The Role of Narcissism and Dissociation in the Indirect Relationship Between Childhood Trauma and Body Dissatisfaction, Bulimia, and Drive for Thinness in a Sample of Adolescents: A Path Analysis Model

Abstract

Abstract This study examined the associations between childhood trauma, body dissatisfaction, bulimia, and drive for thinness in adolescents, with a specific focus on the roles of narcissistic traits and dissociative experiences as intervening variables. A sample of 439 high school students from Southern Italy completed self-report measures assessing eating-disorder-related symptoms, pathological narcissism, childhood trauma, and dissociation. The hypothesised path model showed significant indirect associations between emotional abuse and both drive for thinness and bulimia through vulnerable narcissism and dissociative experiences. More specifically, depersonalisation was positively associated with bulimia, whereas passive influence was positively associated with drive for thinness. Grandiose narcissism showed a negative association with body dissatisfaction and was not positively associated with the eating-related outcomes. Multi-group analyses indicated that the model was not invariant across males and females. In males, absorption was involved in the indirect association between childhood trauma and body dissatisfaction, whereas this pathway was not observed in females. These findings suggest that childhood trauma may be linked to eating-disorder-related features through different psychological pathways involving narcissistic vulnerability, specific dissociative dimensions, and gender. Because of the cross-sectional design, the findings should be interpreted as associative rather than causal.