Early Life Adversity and Disordered Eating: Cognitive and Neural Mechanisms
Abstract
1. Introduction
Neural Development Patterns of ELA
2. Method
Paper Identification and Review
3. Results
3.1. Structural Changes, Functional Changes, and Cognitive Processing Patterns Related to ELA
3.2. Association Between ELA and Disordered Eating
3.2.1. Structural MRI Evidence
3.2.2. Resting States and Task-Based fMRI Evidence
3.2.3. Cognitive Processing Patterns
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
| ELA | early life adversity |
| OFC | orbitofrontal cortex |
| vmPFC | ventromedial prefrontal cortex |
| ACC | anterior cingulate cortex |
| DMN | default mode network |
| IFG | inferior frontal gyrus |
References
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| Study | Sample Size | Age 1 (M ± SD) | Measures of Adversity | Neuroimaging | Task | Main Findings |
|---|---|---|---|---|---|---|
| Summary for Neuroimaging Studies on Early Life/Childhood Experiences | ||||||
| (Buimer et al., 2022) | 1184 | 9.54 ± 0.86 | Adverse childhood experiences | MRI | Substance abuse in the household was associated with larger cortical surface area in the left superior frontal gyrus, right superior frontal gyrus, left pars triangularis, left rostral middle frontal gyrus, and right caudal anterior cingulate gyrus. Household exposure to violence was associated with lower fractional anisotropy in the left and right cingulum bundle hippocampus region. | |
| (Buthmann et al., 2024) | 155 | 11.33 ± 1.05 | The Traumatic Events Screening Inventory for Children; modified version of the UCLA Life Stress Interview | MRI | Severity of ELA was associated with greater likelihood of belonging to the low HCV/high symptom | |
| (Chan et al., 2024) | 549 | 31.1 ± 5.2 | Adversity measured by seven components focused on prenatal exposures | MRI, RSFC | A linear decrease in SC–FC was observed from age 4.5 to 7.5 years. When stratified by ELA, only the high-adversity group showed a curvilinear trajectory, with a steep decrease between age 4.5 and 6 years, suggestive of accelerated neurodevelopment. | |
| (Cheng et al., 2021) | Adversity, n = 127; None, n = 96; Abuse only, n = 33; Neglect only, n = 28; Both, n = 45; Neither, n = 96 | 16.1 ± 2.3; 16.4 ± 2.5; 16.7 ± 2.5; 15.5 ± 2.3; 16.4 ± 2.3; 16.4 ± 2.5 | Adverse Childhood Experiences (ACE) questionnaire; Childhood Trauma Questionnaire | RSFC | In a general model, adversity was associated with altered amygdala RSFC with clusters within the left anterior lateral prefrontal cortex. In a dimensional model, abuse was associated with altered amygdala rs-fc within the orbitofrontal cortex, dorsal praecuneus, posterior cingulate cortex, and dorsal anterior cingulate cortex/anterior mid-cingulate cortex, as well as within the dorsal attention, visual, and somatomotor networks. Neglect was associated with altered amygdala RSFC with the hippocampus, supplementary motor cortex, temporoparietal junction, and regions within the dorsal attention network | |
| (Demers et al., 2022) | 85 | Maternal age at delivery 31.37 ± 5.17 | Adverse Childhood Experiences Questionnaire | MRI | Higher maternal ACEs were associated with smaller left, and right amygdala volume of infants. | |
| (Díaz-Arteche et al., 2021) | 91 | 16.46 ± 0.52 | Event planning and problem-solving interactions measuring mother-adolescent dyads; stressful life events questionnaire and the Child Trauma Questionnaire | MRI | In females, childhood maltreatment predicted larger anterior pituitary gland volume at T4. | |
| RSFC | ELA were associated with decreased anterior hippocampal-cortical functional connectivity. | |||||
| (Elton et al., 2025) | 338 | 9.9 ± 0.1 | Adverse Life Events Scale | RSFC | Adverse life events were related to greater decreases in network-to-subcortical functional connectivity across most networks, but particularly for the cingulo-opercular network and sensorimotor network; adverse life events were also associated with increasing connectivity within and between motor and sensory networks. | |
