhood trauma. By emphasizing the importance of trauma-informed care, the study could lead to improved funding for mental health services, the inclusion of trauma-based interventions in public health policies, and the implementation of preventative programs aimed at reducing child abuse and neglect. Additionally, the study will be valuable to the academic community. It will add to the existing body of literature, enrich academic resources, and serve as a reference point for future researchers working on related topics. 1.6 Scope of the Study This research focuses on examining the influence of childhood trauma on the development of eating disorders in adulthood. In particular, it investigates the prevalence of childhood trauma among adults with eating disorders, explores the impact of trauma on the severity of these conditions, and identifies the psychological factors that mediate the relationship between childhood trauma and disordered eating. It also considers the long-term mental health outcomes in adults who experienced trauma during childhood and developed eating disorders later on. Geographically, the study is limited to students at the University of Ibadan. 1.7 Limitations of the Study As with many research efforts, this study encountered certain limitations. Time Constraints: The researcher faced time limitations due to the need to balance this research with other academic obligations, such as attending lectures and completing coursework. Financial Limitations: Conducting the study required significant financial resources for printing, typesetting, sourcing materials, and collecting data. Limited Availability of Materials: It was also challenging to access sufficient literature on the topic, given the relative scarcity of local or context-specific research on childhood trauma and eating disorders. 1.8 Definition of Terms Childhood Trauma: Refers to harmful or distressing experiences during early life—such as physical, sexual, or emotional abuse, neglect, or family dysfunction—that have lasting negative impacts on psychological well-being. Eating Disorders: A group of mental health conditions involving abnormal or disturbed eating habits, intense fears of gaining weight, and distorted body image. Common examples include anorexia nervosa, bulimia nervosa, and binge-eating disorder. Anorexia Nervosa: An eating disorder marked by a persistent restriction of food intake, a strong fear of weight gain, and a distorted view of one’s body, often resulting in significantly low body weight. Bulimia Nervosa: Characterized by recurring episodes of binge eating followed by inappropriate methods of preventing weight gain, such as self-induced vomiting, fasting, or excessive exercise. Binge-Eating Disorder: Involves episodes of eating large quantities of food in a short period, often to the point of discomfort, without the regular use of compensatory behaviours. Emotional Regulation: The ability to effectively manage and respond to emotional experiences. Difficulty with emotional regulation is common in individuals with a trauma history and can contribute to disordered eating. Trauma-Informed Care: A treatment approach that recognizes the lasting impact of trauma on a person's behaviour and prioritizes safety, empowerment, and collaborative decision-making in care settings.