Intimate partner violence and eating disorders: a systematic review

Current Psychology (2025) 44:1696–1716 https://doi.org/10.1007/s12144-024-07164-1 are serious mental disorders that not only compromise the physical health, but also the emotional and social health of those who suffer from them (American Psychiatric Association [APA], 2013). In quantitative terms, such eating disorders affect more than 30 million people and are a significant cause of mortality (Kutz et al., 2020). These two variables have been exhaustively studied independently (e.g., Ali et al., 2016; Le et al., 2017), however, the interconnection between IPV and EDs is increasingly recognized (Claydon et al., 2024), it being important to clarify the association between them. Since the psychopathological impact that IPV triggers in victims is strongly associated with depressive and anxiety-like pathological symptomatology that has a high degree of comorbidity with ED (Amor et al., 2002), it is vital to understand the mechanisms underlying the relationship between IPV and the ED symptomatological picture itself. In this way, we would have a better understanding of the processes involved in the appearance of ED symptomatology and which variables could be triggering them. Intimate Partner Violence (IPV) and Eating Disorders (ED) have a great impact on the physical and mental health of individuals (Laskey et al., 2019; Oram et al., 2013), thus representing crucial public health issues worldwide. IPV affects millions of people (641.000.000), especially women, in all regions of the world (World Health Organization; [WHO], 2021). EDs, which mainly include Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) Ione Bretaña [email protected] 1 Department of Clinical and Health Psychology & Research Methods, Faculty of Psychology, University of the Basque Country UPV/EHU, Av. Tolosa, 70, 20018 San Sebastian, Spain 2 Basic Psychological Processes and their Development Department, Faculty of Psychology, University of the Basque Country UPV/EHU, San Sebastian, Spain 3 Social Psychology Department, Faculty of Labour Relations and Social Work, University of the Basque Country UPV/ EHU, San Sebastian, Spain Abstract Eating disorders are one of the consequences suffered by individuals who are immersed in intimate partner violence. Knowing that intimate partner violence is a social problem that affects men and women all over the world, it is important to examine and detect which factors affect their physical and emotional health. The aim of the present work was to systematically review the association between IPV and ED. In February 2024, a systematic search of Web of Science, Scopus and PsycINFO databases was performed. A total of 689 papers were obtained, of which 155 were excluded as duplicates, resulting in 535 articles. After reviewing the title, abstract and keywords, 485 articles that did not meet the inclusion criteria were eliminated. Subsequently, the remaining 50 papers were read and discrepancies were resolved, achieving 87.3% agreement among judges. Finally, 40 papers met the inclusion criteria and were included in the systematic review. The results clearly show the relationship between IPV and various EDs. Being a victim of IPV, in its different forms (physical, psychological and sexual), has been related to disorders such as anorexia nervosa, bulimia nervosa and binge eating disorder. In general, some studies found differences between men and women in the association of the presence of sexual violence and ED symptoms. In conclusion, EDs may be a form of control that individuals exert over their bodies in response to the control exercised by their abusive partners. Addressing the interpersonal sphere by focusing on the management of violent dynamics within the couple is the key to change in individual coping. Keywords Intimate partner violence · Type of violence · Anorexia nervosa · Bulimia nervosa · Binge eating disorder Accepted: 17 December 2024 / Published online: 10 January 2025 © The Author(s) 2025 Intimate partner violence and eating disorders: a systematic review IoneBretaña1· JaraMendia2· VirginiaDíaz-Gorriti3· OierRotaetxe1 1 3 Current Psychology (2025) 44:1696–1716 When examining the different dimensions encompassed by the ED, it is essential to understand the responses that individuals with ED may have when they are victims of violence. In fact, understanding this aspect not only contributes to the understanding of abuse and its prevention, but also provides valuable tools for therapists to identify the behaviors exercised by both the victim and the aggressor, so that they can work on these problems and pathologies more effectively (Clavijo Campoverde et al., 2021). Finally, it should be noted that it is also essential to delve deeper into the factors that mediate between IPV and ED, in order to better understand the complex relationship and thus have complete and detailed information (Lucea et al., 2012). Therefore, this systematic review has a twofold objective: a) to explore the relationship between IPV and EDs, analysing how IPV may influence the development and perpetuation of different EDs and their symptomatology and b) to identify the underlying factors that contribute and/or moderate in the relationship between IPV and EDs with the ultimate goal of providing a solid foundation to guide future therapeutic interventions and ultimately contribute to improving the quality of life of those affected by these issues (Lozano-Muñoz et al., 2022). Theoretical framework Intimate partner violence (IPV) IPV refers to acts of aggression, abuse, subjugation and control that occur in a partner relationship (current or past), which