| (Hendrix et al., 2021) | 48 | 26.4 ± 2.7 (weeks) | Childhood Trauma Questionnaire–Short Form; Perceived Stress Scale; Spielberger State-Trait Anxiety Inventory; Edinburgh Depression Scale | RSFC | Emotional neglect from the mother’s childhood positively correlated with left and right amygdala–the dorsal anterior cingulate cortex functional connectivity in neonates | |
| (Holz et al., 2023) | 169 | 29.60 ± 5.92 | Childhood Trauma Questionnaire | MRI | Structural alterations were associated with ELA, including increased volume of the amygdala, hippocampus, and orbitofrontal cortex (OFC), as well as reduced volume of the ventromedial prefrontal cortex (vmPFC) and anterior cingulate cortex (ACC) | |
| (Jeong et al., 2021) | 9270 | 119.17 ± 7.47 (months) | Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) administered to a parent or guardian | MRI | Trauma exposure was associated with thinner cortices in the bilateral superior frontal gyri and right caudal middle frontal gyrus as well as thicker cortices in the left isthmus cingulate and posterior cingulate; trauma exposure was associated with smaller GMV in the right amygdala and right putamen. | |
| (Kawamoto et al., 2023) | 400 | 40.6 ± 10.4 | short form of Egna Minnen Beträffande Uppfostran; Childhood Trauma Questionnaire | MRI | Greater parental rejection resulted in smaller hippocampal and amygdala volumes; | |
| (Kennedy et al., 2021) | 77 | 181 ± 15 (months) | Youth Life Stress Interview | MRI | Greater adversity was associated with lower accumbofrontal tract integrity in both the left and right hemispheres | |
| (Y. Luo et al., 2023a) | 85 | 10.20 ± 0.99 | Family Unpredictability Scale; subjective SES; Children’s Eating Behaviour Questionnaire; Food portion choice in the absence of hunger | RSFC | Environmental harshness and unpredictability were negatively associated with bilateral BLA-left inferior frontal gyrus (IFG) connectivity, while dynamic RSFC analyses found that environmental harshness and unpredictability was negatively associated with right CMA, left inferior parietal lobule, and right CMA-right precuneus connectivity | |
| (Y. Luo et al., 2024) | 501 | 19.22 ± 0.83 | Environmental Harshness and Unpredictability Scale; uncontrolled eating subscale of eating behaviours | RSFC | Harsh, unpredictable childhood environments are associated with significant but modest decreases in connectivity of right inferior frontal gyrus (IFG)-bilateral medial frontal gyrus, right IFG-bilateral inferior parietal lobule (IPL), and right IFG-left superior frontal gyrus connectivity, as well as attentional engagement to high-calorie food and binge eating tendencies. | |
| (Merritt et al., 2023) | 275 | 21.53 ± 1.46 | cumulative psychological trauma; cumulative pre and perinatal risk | MRI | Cumulative pre/perinatal risk was associated with smaller left subgenual cingulate volume; Cumulative childhood trauma was associated with larger left dorsal striatum, right prefrontal cortex and smaller left insula volume | |
| (Miller et al., 2022) | 115 | 11.51 ± 1.08 | modified version of the Traumatic Events Screening Inventory for Children; modified version of the UCLA Life Stress Interview coding system | MRI | ELA was positively associated with change in brain volume (expansion) in 13 of these clusters, which included white matter in the left cerebellum and bilateral superior frontal gyrus, and grey matter in the left caudate, right cuneus, right lateral and inferior occipital gyrus, and various frontal cortical regions (e.g., bilateral superior and inferior frontal gyrus, bilateral medial orbitofrontal cortex). ELA was negatively associated with volumetric change (contraction) in 9 clusters that included gray matter in the right globus pallidus, right entorhinal cortex and fusiform gyrus, left posterior cingulate gyrus, and various frontal, temporal, and parietal cortical regions (e.g., right superior frontal gyrus, left supramarginal gyrus) | |
| (Miller et al., 2024) | 784 | At age 4.5, 6, 7.5 | Perinatal adversity | MRI | Greater adversity was associated with reduced bilateral hippocampal body volume in early childhood, but also to faster growth in the right hippocampal body across childhood. | |
