{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:00:22Z","timestamp":1780574422272,"version":"3.54.1"},"reference-count":61,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["24K10673"],"award-info":[{"award-number":["24K10673"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro Eating Disorders Rev"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The current study aimed to investigate the mediating mechanisms linking adverse childhood experiences (ACEs) to anorexia nervosa (AN) and to examine whether distinct patterns of ACE exposure are associated with differential risks and mediation pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Data for 9746 female individuals were collected from nationally representative Japanese surveys. ACEs were assessed using a 15\u2010item Japanese ACE questionnaire, and AN was identified via self\u2010reported physician diagnosis. Causal mediation analysis and structural equation modelling were used to examine indirect pathways, while latent class analysis (LCA) was used to identify ACE patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Greater ACE exposure was significantly associated with a higher AN prevalence. In mediation analyses, loneliness, psychological distress, and brooding rumination were the most influential mediators, forming a latent \u201cnegative affectivity\u201d factor that significantly mediated ACEs and AN. The LCA identified four ACE profiles: \u201clow adversities\u201d, \u201cpsychological abuse\u201d, \u201cpoverty\u201d, and \u201cmultiple adversities\u201d. Relative to the \u201clow adversities\u201d group, other classes showed higher AN prevalence, although class differences in prevalence and mediators were modest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>We demonstrated that the number of ACEs, rather than their patterns, increases AN risk. Negative affectivity was a consistent strong mediator across ACE patterns; thus, it can be an important target for intervention in trauma\u2010exposed individuals with AN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/erv.70101","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:21:22Z","timestamp":1773742882000},"page":"1140-1149","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adverse Childhood Experiences and Anorexia Nervosa: Mediating Mechanisms and Risk by Adversity Patterns"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7941-442X","authenticated-orcid":false,"given":"Haruka","family":"Sakurai","sequence":"first","affiliation":[{"name":"Department of Psychiatry Hokkaido University Graduate School of Medicine  Sapporo Hokkaido 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