Skip to main content
SpringerLink
Log in

Sexual Abuse and Body Image in Eating and Weight Disorders

  • Chapter
  • First Online:
Body Image, Eating, and Weight

Abstract

Sexual abuse has been associated with several psychopathological conditions, including mood and anxiety disorder pathological eating behaviors and body image disturbances. Longitudinal studies demonstrated that when the abuse occurs during adolescence, the effect in terms of body image disturbances and pathological eating behaviors are particularly severe. This chapter deals with the complex relationship between eating disorders and sexual abuse, focusing on the mediating role of body image disturbances. Indeed, body image disturbance is a key psychological dimension in persons with eating disorders, and the traumatic event of sexual abuse during adolescence interferes with the dynamic process of body image development. The impact of sexual abuse on body image should be considered in the light of a multidimensional pattern, which includes cognitive and affective components (concerns and feelings about the body), perception (estimation of own body size), and behaviors related to the own body perception. Women with history of sexual abuse reported a severe body uneasiness after the traumatic event, with a revulsion about the body in ways that may intermix with concerns about body shape, size, and weight. The subjective feeling of loss-of-control following binge eating behaviors has been reported to be particularly severe in victim of sexual abuse. Finally, dissociative symptoms seem to represent a common psychopathological dimensions in victims of abuse, being related with different symptoms such as binge purging, self-harm, as well as impulsive sexuality.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Chiu GR, Lutfey KE, Litman HJ, Link CL, Hall SA, McKinlay JB. Prevalence and overlap of childhood and adult physical, sexual, and emotional abuse: a descriptive analysis of results from the Boston Area Community Health (BACH) survey. Violence Vict. 2013;28(3):381–402.

    Article  Google Scholar 

  2. Rothman EF, Exner D, Baughman AL. The prevalence of sexual assault against people who identify as gay, lesbian, or bisexual in the United States: a systematic review. Trauma Violence Abuse. 2011;12(2):55–66.

    Article  Google Scholar 

  3. Maniglio R. The impact of child sexual abuse on health: a systematic review of reviews. Clin Psychol Rev. 2009;29:647–57.

    Article  Google Scholar 

  4. Chen LP, Murad MH, Paras ML, Colbenson KM, Sattler AL, Goranson EN, Elamin MB, Seime RJ, Shinozaki G, Prokop LJ, Zirakzadeh A. Sexual abuse and lifetime diagnosis of psychiatric disorders: systematic review and meta-analysis. Mayo Clin Proc. 2010;85:618–29.

    Article  Google Scholar 

  5. Carr CP, Martins CM, Stingel AM, Lemgruber VB, Juruena MF. The role of early life stress in adult psychiatric disorders: a systematic review according to childhood trauma subtypes. J Nerv Ment Dis. 2013;201:1007–20.

    Article  Google Scholar 

  6. Faravelli C, Giugni A, Salvatori S, Ricca V. Psychopathology after rape. Am J Psychiatry. 2004;161(8):1483–5.

    Article  Google Scholar 

  7. Castellini G, Lo Sauro C, Lelli L, Godini L, Vignozzi L, Rellini AH, Faravelli C, Maggi M, Ricca V. Childhood sexual abuse moderates the relationship between sexual functioning and eating disorder psychopathology in anorexia nervosa and bulimia nervosa: a 1-year follow-up study. J Sex Med. 2013;10(9):2190–200.

    Article  Google Scholar 

  8. Dyer A, Borgmann E, Kleindienst N, Feldmann RE Jr, Vocks S, Bohus M. Body image in patients with posttraumatic stress disorder after childhood sexual abuse and co-occurring eating disorder. Psychopathology. 2013;46(3):186–91.

    Article  Google Scholar 

  9. Thompson KM, Wonderlich SA. Child sexual abuse and eating disorders. In: Thompson KM, editor. Handbook of eating disorders and obesity. Hoboken, NJ: Wiley; 2004. p. 679–94.

    Google Scholar 

  10. Johnson JG, Cohen P, Kasen S, Brook JS. Childhood adversities associated with risk for eating disorders or weight problems during adolescence or early adulthood. Am J Psychiatry. 2002;159:394–400.

    Article  Google Scholar 

  11. Jacobi C, Hayward C, de Zwaan M, Kraemer HC, Agras WS. Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for a general taxonomy. Psychol Bull. 2004;130:19–65.

    Article  Google Scholar 

  12. Sanci L, Coffey C, Olsson C, Reid S, Carlin JB, Patton G. Childhood sexual abuse and eating disorders in females: findings from the Victorian Adolescent Health Cohort Study. Arch Pediatr Adolesc Med. 2008;162:261–7.

    Article  Google Scholar 

  13. Dansky BS, Brewerton TD, Kilpatrick DG, O’Neil PM. The National Women’s Study: relationship of victimization and posttraumatic stress disorder to bulimia nervosa. Int J Eat Disord. 1997;21:213–28.

    Article  CAS  Google Scholar 

  14. Favaro A, Dalle Grave R, Santonastaso P. Impact of a history of physical and sexual abuse in eating disordered and asymptomatic subjects. Acta Psychiatr Scand. 1998;97:358–63.

