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Coping, sexual abuse, and compensatory behavior

D L Tobin1, A S Griffing

  • 1Tufts University Medical School, MA, USA.

The International Journal of Eating Disorders
|September 1, 1996
PubMed
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Sexual abuse is prevalent in eating disorder patients, varying significantly by diagnosis. Abused individuals exhibit more severe symptoms and self-criticism, highlighting the need to assess sexual abuse history.

Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Trauma Studies

Background:

  • Sexual abuse is a significant risk factor for developing eating disorders.
  • Understanding the prevalence and impact of sexual abuse within specific eating disorder diagnostic subgroups is crucial for effective treatment.
  • Previous research suggests a link between sexual abuse, eating disorder pathology, and psychological distress.

Purpose of the Study:

  • To investigate the rates of sexual abuse across different eating disorder diagnostic subgroups.
  • To determine if sexually abused eating disorder patients exhibit higher levels of disturbed behavior, affective distress, and personality disturbance.
  • To examine the mediating role of self-criticism between sexual abuse, compensatory behaviors, and personality disturbance, as proposed by Waller's model.

Main Methods:

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  • A cohort of 103 eating disorder patients was assessed for a history of sexual abuse.
  • Abused and non-abused patients were compared using standardized measures for coping strategies, eating disorder symptoms, affective distress, personality disorders, and behavioral dysregulation.

Main Results:

  • The overall prevalence of sexual abuse was approximately 40%, consistent with prior studies.
  • Sexual abuse rates varied significantly across diagnostic subgroups, from 12% in compulsive overeaters to 75% in patients engaging in compensatory behaviors without bingeing or meeting anorexia criteria.
  • Sexually abused patients demonstrated greater psychiatric comorbidity, including higher rates of self-injurious behavior (80%) and suicide attempts (75%).
  • Self-criticism emerged as the sole primary coping strategy differentiating abused from non-abused patients, supporting Waller's hypothesis.

Conclusions:

  • The findings suggest a potential need to re-evaluate the diagnostic classification of purging and compensatory behaviors in eating disorders.
  • Assessing for a history of sexual abuse is critical as a comorbid factor in the comprehensive evaluation and treatment of eating disorder patients.
  • Integrating trauma-informed care and addressing self-criticism may be essential components in the therapeutic approach for sexually abused individuals with eating disorders.