| (Morelli et al., 2021) | 46 | 4.8 ± 0.8 | Early life stress, Exposure to parental depression, Exposure to parental hostility | MRI & fMRI & RSFC | Reward Processing Task | In the reward condition, higher levels of early life stress, were related to decreased right amygdala connectivity with frontal regions during hit trials but increased connectivity during miss trials. Higher levels of early life stress were associated with greater differences in left amygdala connectivity with left dorsal frontal cortex |
| (Peverill et al., 2023) | 161 | 12.64 ± 2.67 | Childhood Experiences of Care and Abuse Interview; Childhood Trauma Questionnaire; Violence Exposure Scale for Children Revised; short form of the Home Observation for Measurement of the Environment | MRI | Greater threat was associated with thinner cortex in a network including areas involved in salience processing (anterior insula, vmPFC), and smaller amygdala volume (particularly in younger participants), after controlling for deprivation. Threat was also associated with thinning in the frontoparietal control network. | |
| (Price et al., 2021) | Maltreatment, n = 96; Comparison, n = 288 | 19.20 ± 0.79; 19.04 ± 0.71 | Childhood Trauma Questionnaire | MRI | Individuals with a maltreatment history had reduced surface areas and cortical thicknesses primarily in frontal-temporal regions; and they also had larger cortical thicknesses in occipital regions and surface areas in frontal regions. | |
| (Qiu et al., 2024) | 381 | 7.5 cohort study | State–Trait Anxiety Inventory; Beck Depression Inventory—II, the Edinburgh Postnatal Depression Scale; questions on pregnancy-related feelings administered at 26–28 weeks of Maternal pregnancy | RSFC, MRI | Girls born to mothers who reported greater positive mental health during pregnancy showed larger bilateral hippocampi.; Children of mothers with greater positive mental health exhibited altered functional connectivity of several networks, including default mode, salience, executive control, amygdala and thalamo-hippocampal networks | |
| (Quidé et al., 2021) | 160 | 40.08 ± 13.64 | Childhood Adversity Questionnaire | MRI | Trauma exposure was negatively associated with GMC of the middle frontal gyrus and parietal lobule, while negatively associated with grey matter volume covariation in the cerebellum. | |
| (Sacu et al., 2025) | 161 | 32.21 ± 0.29 | modified version of Munich Event List; block-designed emotion regulation task | RSFC | While prenatal and childhood stress were associated with lower connectivity between subcortex and cognitive networks, stress exposure unique to adolescence was related to higher connectivity from the salience network to the cognitive networks during emotion regulation. | |
| (Tooley et al., 2024) | 261 | 41.3 ± 8.1 (months) | Area Deprivation Index percentiles; Healthy Eating Index; Prenatal disadvantage | RSFC | The magnitude of associations between prenatal disadvantage and developmental increases in local segregation differed across functional systems, with the strongest associations found in somatomotor-hand, somatomotor-mouth, dorsal attention, visual, and frontoparietal systems | |
| (Wang et al., 2024) | 158 | 22.07 ± 2.08 | Childhood unpredictability | MRI | After controlling for the effect of childhood trauma, childhood unpredictability was correlated with greater GMV in bilateral frontal pole, bilateral precuneus, bilateral postcentral gyrus, right hemisphere of fusiform, and lingual gyrus, and left hemisphere of ventrolateral prefrontal cortex as well as occipital gyrus | |
| (Wong et al., 2023) | Normative, n = 245; Low, n = 377; Moderate, n = 376; High, n = 376 | 14.3 ± 4.2; 13.8 ± 3.3; 14.9 ± 3.4; 16.8 ± 3.1 | Traumatic Stressful Load; Stressor Reactivity Score | MRI | The high SRS group revealed a pattern of accelerated grey matter maturation; Positive correlations between averaged quantile regression index and Stressor reactivity score were found in bilateral thalamus proper and putamen, right caudate and amygdala | |
