Emotional dysregulation in childhood and disordered eating and self-harm in adolescence: Prospective associations and mediating pathways

Naomi Warne, Jon E Heron, Becky Mars, Francesca Solmi, Lucy A Biddle, David J Gunnell, Gemma L Hammerton, Paul A Moran, Marcus R Munafo, Ian S Penton-Voak, Andrew L Skinner, Anne Stewart, Helen E Bould*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

6 Citations (Scopus)
107 Downloads (Pure)


Background: Emotional dysregulation may be a risk factor for disordered eating and self-harm in young people, but few prospective studies have assessed these associations long-term, or considered potential mediators. We examined prospective relationships between childhood emotional dysregulation and disordered eating and self-harm in adolescence; and social cognition, emotional recognition and being bullied as mediators.

Methods: We analysed Avon Longitudinal Study of Parents and Children data on 3453 males and 3481 females. We examined associations between emotional dysregulation at 7 years and any disordered eating and any self-harm at 16 years with probit regression models. We also assessed whether social cognition (7 years), emotional recognition (8 years) and bullying victimisation (11 years) mediated these relationships.

Results: Emotional dysregulation at age 7 years was associated with disordered eating (fully adjusted probit B (95% CI) = 0.082 (0.029, 0.134)) and self-harm (fully adjusted probit B (95% CI) = 0.093 (0.036, 0.150)) at age 16 years. There was no evidence of sex interactions or difference in effects between self-harm and disordered eating. Mediation models found social cognition was a key pathway to disordered eating (females 51.2%; males 27.0% of total effect) and self-harm (females 15.7%; males 10.8% of total effect). Bullying victimisation was an important pathway to disordered eating (females 17.1%; males 10.0% of total effect), but only to self-harm in females (15.7% of total effect). Indirect effects were stronger for disordered eating than self-harm.

Conclusions: In males and females, emotional dysregulation in early childhood is associated with disordered eating and self-harm in adolescence and may be a useful target for prevention and treatment. Mediating pathways appeared to differ by sex and outcome, but social cognition was a key mediating pathway for both disordered eating and self-harm.
Original languageEnglish
Number of pages10
JournalJournal of Child Psychology and Psychiatry
Early online date21 Dec 2022
Publication statusE-pub ahead of print - 21 Dec 2022

Structured keywords

  • self-harm
  • disordered eating
  • emotional regulation
  • prospective
  • mediation
  • SASH


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