ABSTRACT

Individuals with bulimia nervosa report elevated rates of childhood maltreatment, which appears to increase risk for co-occurring substance use problems and negatively impact clinical course. The current study sought to examine the mechanistic pathways by which specific forms of childhood maltreatment may give rise to substance use problems among individuals with bulimic-spectrum pathology. Women with bulimic-spectrum disorders (N = 204) completed measures of childhood trauma, emotion dysregulation, impulsivity, and substance use. Path analysis was used to examine emotion dysregulation and impulsivity as mediators of the relationship between distinct forms of childhood trauma (physical abuse, physical neglect, emotional abuse, emotional neglect, and sexual abuse) and the presence of problematic alcohol/drug use. In the full path model, significant pathways from childhood emotional abuse to emotion dysregulation, childhood emotional neglect to impulsivity, and emotion dysregulation to problematic substance use emerged. Further, emotion dysregulation significantly mediated the relationship between emotional abuse and substance use. Results indicate that emotion dysregulation may be an important mechanism linking a history of childhood emotional maltreatment to later eating and substance use problems, and therefore may be an important treatment target among individuals with co-occurring eating and substance use concerns.

• Childhood emotional abuse was related to greater emotion dysregulation.

• Childhood emotional neglect was related to greater impulsivity.

• Emotion dysregulation was related to greater problematic substance use.

• Emotional abuse may impact substance use through emotion dysregulation.

• Creating emotion dysregulation may improve substance and eating disorder symptoms.

摘要

患有神经性贪食症的人报告儿童虐待率升高，这似乎增加了同时发生物质使用问题的风险并对临床过程产生负面影响。目前的研究试图检查特定形式的儿童虐待可能导致暴食症患者的物质使用问题的机制途径。患有暴食症的女性（N= 204) 完成了儿童创伤、情绪失调、冲动和物质使用的测量。路径分析用于检查情绪失调和冲动作为不同形式的童年创伤（身体虐待、身体忽视、情感虐待、情感忽视和性虐待）与存在问题的酒精/药物使用之间关系的中介。在全路径模型中，出现了从儿童情绪虐待到情绪失调、儿童情绪忽视到冲动、情绪失调到有问题的物质使用的重要途径。此外，情绪失调显着介导了情绪虐待和物质使用之间的关系。

• 儿童时期的情绪虐待与更大的情绪失调有关。

• 童年的情感忽视与更大的冲动有关。

• 情绪失调与更大的问题物质使用有关。

• 情绪虐待可能会通过情绪失调影响物质使用。

• 制造情绪失调可能会改善物质和饮食失调症状。