The Path from Childhood Emotional Maltreatment to Disordered Eating Behaviors: The Role of Reflective Functioning and Food Addiction

Introduction: Childhood emotional maltreatment, which includes emotional abuse and neglect, has been identified as a significant risk factor for the development of disordered eating behaviors related to overeating and reduced dietary control. At the same time, the literature suggests that childhood emotional maltreatment appears to be linked to deficits in reflective functioning which, in turn, may increase vulnerability to dysregulated, impulsive, and addictive behaviors. However, to date, the role of a key factor, such as food addiction (FA), within this model has not yet been investigated. Therefore, the aim of this study was to test a mediation model in which emotional abuse and neglect predict overeating and reduced dietary control through deficits in reflective functioning and FA symptoms. Method: Using a cross-sectional design, a conventional non-clinical sample of 543 participants was recruited and completed a set of standardized questionnaires. A multiple mediation model with observed variables was specified (10,000 bootstrap resampling). Results: The multiple mediation model showed good results, confirming the initial hypotheses. Specifically, emotional abuse and neglect were associated with FA symptoms through deficits in reflective functioning. In turn, FA symptoms predicted overeating behaviors and poor dietary control. Discussion: These findings highlight the central role of FA in linking reflective functioning deficits to disordered eating patterns associated with excessive food consumption. This study advances our understanding of the psychological mechanisms underlying disordered eating behaviors and underscores the need for targeted interventions addressing reflective functioning deficits and food addiction in individuals with a history of childhood emotional maltreatment.