may cause physical, psychological or sexual harm (Sardinha et al., 2022). Several studies conducted by organizations such as WHO in 2021 have highlighted the alarming prevalence of IPV worldwide. Specifically, according to data provided by WHO (2021) it is estimated that 27% of women aged 15–49 years have been subjected to physical and/or sexual violence by an intimate partner. It was also found that approximately one in four women and one in ten men have experienced IPV in their lifetime (Sardinha et al., 2022). IPV can have serious physical, mental, and sexual consequences for victims, increasing the risk of depression, post-traumatic stress disorder (PTSD), alcohol and drug abuse, and sexual and reproductive health problems (WHO, 2021). According to the study by Burgos et al. (2012) there are different forms of violence. On the one hand, economic violence, which involves the control and management of money, property and, in general, all the family's resources. On the other hand, there is psychological violence, a type of violence that manifests itself through shouting, threats, social isolation, jealousy, intimidation, degradation, insults and blame (Burgos et al., 2012). Another type of violence is physical violence, which refers to acts such as hitting, pushing and/or slapping, which can lead to situations that cause physical injury and/or even death (Burgos et al., 2012). This type of violence not only causes immediate physical injury, but also is associated with a number of long-term health problems, including mental disorders such as depression and PTSD (Dillon et al., 2013). Finally, there is sexual violence, which according to the description of Burgos et al. (2012) is exercised through physical or psychological pressures that impose unwanted sexual relations through coercion, intimidation or helplessness. Research on IPV reveals that both men and women can be perpetrators and victims of violence (Arnoso et al., 2017; Chen & Chan, 2021; Rojas-Solís et al., 2017), an aspect referred to as bidirectional violence (Johnson, 2011). Bidirectional violence is the most common form of violence in couples with an intimate relationship (Muñoz & Echeburúa, 2016). Psychological violence is more prevalent (80%) compared to physical violence (25%) within relationships where bidirectional violence exists (Graña & Cuenca, 2014). In the case of unidirectional violence, also called intimate terrorism (Johnson, 2011), one partner resorts to violent aggression while the other partner is the victim (Ferrer-Pérez & Bosch-Fiol, 2019). Likewise, there are findings that reveal that women are more perpetrators of psychological and mild physical violence and men of severe physical violence (Chen & Chan, 2021; Rubio-Garay et al., 2017). Regarding the directionality of violence and its consequences on the health of individuals, several researchers are beginning to study both the individual and the partner in relationships in order to better understand the extent of victimization and aggression in these situations (Herrero et al., 2020; Taylor et al., 2019; Xu et al., 2022). Studies focused on analysing the different forms of violence and their consequences on the physical and mental health of individuals have shown that the directionality of violence is associated with both the severity and the symptomatology presented (Chatterji & Heise, 2021), thus being an essential aspect to consider. Factors influencing the occurrence of IPV With regard to the development and emergence of violent dynamics, it has been observed that various factors, both individual and social, can facilitate violent interactions in couple`s relationships. Social factors such as social imaginaries that legitimize violence, low educational level, job insecurity, unemployment, machismo and LGTBI-phobia play a determining role. However, other intraindividual factors may also be influencing the occurrence of violence, as well as its consequences. Among the individual factors 1 3 1697 Current Psychology (2025) 44:1696–1716 we would have those that include psychopathology that the individual may be suffering from such as depression, anxiety, PTSD (Muñoz Fernández et al., 2020), as well as ED (Muñoz Fernández et al., 2020). Eating disorders (ED) EDs are complex mental disorders that affect the way people perceive their body and their relationship with food (Uribe et al., 2024). AN, BN and BED are just some of the manifestations of these disorders, which can have serious consequences for the physical and psychological health of those who suffer from them (Carolina & Janet, 2011). According to the DSM-5 (APA, 2013), EDs affect approximately 8.4% of women and 2.2% of men (Galmiche et al., 2019) at some point in their lives, these prevalences being very different depending on the type of ED. Between 1990 and 2020, deaths caused by EDs have doubled globally. According to the National Eating Disorder Association, an estimated 70 million people have been diagnosed with ED, and a significant increase in ED-related deaths has been observed (Wu et al., 2020). The magnitude of this problem is alarming, and it is crucial to effectively address the prevention, detection, and treatment of EDs to avoid devastating consequences on the health and wellbeing of affected individuals. According to the APA (2013), EDs are complex psychological conditions that affect a person's relationship with food, their weight and their body. On the one hand, AN is characterized by extreme restriction in food intake and excessive forms of exercise and/or diuretics, accompanied by an intense fear of gaining weight and a distortion in the perception of one's own body. It can manifest in two