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Childhood sexual, physical, and psychological abuse and their relationship to comorbid psychopathology in bulimia nervosa
Author(s) -
Rorty Marcia,
Yager Joel,
Rossotto Elizabeth
Publication year - 1994
Publication title -
international journal of eating disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.785
H-Index - 138
eISSN - 1098-108X
pISSN - 0276-3478
DOI - 10.1002/1098-108x(199412)16:4<317::aid-eat2260160402>3.0.co;2-j
Subject(s) - sexual abuse , psychopathology , psychology , psychiatry , clinical psychology , physical abuse , substance abuse , bulimia nervosa , eating disorders , child abuse , psychological abuse , alcohol abuse , anxiety , mood , comorbidity , personality , personality disorders , poison control , borderline personality disorder , suicide prevention , medicine , social psychology , environmental health
We examined the relationship between childhood sexual, physical, psychological, and “multiple” abuse (i.e., abuse in more than one form) and comorbid Axis I and personality psychopathology among women with a lifetime history of bulimia nervosa (BN group; n = 80) and a control group of noneating‐disordered women (n = 40). Subjects were recruited primarily by newspaper advertisement. They participated in structured clinical interviews for diagnosis of Axis I and personality pathology, and they completed child abuse questionnaires in the interview setting. At odds with prediction, child abuse in various forms was not associated with the presence of lifetime comorbid Axis I disorders in general (i.e., 1 or more) or disorder classes in particular (mood, alcohol/substance use, anxiety) among BN subjects, although sexual, psychological, and multiple abuse were associated with the diagnosis of a higher total number of Axis I conditions. A history of psychological and multiple abuse (but not physical or sexual abuse alone) among BN subjects was strongly associated with the presence of personality disorder diagnoses, especially those in the “anxious‐fearful” cluster (Cluster C). Finally, we found that when a personality disorder was present in addition to the Axis I conditions in question, significant relationships emerged between abuse and Axis I pathology, particularly for psychological and multiple abuse. In general, control group findings were in accord with BN group findings, indicating that our findings were not specific to eating‐disordered women. Our results suggest that childhood abuse, particularly psychological abuse and abuse in multiple forms, increase the likelihood of lifetime comorbid Axis I disorders and personality pathology among bulimic patients. Eating‐disordered women with a history of child abuse may thus represent a subgroup of patients requiring especially intensive intervention. © 1994 by John Wiley & Sons, Inc.