{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T07:26:42Z","timestamp":1766820402858,"version":"build-2065373602"},"reference-count":42,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Pregnancy is a critical period marked by significant transformations that can trigger or exacerbate eating disorder symptoms. Childhood emotional maltreatment, including abuse and neglect, is a known risk factor for disordered eating, yet its specific impact during pregnancy remains unexplored. For this reason, this study aimed to examine the link between childhood emotional maltreatment and eating disorder symptoms in pregnant women, also focusing on the potential mediating and moderating variables involved in this association. Specifically, this study explored the mediating role of prenatal emotional distress, whereas prenatal social support was investigated as a protective factor able to moderate the effects of past trauma on disordered eating during this sensitive period. Methods: Participants were 272 Italian pregnant women (aged 18\u201348, Mage = 31.21, SD = 4.95) who were asked to respond to four self-report instruments: Childhood Trauma Questionnaire\u2014Short Form; Eating Disorder Examination\u2014Questionnaire Short; Perinatal Assessment of Maternal Affectivity; and Maternity Social Support Scale. Results and Conclusions: The results showed that prenatal emotional distress totally mediated the association between childhood emotional maltreatment and eating disorder symptoms in pregnant women (\u03b2 = 0.20; SE = 0.06; 95% CI: 0.08, 0.33; p &lt; 0.001). Moreover, moderation analysis showed that prenatal social support only moderated the direct link between childhood emotional maltreatment and disordered eating, so higher levels of childhood emotional maltreatment were predictive of higher levels of eating disorder symptoms only among pregnant women with low levels of prenatal social support (b = 0.17; SE = 0.06; t = 2.73; 95% CI: 0.05, 0.30; p &lt; 0.01). The limitations and clinical implications are discussed.<\/jats:p>","DOI":"10.3390\/nu17050902","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T05:54:38Z","timestamp":1741154078000},"page":"902","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Exploring the Association Between Childhood Emotional Maltreatment and Eating Disorder Symptoms During Pregnancy: A Moderated Mediation Model with Prenatal Emotional Distress and Social Support"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2202-820X","authenticated-orcid":false,"given":"Giulia","family":"Costanzo","sequence":"first","affiliation":[{"name":"Department of Psychology, Educational Science, and Human Movement, University of Palermo, 90128 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Barberis","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Cannav\u00f2","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5527-7929","authenticated-orcid":false,"given":"Maria Rita","family":"Infurna","sequence":"additional","affiliation":[{"name":"Department of Psychology, Educational Science, and Human Movement, University of Palermo, 90128 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Bevacqua","sequence":"additional","affiliation":[{"name":"Department of Psychology, Educational Science, and Human Movement, University of Palermo, 90128 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Guarneri","sequence":"additional","affiliation":[{"name":"Department of Psychology, Educational Science, and Human Movement, University of Palermo, 90128 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jada","family":"Sottile","sequence":"additional","affiliation":[{"name":"Department of Psychology, Educational Science, and Human Movement, University of Palermo, 90128 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Tomba","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Bologna, 40127 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4387-7393","authenticated-orcid":false,"given":"Giorgio","family":"Falgares","sequence":"additional","affiliation":[{"name":"Department of Psychology, Educational Science, and Human Movement, University of Palermo, 90128 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12884-018-1849-3","article-title":"Signs and symptoms of disordered eating in pregnancy: A Delphi consensus study","volume":"18","author":"Bannatyne","year":"2018","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s00404-023-07051-3","article-title":"Prevalence and related factors of eating disorders in pregnancy: A systematic review and meta-analysis","volume":"309","author":"Ouyaba","year":"2023","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_3","first-page":"e31429","article-title":"Association of eating disorders in prenatal and perinatal women and its complications in their offspring","volume":"14","author":"Dutta","year":"2022","journal-title":"Cureus"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1002\/eat.23264","article-title":"Psychosocial factors, mental health symptoms, and disordered eating during pregnancy","volume":"53","author":"Baskin","year":"2020","journal-title":"Int. J. Eat. Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/s11199-022-01345-7","article-title":"Mothering ideology: A qualitative exploration of mothers\u2019 perceptions of navigating motherhood pressures and partner relationships","volume":"88","author":"Williamson","year":"2023","journal-title":"Sex Roles"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Sommerfeldt, B., Sk\u00e5rderud, F., Kvalem, I.L., Gulliksen, K.S., and Holte, A. (2022). Bodies out of control: Relapse and worsening of eating disorders in pregnancy. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.986217"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1192\/bjp.187.3.268","article-title":"Early experiences and their relationship to maternal eating disorder symptoms, both lifetime and during pregnancy","volume":"187","author":"Senior","year":"2005","journal-title":"Br. J. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1089\/jwh.2010.2360","article-title":"Eating disorders and trauma history in women with perinatal depression","volume":"20","author":"Zerwas","year":"2011","journal-title":"J. Women\u2019s Health"},{"key":"ref_10","first-page":"745","article-title":"Childhood emotional maltreatment and internalizing problems in a non-clinical sample of adolescents: A moderated-mediation model of insecure anxious attachment style and gender","volume":"27","author":"Falgares","year":"2024","journal-title":"Res. Psychother."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"104811","DOI":"10.1016\/j.chiabu.2020.104811","article-title":"Developmental consequences of emotional abuse and neglect in vulnerable adolescents: A multi-informant, multi-wave study","volume":"111","author":"Cohen","year":"2021","journal-title":"Child Abuse Negl."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.chiabu.2011.08.005","article-title":"Deficits in emotion regulation mediate the relationship between childhood abuse and later eating disorder symptoms","volume":"36","author":"Burns","year":"2012","journal-title":"Child Abuse Negl."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"105224","DOI":"10.1016\/j.appet.2021.105224","article-title":"Childhood maltreatment and disordered eating attitudes and behaviors in adult men and women: Findings from project EAT","volume":"163","author":"Emery","year":"2021","journal-title":"Appetite"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1097\/NMD.0000000000001556","article-title":"The effects of childhood emotional and physical maltreatment on adolescents\u2019 disordered eating behaviors: The mediating role of borderline personality features","volume":"210","author":"Gioia","year":"2022","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Infurna, M.R., Fazio, L., Bevacqua, E., Costanzo, G., Falgares, G., Maiorana, A., Giannone, F., and Antonucci, L.A. (2024). Understanding the relationship between childhood emotional abuse and neglect and psychological distress in pregnant women: The role of prenatal attachment. BMC Psychol., 12.","DOI":"10.1186\/s40359-024-02024-w"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3390\/women3010010","article-title":"Psychosocial risk factors and psychopathological outcomes: Preliminary findings in Italian pregnant women","volume":"3","author":"Infurna","year":"2023","journal-title":"Women"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/NMD.0000000000001610","article-title":"The role of childhood trauma on prenatal attachment: A cross-sectional study","volume":"211","author":"Yilmaz","year":"2023","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.chiabu.2016.12.001","article-title":"Maternal history of child maltreatment and maternal depression risk in the perinatal period: A longitudinal study","volume":"63","author":"Li","year":"2017","journal-title":"Child Abuse Negl."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1002\/erv.2675","article-title":"Disordered eating and the perinatal period: A systematic review and best evidence synthesis of mental health and psychosocial correlates","volume":"27","author":"Baskin","year":"2019","journal-title":"Eur. Eat. Disord Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1037\/vio0000273","article-title":"Past made present: The legacy of childhood maltreatment for romantic relationship quality and psychopathology during pregnancy","volume":"10","author":"River","year":"2020","journal-title":"Psychol. Violence"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.chiabu.2019.02.008","article-title":"Perinatal promotive and protective factors for women with histories of childhood abuse and neglect","volume":"91","author":"Atzl","year":"2019","journal-title":"Child Abuse Negl."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s00737-022-01278-w","article-title":"Maternal childhood adversity and prenatal depression: The protective role of father support","volume":"26","author":"Fields","year":"2023","journal-title":"Arch. Women\u2019s Ment. Health"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Merrick, J.S., and Narayan, A.J. (2024). A replication and extension of adverse and benevolent childhood experiences along with contemporaneous social support and sociodemographic stress for perinatal mental health problems. Dev. Psychopathol., 1\u201314.","DOI":"10.1017\/S095457942400097X"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1037\/0033-2909.98.2.310","article-title":"Stress, social support, and the buffering hypothesis","volume":"98","author":"Cohen","year":"1985","journal-title":"Psychol. Bull."