Ci a ion: Momeñe, J.; Es é ez, A.;
G i i hs, M.D.; Macía, P.; He e o, M.;
Ola e, L.; I ua izaga, I. Ea ing
Diso de s and In ima e Pa ne
Violence: The In luence o Fea o
Loneliness and Social Wi hd awal.
Nu ien s 2022,14, 2611. h ps://
doi.o g/10.3390/nu14132611
Academic Edi o :
Palmie o Mon eleone
Recei ed: 23 May 2022
Accep ed: 20 June 2022
Published: 24 June 2022
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nu ien s
A icle
Ea ing Diso de s and In ima e Pa ne Violence: The In luence
o Fea o Loneliness and Social Wi hd awal
Jani e Momeñe 1, Ana Es é ez 1, Ma k D. G i i hs 2, Pa icia Macía3, Ma a He e o 1, Le icia Ola e 4
and I zia I ua izaga 4,*
1Psychology Depa men , School o Heal h Sciences, Uni e si y o Deus o, 48080 Bilbao, Spain;
[email p o ec ed] (J.M.); [email p o ec ed] (A.E.); m.he e [email p o ec ed] (M.H.)
2In e na ional Gaming Resea ch Uni , Psychology Depa men , No ingham T en Uni e si y,
No ingham NG1 4FQ, UK; [email p o ec ed]
3Depa men o Basic Psychological P ocesses and Thei De elopmen ,
Uni e si y o he Basque Coun y/Euskal He iko Unibe si a ea (UPV/EHU),
20018 Donos ia-San Sebas ián, Spain; [email p o ec ed]
4Depa men o Expe imen al Psychology, Cogni i e P ocesses and Speech The apy, Facul y o Social Wo k,
Complu ense Uni e si y o Mad id, Pozuelo de Ala cón, 28223 Mad id, Spain; [email p o ec ed]
*Co espondence: icia i [email p o ec ed]
Abs ac :
Ea ing diso de s a e ulne abili y ac o s ha inc ease he likelihood o in ima e pa ne
iolence. Howe e , he mechanisms unde lying his ela ionship a e unclea . Al hough ea ing
diso de s ha e been associa ed wi h inc eased pe cep ion and ea o loneliness, hey ha e also been
associa ed wi h inc eased social wi hd awal esul ing om dec eased enjoymen o social si ua ions
and poo e social unc ioning. The pu pose o he p esen s udy was o examine he media ing ole
o ea o loneliness in he ela ionship be ween he beha iou al cha ac e is ics o ea ing diso de s
and in ima e pa ne iolence, as well as o explo e he mode a ing ole o social wi hd awal in he
ela ionship be ween ea o loneliness and in ima e pa ne iolence. The sample comp ised 683
pa icipan s (78% emale and 22% male) wi h a mean age o 21.14 yea s (SD = 2.72). The psychome ic
scales used we e Ea ing Diso de s In en o y (EDI 2), Emo ional Dependency Ques ionnai e (EDQ),
Coping S a egies In en o y (CSI) and he Violence Recei ed, Exe cised and Pe cei ed in You h and
Adolescen Da ing Rela ionships Scale (VREPS). The hypo hesised model was es ed by pa h analysis
using maximum likelihood. The pa h analysis o he hypo hesised model showed ha ine icacy, ea
o ma u i y, and impulsi i y we e he beha iou al cha ac e is ics o ea ing diso de s p edominan ly
ela ed o ea o loneliness. Fea o loneliness had no di ec signi ican e ec on any o he ecei ed
iolence a iables. Howe e , in e ac ion e ec s indica ed ha he e was a mode a ely signi ican
e ec o ea o loneliness on physical, psychological, and social iolence ecei ed as a unc ion
o le els o social wi hd awal. These indings show he need o ake in o accoun and wo k on
ea o loneliness and social wi hd awal among indi iduals wi h an ea ing diso de o dec ease he
likelihood o es ablishing iolen in ima e pa ne ela ionships. Imp o ing in e pe sonal unc ioning
and social suppo is key o eco e y om ea ing diso de s.
Keywo ds:
ea ing diso de s; in ima e pa ne iolence; iolence ecei ed; social wi hd awal; ea o
loneliness; ulne abili y ac o s; pa h analysis
1. In oduc ion
Ea ing Diso de s (EDs) a e se ious psychia ic diso de s [
1
] ha signi ican ly impai
he physical and psychological heal h o su e e s. Mo eo e , he mo ali y a e is one o he
highes compa ed o o he psychia ic condi ions (5–10%) [
2
,
3
]. Cu en ly, he main ypes
o EDs ha indi iduals su e om wo ldwide a e ano exia ne osa, bulimia ne osa, and
binge ea ing diso de [
4
], cha ac e ised by pe sis en dis u bance o ea ing beha iou [
5
].
I has been es ima ed ha EDs a ec 15% o he wo ld popula ion and hei incidence
Nu ien s 2022,14, 2611. h ps://doi.o g/10.3390/nu14132611 h ps://www.mdpi.com/jou nal/nu ien s
Nu ien s 2022,14, 2611 2 o 12
con inues o inc ease. Mo eo e , hey begin o mani es hemsel es be ween ea ly and la e
adolescence. I is a his s age o he li e cycle ha impo an physical, psychological and
neu onal changes occu [
6
]. I s ae iology is mul i ac o ial, and psychological, de elopmen-
al, biological and/o sociocul u al ac o s may in luence i . Howe e , he ae iology is no
ye ully elucida ed. In ecen yea s, he need o u he esea ch has been no ed [2,7].
