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Welch S.L., Fairburn, C.G.

Sexual Abuse and Bulima Nervosa:
Three Integrated Case Control Comparisons

American Journal of Psychiatry 151,3: 402-407 (1994)

Abstract

Objective:

This study had three aims: to determine whether sexual abuse increases the risc of developing bulima nervosa, to see whether any increase in risc is specific to bulima nervosa, and to determine whether patients referred for treatment of bulima nervosa differ from a community group of subjects with bulima 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 bulima nervosa were compared with 100 community-based comparison subjects without an eating disorder, 50 community-based comparison subjects with other physical disorders, and 50 patients (secondary referrals) with bulima 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 bulima nervosa. It was more common among this group than among th normal comparison subjects. There was no difference between the community-based subjects with bulima nervosa and either the subjects with general psychatric disorders or the patients with bulima nervosa.

Conclusions:

While the findings indicate that sexual abuse is a risc factor for the development of bulima nervosa, it does not appear to be specific to bulima nervosa nor is it relevant for most cases. Sexual abuse appears to be a risc factor for psychatric disorder in general (including bulima nervosa) among young adult women. There was no evidence that secondary referrals of bulima nervosa are biased with respect to sexual abuse.

Some Quotes

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[...] However, since a history of sexual abuse, including subcategories of abuse such as rape and abuse by relatives, was found to be just as common among the comparison group of women with other psychiatric disorders as among those with bulima nervosa, we found no evidence to support the notion that sexual abuse is a risc factor specific to bulima nervosa. Rather, it appears to be a risc factor for psychiatric disorder in general (including bulima nervosa) among young adult women. This conclusion is the same as that reached by Palmer and Oppenheimer on the basis of their research with patient samples.