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1002\/eat.20797","article-title":"Factors associated with binge eating disorder in pregnancy","volume":"44","author":"Torgersen","year":"2011","journal-title":"Int. J. Eat Disord."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"World Medical Association (2001). World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. Bull. World Health Organ, 79, 373\u2013374.","DOI":"10.4414\/smf.2001.04031"},{"key":"ref_27","unstructured":"American Psychological Association (2010). Ethical Principles of Psychologists and Code of Conduct, American Psychological Association. Available online: http:\/\/www.apa.org\/ethics\/code\/principles.pdf."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0145-2134(02)00541-0","article-title":"Development and validation of a brief screening version of the Childhood Trauma Questionnaire","volume":"27","author":"Bernstein","year":"2003","journal-title":"Child Abuse Negl."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1037\/tra0000333","article-title":"Italian validation of the Childhood Trauma Questionnaire-Short Form on a college group","volume":"10","author":"Sacchi","year":"2018","journal-title":"Psychol. Trauma"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Baldoni, F., Agostini, F., Terrone, G., Casu, G., and Giannotti, M. (2023). A psychometric study of the Perinatal Assessment of Maternal Affectivity (PAMA) for the screening of perinatal affective disorders in mothers. Healthcare, 11.","DOI":"10.3390\/healthcare11060907"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Gideon, N., Hawkes, N., Mond, J., Saunders, R., Tchanturia, K., and Serpell, L. (2016). Development and psychometric validation of the EDE-QS, a 12 item short form of the Eating Disorder Examination Questionnaire (EDE-Q). PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0152744"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s40519-016-0276-6","article-title":"The Eating Disorder Examination Questionnaire: Reliability and validity of the Italian version","volume":"22","author":"Calugi","year":"2017","journal-title":"Eat Weight Disord."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1002\/1098-108X(199412)16:4<363::AID-EAT2260160405>3.0.CO;2-#","article-title":"Assessment of eating disorders: Interview or self-report questionnaire?","volume":"16","author":"Fairburn","year":"1994","journal-title":"Int. J. Eat Disord."},{"key":"ref_34","first-page":"141","article-title":"Il supporto sociale in gravidanza: Validazione italiana e valutazione dello strumento","volume":"3","author":"Dabrassi","year":"2009","journal-title":"G. Psicol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1046\/j.1523-536x.2000.00097.x","article-title":"Measuring social support in pregnancy: Can it be simple and meaningful?","volume":"27","author":"Webster","year":"2000","journal-title":"Birth"},{"key":"ref_36","unstructured":"Hayes, A.F. (2013). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach, Guilford Press."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1177\/0956797613502676","article-title":"Power anomalies in testing mediation","volume":"25","author":"Kenny","year":"2014","journal-title":"Psychol. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1111\/j.1469-7610.2009.02202.x","article-title":"Longitudinal pathways linking child maltreatment, emotion regulation, peer relations, and psychopathology","volume":"51","author":"Kim","year":"2010","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"105494","DOI":"10.1016\/j.chiabu.2022.105494","article-title":"The impact of childhood maltreatment on adaptive emotion regulation strategies","volume":"125","author":"Wooten","year":"2022","journal-title":"Child Abuse Negl."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.chiabu.2014.05.011","article-title":"Emotional maltreatment and disordered eating in adolescents: Testing the mediating role of emotion regulation","volume":"39","author":"Mills","year":"2015","journal-title":"Child Abuse Negl."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1007\/s10896-021-00312-2","article-title":"Cumulative childhood maltreatment and non-suicidal self-injury: The mediating and moderating role of perceived social support in a sample of university students","volume":"37","author":"Manna","year":"2022","journal-title":"J. Fam. Violence"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Stephens, J., Ellis, A., Roberts, S., Gillespie, K., Bannatyne, A., and Branjerdporn, G. (2024). Disordered eating instruments in the pregnancy cohort: A systematic review update. Eat Disord, 1\u201325.","DOI":"10.1080\/10640266.2024.2386469"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/5\/902\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:47:18Z","timestamp":1760028438000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/5\/902"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,5]]},"references-count":42,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["nu17050902"],"URL":"https:\/\/doi.org\/10.3390\/nu17050902","relation":{},"ISSN":["2072-6643"],"issn-type":[{"type":"electronic","value":"2072-6643"}],"subject":[],"published":{"date-parts":[[2025,3,5]]}}}