Adverse Childhood Experiences and Disordered Eating Behaviors Among <scp>US</scp> Children: Untangling the Developmental Sex Differences
Bibliographic record
Abstract
OBJECTIVE: This study examined associations between adverse childhood experiences (ACEs) and heterogeneous disordered eating behaviors (DEBs) in a nationally representative sample of US children, investigating how sex and developmental stage jointly moderate these relationships. METHOD: Data from the 2022-2023 National Survey of Children's Health included 67,607 children aged 6-17 years (weighted N = 50,023,339), with information collected from caregivers. Latent class analysis identified DEB patterns. Multinomial logistic regression analyzed associations between both cumulative ACE scores and specific ACE types with DEB classes. Average marginal effects assessed how sex and developmental stage modified these associations. RESULTS: Among participants, 44% had experienced at least one ACE. Four distinct DEB classes emerged: Minimal Disordered Eating (81.7%), Binge/Fasting Eating (7.3%), Picky/Restrictive Eating (8.9%), and Severe Mixed Dysregulation (2.1%). Cumulative ACE exposure showed significant relationships with all DEB subtypes. Each additional ACE increased the likelihood of Severe Mixed Dysregulation by 70% (RRR = 1.70, 95% CI [1.62, 1.75]). Economic hardship, household mental illness, and health discrimination showed significant positive associations across all DEB subtypes. Sex and developmental stage significantly moderated these associations: boys exhibited increasing ACE effects with developmental stage in the Binge/Fasting Eating group, while girls showed intensified ACE effects with increasing developmental stage in the Severe Mixed Dysregulation group, particularly for health discrimination. DISCUSSION: Findings support the adoption of trauma-informed and developmentally sensitive approaches. Sex-specific patterns highlight the need for interventions that consider both sex and developmental stage, with particular attention to girls entering middle-late adolescence who demonstrate elevated vulnerability to developing eating dysregulation following ACE exposure.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".