Abstract
BACKGROUND: Although traumatic experiences in childhood have been recognized as contributors to disordered eating behaviors, critical gaps remain in our understanding. There is limited evidence on the individual, cumulative, and distinct patterns of childhood trauma associated with risky restrictive eating and binge/purging behaviors. METHODS: Individuals aged 12-25 years from Xiamen, Fujian Province, China, completed online questionnaires assessing childhood trauma, risky restrictive eating and binge/purging behaviors. Childhood trauma was examined through three analytical approaches: individual types, cumulative trauma scores, and latent class analysis. Logistic regression models were used to investigate the associations between childhood trauma and disordered eating behaviors. RESULTS: Among the 3424 participants, 7.3% (n = 251) reported disordered eating behaviors occurring two or more times per month over the past year. After adjusting for covariates, our analyses showed that emotional abuse independently associated with increased odds of both risky restrictive eating (OR: 2.11, 95% CI 1.28-3.47) and binge/purging behaviors (OR: 2.20, 95% CI 1.34-3.62). Physical abuse was associated only with increased odds of binge/purging behavior (OR: 2.09, 95% CI 1.20-3.64). Traumatic experiences showed a cumulative effect on disordered eating, significant at two or more incidents. Three trauma patterns were identified: 'low trauma,' 'low neglect,' and 'high trauma.' Youth with the 'high trauma' pattern exhibited the highest odds of both risky restrictive eating (OR: 2.88, 95% CI 1.65-5.02) and binge/purging behaviors (OR: 3.21, 95% CI 1.85-5.54), whereas those in the 'high neglect' pattern showed increased odds only for binge/purging behavior (OR: 1.52, 95% CI 1.01-2.29). CONCLUSIONS: Our findings highlight the need to consider the types, numbers, and patterns of childhood trauma when developing prevention and treatment strategies for disordered eating behaviors.