In addi ion o he de e io a ion p oduced in physical and psychological heal h, EDs
can also nega i ely impac s social unc ioning [
8
–
11
]. The pe cep ion o loneliness has
been ound o be p esen in indi iduals wi h his p oblem, and i is conside ed a nega i e
emo ion ha con ibu es o and inc eases hei symp oma ology. Mo eo e , EDs also
exace ba e eelings o loneliness [
12
]. Pe cei ed loneliness is de ined as emo ional dis ess
s emming om a eeling o ejec ion o isola ion by o he s o he lack o a social pa ne o
lean on and engage in ac i i ies wi h. Mo eo e , i has been shown o se e ely in luence
indi iduals’ quali y o li e [13,14].
Recen esea ch has highligh ed he eeling o loneliness as one o he mos commonly
p esen issues among young adul s [
15
]. Howe e , e y ew s udies ha e examined he
eeling o loneliness in eme ging adul hood [
16
] and e en ewe in Spain (whe e he p esen
s udy was ca ied ou ) in ela ion o EDs. Unde s anding he ela ionship be ween EDs and
ea o loneliness is i al o add ess hese in ense emo ions wi hin p e en ion and ea men
p og ams. The e o e, i is impo an o analyse he impac exe ed by he ea o loneliness
among indi iduals wi h his p oblem [12,17].
In addi ion, p e ious s udies ha e no ed he use o dys unc ional coping s a egies
by indi iduals wi h an ED [
18
,
19
] ha con ibu e o he ae iology and main enance o
his p oblem [
6
,
20
]. The e o e, he beha iou s cha ac e is ic o EDs can be employed as
dys unc ional coping mechanisms o egain con ol o e s ess ul ci cums ances [
21
]. Mo e
speci ically, indings sugges ha indi iduals wi h an ED p edominan ly employ coping
s a egies based on sel -c i icism and social isola ion. Fu he mo e, he impo ance o
u he esea ch has been poin ed ou because coping s a egies play an impo an ole
in he p ognosis and ea men o EDs [
22
], especially social isola ion. Empi ical s udies
sugges ha social isola ion and low sense o social suppo inc ease ED symp oma ology
and ha e a de imen al impac on eco e y [
23
–
26
]. This may be because social isola ion
p omo es inc eased maladap i e ea ing habi s and body dissa is ac ion [
27
]. The e o e,
i has been no ed ha social suppo and adap i e social unc ioning a e key o a mo e
e ec i e and comple e eco e y [28,29].
Likewise, he empi ical li e a u e has no ed ha EDs inc ease he p obabili y o su -
e ing in ima e pa ne iolence (IPV) h oughou li e [
30
]. The e o e, he p e alence o
IPV among indi iduals wi h EDs is high [
31
]. I should be no ed ha p e ious li e a u e
has also posi ed a bidi ec ional ela ionship be ween IPV and EDs because he di ec ion
o causali y can be in bo h di ec ions [
32
]. Howe e , he mechanisms unde lying his
ela ionship a e unclea . P e ious s udies ha e ound ha social isola ion and ea o
loneliness a e ulne abili y ac o s o s aying in iolen ela ionships [
33
]. Despi e his, he
ole hey play in he ela ionship be ween EDs and IPV has no been es ablished. Conse-
quen ly, hei s udy is o u mos impo ance in designing ea ly and e ec i e p e en ion
and in e en ion p og ams [34].
In ecen yea s, his line o esea ch examining he ela ionship be ween EDs and IPV
has gained ele ance due o i s clinical and p ognos ic implica ions. The e o e, he p esen
s udy’s main objec i es we e o: (i) analyse he ela ionships be ween co e symp oms
a e sing Eds; (ii) explo e he media ing ole o ea o loneliness in he ela ionship
be ween he beha iou al cha ac e is ics o EDs and IPV; and (iii) explo e he mode a ing
ole o social isola ion in he ela ionship be ween ea o loneliness and IPV. Based on
he a o emen ioned li e a u e, he hypo heses o he p esen s udy we e ha : (i) he co e
symp oms a e sing EDs will ha e a signi ican di ec e ec on ecei ed pa ne iolence;
and (ii) he co e symp oms a e sing EDs will ha e a signi ican indi ec e ec on ecei ed
pa ne iolence h ough he media ing ole o ea o loneliness and he mode a ing ole o
social isola ion.
Nu ien s 2022,14, 2611 3 o 12
2. Me hod
2.1. Pa icipan s
The sample comp ised 683 eme ging Spanish adul s who pa icipa ed in a c oss-
sec ional su ey s udy. The a e age age o he pa icipan s was 21.14 yea s old (SD = 2.72;
78% emale and 22% male). The pa icipan s we e mos ly s uden s (80.1%) and wo ke s
(19.3%). The emaining pa icipan s we e unemployed (0.6%).
