SEXUAL ABUSE AND BULIMIA - RESPONSE TO INPATIENT TREATMENT AND PRELIMINARY OUTCOME

The purpose of this study was to explore the clinical impact of child sex abuse on bulimic patients. Specifically, differences in treatment response and preliminary treatment outcome between hospitalized bulimi c patients with and without a reported history of sexual abuse were ex amined. The patients were evaluated for past history of alleged sexual abuse by investigator-based interview and ratings of severity of sexu al abuse were made. Assessments of mood, eating disordered-related att itudes, and eating behaviors were conducted at the start of treatment, weekly during treatment, and three months post discharge. Sixty-one p er cent (45) of the 74 patients enrolled in the study reported a histo ry of child sexual abuse. The majority of such events constituted seri ous and very serious abuse by this study's criteria. The abused subjec ts exhibited higher levels of depression, anxiety, and eating disorder ed attitudes at each assessment point relative to nonabused subjects. In addition, abused subjects were more likely to be re-hospitalized in the 3 month post-discharge period. Significant differences in the ext ent of actual bulimic behaviors were not detected. Both the abused and nonabused bulimic patients demonstrated significant reductions in psy chiatric symptomatology from pretreatment to posttreatment, and from p osttreatment to follow-up. Contrary to prediction, differences in symp tomatology between the very serious, serious, and least serious abused groups were not detected. Results suggest that bulimic patients with reported histories of sexual abuse can be effectively engaged in a con ventional eating disorder treatment program, but that such abuse may p lace patients at a disadvantage owing to higher levels of pretreatment symptom severity. Findings suggest that extended and/or more specific intervention may be warranted for the abused bulimic patient. (C) 199 7 Elsevier Science Ltd. All rights reserved.