Childhood trauma and eating attitudes and behaviours: exploring the role of daily stressors and perfectionistic thinking

Introduction: Childhood trauma has been consistently linked to a number of adverse health outcomes and behaviours in adulthood, including a greater likelihood of disordered eating attitudes and behaviours. Furthermore, childhood trauma has been implicated in the development of stress and perfectionistic thinking, which have, separately, been linked to disordered eating outcomes. However, the impact of childhood trauma on daily disordered eating outcomes amongst non-clinical populations, has not been examined in conjunction with daily stress and daily perfectionistic thinking. Method: A multi-level, prospective, daily diary design was utilised, whereby 135 participants over the age of 18 completed background measurements of childhood trauma, perfectionism, disordered eating outcomes, and stress. Participants subsequently completed a seven-day diary that captured daily perceived stress, perfectionistic cognitions, and eating attitudes and behaviours. Hierarchical linear modelling was used to analyse the influence of daily stress and perfectionistic thinking on daily eating outcomes, with childhood trauma examined as a moderator. Results: Results demonstrated a significant main effect of childhood trauma on daily relationship with food, concerns over food and weight gain, and restrictive and compensatory practices, but not on a disordered idea of eating or feeling toward eating. Furthermore, higher levels of daily perceived stress were significantly associated with higher scores on disordered relationships with food and concerns over food and weight gain, with childhood trauma found to moderate the relationship between daily stress and restrictive and compensatory practices, such that greater levels of disordered eating were evident in those with higher levels of childhood trauma. Increases in daily perfectionistic thinking were associated with increased daily concerns over food and weight gain but did not significantly affect the remaining four daily eating outcomes. Additionally, childhood trauma did not moderate any of the perfectionistic thinking-eating outcome relationships. Discussion: Experiences of childhood trauma have a significant adverse impact on some, but not all, disordered eating attitudes and behaviours. Stress and perfectionistic thinking were found to have less of an impact on disordered eating attitudes and behaviours when measured at the daily level. The importance of examining experiences of childhood trauma in the assessment, formulation, and intervention of disordered eating behaviours is emphasised.