2.2. P ocedu e
Pa icipan s we e ec ui ed h ough wo channels: online and ace- o- ace. Fo he
online ec ui men , su eys we e made a ailable h ough an online pla o m (su eymonkey.
com accessed on 1 Janua y 2020). Pa icipa ion was p omo ed h ough di e en social
ne wo ks and ad e isemen s on esea ch websi es. Fo he ace- o- ace ec ui men , pa ic-
ipan s we e ec ui ed a he Complu ense Uni e si y o Mad id and a gyms in he Mad id
communi y. The only exclusion c i e ion was being unde 18 yea s o age. All pa icipan s
ga e hei in o med consen by con i ming o clicking on a bu on indica ing ha hey had
ead he s udy in o ma ion and ag eed o pa icipa e olun a ily. The s udy ollowed he
e hical p inciples o he 2013 Helsinki Decla a ion and was app o ed by he esea ch eam’s
uni e si y e hics commi ee.
2.3. Ins umen s
Ea ing diso de cha ac e is ics. The Ea ing Diso de s In en o y-2 (EDI-2) [
35
] was used
o assess clinically ele an beha iou s and psychological ai s ha accompany EDs. The
EDI-2 consis s o 91 i ems di ided in o 11 scales (obsession wi h hinness, bulimia, body
dissa is ac ion, ine icacy, pe ec ionism, in e pe sonal dis us , in e ocep i e awa eness,
ea o ma u i y, asce icism, impulsi i y and social insecu i y). All i ems (e.g., “I end o ea
when I am upse ”;“I ind i di icul o exp ess my emo ions o o he s”;“I hink my s omach is oo
big”) a e a ed on a six-poin scale om 0 (“Ne e ”) o 5 (“Always”). The highe he sco es
ob ained on each scale, he g ea e he mani es a ions o he ai e alua ed. The in e nal
consis ency (C onbach’s α) o he subscales in he p esen s udy anged om 0.73 o 0.90.
Fea o loneliness. The ea o loneliness subscale om he Emo ional Dependency
Ques ionnai e (EDQ) [
36
] was used o assess ea o loneliness. All i ems (e.g., “I eel
helpless when I am alone”;“I eel a s ong sense o emp iness when I am alone”;“I canno ole a e
loneliness”) a e a ed on a six-poin scale om 1 (“Comple ely un ue o me”) o6(“Desc ibes
me pe ec ly”). The highe he sco e ob ained, he g ea e he ea o loneliness. The in e nal
consis ency in he p esen s udy was α= 0.82.
Social a oidance. The Coping S a egies In en o y (CSI) [
37
] was used o assess social
a oidance. The scale assesses eigh s yles o coping wi h s ess ul si ua ions by means o
41 i ems (p oblem sol ing, cogni i e es uc u ing, social suppo , emo ional exp ession,
p oblem a oidance, deside a i e hinking, social wi hd awal, sel -c i icism). All i ems (e.g.,
“I a oided being wi h people”;“I didn’ le anyone know how I el ”) a e a ed on a i e-poin
scale om 0 (“No a all”) o 4 (“Comple ely”). The highe he sco e ob ained, he g ea e he
social a oidance. The in e nal consis ency in he p esen s udy was α= 0.74.
Recei ed iolence. The Violence Recei ed, Exe cised and Pe cei ed in You h and Adoles-
cen Da ing Rela ionships Scale (VREPS) [
38
] was used o assess ecei ed iolence. The scale
comp ises 28 i ems including i e iolence subscales (physical iolence, sexual iolence, so-
cial psychological iolence, psychological iolence humilia ion–coe cion, and psychological
iolence con ol-jealousy) and encompassing h ee aspec s o iolence: ecei ed, exe ed,
and pe cei ed. Fo iolence ecei ed and exe cised, i ems (e.g., “My boy iend/gi l iend ells
me o change he way I d ess, do my hai
. . .
and c i icizes i ”;“My boy iend/gi l iend wan s o
know whe e I am a all imes and who I am wi h”;“My boy iend/gi l iend has un ou o iends
because I didn’ like hem and old him/he no o be wi h hem”) a e a ed on a six-poin scale
(0 “Ne e ”, 1“Once”, 2“F om 2 o 5 imes”, 3“F om 6 o 10 imes”, 4“F om 11 o 15 imes” and
5“Mo e han 15 imes”) and o pe cei ed iolence i ems (e.g., “My boy iend/gi l iend has
o ced me o ha e sex (any kind o o al o pene a ion) when I did no wan o. Is his iolence?”) a e
Nu ien s 2022,14, 2611 4 o 12
a ed on a i e-poin scale (1 “No iolence”, 2“Li le iolence”, 3“Somewha iolen ”, 4“Qui e
iolen ” and 5 “Ve y iolen ”). In addi ion, pa icipan s indica e whe he hey conside
he si ua ions men ioned o be iolence. The highe he sco e ob ained, he g ea e he
ecei ed iolence. In he p esen s udy, he iolence ecei ed was o pa icula in e es
in he analysis. The in e nal consis ency o he i e subscales o ecei ed iolence in he
p esen s udy anged om α= 0.82 o 0.89.
2.4. S a is ical Analysis
Da a analyses we e ca ied ou using Mplus 7.0 [
39
]. The hypo hesised model was
es ed by pa h analysis using maximum likelihood. Following he model desc ibed in
Figu e 1, he model included he ea ing diso de cha ac e is ics (i.e., obsession o hinness,
bulimia, body dissa is ac ion, ine ec i eness, pe ec ionism, in e pe sonal dis us , in e-
ocep i e awa eness, ea o ma u i y, asce icism, impulsi eness and social insecu i y) as
independen a iables, ecei ed iolence as he dependen a iable (i.e., physical, sexual,
psychological humilia ion–coe cion, psychological con ol-jealousy and social), he ea
o loneliness as he media o , and social wi hd awal as he mode a o in he ela ionship
be ween he media o and he dependen a iables. Gende and age we e included as
con ols in he model.