| (Y. Yang et al., 2024) | 5885 | 119.13 ± 7.51 (months) | Life Events Scale | RSFC | Unpredictability was associated with a smaller increase in RSFC within default mode network (DMN) and a smaller decrease in RSFC between cingulo-opercular network (CON) and DMN. | |
| (Y. Yang et al., 2025) | 5885 | 119.13 ± 7.51 (months) | Interpersonal and socioeconomic threat; Interpersonal and socioeconomic unpredictability; Interpersonal and socioeconomic deprivation | RSFC | Interpersonal unpredictability was associated with a greater decrease in RSFC of cingulo-opercular network(CON)-left amygdala, CON-right amygdala, CON-right hippocampus, and retrosplenial temporal network(RTN)-left hippocampus, as well as a greater increase in RSFC of RTN-right hippocampus; socioeconomic deprivation was associated with a greater decrease in RSFC of CON-left amygdala, CON-right amygdala, CON-right hippocampus, and RTN-left hippocampus, as well as a greater increase in RSFC of RTN-left amygdala and RTN-right hippocampus. | |
| (Zhang et al., 2022) | 215 | 25.5 ± 6.3 | Self-reported retrospective childhood trauma questionnaire | RSFC | FPN and DN networks made large contribution to predicting emotional abuse and physical neglect, FPN, DN, and VIS networks made large contribution to predicting emotional neglect, FPN, DAT, and VAT networks made large contribution to predicting sexual abuse, and VIS, DN, FPN, and VAT showed large contribution to predictingphysical abuse. | |
| (Zhu et al., 2023) | 202 | 23.2 ± 1.7 | Maltreatment and Abuse Chronology of Exposure scale | fMRI | Food Pictures Task | BOLD activation fMRI response to threatening versus neutral facial images was assessed in key components of the threat detection system (i.e., amygdala, hippocampus, anterior cingulate, inferior frontal gyrus and ventromedial and dorsomedial prefrontal cortices); |
| (Furtado et al., 2024) | 521 | 10.47 ± 2.79 | Alabama Parenting Questionnaire (APQ), Barratt Simplified Measure of Social Status (Barratt), Family History—Research Diagnostic Criteria (PreInt_RDC), Financial Security Questionnaire (FSQ), Negative Life Events Scale (NLES) and PhenX neighbourhood Safety (PhenX) | Task-based fMRI | Viewing Emotion-specific and Emotion Non-specific Content | DMN, VAN, CON and amygdala activation during sad/emotional, bonding, action, conflict, sad, or fearful scenes; Greater inconsistent discipline was associated with greater VAN activation during sad or emotional scenes. |
| (R. Yang et al., 2021) | 45 | 14.9 ± 1.9 | Childhood Trauma Questionnaire | Task-based fMRI | Monetary Incentive Delay Task | Adolescents who experienced higher levels of abuse show greater activation in right dorsal prefrontal cortex, right inferior frontal gyrus, and right ventrolateral prefrontal cortex in the non-reward compared to reward condition during reward anticipation; individuals with higher abuse show much more exaggerated differences among conditions, especially during misses: greater activation when missing a potential reward vs. missing when there was no potential reward in multiple temporoparietal (left temporoparietal junction, right middle/superior temporal gyrus, right precuneus, right temporal pole, right Para hippocampal gyrus, left middle/inferior temporal and fusiform gyri, right angular/inferior parietal lobule, left precuneus/angular gyrus), posterior (left precuneus/posterior cingulate gyrus), and prefrontal (left dorsolateral) cortical regions during performance. |
| Summary for Neuroimaging Studies on disordered eating | ||||||
| (Brennan et al., 2022) | Young, n = 21; Old, n = 20 | 23.59 ± 4.22; 67.01 ± 3.68 | Three Factor Eating Questionnaire | RSFC | Older, compared to younger, individuals reported lower levels of disinhibited eating, consumed a healthier diet, and had weaker connectivity in the frontoparietal (FPN) and default mode (DMN) networks. | |
| (X. Chen et al., 2021) | 693 | 18.37 ± 0.87 | Eating disorder diagnosis scale | RSFC | Bulimia-type eating was associated with weaker intra-network and inter-network functional synchrony; | |
