Introduction

It is well known, and well documented, that childhood trauma — whether abuse or adverse experiences — plays an integral role in the development of dysfunctional behavior patterns and mental health disorders. These developments are as diverse as acting out behaviors, anger management issues, impulsivity issues, relationship dysfunctions, substance use/abuse disorders, anxiety, depression, obsessive-compulsive disorder, and many more. The differences in the type of abuse, level of abuse, and duration of abuse impact the development and level of severity of other patterns and disorders, as does the difference between abuse and adversity. One specific area of study is the development of disordered eating behaviors and diagnostically significant eating disorders. Once again, the difference between adversity and abuse — and the type, level, and duration of abuse — impact the type of disordered eating behavior that develops and the level to which it escalates. Gender differences play a role in its development and progression, as well. What precise role does childhood abuse and adversity play in the development of eating disorders, and how do the types of disorders differ in impact?

What are Adverse Childhood Experiences (ACES)

Childhood abuse takes many forms: physical abuse, sexual abuse, emotional abuse, physical neglect, and emotional neglect. Some abuse takes place in isolated or time-limited circumstances; other abuse takes place consistently over years. Abuse is a direct attack on the individual, physically, sexually, or emotionally. Neglect takes two forms: physical neglect is not being provided basic necessities such as shelter, food, and clothing; emotional neglect is not receiving attention, engagement, and validation (Gander, Sevecke & Buchheim, 2018). Neglect is a long term situation in which a child does not receive physical and/or emotional support for years — it is construed differently than temporary situations which give rise to short term home or food insecurity, or short term inattention and engagement on the part of caregivers. Both of these things fall into the category of adversity, circumstances in which parents who otherwise provide, love, and attend to their children fail to do so during adverse experiences. 

There is a specific list of ten childhood experiences that are known to be especially problematic in the development of behavior disorders and mental health disorders. This list is collectively known as Adverse Childhood Experiences. It includes the three types of abuse and two types of neglect already discussed and five additional things: parental divorce; the mother in the home being abused; incarcerated immediate family member(s); immediate family member(s) with substance use/abuse issues; and mental illness in immediate family member(s). More recently, other external ACEs have been added: experiencing racism, experiencing bullying, and experiencing violence in the community (Joining Forces for Children, 2018).