The main objective of the present study was to analyse the association between core symptoms traversing eating disorders, and explore the role of fear of loneliness and social isolation in relation to behavioural eating disorder characteristics (EDCs) and intimate partner violence (IPV) received. First, it was hypothesised that core symptoms traversing EDs would have a significant direct effect on received partner violence. Results showed that some of the EDCs were not significantly associated with any of the received violence indicators (e.g., bulimia, body dissatisfaction, and fear of maturity). However, other indicators such as obsession for thinness, ineffectiveness, perfectionism, interoceptive awareness, asceticism, impulsiveness, and social insecurity were all significantly and positively related to received violence. These results are in accordance to previous scientific literature that eating disorders increase likelihood of IPV among both females and males (Bundock et al., 2013; Pichiule et al., 2014). Although EDs have traditionally been considered female disorders, recent evidence suggests that it is not uncommon among males, and that males can present similar severe ED symptoms. In fact, there are specific risk factors for developing ED in young and adolescent males, such as body image concerns related to muscularity and sexual orientation (Gorrell & Murray, 2019). As aforementioned, eating disorders can emerge as maladaptive coping mechanisms that enable individuals to regain control over adverse situations, as can be receiving violence (Schlegl et al., 2020; Wong & Chang, 2016). Another factor associated with EDs and violence exposure among both sexes is social isolation, which has been associated with adoption of unhealthy weight control practices (Martins et al., 2019).
With the aim of exploring more deeply the role of social aspects, the second hypothesis was that core symptoms traversing EDs would have a significant indirect effect on received partner violence through the mediating role of fear of loneliness and the moderating role of social isolation. On the one hand, results showed that ineffectiveness, fear of maturity, and impulsivity were the behavioural EDCs predominantly related to fear of loneliness. Fear of loneliness had no direct significant effect on any of the received violence variables. Nevertheless, interaction effects indicated a moderately significant influence of fear of loneliness on physical violence, psychological humiliation-coercion, and social received violence as a function of levels of social withdrawal.
It was also found that the indirect effects of ineffectiveness, fear of maturity, and impulsiveness on physical and social received violence, through fear of loneliness, were significant only at high social withdrawal levels. Results refine the understanding of the relationship between social withdrawal and the development of eating disorders in individuals exposed to partner violence. Individuals suffering loneliness appear to be more susceptible to developing disordered eating patterns (Wright & Pritchard, 2009). For instance, the pandemic and subsequent social restrictions have limited and deprived individuals of social interaction and therefore, of social support and similar coping strategies in facing this unprecedented situation (Monteleone et al., 2021). Therefore, eliminating social protection factors when coping with adverse events could increase risk and symptoms of ED (Rodgers et al., 2020). In this sense, loneliness has been conceived as a mediator between emotional dysregulation and eating disorders-related psychopathology (Southward et al., 2014).
This lack of perceived social support associated with the exposure to partner violence could culminate in many psychological health consequences, such as depression, post-traumatic stress, anxiety, and eating disorders, among other mental health illnesses (Mazza et al., 2021). Low levels of social support have been related to increased risk of ED among women exposed to IPV. Social support has shown protective effects against ED by decreasing levels of anxiety and promoting mechanisms related to functional coping strategies (Schirk et al., 2015). However, IPV-exposure and trauma history can precede the development of ED symptoms. The extant literature highlights the presence of childhood abuse among individuals suffering IPV and Eds. Children who have experienced exposure to violent situations appear to be more susceptible to developing Eds (Bundock et al., 2013; Kimber et al., 2017).
Other studies have identified specific aspects related to altered-eating behaviours and IPV-exposure including somatization, avoiding abuse, coping, self-harm, and challenging abusive partners (Wong & Chang, 2016). All of these aspects support the notion that ED-related behaviours are used as ways to cope with adverse and stressful situations such as received violence. This could be important information for therapists who work with those experiencing IPV and who develop interventions for patients with clinical symptoms of eating disorders. Results emphasize the importance of understanding the vulnerability and absence of coping resources among individuals who suffer IPV and develop Eds, with the aim of designing interventions focused on the promotion of coping through seeking social support and avoiding isolation.
The present study has some limitations that should be noted. First, the cross-sectional design employed in the present study does not allow determining conclusions in terms of causality. Therefore, longitudinal studies would be needed to determine any casual inference among different variables examined in the present study. Secondly, the sample in the present study was limited to emerging adults, with an average age of 21 years old, therefore results cannot be generalized to other age groups. In future research, it would be interesting to extend the study to other age populations, with the aim of exploring differences in ED-behaviour patterns and IPV related to social isolation aspects in other developmental phases. In addition, the present study did not explored differences by sex in the variables of interest. Efforts to increase the number of male participants would be of utility with the objective of homogenizing the sample and analysing differences in ED patterns and different symptoms related to received violence in relationships.
Overall, the results of the present study demonstrate the role of social-related aspects in the relationship between eating disorders and IPV. It is suggested that individuals exposed to violent situations in relationships may develop ED-related symptoms as a way of coping adverse situations. However, this relationship is not direct, and it appears that underlying mechanisms related to fear to loneliness and social withdrawal prevent the developing of coping resources for facing received violence. Future research should focus on finding ways of empowering victims through increasing social support and promoting resilience and adaptive coping resources as ways to reduce exposure to violent situations.