Nu ien s 2022, 14, x FOR PEER REVIEW 4 o 13
iend/gi l iend ells me o change he way I d ess, do my hai ... and c i icizes i ”; “My boy-
iend/gi l iend wan s o know whe e I am a all imes and who I am wi h”; “My boy iend/gi l-
iend has un ou o iends because I didn’ like hem and old him/he no o be wi h hem”) a e
a ed on a six-poin scale (0 “Ne e ”, 1 “Once”, 2 “F om 2 o 5 imes”, 3 “F om 6 o 10 imes”,
4 “F om 11 o 15 imes” and 5 “Mo e han 15 imes”) and o pe cei ed iolence i ems (e.g.,
“My boy iend/gi l iend has o ced me o ha e sex (any kind o o al o pene a ion) when I did no
wan o. Is his iolence?”) a e a ed on a i e-poin scale (1 “No iolence”, 2 “Li le iolence”,
3 “Somewha iolen ”, 4 “Qui e iolen ” and 5 “Ve y iolen ”). In addi ion, pa icipan s indi-
ca e whe he hey conside he si ua ions men ioned o be iolence. The highe he sco e
ob ained, he g ea e he ecei ed iolence. In he p esen s udy, he iolence ecei ed was
o pa icula in e es in he analysis. The in e nal consis ency o he i e subscales o e-
cei ed iolence in he p esen s udy anged om α = 0.82 o 0.89.
2.4. S a is ical Analysis
Da a analyses we e ca ied ou using Mplus 7.0 [39]. The hypo hesised model was
es ed by pa h analysis using maximum likelihood. Following he model desc ibed in Fig-
u e 1, he model included he ea ing diso de cha ac e is ics (i.e., obsession o hinness,
bulimia, body dissa is ac ion, ine ec i eness, pe ec ionism, in e pe sonal dis us , in e -
ocep i e awa eness, ea o ma u i y, asce icism, impulsi eness and social insecu i y) as
independen a iables, ecei ed iolence as he dependen a iable (i.e., physical, sexual,
psychological humilia ion–coe cion, psychological con ol-jealousy and social), he ea o
loneliness as he media o , and social wi hd awal as he mode a o in he ela ionship
be ween he media o and he dependen a iables. Gende and age we e included as
con ols in he model.
Figu e 1. Hypo hesised model.
The adequacy o he p oposed model was analysed acco ding o he ollowing model
i indica o s: a io o chi-squa e (χ2) and he deg ees o eedom, he compa a i e i index
(CFI), he Tucke –Lewis index (TLI), he oo mean squa ed e o o app oxima ion
(RMSEA), and he s anda dised oo mean squa e esidual (SRMR). Values o χ2/d o <3.0,
CFI and TLI ≥ 0.90, and RMSEA and SRMR < 0.08 we e conside ed indica o s o good i
[40].
In o de o es he mode a ed media ion, he di ec e ec o EDCs (ea ing diso de
cha ac e is ics) on he dependen a iables was included, and he a iables o he p od-
uc s we e s anda dised. Addi ionally, he analysis adap ed he code p o ided by S ide e
Figu e 1. Hypo hesised model.
The adequacy o he p oposed model was analysed acco ding o he ollowing model
i indica o s: a io o chi-squa e (
χ2
) and he deg ees o eedom, he compa a i e i
index (CFI), he Tucke –Lewis index (TLI), he oo mean squa ed e o o app oxima ion
(RMSEA), and he s anda dised oo mean squa e esidual (SRMR). Values o
χ2
/d o
<3.0, CFI and TLI
≥
0.90, and RMSEA and SRMR < 0.08 we e conside ed indica o s o
good i [40].
In o de o es he mode a ed media ion, he di ec e ec o EDCs (ea ing diso de
cha ac e is ics) on he dependen a iables was included, and he a iables o he p oduc s
we e s anda dised. Addi ionally, he analysis adap ed he code p o ided by S ide e al.
(2015) [
41
] in Model 1 and Model 14 o es he simple slopes o he di ec and indi ec e ec s.
Fo he compu a ion o he indi ec e ec s, boo s ap was applied wi h 5000 samples. All
signi ican mode a ions and mode a ed-media ions we e es ed a low (
−
1.5 SD), a e age
(a he mean) and high le els (+1.5 SD) o he mode a o o examine simple slopes.
3. Resul s
Fi s , he desc ip i e s a is ics o he sample and he co ela ions be ween he s udy
a iables we e calcula ed (see Tables 1and 2). Some o he EDCs we e no signi ican ly
co ela ed wi h any o he ecei ed iolence indica o s (i.e., bulimia, body dissa is ac ion
and ea o ma u i y). Fea o loneliness and social wi hd awal we e signi ican ly co ela ed
wi h all a iables.
Nu ien s 2022,14, 2611 5 o 12
Table 1. Desc ip i e s a is ics and eliabili y o he s udy a iables (n = 683).