forms: restrictive, where weight loss is achieved by dietary restriction; and binge/purge, which involves recurrent episodes of excessive food intake or purging. On the other hand, BN involves recurrent episodes of binge eating, followed by inappropriate compensatory behavior to avoid weight gain, such as self-induced vomiting. The person's self-evaluation is negatively influenced by his or her body weight and shape. Finally, BED also involves recurrent episodes of binge eating, but without compensatory behavior. These episodes are associated with significant distress and do not occur exclusively during episodes of AN or BN. Although the exact etiology of ED is not fully understood, it has been shown that factors such as cultural pressure to achieve certain standards of beauty may influence the very development of the disorder (Campos del Portillo et al., 2024) and there have even been studies reporting the effects of some social networks on these disorders (MuñizRivas et al., 2020). Similarly, exposure to traumatic experiences and underlying psychological disorders have been relevant and key mediating variables in the development of this psychopathology (López Fernández Cao, 2017), as is depression and anxiety (Lacey & Mouzon, 2016). Regarding relational variables, it is observed, that the development of EDs can also come not only from the intrapersonal variables themselves, but also from the form of relationship of individuals, such as the type of attachment (Valledor et al., 2024). Therefore, we can conclude that it is not only those variables originating from the individual, but also some relational and interpersonal aspects can influence the appearance of the symptomatology associated with ED. However, at present we have little evidence on the impact of all these measures on well-being and the development of new evidence (Graell et al., 2020). Relationship between IPV and ED IPV and ED are complex and multidimensional problems, influenced by various individual, relational, contextual, and sociocultural factors. Studies have revealed that women who experience IPV are at increased risk of developing ED, with PTSD and depression as significant mediators in this relationship (Creech et al., 2021). In addition, both IPV and ED share common risk factors, such as exposure to childhood trauma and cultural pressure to meet certain beauty standards (Chen et al., 2024). These factors interact in complex ways, exacerbating the negative effects on the health and well-being of affected individuals. In the relationship dynamics between the perpetrator and the IPV victim, as well as between the individual and his or her ED, similarities are observed in patterns of control and abuse that negatively impact the lives of affected individuals. These findings highlight the complexity and severity of the effects of IPV and ED on mental and physical health (WHO, 2021), underscoring the importance of addressing these problems in a comprehensive manner and from interdisciplinary approaches (Wuest et al., 2003). Therefore, a systematic review would allow us to better understand this association, as well as to identify mediators and risk factors, and to understand how they affect the health and well-being of affected individuals. This would provide a solid basis for the development of future therapeutic interventions and effective prevention policies to improve the quality of life of individuals in abusive relationships with their partners. Method Data collection This systematic review was conducted taking into account the recommendations of the Preferred Reporting Items for 1 3 1698 Current Psychology (2025) 44:1696–1716 On the other hand, the following exclusion criteria were applied: (1) studies in which the type of violence was not specified; (2) theoretical articles; (3) systematic reviews or meta-analyses; (4) single-case studies; and (5) documents that were not accessible. Selection of studies The selection of studies was performed independently by three authors of this paper. The initial search yielded 689 papers, of which 155 were excluded because they were duplicates. After reading the title, abstract and keywords of the remaining 536 papers, 485 papers that did not meet the inclusion criteria were eliminated. The 50 papers were then read in full and discrepancies between the two authors were resolved. The degree of agreement between the two judges was high; specifically, they agreed in 87.3% of the cases. Finally, 40 papers met the inclusion criteria and were included in the systematic review (see Fig. 1). Systematic reviews and Meta-Analyses (PRISMA) statement (Page et al., 2021). A systematic search was conducted in February 2024, using the following databases: Web of Science, Scopus and APA PsycINFO. Specifically, a search equation combining the following terms was used: "intimate partner violence", "mutual violence", "perpetration", "victimization", "domestic violence", "partner abuse", "partner violence", "spouse abuse", "battered women" and "eating disorder", "eating pathology", "binge eating", "bulimia", "anorexia" and "disordered eating" (see pre-registration for more information: h t t p s : / / o s f . i o / j v r u d / ? v i e w _ o n l y = c 4 1 4 9 d 0 8 9 9 6 4 4 4 9 3 8 4 9 7 3 1 9 5 2 c 8 b 7 6 1 1 ) . Eligibility criteria We considered studies that met the following criteria: (1) analysed the relationship between IPV and ED symptomatology; (2) papers in article format that had undergone a peer review process; and (3) published in English or Spanish. Fig.1 PRISMA 2020 flow diagram for new systematic reviews which included searches of databases and registers only 1 3 1699 Current Psychology (2025) 