Date of Award

January 2014

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

F. Richard Ferraro


Eating disorders are serious, potentially life-threatening psychiatric disorders associated with a variety of negative medical, social, and psychological consequences. Comorbid mental disorders, such as substance use disorders, present an increasingly complex clinical picture. A significant body of research has been devoted to investigating the etiology of eating disorders and their comorbid conditions. One factor that has received research attention is that of childhood trauma experiences. Childhood trauma has been related to the development of both bulimia nervosa and substance use disorders, and more broadly, an impulsive, behaviorally dysregulated trajectory. Affect dysregulation is one factor proposed to play a role in the development of eating disorders, substance use disorders, and other forms of impulsive behavior. The current study sought to examine affect dysregulation as a mediator of the relationship between childhood trauma and comorbid substance use disorder and bulimia nervosa. Mediation analyses using a bootstrapping procedure were conducted. Findings suggest that a relationship exists between childhood trauma and the development of drug use disorders, but not alcohol use disorders, in individuals with bulimia nervosa through indirect and/or direct pathways. Additionally, affect dysregulation serves as a mediator of the relationship between childhood sexual abuse and comorbid drug use disorders and as an indirect pathway for the relationship between both childhood physical and emotional abuse and drug use disorders. Overall, affect dysregulation appears to function as a key mechanism in the development of drug use disorders and bulimia nervosa in individuals with a history of childhood trauma.