Va iables Means and S anda d De ia ions Reliabili y
M SD Min Max αCR AVE
Ea ing diso de cha ac e is ics
Obsession o hinness 13.68 9.30 0 35 0.90 0.93 0.64
Bulimia 9.10 6.08 0 32 0.80 0.85 0.46
Body dissa is ac ion 20.39 7.18 2 41 0.89 0.91 0.54
Ine ec i eness 15.14 8.78 0 48 0.88 0.90 0.48
Pe ec ionism 11.60 5.67 0 30 0.73 0.82 0.43
In e pe sonal dis us 11.92 5.97 0 32 0.73 0.82 0.41
In e ocep i e awa eness 17.74 8.76 0 45 0.84 0.88 0.43
Fea o ma u i y 19.18 6.43 2 40 0.73 0.81 0.35
Asce icism 12.31 6.20 0 40 0.73 0.81 0.36
Impulsi eness 14.44 8.44 0 55 0.82 0.86 0.36
Social insecu i y 13.84 6.51 0 40 0.79 0.84 0.41
Fea o loneliness 5.53 2.99 2 18 0.82 0.90 0.74
Social wi hd awal 5.80 4.11 0 20 0.74 0.83 0.50
Recei ed iolence
Physical 0.21 0.55 0 5 0.82 0.89 0.61
Sexual 0.33 0.73 0 5 0.88 0.91 0.64
Psychological humilia ion–coe cion 0.41 0.82 0 5 0.88 0.91 0.63
Psychological con ol-jealousy 0.60 0.96 0 5 0.89 0.92 0.65
Social 0.28 0.67 0 4.6 0.85 0.90 0.65
No e. Min = Minimum; Max = Maximum;
α
= C onbach’s alpha; CR = Composi e eliabili y; AVE = A e age
a iance ex ac ed.
Second, he pa h analysis o he hypo hesised model was pe o med. All model i in-
dica o s showed a good i o he model,
χ2
/d = 2.26, CFI = 0.99, TLI = 0.95,
RMSEA = 0.04,
SRMR < 0.01. The e o e, he model adequa ely explained he s udy da a. As displayed in
Table 3, he di ec e ec s showed ha ine ec i eness, ea o ma u i y, and impulsi eness
we e he EDCs ela ed o ea o loneliness. Fea o loneliness had no di ec signi ican
e ec on any o he a iables o ecei ed iolence. Howe e , he in e ac ion e ec s in-
dica ed ha he e was a signi ican mode a ed e ec o ea o loneliness on physical,
psychological humilia ion–coe cion, and social ecei ed iolence depending on he le els
o social wi hd awal.
Based on he exposed a iables, he simple slopes we e examined o unde s and
he mode a ion e ec s. Simple slopes showed ha highe ea o loneliness was signi i-
can ly ela ed o mo e physical iolence (
β
= 0.16, SE = 0.03, p< 0.001) and psychological
humilia ion–coe cion ecei ed iolence (
β
= 0.11, SE = 0.05, p= 0.028) when he social
wi hd awal was high, bu he e was no signi ican ela ionship when he social wi hd awal
was low (physical:
β
=
−
0.07, SE = 0.03, p= 0.063; psychological humilia ion—-coe cion:
β=−0.06,
SE = 0.05, p= 0.281) o medium (physical:
β
= 0.16, SE = 0.03, p= 0.053; psycho-
logical humilia ion—-coe cion: β= 0.02, SE = 0.03, p= 0.444).
Rega ding social ecei ed iolence, he simple slopes indica ed ha g ea e ea o
loneliness was signi ican ly ela ed o lowe social ecei ed iolence when he social wi h-
d awal was low (
β
=
−
0.19, SE = 0.04, p= 0.043), bu was ela ed o g ea e social iolence
when he social wi hd awal was high (
β
= 0.13, SE = 0.04, p= 0.002). The ela ionship a
medium le els o social wi hd awal was no signi ican (β= 0.01, SE = 0.02, p= 0.499).
As a inal s ep, he mode a ed media ion o he EDCs was es ed on he a iables
o ecei ed iolence (see Table 4). The indi ec e ec s o ine ec i eness, ea o ma u i y
and impulsi eness on physical iolence, and social ecei ed iolence, h ough ea o
loneliness, we e signi ican only a high social wi hd awal le els. Howe e , none o he
indi ec e ec s on psychological humilia ion–coe cion ecei ed iolence was signi ican ,
al hough a endency was obse ed owa ds high social wi hd awal le els.
Nu ien s 2022,14, 2611 6 o 12
Table 2. Bi a ia e co ela ions be ween he s udy a iables.
