Childhood abuse and neglect are differentially associated with quality of life changes during inpatient treatment for eating disorders

Quality of life (QoL) is markedly impaired in eating disorders (EDs) and often remains compromised after treatment. Although adverse childhood experiences (ACEs) are linked to ED severity and prognosis, less is known about how specific ACE subtypes are associated with changes in functional outcomes. A sample of 221 cisgender women inpatients with EDs completed the Childhood Trauma Questionnaire (CTQ) and the Eating Disorder Quality of Life questionnaire (EDQoL) at admission and discharge. Moderation models examined whether ACE dimensions were associated with differences in the association between baseline and discharge QoL, adjusting for age, body mass index, and illness duration. Patients showed marked QoL impairment at admission and significant improvement by discharge. Emotional and physical neglect were differentially associated with QoL change patterns: higher emotional neglect was associated with weaker baseline-discharge continuity, whereas higher physical neglect was associated with stronger continuity. Overall, 54% of patients achieved reliable improvement. Abuse-only and neglect-only profiles were associated with a lower likelihood of reliable QoL improvement compared with no CTQ elevation. Specific forms of childhood adversity, particularly neglect, are differentially associated with short-term functional recovery during inpatient treatment for EDs, highlighting the relevance of ACE-informed, subtype-sensitive clinical approaches.