Early Maladaptive Schemas Mediate the Relationship Between Childhood Trauma and Interpersonal Problems in Eating Disorders

Recent research highlights the role of childhood trauma in the development of eating disorders (EDs), suggesting that adverse experiences can disrupt emotional and cognitive development, leading to early maladaptive schemas (EMSs) and interpersonal problems. EMSs are psychological structures encompassing cognition, emotions, images, and bodily sensations. These EMSs are hypothesized to mediate the relationship between childhood trauma and ED pathology. This study aimed to extend the investigation of how childhood trauma leads to interpersonal difficulties, mediated by EMSs. This cross-sectional study recruited 321 patients with EDs: n = 77 Anorexia Nervosa–Restricting (AN-R), n = 26 AN–Binge/Purge (AN-BP), n = 94 Bulimia Nervosa (BN), and n = 124 Binge Eating Disorder (BED). They completed the Eating Disorder Examination (EDE), Inventory of Interpersonal Problems (IIP-32), Young Schema Questionnaire (YSQ-S3), and Childhood Trauma Questionnaire (CTQ-SF). Path analyses were conducted to examine associations between childhood trauma, EMSs, and interpersonal problems. Results indicated that patients with BED reported the highest levels of sexual abuse. Those with BN exhibited higher scores across all EMS domains. Positive correlations were found between childhood adversities, EMS domains, and interpersonal problems, except for the relationship between sexual abuse and schema domains. Mediation analyses revealed significant indirect effects of emotional abuse on interpersonal problems through disconnection and rejection domain. This study consolidates the notion that EMSs mediate the relationship between childhood trauma and interpersonal problems in ED patients, highlighting the importance of addressing early trauma and EMSs to improve therapeutic outcomes. Future research should focus on longitudinal analyses to better understand the temporal development of these relationships.