Structural differences in eating disorder psychopathology after history of childhood abuse: Insights from a Bayesian network analysis.

Childhood abuse is frequent among individuals with eating disorders and is associated with complex clinical presentations. However, to date, the differences in the presentations of eating disorders between these groups are poorly understood. The present study employed a Bayesian network approach to model the interactive network structure of eating disorder psychopathology, and to investigate the differences in symptom importance and network structure between individuals with eating disorders with and without an experience of childhood abuse in a sample 327 treatment-seeking individuals. Among individuals with a history of childhood abuse, a specific 4-symptom pathway emerged, leading from overvaluation of shape and weight and ending in overeating (overvaluation of weight and shape → loss of control → depressed mood → overeating). Loss of control eating and depressed mood emerged as the more important driving symptoms. In contrast, the eating disorder symptom network among the group with no abuse was organized around a heightened investment in weight and shape, and resulting efforts to control or alter weight and shape through dieting and exercise behaviors. The symptoms with the highest importance in this nonabuse group were overeating and overvaluation of weight and shape. These results support the existence of a distinct eating disorder symptom network characteristic of individuals with a history of childhood trauma, and add to the hypotheses of a maltreated eco-phenotype in eating disorders. They may be also inform treatment target in abused people with eating disorders. (PsycINFO Database Record (c) 2019 APA, all rights reserved).