44:1696–1716 only one study each (n = 2). In addition, the Abuse Assessment Screen (ASS), Conflict in Adolescent Dating Relationship Inventory (CARDI), and Extended/Hurt/Insult/ Threaten/Scream/Modified Version (EHITS-MV) instruments were also used in a single study each (n = 3). The Conflict Tactic Scale-2 (CTS-2) questionnaire was used in four studies (n = 4), and the Woman Abuse Screening Tool (WAST) instrument in one study (n = 1). Regarding the instruments found in the review to measure EDs, 44.18% of the studies used questionnaires or surveys designed to assess EDs. Regarding the instruments to measure EDs, 55.82% of the studies used standardized questionnaires. On the one hand, Eating Disorder Diagnostic Scale (EDDS) was used in three studies (n = 3), while Eating Disorder Inventory-2 (EDI-2) and the Eating Disorder Examination Questionnaire (EDE-Q) were applied in two and three studies respectively (n = 5). On the other hand, Eating Attitudes Test (EAT) was used in two studies (n = 2), and Sick-Control-Fat-Food (SCOFF) was the most used (n = 4). In addition, Diagnostic and Statistical Manual of Mental Disorders (DSM) was employed in three studies (n = 3), and World Mental Health Composite International Diagnostic Interview (WHO-CIDI) in two studies (n = 2). Instruments such as Eating Disorder Screen for Primary Care (EDSPC) and the Questionnaire on Eating and Weight Patterns-Revised (QEWP-5) were used in one study each (n = 2). Finally, Youth Risk Behaviour Surveillance System (YRBSS) and the Drive for Muscularity Scale (DMS) were also used in one study each (n = 2). Relationship between IPV and ED Overall, Huston et al. (2019) reported that approximately 14.11% met criteria for ED (7.83% BN and 6.28% BED), and 49.42% reported lifetime histories of IPV. The relationship between IPV and EDs has been extensively investigated, revealing a complex and multidimensional connection between these variables. Specifically, Huston et al. (2019) found that IPV history is significantly associated with ED symptoms (β = 6.21, p = 0.03). Likewise, findings such as those of McGee and Thompson (2013) revealed that adolescent males who reported experiences of forced sexual intercourse were more likely to report disordered eating behavior, with an odds ratio (OR) of 2.50, 95% CI:1.69– 3.70 indicating that victims of sexual victimization have a significantly increased risk of developing unhealthy eating behavior. To conclude, in the study by Huston et al. (2019) it was seen how approximately 14.11% of participants met criteria for some ED, with 7.83% for BN disorder and 6.28% for BED and that ED symptoms were significantly associated with IPV (β = 6.21, p = 0.03). In turn, Jonas et al. (2014) identified that women who had experienced IPV Coding studies Taking into account the guidelines of Lipsey and Wilson (2001), two authors created a coding scheme in which the following information was recorded: authors, title of the document, year of publication, study design, sample size, information regarding the age of the participants (mean, standard deviation, range), percentage of women, place of residence, type of sample (clinical vs. non-clinical), measurement instruments used, sexual orientation of the partners, type of violence (physical, psychological, sexual…), direction of partner violence (male to female, female to female…), objective and main results. Results Sample and instruments used Of the total number of studies analysed, 38 of these studies were quantitative and the remaining two were qualitative. Likewise, with regard to the type of research design, 35 studies of those studies were cross-sectional and five longitudinal ones. The studies identified in this review written in Spanish and English were published between 1989 and 2024: 1989 (n = 1), 2002 (n = 1), 2003 (n = 1), 2006 (n = 1), 2009 (n = 1), 2012 (n = 2, 2013 (n = 4), 2014 (n = 2), 2015 (n = 7), 2016 (n = 4), 2018 (n = 2), 2020 (n = 2), 2021 (n = 4), 2022 (n = 5) 2023 (n = 3) and 2024 (n = 2). The studies were conducted with samples from several countries such as Portugal, Spain, UK, Turkey, Japan, Iceland, Italy, Canada, Lebanon, Australia and the U.S. Thus, the samples came from the following continents: America (n = 26), Europe (n = 10), Asia (n = 2), Africa (n = 0) and Oceania (n = 1) (see Table 1). It was observed that in almost half of the studies (n = 20), 100% of the sample was composed of women. In 15 studies, women accounted for more than half of the sample, while in only four studies were men in the majority. Only in two studies was the sample composed exclusively of men. Regarding the instruments used to measure IPV, various validated questionnaires were found in 54.77% of the studies, while the remaining 45.23% used specific items to assess the type of violence. Among the instruments highlighted, the Humiliate-Afraid-Rape-Kick (HARK) questionnaire was used in three studies (n = 3), the Hurt-Insult-ThreatenScream (HITS) in two studies (n = 2), and the Avon Longitudinal Study of Parents and Children (ALSPAC) in three studies (n = 3). Other instruments such as Violence Received, Exercised and Perceived in Youth and Adolescent Dating Relationship Scale (VREPS) and Composite Abuse Scale Revised-Short Form (CASR-SF) were used in 1 3 1700 Current Psychology (2025) 44:1696–1716 Authors (year) Country n, type of sample and % of women Type of instrument used for intimate partner violence (type of violence) Type of instrument used for ED (types of ED/symptoms) Main results 1. Ackard and NeumarkSztainer (2002) USA 81,247 students (50%) A single two ítems adhoc with yes/no answer. (Violence and Rape) A single items adhoc with yes/no answers. (Binge