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Kinzl J.F., Traweger C., Guenther V., Biebl W.

Family Background and Sexual Abuse Associated With Eating Disorders

American Journal of Psychiatry 151,8: 1127-1131 (1994)


Abstract

Objective:

The authors examined the possible relationship of negative early familial experiences and childhood sexual abuse to the later development of eating disorders.

Method:

Three anonymous questionaires - a sexual abuse screening checklist, the Biographic Inventory for Diagnosis of Behavioral Disturbances, and the Eating Disorder Inventory - were distributed to 350 female university students.

Results:

Of the 202 women who completed the questionaire, 44 (21.8%) were victims of childhood sexual abuse. There were no significant differences in the total or the subscale scores on the Eating Disorder Inventory among women with no, one, or repeated incidents of sexual abuse. However, women who reported an adverse family background displayed significantly higher Eating Disorder Inventory total and subscale scores than did women who assessed family background as a secure base.

Conclusions:

The data in this nonclinical female cohort suggest that childhood sexual abuse is neither necessary nor sufficient for later development of an eating disorder, while an adverse family background may be an important etiological factor.

Some Quotes

Research studies in clinical and nonclinical populations have attempted to clarify how family background and childhood sexual abuse are possibly associated and linked with the development of an eating disorder, but the findings of these investigations are quite diverse (Connors 1993). Most studies that looked for associations between reported abuse and scores on measures of eating disorders generally did not report a strong relationship (Bailey 1989, Bulik 1989, Calam 1989). Conners and Worse reviewed the literature on the relationship between sexual abuse and eating disorders and concluded that about 30% of patients with eating disorders have been sexually abused. Smolak et al. found a significant difference between victims and nonvictims on the total score on the Eating Disorder Inventory, but not on subscale scores. Furthermore, Eating Disorder Inventory scores were unrelated to two measures, severity of abuse and familarity with the abuser. Their composite results suggests that there is no direct, simple relationship between childhood sexual abuse and the attitudes and behaviours of subject with eating disorders.

[...]

The effects of sexual abuse are difficult to differentiate from the dysfunctional family experience with which they often coexists. We concur with Alexander's statement that any attempt to predict the onset of sexual abuse and its long-term sequelae must include a consideration of the family context that mediates the experience of the abuse, and the nature of long-term effects seen in sexual abuse victims are better understood through the parental and aprent-child relationships consurrent with the abuse. The eating disorders frequently observed in sexually abused woman is due less to sexual abuse per se than to a dysfunctional family background, which increases the risc of falling victim to (particularly repeated) intrafamilar or extrafamilar childhood sexual abuse.