Va iables Co ela ions
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
Ea ing diso de cha ac e is ics
1. Obsession o hinness (0.90)
2. Bulimia 0.41 ** (0.80)
3. Body dissa is ac ion 0.58 ** 0.32 ** (0.89)
4. Ine ec i eness 0.45 ** 0.39 ** 0.35 ** (0.88)
5. Pe ec ionism 0.27 ** 0.39 ** 0.15 ** 0.26 ** (0.73)
6. In e pe sonal dis us 0.15 ** 0.14 ** 0.17 ** 0.53 ** 0.10 ** (0.73)
7. In e ocep i e awa eness 0.49 ** 0.56 ** 0.38 ** 0.65 ** 0.39 ** 0.46 ** (0.84)
8. Fea o ma u i y 0.23 ** 0.17 ** 0.19 ** 0.35 ** 0.20 ** 0.26 ** 0.40 ** (0.73)
9. Asce icism 0.44 ** 0.57 ** 0.34 ** 0.49 ** 0.48 ** 0.17 ** 0.60 ** 0.25 ** (0.73)
10. Impulsi eness 0.35 * 0.52 ** 0.29 ** 0.52 ** 0.39 ** 0.24 ** 0.67 ** 0.28 ** 0.67 ** (0.82)
11. Social insecu i y 0.21 ** 0.20 ** 0.20 ** 0.66 ** 0.13 ** 0.67 ** 0.43 ** 0.26 ** 0.27 ** 0.38 ** (0.79)
12. Fea o loneliness 0.22 ** 0.26 ** 0.20 ** 0.37 ** 0.23 ** 0.16 ** 0.34 ** 0.25 ** 0.35 ** 0.38 ** 0.24 ** (0.82)
13. Social wi hd awal 0.19 ** 0.23 ** 0.17 ** 0.39 * 0.22 ** 0.42 ** 0.38 ** 0.21 ** 0.31 ** 0.30 ** 0.43 ** 0.19 ** (0.74)
Recei ed iolence
14. Physical 0.05 0.04 −0.03 0.04 0.06 0.01 0.10 ** 0.07 0.09 * 0.11 ** 0.05 0.12 ** 0.10 ** (0.82)
15.Sexual 0.13 ** 0.04 0.02 0.11 ** 0.09 * 0.04 0.11 ** 0.01 0.12 ** 0.15 ** 0.09 * 0.09 * 0.11 ** 0.53 ** (0.88)
16. Psychological humilia ion–coe cion 0.07 * 0.03 0.01 0.09 ** 0.10 ** 0.03 0.07 * 0.02 0.12 ** 0.14 ** 0.10 ** 0.09 * 0.08 * 0.64 ** 0.67 ** (0.88)
17. Psychological con ol-jealousy 0.10 ** 0.06 0.03 0.08 * 0.11 ** 0.04 0.11 ** 0.03 0.14 ** 0.19 ** 0.09 * 0.11 ** 0.12 ** 0.57 ** 0.64 ** 0.81 ** (0.89)
18. Social 0.08 * 0.03 0.03 0.12 ** 0.07 0.08 * 0.10 ** 0.02 0.11 ** 0.13 ** 0.15 ** 0.09 * 0.11 ** 0.60 ** 0.65 ** 0.86 ** 0.81 ** (0.85)
No e. * p< 0.05, ** p< 0.01.
Nu ien s 2022,14, 2611 7 o 12
Table 3. S anda dised di ec and in e ac ion e ec s o he model based on pa h analysis.
Dependen Va iables
Recei ed Violence
Independen
Va iables
Fea o
Loneliness Physical Sexual
Psychological
Humilia ion–
Coe cion
Psychological
Con ol-
Jealousy
Social
βSE βSE βSE βSE βSE βSE
Ea ing diso de
cha ac e is ics
Obsession o
hinness −0.03
0.04
0.08
0.05
0.14 ** 0.05 0.06 0.05 0.10 * 0.05 0.06
0.05
Bulimia 0.02
0.04
−0.06
0.04
−0.08 0.05 −
0.08
0.05 −0.09 * 0.04 −0.08
0.05
Body
dissa is ac ion 0.05
0.04
−0.12 *
0.04
−0.09 * 0.04 −
0.05
0.04 −0.04 0.04 0.04
0.04
Ine ec i eness
0.20 ***
0.05
−0.12
0.06
0.01 0.06
<
−
0.01
0.06 −0.08 0.06 <0.01
0.06
Pe ec ionism 0.05
0.04
<0.01
0.04
0.04 0.04 0.06 0.04 0.04 0.04 0.03
0.04
In e pe sonal
dis us −0.03
0.04
−0.08
0.05
−0.03 0.05 −
0.04
0.05 −0.02 0.05 −0.03
0.05
In e ocep i e
awa eness −0.04
0.06
0.14 *
0.06
<0.01 0.06 −
0.03
0.06 0.01 0.06 <0.01
0.06
Fea o ma u i y 0.12 **
0.03
0.03
0.04
−0.06 0.04 −
0.03
0.04 −0.03 0.04 −0.05
0.04
Asce icism 0.09
0.05
<0.01
0.05
< 0.01 0.05 0.05 0.05 <0.01 0.05 0.05
0.05
Impulsi eness 0.17 **
0.05
0.03
0.05
0.13 * 0.05 0.11 0.05 0.18 ** 0.05 0.06
0.05
Social insecu i y <0.01
0.05
0.07
0.05
0.02 0.06 0.08 0.06 0.05 0.05 0.12 *
0.05
Fea o loneliness 0.08
0.04
0.03 0.04 0.03 0.04 0.04 0.04 0.02
0.04
Social wi hd awal 0.06
0.04
0.07 0.04 0.03 0.04 0.07 0.04 0.04
0.04
Fea o loneliness X
Social wi hd awal 0.15 ***
0.03
0.03 0.03
0.07 *
0.03 0.06 0.03 0.12 **
0.03
20.21 *** 0.07 *** 0.05 ** 0.04 ** 0.06 *** 0.05 **
No e. * p< 0.05, ** p< 0.01, *** p< 0.001.
