Cognitive emotion regulation strategies as mediators between childhood maltreatment and eating disorders: A cross-sectional study

Abstract

Background: Eating disorder (ED) symptoms are common in the general population and are often associated with childhood maltreatment (CM). Emotion regulation difficulties are likewise linked to both CM and ED symptoms, yet the role of cognitive emotion regulation strategies (CERS) in this relationship remains underexplored. Culturally specific forms of adversity, such as parental overprotection and overcontrol (OP–OC), have also been largely overlooked. Method: This cross-sectional study investigated whether adaptive and maladaptive CERS mediate the associations between six forms of CM and ED symptoms in a non-clinical sample of 352 Turkish adults. Participants completed the Childhood Trauma Questionnaire–Expanded, the Eating Disorder Examination Questionnaire–Short Form, and the Cognitive Emotion Regulation Questionnaire. Mediation analyses were conducted using the PROCESS macro (Model 4) in SPSS v29. Results: The results revealed that, except for physical abuse, maladaptive CERS significantly mediated the associations between all CM types and ED symptoms, with full mediation found for emotional neglect and sexual abuse. Although adaptive CERS did not mediate these relationships, their use was significantly lower among individuals exposed to emotion-related maltreatment, including OP–OC. Discussion: These findings underscore the potential of maladaptive CERS as early indicators and modifiable risk factors in subclinical populations. Tailoring emotion regulation components within interventions like Cognitive Behavioural Therapy–Enhanced (CBT-E) and Dialectical Behaviour Therapy (DBT) may enhance efficacy, especially for trauma-exposed individuals. Preventive psychoeducational programmes in youth and community settings could offer timely support before clinical symptoms emerge.