eating) Significant associations were found between disordered eating behaviors and date-related experiences. For girls and boys, results indicate that experiencing date violence or rape is associated with significantly higher rates of binge-eating, fasting or skipping meals, taking diet pills, vomiting, and taking laxatives over the past year than for their peers who have experienced neither date violence nor rape. 2. Ackard et al. (2003) USA 3,533 students (48.9%) A single two item adhoc with yes/no answer. (Physical and sexual violence). A single two item adhoc with yes/no answer. (Dieting and beingpurge behaviors) Violence was significantly associated with dieting and being-purge behaviors. Girls and boys who report both physical and sexual dating violence where significantly more likely than their non-abused peers to report dieting and being-purge behaviors 3. Bailey y Gibbons (1989) USA 542 students (54.2%) A single item adhoc with yes/no answer. (Physical violence) They are based on DSM-III criteria to assess both bulimia symptoms and subclinical symptoms. (Bulimia nerviosa) The relationship between the other forms of victimization (rape, sexual molestation, and partner abuse) are smaller but all in the predicted direction. 4. Bartlett et al. (2018) USA 837 war veterans (23.7%) HARK (Humiliation, Afraid, Rape, Kick screening; Sohal et al., 2007) (Physical, sexual and psychological violence) EDDS (The Eating Disorder Diagnostic Scale; Stice et al., 2000) (Anorexia nervosa, bulimia nervosa, and binge eating disorder) In the case of men, each type of past-year IPV were significantly associated with Disordered Eating symptoms. In women, the results showed that past-year physical IPV (β = 13.74, SE = 3.96, p <.01), sexual IPV (β = 15.37, SE = 3.75, p <.001), severe psychological IPV (β = 14.68, SE = 3.63, p <.001), and a composite “any IPV” variable (β = 10.54, SE = 3.27, p <.001) were all significantly associated with EDDS scores. 5. Bonomi et al. (2013) USA 585 students (76%) A single ítem adhoc with yes/no answers. (Physical and psychological violence) Three questions from the Youth Risk Behavior Surveillance System (Dines, 2010) (Fasted, vomited, or took diet aids to lose weight) For females, any dating violence victimization was associated with disordered eating (taking diet aids, fasting, vomiting). For males, any dating violence victimization was associated with taking diet aids. Compared to non-exposed females, females with non-physical dating violence only were at increased risk of eating disorders (fasting, PR = 3.37; vomiting, PR = 2.66), 6. Brewer and Thomas (2019)1 USA 84,734 students (67,2%) A single 2 item adhoc with yes/no answer. (Physical, psychological and sexual violence) A simple item adhoc Undergraduate past-year survivors of IPV were more likely than their non-abused peers to report disordered eating (β = 0.36, p <.001), 7. Caceres et al. (2021) USA 615 women with heart disease (100%) A single two items adhoc with yes/no answer. (Physical and sexual violence) A single two items adhoc with yes/no answer. (Binge eating) Sexual and physical victimization was associated with binge eating. Physical revictimization was associated with higher odds of obesity (OR = 2.38, 95% CI: 1.38–4.10). Women who experienced physical abuse revictimization (OR = 3.11, 95% CI: 1.42–6.80), sexual abuse revictimization (OR = 2.79, 95% CI: 1.24–6.27), or any type of revictimization (OR = 2.78, 95% CI: 1.25–6.15) were more likely to report binge eating than those who reported no abuse in their lifetime. Table1 General results of studies selected for systematic review 1 3 1701 Current Psychology (2025) 44:1696–1716 Authors (year) Country n, type of sample and % of women Type of instrument used for intimate partner violence (type of violence) Type of instrument used for ED (types of ED/symptoms) Main results 8. Cha et al. (2016) USA 9,677 students (51.2%) A single two ítems adhoc where answer were categorized into the following mutually exclusive groups: 1) physical Dating Violence (DV) only 2) sexual DV only, 3) both physical and Sexual DV 4) no DV A single three items adhoc about unhealthy weight control behaviors with yes/no answers. (Anorexia nervosa and bulimia nervosa) Male and female adolescents who reported VPI had increased odds of eating disorder compared to those with no VPI. Notable gender differences were observed such that the relationship between VPI and disordered eating was stronger for males than for females regardless of DV type. Males who reported physical VPI only (OR = 1.83, 95% CI: 1.15–2.91), both physical and sexual DV (OR = 2.54, 95% CI: 1.55–4.16), and any form of DV (OR = 2.43, 95% CI: 1.81–3.25) were significantly more likely to report eating disorder than male adolescents with no DV. No significant differences were observed for males with sexual DV compared to those with no DV experience. Female adolescents who reported both physical and sexual violence were more than twice as likely to report eating disorder compared to those with no DV (OR = 2.54, 95% CI = 1.75–3.69). 9. Claydon et al. (2022) USA 1,580 university students (61.4%) Adapted from Conflict Tactic Scale-2 (CTS-2, Straus et al., 1996) (Verbal and physical violence) SCOFF (Sick, Control, One, Fat, Food; Morgan et al., 1999) During COVID-19 quarantine, the home becomes a dangerous place for victims of domestic violence. The article highlights the need for domestic violence prevention programs and accurate assessment of multiple domains of abuse during the COVID-19 emergency. 