Table 4.
Mode a ed indi ec e ec s o ine ec i eness, ea o ma u i y and impulsi eness on physical,
psychological humilia ion–coe cion and social ecei ed iolence h ough ea o loneliness.
Dependen Va iables
(Recei ed Violence)
Physical
Psychological
Humilia ion–
Coe cion
Social
Independen
a iables Le el o he mode a o zpzpzp
Ine ec i eness
Low social wi hd awal −1.65 0.099 −1.03 0.302 −1.76 0.078
A e age social wi hd awal 1.70 0.089 0.74 0.454 0.66 0.507
High social wi hd awal 2.81 * 0.005 1.86 0.062 2.34 * 0.019
Fea o ma u i y
Low social wi hd awal −1.60 0.109 −1.02 0.308 −1.71 0.088
A e age social wi hd awal 1.65 0.099 0.74 0.456 0.66 0.509
High social wi hd awal 2.61 ** 0.009 1.80 0.071 2.22 * 0.026
Impulsi eness
Low social wi hd awal −1.61 0.106 −1.02 0.306 −1.72 0.085
A e age social wi hd awal 1.66 0.096 0.74 0.456 0.66 0.508
High social wi hd awal 2.66 ** 0.008 1.82 0.068 2.25 * 0.024
No e. * p< 0.05, ** p< 0.01.
4. Discussion
The main objec i e o he p esen s udy was o analyse he associa ion be ween co e
symp oms a e sing ea ing diso de s (EDs) and o explo e he ole o ea o loneliness
Nu ien s 2022,14, 2611 8 o 12
and social isola ion in ela ion o beha iou al ea ing diso de cha ac e is ics (EDCs) and
in ima e pa ne iolence (IPV) ecei ed. Fi s , i was hypo hesised ha co e symp oms
a e sing EDs would ha e a signi ican di ec e ec on ecei ed pa ne iolence. Resul s
showed ha some o he EDCs we e no signi ican ly associa ed wi h any o he ecei ed
iolence indica o s (e.g., bulimia, body dissa is ac ion, and ea o ma u i y). Howe e ,
o he indica o s such as obsession o hinness, ine ec i eness, pe ec ionism, in e ocep i e
awa eness, asce icism, impulsi eness, and social insecu i y we e all signi ican ly and
posi i ely ela ed o ecei ed iolence.
These esul s a e in acco dance wi h p e ious scien i ic li e a u e ha EDs inc ease he
likelihood o IPV among bo h emales and males [
30
,
31
]. Al hough EDs ha e adi ionally
been conside ed emale diso de s, ecen e idence sugges s ha i is no uncommon among
males, and ha males can p esen simila se e e ED symp oms. In ac , he e a e speci ic
isk ac o s o de eloping EDs among young and adolescen males, such as body image
conce ns ela ed o muscula i y and sexual o ien a ion [
1
]. As men ioned, EDs can eme ge
as maladap i e coping mechanisms ha enable indi iduals o egain con ol o e ad e se
si ua ions, as can be ecei ing iolence [21,42].
Ano he ac o associa ed wi h EDs and iolence exposu e among bo h sexes is social
isola ion, which has been associa ed wi h adop ion o unheal hy weigh con ol p ac-
ices [
26
]. Wi h he aim o explo ing mo e deeply he ole o social aspec s, he second
hypo hesis was ha co e symp oms a e sing EDs would ha e a signi ican indi ec e -
ec on ecei ed pa ne iolence h ough he media ing ole o ea o loneliness and he
mode a ing ole o social isola ion.
On he one hand, esul s showed ha ine ec i eness, ea o ma u i y, and impulsi i y
we e he beha iou al EDCs p edominan ly ela ed o ea o loneliness. Fea o loneliness
had no di ec signi ican e ec on any o he ecei ed iolence a iables. Ne e heless,
in e ac ion e ec s indica ed a mode a ely signi ican in luence o ea o loneliness on
physical iolence, psychological humilia ion—coe cion, and social ecei ed iolence as
a unc ion o le els o social wi hd awal.
I was also ound ha he indi ec e ec s o ine ec i eness, ea o ma u i y, and
impulsi eness on physical and social ecei ed iolence, h ough ea o loneliness, we e
signi ican only a high social wi hd awal le els. Resul s e ine he unde s anding o
he ela ionship be ween social wi hd awal and he de elopmen o EDs in indi iduals
exposed o pa ne iolence. Indi iduals su e ing loneliness appea o be mo e suscep ible
o de eloping diso de ed ea ing pa e ns [43].
Pa icipan s in he p esen s udy a e cha ac e ised as being young. Mo eo e , i
should be no ed ha eme ging adul hood can be a c i ical pe iod o de eloping men al
heal h p oblems [
15
,
16
]. In pa icula , EDs a e equen ly ini ia ed in his pe iod, especially,
conside ing he g ea ele ance ha acqui e social in e ac ions a his de elopmen al
s age [
18
]. Fea o loneliness and social isola ion a e among he mos common conce ns
o young people, and esul s ha e e idenced hei impac on he ela ion be ween EDs
and IPV [15].
