CHILDHOOD SEXUAL AND PHYSICAL ABUSE AS RISK-FACTORS FOR THE DEVELOPMENT OF BULIMIA-NERVOSA - A COMMUNITY-BASED CASE-CONTROL STUDY

Objective. There were two aims: First, to determine whether sexual or physical abuse in childhood or adolescence increases the risk of devel oping bulimia nervosa, and second, to see whether any increase in risk is specific to bulimia nervosa rather than being common to psychiatri c disorders in general. Method. A case control design with individual matching was used. There were two related case control comparisons bas ed on community samples. One hundred and two young adult women with bu limia nervosa were compared with 204 control subjects without an eatin g disorder, and with 102 control subjects with other psychiatric disor ders, all recruited from the same community source. An investigator-ba sed interview was used to assess sexual and physical abuse. Results. S exual abuse involving physical contact was reported by 35% of the case s of bulimia nervosa. It was more common among this group than among t he normal controls. Physical abuse was also reported by a minority of the cases of bulimia nervosa, and was more common among this group tha n among the normal controls. However, there were no significant differ ences between the cases of bulimia nervosa and the controls with gener al psychiatric disorder, except in the category of repeated severe sex ual abuse: this was more common among the cases of bulimia nervosa alt hough,present only in small numbers within these two groups. Conclusio ns. The findings indicate that sexual and physical abuse are both risk factors for the development of bulimia nervosa. However, they are not present in the majority of cases. This indicates that other risk fact ors must operate in these cases. Sexual and physical abuse do not appe ar to be risk factors specific to bulimia nervosa; rather, they appear to be risk factors for psychiatric disorder in general in young adult women.