10. Claydon et al. (2024) USA 1,580 university students (61.4%) Conflict-Tactics Scale (CTS; Straus, 1979) (verbal and physical violence) SCOFF Questionnaire (Morgan et al., 1999) (AN and BN) Perpetuation of intimate partner violence was significantly associated with alcohol use (β = 0.13, p <.01) and alcohol relevance in college life (β = 0.11, p <.01), but not with ED symptoms. 11. Convertino et al. (2021) USA 217 minority (0%) HITS screening tool (Hurt-InsultThreatenScream; Sherin et al., 1998), (Physical and psychological violence) DMS (Drive for Muscularity Scale; McCreary, 2007, Spanish validation Escoto et al., 2013). (Musculatura) VPI experiences were negatively associated with muscularity-related dissatisfaction. 12. Creech et al. (2021) USA 442 pregnant veterans (100%) EHITS (ExtendedHurt/Insult/ Threaten/Scream– Modified Version; Portnoy et al., 2018). (nr) Mental health history was assessed via self-report measure and chart review. (nr) The IPV group had significantly higher proportions of women reporting eating disorders, compared to the IPV − group. 13. Gezen and Oral (2013) Turkey 81 women victims of violence (100%) nr (nr) SCL-90 (Symptom Check List-90; Derogatis, 1994). Levels of symptoms related with eating disorders were found high in both groups. 14. Gonçalves et al. (2022) Portugal 64 ED outpatients (95.3%) CADRI (Conflict in Adolescent Dating Relationships Inventory; Wolfe et al., 2001) (Physical, sexual and psychological violence) EDE-Q (Eating Disorder Examination Questionnaire; Machado et al., 2014) (ED symptomtology) More episodes of dating violence perpetration were associated with a high EDE-Q global score (r =.46, p <.001) and with high restraint (r =.49, p <.001), high shape concern (r =.41, p =.002), and high weight concern (r =.42, p <.001). No significant correlations were found between DA perpetration and eating concern (r =.25, p =.06). More episodes of DA victimization were associated with a high EDE-Q global score (r =.40, p =.002) and with high restraint (r =.34, p =.01), high eating concern (r =.26, p =.04), high shape concern (r =.45, p <.001), and high weight concern (r =.42, p <.001). Table 1 (continued) 1 3 1702 Current Psychology (2025) 44:1696–1716 Authors (year) Country n, type of sample and % of women Type of instrument used for intimate partner violence (type of violence) Type of instrument used for ED (types of ED/symptoms) Main results 15. Holmes et al. (2023) USA 212 survivors of intimate partner violence (100%) CASR-SF (The Composite Abuse Scale Revised-Short Form; Ford-Gilboe et al., 2016). (Physical, sexual and psychological violence) EDDS (The Eating Disorder Diagnostic Scale; Bohon & Stice, 2015). (Anorexia, bulimia, binge eating, atypical anorexia) There was a significant total effect of IPV on disordered eating and an indirect effect through PTSD symptoms. IPV was significantly associated with weight/shape concerns and there was an indirect effect through PTSD. There was a significant total effect of IPV on binge symptoms. Higher levels of IPV were associated with greater PTSD symptom severity which was associated with both weight/shape concerns and binge symptoms. 16. Huston et al. (2019) USA 190 female veteran (100%) HARK screening tool (Humiliate/ Afraid/Rape/Kick; Sohal et al., 2007) (physical, sexual or psychological) Eating Disorder Diagnostic Scale (EDDS; Stice et al., 2000) (anorexia nervosa, bulimia nervosa and binge eating disorder). Approximately 14.11% of participants met criteria for any ED (7.83% BN; 6.28% BED), and 49.42% reported lifetime IPV histories. Eating disorder symptoms were significantly associated with lifetime IPV, PTSD symptoms, and depression at the bivariate level. Results from the mediation model revealed that lifetime IPV was indirectly associated with EDDS scores, through PTSD symptoms and depression symptoms. 17. Jonas et al. (2014) United Kingdom 7,407 general population living in private households (59.7%) British Crime Survey questions, with positive or negative answer to the questions. (Physical and psychological violence) SCOFF (SickControl-One, Fat-Food; Morgan et al. 1999). (Potential eating disorders) For lifetime IPV, the association was significant in for eating disorder OR = 3.2 (2.0–5.0). When the sample is separated by gender, this association remains significant for women OR = 3.6 (2.1–6.1), but not for men 2.0 (0.7–6.6). The ORs were greater for physical than for emotional IPV for eating disorders. 18. Kondo et al. (2023) Japan 699 university students (34%) Nationally administered questionnaire on experiences of intimate partner violence. Nationally administered questionnaire on eating disorder symptoms SCOFF (screening tool for eating disorders) and DEBQ (disordered eating behavior questionnaire). Women were more likely to experience physical and emotional abuse by their partners and overeating when there is a history of treatment than women without a history of treatment. 19. Kothari et al. (2015) United Kingdom G1: 10,041 pregnant women at prenatal stage (100%) A series of five self-report questionnaires, designed and extensively piloted by ALSPAC, were sent to mothers over the perinatal period and included questions regarding their experience of IPV (Physical and psychological violence) At 12 weeks gestation, women were sent a questionnaire that included a brief self-report screening for history of psychiatric illness and Eating Disorders Examination Questionnaire (EDE-Q; Peláez-Fernandez et al., 2012). (Anorexia and Bulimia nerviosas) Prevalence of physical and emotional IPV was higher among women with lifetime eating disorder than those without. In comparison with women without eating disorder women with lifetime eating disorder showed higher odds of reporting physical IPV during the prenatal period (OR = 2.24, 95% CI: 