Fo ins ance, he pandemic and subsequen social es ic ions ha e limi ed and de-
p i ed indi iduals o social in e ac ion esul ing in dec eased social suppo and simila
coping s a egies in acing his unp eceden ed si ua ion [
44
]. The e o e, elimina ing social
p o ec ion ac o s when coping wi h ad e se e en s could inc ease isk and symp oms
o ED [
45
]. In his sense, loneliness has been concei ed as a media o be ween emo ional
dys egula ion and ea ing diso de s- ela ed psychopa hology [46].
This lack o pe cei ed social suppo associa ed wi h he exposu e o pa ne iolence
could culmina e in many psychological heal h consequences, such as dep ession, pos -
auma ic s ess, anxie y, and EDs, among o he men al heal h illnesses [
47
]. Low le els
o social suppo ha e been ela ed o inc eased isk o ED among women exposed o IPV.
Social suppo has shown p o ec i e e ec s agains ED by dec easing le els o anxie y
and p omo ing mechanisms ela ed o unc ional coping s a egies [
48
]. Howe e , IPV-
exposu e and auma his o y can p ecede he de elopmen o ED symp oms. The ex an
Nu ien s 2022,14, 2611 9 o 12
li e a u e highligh s he p esence o childhood abuse among indi iduals su e ing IPV and
EDs. Child en who ha e expe ienced exposu e o iolen si ua ions appea o be mo e
suscep ible o de eloping EDs [
30
,
49
]. O he s udies ha e iden i ied speci ic aspec s ela ed
o al e ed-ea ing beha iou s and IPV exposu e including soma iza ion, a oiding abuse,
coping, sel -ha m, and challenging abusi e pa ne s [42].
O e all, esul s in he p esen s udy con i m he bidi ec ional ela ionship be ween ED
and IPV, in luenced by aspec s such as ea o loneliness and social wi hd awal. On he
one hand, i was obse ed ha childhood abuse is highly ela ed o bo h EDs and IPV, so i
could be conside ed a possible explana o y ac o [
32
,
49
–
51
]. On he o he hand, i should
be no ed ha he associa ion be ween EDs and IPV also depends on he ype o ED, due
o he ac ha di e en EDs ha e di e se ae iology [
52
]. Ne e heless, he p esen s udy
highligh s social- ela ed aspec s in explaining some o he mechanisms unde lying his
bidi ec ional ela ionship be ween EDs and IPV. Indi iduals who su e om EDs usually
show ea o loneliness and social isola ion pa e ns, which a e also consequences o IPV,
and could likewise de i e in de eloping ED- ela ed symp oms.
All o hese aspec s suppo he no ion ha ED- ela ed beha iou s a e used as ways
o cope wi h ad e se and s ess ul si ua ions such as ecei ed iolence. This could be
impo an in o ma ion o he apis s who wo k wi h hose expe iencing IPV and who
de elop in e en ions o pa ien s wi h clinical symp oms o an ED. Resul s emphasise he
impo ance o unde s anding he ulne abili y and absence o coping esou ces among
indi iduals who su e IPV and de elop EDs, wi h he aim o designing in e en ions
ocused on he p omo ion o coping h ough seeking social suppo and a oiding isola ion.
5. Limi a ions
The p esen s udy has some limi a ions ha should be no ed. Fi s , he c oss-sec ional
design employed in he p esen s udy does no allow de e mining conclusions in e ms o
causali y. The e o e, longi udinal s udies a e needed o de e mine any casual in e ences
among di e en a iables examined in he p esen s udy. Secondly, he sample in he
p esen s udy was limi ed o eme ging adul s, wi h an a e age age o 21 yea s old, he e o e
esul s canno necessa ily be gene alised o o he age g oups.
In u u e esea ch, i would be in e es ing o ex end he s udy o o he age popula ions,
wi h he aim o explo ing di e ences in ED-beha iou pa e ns and IPV ela ed o social
isola ion aspec s in o he de elopmen al phases. In addi ion, he p esen s udy did no
explo e di e ences by sex in he a iables o in e es . E o s o inc ease he numbe o
male pa icipan s would be o u ili y wi h he objec i e o homogenising he sample and
analysing di e ences in ED pa e ns and di e en symp oms ela ed o ecei ed iolence
in ela ionships.
6. Conclusions
Ea ing diso de s a e ulne abili y ac o s ha inc ease he likelihood o in ima e pa -
ne iolence. Ne e heless, he mechanisms unde lying his ela ionship a e unclea . The
p esen s udy has explo ed he in luence o wi hd awal as a esul o dec eased enjoymen
o social si ua ions and poo e social unc ioning. O e all, he esul s o he p esen s udy
demons a e he ole o social- ela ed aspec s in he ela ionship be ween EDs and IPV.
I is sugges ed ha indi iduals exposed o iolen si ua ions in ela ionships may
de elop ED- ela ed symp oms as a way o coping wi h ad e se si ua ions. Howe e , his
ela ionship is no di ec , and i appea s ha unde lying mechanisms ela ed o ea o lone-
liness and social wi hd awal p e en he de eloping o coping esou ces o acing ecei ed
iolence. These indings highligh he signi icance o wo king on ea o loneliness and
social wi hd awal among indi iduals wi h an ED o dec ease he likelihood o es ablishing
iolen in ima e pa ne ela ionships.
Fu u e esea ch should ocus on inding ways o empowe ing ic ims h ough in-
c easing social suppo and p omo ing esilience and adap i e coping esou ces as ways
