Eating disorders and sexual abuse: Lack of confirmation for a clinical hypothesis

The frequent cooccurrence of these two phenomena in female therapy clients may be sufficiently explained by their high base rates in this population but may have led clinicians to perceive a relationship where none exists.

Abstract

Undocumented clinical reports have suggested that, among women in psychotherapy, women who have been sexually abused manifest an increased prevalence of eating disorders. The relationship between these two phenomena was investigated in a sample of women (N = 87) who were receiving group psychotherapy. Individual interviews were used to document the presence of a sexual abuse history. Diagnoses of anorexia nervosa and bulimia were based on DSM-III criteria. Rates of abnormal eating patterns in the absence of a fully diagnosable syndrome were also assessed. The following rates of eating disturbance were found in the total sample: 21% bulimic, 1% anorexic, and 82% with at least moderately abnormal eating patterns. Comparisons of women with and without histories of sexual abuse suggested no association between the occurrence of eating disturbance and a history of sexual abuse. The frequent cooccurrence of these two phenomena in female therapy clients may be sufficiently explained by their high base rates in this population but may have led clinicians to perceive a relationship where none exists.