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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.