Child sexual abuse and later disordered eating: A New Zealand epidemiological study

Objective: This community-based study examined how some women who have expe rienced childhood sexual abuse (CSA) develop an eating disorder (ED), where as others develop depression and anxiety, and others show no adverse psycho logical sequelae. Methods: A two-stage random community sampling strategy w as used to select two groups of women: (1) women with CSA prior to age 16 y ears and (2) a comparison group of women reporting no abuse. Both groups co mpleted the Parental Bonding Instrument (PBI), the Present State Examinatio n, and additional ICD-10 eating disorders questions. Information on the nat ure and frequency of the CSA was obtained at interview. CSA women with ED ( CSA+ED) were compared with CSA women without ED (CSA-noED) and with CSA wom en with anxiety and/or depression (psychiatric comparison group). Results: Higher rates of EDs in women who have experienced CSA were confirmed in thi s study. Belonging to a younger age cohort, experiencing menarche at an ear ly age, and high paternal overcontrol on the PBI independently increased th e risk of developing an ED in women who had experienced CSA. Low maternal c are was specifically associated with the development of anorexia nervosa, w hereas early age of menarche differentiated women with bulimia nervosa. You nger age and early age of menarche also differentiated the CSA+ED women fro m the psychiatric comparison group. Discussion: Early maturation and patern al overcontrol emerged as risk factors for ED development in women with CSA . Although these variables are also risk factors in the general population, women with CSA may be vulnerable to ED development because these risk fact ors are particular domains of concern that emanate from experiences of CSA. (C) 2001 by John Wiley & Sons, Inc.