| (X. Chen et al., 2022) | 76 | 9.86 ± 0.83 | The eating disorder inventory-child-bulimia subscale | RSFC, MRI | Higher levels of BE were correlated with greater grey matter volumes (GMV) in the left fusiform and right insula and weaker RSFC between the right insula and following three regions: right orbital frontal cortex, left cingulate gyrus, and left superior frontal gyrus | |
| (X. Chen et al., 2023) | 660 | 18.51 ± 1.04 | Eating disorder diagnosis scale | RSFC | The connectivity predictive of body image concerns was identified within and between networks implicated in cognitive control (frontoparietal and medial frontal), reward sensitivity (subcortical), and visual perception (visual). | |
| (L. Luo et al., 2024) | sub-BN Group, n = 145; Control Group, n = 140 | 18.99 ± 0.76; 18.89 ± 0.91 | Eating disorder diagnosis scale | MRI; RSFC | The sub-BN group exhibited abnormalities of the right dorsolateral prefrontal cortex and right orbitofrontal cortex in both GMV and DC, and displayed decreased FC between these regions and the precuneus. We also observed that sub-BN presented with reduced FC between the calcarine and superior temporal gyrus, middle temporal gyrus and inferior parietal gyrus. | |
| (Martin et al., 2024) | BED symptoms, n = 83; Control Group, n = 123 | 9.9 ± 0.60; 10.0 ± 0.60 | Kiddie Schedule for Affective Disorders and Schizophrenia | RSFC | The BED-S group showed alterations in topological properties associated with the frontostriatal subnetwork, such as reduced nodal efficiency in the superior frontal gyrus, nucleus accumbens, putamen. | |
| (Martin et al., 2025) | BE symptoms, n = 77; Control Group, n = 104 | 9.95 ± 0.62; 9.97 ± 0.60 | Parent/guardian responses to the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) based on DSM-5 criteria; parent reports of binge eating (ABCD K-SADS item: Symptom—Binge Eating Present) | RSFC | The nodal topological properties, i.e., nodal efficiency, betweenness-centrality and degree, of the caudate nucleus, hippocampus and inferior parietal gyrus (IPG) significantly differentiated children with and without BE symptoms; | |
| (Ravichandran et al., 2024) | No food addiction, n = 72; Food Addiction, n = 42 | 33.24 ± 10.92 30.33 ± 9.35 | Early Traumatic Inventory-Self Report; Yale Food Addiction Scale | MRI | Individuals with high FA had greater cortical thickness of the ACC, and greater surface area and volume of the orbital gyrus, while individuals with low FA had greater surface area and volume of the posterior central sulcus; participants with FA had greater volume of the caudate nucleus, greater cortical thickness of the short insular gyrus, and greater volume of the laterodorsal tegmentum nucleus; participants with the highest levels of ELA showed the strongest negative association between the Reward Control brain signature and FA scores. | |
| (Tie et al., 2025) | 212 | 18.87 ± 0.97 | Muscularity-Oriented Eating Test; Childhood Trauma Questionnaire | RSFC | CPM identified the most significant predictive connections in the dorsolateral prefrontal cortex, inferior frontal gyrus, and cerebellum, with positive muscularity-oriented disordered eating networks primarily linking the salience/limbic network to the cerebellum and the fronto-parietal network to the default mode network. | |
| (Yu et al., 2025b) | REs, N = 324; E/UEs, N = 249; HEs, N = 423 | 14.56 ± 0.43; 14.49 ± 0.41; 14.49 ± 0.42 | ED section (section P) of the Development and Well-being Assessment; short version of the TFEQ | MRI | Compared with HEs, REs showed smaller grey matter volume (GMV) reductions in the left cerebellum. E/UEs had smaller GMV reductions in two subclusters in the left cerebellum and five subclusters in the right hemisphere, including the middle frontal gyrus (MFG), putamen, medial superior frontal gyrus and postcentral gyrus. A lower GMV increase in the right parahippocampal gyrus was also observed; for cortical thickness (CT), with REs experiencing more pro nounced CT reduction. In contrast, comparing E/UEs with HEs showed significant interactions across nine brain regions. These included the left lingual gyrus, bilateral frontal pole, bilateral rostral MFG, left pericalcarine, left cuneus, right caudal MFG and right caudal anterior cingulate gyrus, with E/UEs showing less CT reduction than HEs; for sulcal depth (SD), REs had a less pronounced reduction in the left frontal pole compared with E/UEs. Moreover, E/UEs showed larger SD reductions across nine regions compared with HEs, including the bilateral rostral MFG, left frontal pole, bilateral superior frontal gyrus, right caudal MFG, right pars orbitalis, right pars opercularis and right pars triangularis gyrus | |
