Distress Tolerance and Dissociation in the Pathway between Invalidating Childhood Environment and Disordered Eating Behavior: A Mediation Analysis among Emerging Adults in India

Background: Emerging adulthood is a developmental stage marked by increased vulnerability to various psychopathological disorders, with disordered eating behavior (DEB) being a prominent risk. An invalidating childhood environment (ICE) emerged as a significant factor associated with DEB; however, the pathway through which ICE influences DEB remains unclear, especially in the Indian context. Aim: The study aimed to assess the association between IEC from both parents, distress tolerance (DT), dissociation, and DEB and to test whether DT and dissociation significantly mediate these relationships. Materials and Methods: Using a cross-sectional design with a quantitative approach, 302 emerging adults aged 18–29 years, encompassing both male and female, were recruited through convenience and snowball sampling. Data were collected using an online Google Form containing standardized tool: ICE Scale; Dissociative Experiences Scale – II; DT Scale, and Eating Attitudes Test. Results: The findings indicated a significant association between ICE from both parents, DT, dissociation, and DEB ( P < 0.005). Mediation analysis indicated a significant direct effect of ICE-M (β = 1.0396, t = 9.75, 95% confidence interval [CI] [0.8297, 1.2494]) and ICE-F (β = 1.011, t = 9.92, 95% CI [0.8105, 1.2116]) on DEB. In addition, the indirect effect of ICE-M and ICE-F on DEB through DT and dissociation was also significant, indicating that DT and dissociation partially mediated these associations among emerging adults. Conclusions: The findings underscore the significance of targeting both DT and dissociation as crucial components in interventions of DEB among emerging adults with a history of parental invalidation in childhood.