1.09–4.62) and at 8–33 months after delivery (OR = 2.47, 95% CI: 1.40–4.33), but not during the postnatal period. In comparison with women without eating disorder, women with lifetime eating disorder showed higher odds of reporting emotional IPV during the prenatal (OR = 2.27, 95% CI: 1.51–3.43, p <.001) and postnatal periods (OR = 2.38 95% CI: 1.56–3.64, p <.001), and at 8–33 months after delivery (OR = 1.57, 95% CI: 1.06–2.33, p <.02). Table 1 (continued) 1 3 1703 Current Psychology (2025) 44:1696–1716 Authors (year) Country n, type of sample and % of women Type of instrument used for intimate partner violence (type of violence) Type of instrument used for ED (types of ED/symptoms) Main results 20. Kothari et al. (2015) United Kingdom G2: 10,620 newly delivered women (100%) A series of five self-report questionnaires, designed and extensively piloted by ALSPAC, were sent to mothers over the perinatal period and included questions regarding their experience of IPV. (Physical and psychological violence) At 12 weeks gestation, women were sent a questionnaire that included a brief self-report screening for history of psychiatric illness and Eating Disorders Examination Questionnaire. The results of the study indicate that women with eating disorders (ED) are more likely to experience physical and emotional intimate partner violence (IPV) during and after the perinatal period compared to those without ED. The prevalence of IPV was higher among women with lifetime EDs, especially those with marked weight and shape concerns and/or purging during pregnancy. Women with ED and concerns during pregnancy face an increased risk of IPV, highlighting the importance of addressing these conditions comprehensively during perinatal care. 21. Kothari et al. (2015) United Kingdom G3: 8,812 newly delivered women 8–33 weeks (100%) A series of five self-report questionnaires, designed and extensively piloted by ALSPAC, (Physical and psychological violence) Brief self-report screening for history of psychiatric illness and Eating Disorders Examination Questionnaire. Women with lifetime ED showed higher prevalence of IPV during and after the perinatal period (physical = 9.6%– 14.3% and emotional = 24.1%–28.1%). Lifetime ED was associated with higher odds of physical IPV during the perinatal period (OR = 2.34, 95% CI: 1.11–4.93, p =.03). Lifetime ED with and without pregnancy shape and weight concerns and/or purging was associated with higher odds of IPV after the perinatal period, and higher odds of reporting emotional IPV at all time points. Associations were moderated by partner's response to pregnancy and maternal experience of childhood sexual abuse. 22. Lacey and Mouzon (2016) USA 949 women victims of violence (100%) A single item adhoc with yes/no answer (Physical violence) WMH-CIDI (World Mental Health (WMH) SurveyInitiative Version of the World HealthOrganization (WHO) CompositeInternational Diagnostic Interview (CIDI), Kessler & Üstün 2004). Rates of eating disorders were generally higher for those with a history of IPV than those without such a history. More than a twofold difference was found between the two groups for bulimia (7.9% vs. 2.8%, p <.05) and more than a threefold difference in rates of binge eating was also detected (19.5% vs. 6.1%, p <.05). 23. Lacey et al. (2015a, 2015b) USA 3,277 Black women of African and AfricanAmerican origin (100%) A single item adhoc with yes/no answer (Physical violence). A modified version of the WHO CIDI (WHO Composite International Diagnostic Interview). The control variables (age, family income and educational level) did not significantly predict acceptance of intimate partner violence. When adding anxiety, aggressiveness, and collectivism, the variance explained increased significantly Aggressiveness increased the acceptance of violence (β = 0.62), whereas collectivism reduced it (β = -0.21). Anxiety was not significant. Acceptance of violence was not related to age, but was negatively related to income and educational level. Aggressiveness showed a strong positive relationship with violence acceptance (β = 0.45), and anxiety a weak positive relationship (β = 0.15). Collectivism was negatively associated with the acceptance of violence. 24. Lacey et al. (2015a, 2015b) USA 6,082 general population (100%) A simple item adhoc (Physical violence) World Health Organization Composite International Diagnostic Interview (DSM-IV) (Anorexia nerviosa, bulimia nerviosa y trastorno por atracón) Abused women were vulnerable to eating disorders (bulimia and binge eating). Table 1 (continued) 1 3 1704 Current Psychology (2025) 44:1696–1716 Limitations There are limitations in the reviewed studies. First, publication bias and reliance on self-reporting may introduce biases due to underestimation or overestimation of experiences of violence and disordered eating behavior (Cárdenas et al., 2023). Secondly, the selected studies cover a fairly wide range of years; specifically, from 1989 to 2024. Considering the diagnostic criteria for mental disorders such as those being analysed in the present study, it should be noted that during these years the versions of the diagnostic manuals for mental disorders, such as the ICD and DSM, have been modified. Likewise, intimate partner violence is a constantly changing construct that is being shaped and nuanced based on the passage of time and new policies against violence against women and domestic violence. Therefore, it should be borne in mind that the constructs studied and analysed in the studies of the current systematic review may have slight variations. Thirdly, it is important to note the absence of explicit coding of transgender people in