Binge eating & childhood emotional abuse: The mediating role of anger

Recent studies reveal that childhood emotional abuse (CEA) is the trauma most clearly associated with adult eating pathology. Yet, relatively little is understood about psychological mechanisms linking these distal experiences. Anger's mediational role in the relationship between CEA and adult binge eating (BE) is explored in a community-based sample of 498 adult women (mean age 44). Detailed telephone interviews assess BE (7 items), CEA (single item), and unresolved anger (single item) along with self-criticism (modified Rosenberg self-esteem scale), depression and anxiety symptoms (BSI sub-scales). Statistical analyses include Pearson correlations, Baron and Kenny's steps for mediation, and Preacher and Hayes bootstrapping method to test proposed multiple mediators simultaneously. Findings reveal significantly more respondents (n = 476 with complete data) with serious BE behaviors report a history of CEA compared to women with considerable and/or minimal BE (53% vs 37%, p = 0.002 respectively). Significant correlations are found among all study variables. Mediation analyses focus on anger together with self-criticism, depression and anxiety. Findings reveal anger and self-criticism fully mediate the CEA-BE relationship. In contrast, depression and anxiety symptoms are not significant mediators in a model that includes anger and self-criticism. Although additional research is warranted to more fully understand complex causal processes, in the interim, treatment interventions should be broadened to include assessments of anger among adult women with BE behaviors, especially those with histories of childhood abuse. Additionally, prevention strategies that incorporate learning how to express anger directly and positively may be particularly effective in reducing various disordered eating behaviors among women and girls. (C) 2016 Published by Elsevier Ltd.