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Am J Psychiatry 1994; 151:402-407
Copyright © 1994 by American Psychiatric Association
Sexual abuse and bulimia nervosa: three integrated case control comparisons
SL Welch and CG Fairburn
Oxford University, Department of Psychiatry, Warneford Hospital, U.K.
OBJECTIVE: This study had three aims: to determine whether sexual abuse
increases the risk of developing bulimia nervosa, to see whether any
increase in risk is specific to bulimia nervosa, and to determine whether
patients referred for treatment of bulimia nervosa differ from a community
group of subjects with bulimia nervosa with respect to their exposure to
sexual abuse. METHOD: A case control design with individual matching was
used. There were three related case control comparisons. Fifty
community-based subjects with bulimia nervosa were compared with 100
community-based comparison subjects without an eating disorder, 50
community-based comparison subjects with other psychiatric disorders, and
50 patients (secondary referrals) with bulimia nervosa. An
investigator-based interview was used to assess sexual abuse. RESULTS:
Sexual abuse involving physical contact was reported by a minority of the
community-based subjects with bulimia nervosa. It was more common among
this group than among the normal comparison subjects. There was no
difference between the community-based subjects with bulimia nervosa and
either the subjects with general psychiatric disorders or the patients with
bulimia nervosa. CONCLUSIONS: While the findings indicate that sexual abuse
is a risk factor for the development of bulimia nervosa, it does not appear
to be specific to bulimia nervosa nor is it relevant to most cases. Sexual
abuse appears to be a risk factor for psychiatric disorder in general
(including bulimia nervosa) among young adult women. There was no evidence
that secondary referrals of bulimia nervosa are biased with respect to
sexual abuse.
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[Abstract]
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