The impact of childhood sexual abuse in anorexia nervosa

• Published in: Child abuse & neglect 2006-03, Vol.30 (3), p.257-269
• Main Authors: Carter, Jacqueline C., Bewell, Carmen, Blackmore, Elizabeth, Woodside, D. Blake
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Anorexia; Anorexia Nervosa; Anorexia Nervosa - epidemiology; Anorexia Nervosa - psychology; Anorexia Nervosa - rehabilitation; Anxiety; Anxiety Disorders; Biological and medical sciences; Canada; Child; Child Abuse; Child abuse & neglect; Child Abuse, Sexual - psychology; Child Abuse, Sexual - statistics & numerical data; Child Sexual Abuse; Comorbidity; Correlation; Depression; Depression (Psychology); Diagnostic and Statistical Manual of Mental Disorders; Eating behavior disorders; Eating Disorders; Female; Foreign Countries; Health services utilization; Hospitalization; Humans; Incidence; Interpersonal Relationship; Medical sciences; Obsessive-Compulsive Disorder - epidemiology; Patients; Prevalence; Psychiatry; Psychological aspects; Psychology. Psychoanalysis. Psychiatry; Psychopathology; Psychopathology. Psychiatry; Self Esteem; Sex crimes; Sexual Abuse; Symptoms (Individual Disorders); Termination; Termination of Treatment; Treatment; Treatment dropout; Victimology
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/j.chiabu.2005.09.004

The aim of this study was to examine the impact of childhood sexual abuse (CSA) on clinical characteristics and premature termination of treatment in anorexia nervosa (AN). The participants were 77 consecutive patients with AN admitted to an inpatient eating disorders unit. The patients were assessed in terms of eating disorder symptoms, general psychopathology, and CSA history at admission to hospital. Thirty-seven patients (48%) reported a history of CSA before the onset of the eating disorder. Individuals with a history of CSA reported significantly greater psychiatric comorbidity, including higher levels of depression and anxiety, lower self-esteem, more interpersonal problems, and more severe obsessive-compulsive symptoms. Patients with the binge-purge subtype of AN (AN-BP) were significantly more likely to report a history of CSA prior to the onset of the eating disorder as compared with patients with the restricting subtype (AN-R) of the illness (65% of the AN-BP patients vs. 37% of the AN-R patients; p < .02). Contrary to our predictions, abused patients were not significantly more likely to dropout of treatment overall. However, patients of the binge-purge subtype (AN-BP) with a history of CSA were significantly more likely to terminate treatment prematurely as compared with the other patients. Consistent with previous findings, the present results indicate that the prevalence of CSA is high among individuals seeking inpatient treatment for AN. A history of CSA was associated with greater psychiatric disturbance overall and a higher rate of dropout for patients of the binge-purge subtype. Le but de cette étude était d’examiner l’impact de l’agression sexuelle infantile (AS) sur les caractéristiques cliniques et l’abandon prématuré du traitement dans l’anorexie mentale (AM). Les participantes étaient 77 patientes anorexiques (AM) admises dans une unité d’hospitalisation spécialisée dans les troubles des conduites alimentaires. Les patientes ont été évaluées en terme de symptômes de troubles alimentaires, de psychopathologie et de passé d’AS lors de l’admission à l’hôpital. Trente-sept patientes (48%) ont rapporté un passé d’AS avant la survenue du trouble alimentaire. Les cas avec passé d’AS avaient une comorbidité psychiatrique significativement plus importante, comportant des niveaux plus élevés de dépression et d’anxiété, une estime de soi plus basse, davantage de problèmes relationnels, et des symptômes obsessionnels et compulsifs plus sévères.