| (Avery et al., 2025) | 43 | 31 ± 7.8 | — | Task-based fMRI | Food Pictures fMRI task | Regions positively associated with both Pleasantness and Self-Control included reward-associated regions such as the bilateral orbitofrontal cortex and ventral striatum, along with other regions such as the ventromedial prefrontal cortex. |
| (X. Chen et al., 2025) | Binge Eating subgroup, n = 30; Control Group, n = 29 | 20.37 ± 1.45; 19.41 ± 1.35 | Eating disorder diagnosis scale | Task-based fMRI | Go/no go Task | The binge eating subclinical group relative to controls displayed fewer reward-inhibition undirectional and directional synchronisations (i.e., medial orbitofrontal cortex [mOFC]-superior parietal gyrus [SPG] connectivity, mOFC → SPG excitatory connectivity) during food reward_nogo condition. |
| (Hagan et al., 2023) | 59 | 25.67 ± 5.11 | Eating Disorders Examination (EDE) version 16 | Task-based fMRI | Monetary Incentive Delay Task | Mean percent signal change in the right nucleus accumbens was significantly lower in women with BE versus women without BE. |
| (Stice et al., 2025) | 88 | 14.5 ± 0.9 | Eating Disorder Diagnostic Interview | Task-based fMRI | Food Go/no-go paradigm; Food Receipt Paradigm; Negative Mood Induction Paradigm; | Elevated responsivity of regions implicated in attention and valuation (dorsal anterior cingulate cortex; ventromedial prefrontal cortex) to thin models and lower responsivity of a reward valuation region (caudate) to anticipated milkshake tastes (which correlated with feeling fat) predicted the future onset of binge eating or compensatory behaviours |
| (Yu et al., 2025a) | Healthy control, n = 57; Bulimia nervosa subtypes, n = 65; Anorexia nervosa subtypes, n = 65 | 22.63 ± 0.62; 21.70 ± 2.08; 22.21 ± 2.01 | Three-Factor Eating Questionnaire | MRI, Task-based fMRI | MID Task; Emotional Face Task; Stop Signal Task | Compared with healthy control participants, eating disorder subgroups showed reduced GMV in the left lateral orbitofrontal cortex and lower cortical thickness in the left rostral middle frontal gyrus and precuneus; eating disorder subgroups exhibited smaller thickness in several left-lateralized regions than HCs, including the left rostral MFG, paracentral lobule, lingual gyrus/precuneus, and left middle temporal gyrus; eating disorder subgroups showed deactivations in the bilateral cerebellum (crus II) and right SFG compared with HCs and lower activations in the visual cortex (left lingual gyrus/right calcarine fissure) during reward anticipation; deactivations in the right middle temporal gyrus and the triangular part of the left IFG were also observed in the BN and AN subgroups, with lower activations or deactivation in other visual areas (right fusiform gyrus and left middle occipital gyrus [MOG]). |
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Luo, Y.; Zhang, J.; Chen, H. Early Life Adversity and Disordered Eating: Cognitive and Neural Mechanisms. Behav. Sci. 2025, 15, 1739. https://doi.org/10.3390/bs15121739
Luo Y, Zhang J, Chen H. Early Life Adversity and Disordered Eating: Cognitive and Neural Mechanisms. Behavioral Sciences. 2025; 15(12):1739. https://doi.org/10.3390/bs15121739
Chicago/Turabian StyleLuo, Yijun, Jingqiu Zhang, and Hong Chen. 2025. "Early Life Adversity and Disordered Eating: Cognitive and Neural Mechanisms" Behavioral Sciences 15, no. 12: 1739. https://doi.org/10.3390/bs15121739
APA StyleLuo, Y., Zhang, J., & Chen, H. (2025). Early Life Adversity and Disordered Eating: Cognitive and Neural Mechanisms. Behavioral Sciences, 15(12), 1739. https://doi.org/10.3390/bs15121739