most of the studies, a fact that does not imply that there are no transgender women and men in these samples. One aspect to note is that the formulation of questions does not distinguish between cisgender and transgender. This may have led to a simplification where the complexities of gender identity have not been recognized, limiting the visibility and representation of transgender people in these studies. Finally, the heterogeneity of studies and lack of longitudinal research are also significant limitations. Future studies should focus on inclusive and longitudinal methodologies to better understand the causal relationships and temporal factors in this relationship. Conclusion and future directions This work contributes significantly to the understanding of the complex relationship between IPV and EDs, highlighting the need for more inclusive and personalized approaches to research and treatment. Recognizing and addressing these differences is crucial to developing effective strategies to promote mental health across the population. Likewise, the importance of advocating for the proper collection of gender-related information is now crucial for both research and the development of prevention and treatment programs. Indeed, transgender people, especially non-binary people, face increased risks of mental health problems, discrimination, and violence, including elevated rates of EDs, anxiety, and suicide (Lefevor et al., 2019). The findings highlight the importance of personalizing interventions and underscore the urgency for mental health polies and programs that address both IPV and EDs in a comprehensive manner, repeatedly or prolonged (Lebed et al., 2023; Lucea et al., 2012). These data underscore the need to implement preventive IPV screening methods to reduce harmful physical and mental health consequences (Johnson, 2006). If we consider the relationship between IPV and EDs, we note that in between there may be other factors or symptomatology that may explain this relationship more comprehensively. In addition to violence, factors such as perfectionism, childhood trauma, and substance abuse act as mediators in this relationship. Muyan et al. (2015) found that several dimensions of perfectionism were associated with dieting and/or binge eating. Weight-related teasing by a partner can lead to increased body dissatisfaction and trigger restrictive ED symptoms. Coping with abandonment or loss of a significant relationship can result in binge eating and purgative behavior characteristic of BN (Canals & Val, 2022). The relationship between IPV and ED points to how trauma and stress affect mental health and eating behavior, with eating acting as a coping mechanism to manage stress and perceived control over one's life. The importance of diagnosis and effective assessment In several studies reviewed, validated questionnaires were used to assess for the presence of ED and IPV. Although useful and accessible, these questionnaires may limit indepth understanding of these complex conditions, as they do not fully capture the individual experience, especially in contexts of trauma and abuse (Briere, 1997). There is a risk of self-report bias, where individuals may underestimate or overestimate their experiences due to shame, stigma, or lack of self-awareness. In addition, standardized questionnaires may not be sensitive to cultural, gender, or contextual particularities, limiting diagnostic accuracy (Noyes et al., 2019). To improve the accuracy and efficacy of diagnosis and intervention, it is crucial to incorporate a variety of assessment tools and methods. For example, questionnaires could be complemented by structured clinical interviews that allow for a more in-depth and personalized exploration of IPV and ED experiences (Valdez-Santiago et al., 2006). Adopting a comprehensive, evidence-based approach to assessment and diagnosis will help provide a more complete understanding of individual needs, allowing for more targeted and effective interventions, minimizing misdiagnosis or incomplete diagnoses, and providing more accurate data for research, contributing to better practices in therapeutic intervention. 1 3 1711 Current Psychology (2025) 44:1696–1716 multicultural. 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Violencia de pareja intima contra la mujer: Revisión sistemática de tipologías, metodologías y tópicos actuales en su investigación. Salud, Ciencia y Tecnología, 3, 598. h t t p s : / / d o i . o r g / 1 0 . 5 6 2 9 4 / s a l u d c y t 2 0 2 3 5 9 8 Carolina, L. G., & Janet, T. (2011). Trastornos de la conducta alimentaria en adolescentes: Descripción y manejo. Revista Médica Clínica Las Condes, 22(1), 85–97. h t t p s : / / d o i . o r g / 1 0 . 1 0 1 6 / S 0 7 1 6 - 8 6 4 0 ( 1 1 ) 7 0 3 9 6 - 0 promoting a holistic approach that can significantly improve the quality of life of affected individuals. Acknowledgements This research was supported by a predoctoral grant from the Basque Government to JM (PRE_2021_1_0065), by a Basque Government Research Groups grant (‘Culture, Cognition, and Emotion’ Group; IT1598-22), and by two Spanish Ministry of Science and Innovation grants (PID2020-115738GB-I00 and PID2020-116658GBI00), funded by MCIN/AEI/10.13039/501100011033/. Funding Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Data availability Data generated and analysed during this study are not publicly available. However, they may be obtained from the corresponding author upon reasonable request. Declarations Conflict of interest The authors have no conflicts of interest to declare. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. 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