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Pope H.G., Mangweth B., Negrao A.B., Hudson J.I., Cordas T.A.

Childhood Sexual Abuse and Bulima Nervosa:
A Comparison of American, Austrian, and Brazilian Women

American Journal of Psychiatry 151,5: 732-737 (1994)

Abstract

Objective:

This study was designed to assess the prevalence of childhood sexual abuse among women with bulima nervosa in three countries: the United States, Austria and Brazil. In addition, it assessed whether bulimic subjects might have experienced more severe sexual abuse than women in the general population and whether bulimic subjects who report abuse might display greater psychopathology than those who do not report abuse.

Method:

Thirtythree university students in Innsbruck, Austria, 33 university students in Boston, and 25 women in Sao Paulo, Brazil, all meeting DSM-III-R criteria for bulima nervosa, were recruited by advertisement. Detailed histories of sexual abuse, obtained at the conclusion of a somprehensive evaluation interview, were prepared, translated into English, and rated by an investigator who was blind to the nationality of the subject. Subjects were compared on frequency of eating binges, history of major depression, body mass index, and satisfaction with body image.

Results:

Narrowly defined childhood sexual abuse was reported by 24%-36% of women in the three countries, although only 15%-32% of women reported abuse before the onset of bulima nervosa. There were no significant differences between countries in rates of abuse. Overall, these rates appear no greater than those reported in comparable studies of women in the general population. The data also did not support the hypothesis that bulimic subjects had endured more severe sexual abuse than other women, nor was there a significant association between history of childhood sexual abuse and severity of bulimic symptoms.

Conclusions:

These findings add to the weight of evidence suggesting that childhood sexual abuse is not a risc factor for bulima nervosa.

Some Quotes

Several reports have suggested that childhood sexual abuse may lead to the development of bulima nervosa, perhaps by the mechanism of creating shame and disgust with body image. However, in a recent review of this literature, we found that the weight of evidence presently does not support such an association: the frequency of childhood sexual abuse in various series of bulimic women appears equal to or less than that reported among women in the general population.

Nevertheless, data in this area remain limited. For example, of the studies that we reviewed, all were performed in the United States, Canada, or England; we found no comparable studies in non-English-speaking countries.

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