    Article  CAS  Google Scholar 

  15. Preti A, Incani E, Camboni MV, Petretto DR, Masala C. Sexual abuse and eating disorder symptoms: the mediator role of bodily dissatisfaction. Compr Psychiatry. 2006;47(6):475–81.

    Article  Google Scholar 

  16. Castellini G, Maggi M, Ricca V. Childhood sexual abuse and psychopathology. In: Corona G, Jannini E, Maggi M, editors. Emotional, physical and sexual abuse: impact in children and social minorities. New York: Springer; 2014.

    Google Scholar 

  17. Smolak L, Murnen SK. A meta-analytic examination of the relationship between child sexual abuse and eating disorders. Int J Eat Disord. 2002;31:136–150 599.

    Article  Google Scholar 

  18. Bird ER, Seehuus M, Clifton J, Rellini AH. Dissociation during sex and sexual arousal in women with and without a history of childhood sexual abuse. Arch Sex Behav. 2014;43(5):953–64.

    Article  Google Scholar 

  19. Vanderlinden J, Van Dyck R, Vandereycken W, Vertommen H. Dissociation and traumatic experiences in the general population of the Netherlands. Hosp Community Psychiatry. 1993;44:786–8.

    CAS  PubMed  Google Scholar 

  20. McManus F, Waller G. A functional analysis of binge-eating. Clin Psychol Rev. 1995;15:845–63.

    Article  Google Scholar 

  21. Heatherton TF, Baumeister RF. Binge eating as escape from selfawareness. Psychol Bull. 1991;110:86–108.

    Article  CAS  Google Scholar 

  22. Fairburn CG, Harrison PJ. Eating disorders. Lancet. 2003;361(9355):407–16.

    Article  Google Scholar 

  23. American Psychiatric Association. Diagnostic and statistical manual for mental disorders. 5th ed. Washington, DC: American Psychiatric Press; 2003.

    Google Scholar 

  24. Ricca V, Castellini G, Lo Sauro C, et al. Cognitive-behavioral therapy for threshold and subthreshold anorexia nervosa: a three-year follow-up study. Psychother Psychosom. 2010;79:238–48.

    Article  Google Scholar 

  25. Bardone-Cone AM, Harney MB, Maldonado CR, et al. Defining recovery from an eating disorder: conceptualization, validation, and examination of psychosocial functioning and psychiatric comorbidity. Behav Res Ther. 2010;48:194–202.

    Article  Google Scholar 

  26. Castellini G, Lo Sauro C, Mannucci E, et al. Diagnostic crossover and outcome predictors in eating disorders according to DSM-IV and DSM-V proposed criteria: a 6-year follow-up study. Psychosom Med. 2011;73:270–9.

    Article  Google Scholar 

  27. Chen FR, Rothman EF, Jaffee SR. Early puberty, friendship group characteristics, and dating abuse in US girls. Pediatrics. 2017;8:e20162847.

    Article  Google Scholar 

  28. Castellini G, Stanghellini G, Godini L, Lucchese M, Trisolini F, Ricca V. Abnormal bodily experiences mediate the relationship between impulsivity and binge eating in overweight subjects seeking bariatric surgery. Psychother Psychosom. 2015;84(2):124–6.

    Article  Google Scholar 

  29. Stanghellini G, Trisolini F, Castellini G, Ambrosini A, Faravelli C, Ricca V. Is feeling extraneous from one’s own body a core vulnerability feature in eating disorders? Psychopathology. 2015;48(1):18–24.

    Article  Google Scholar 

  30. Stanghellini G, Castellini G, Brogna P, Faravelli C, Ricca V. Identity and eating disorders (IDEA): a questionnaire evaluating identity and embodiment in eating disorder patients. Psychopathology. 2012;45(3):147–58.

    Article  Google Scholar 

  31. Preti A, Incani E, Camboni MV, Petretto DR, Masala C, Lockwood R, Lawson R, Waller G. Compulsive features in the eating disorders: a role for trauma? J Nerv Ment Dis. 2004;192:247–9.

    Article  Google Scholar 

  32. Van der Kolk BA. The neurobiology of childhood trauma and abuse. Child Adolesc Psychiatr Clin North Am. 2003;12:293–317.

    Article  Google Scholar 

  33. Boysan M, Goldsmith RE, Cavuş H, Kayri M, Keskin S. Relations among anxiety, depression, and dissociative symptoms: the influence of abuse subtype. J Trauma Dissociation. 2009;10:83–101.

    Article  Google Scholar 

  34. Kearney-Cooke A, Ackard DM. The effects of sexual abuse on body image, self-image, and sexual activity of women. J Gend Specif Med. 2000;3:54–60.

    CAS  PubMed  Google Scholar 

  35. Favaro A, Tenconi E, Santonastaso P. The interaction between perinatal factors and childhood abuse in the risk of developing anorexia nervosa. Psychol Med. 2010;40:657–65.

    Article  CAS  Google Scholar 

  36. Falloon P, Ackard DM. Sexual abuse and body image. In: Cash TF, Pruzinsky T, editors. Body image. Oxford: Guilford Press; 2002. p. 117–8.

    Google Scholar 

  37. Reto CS, Dalenberg CJ, Coe MT. Dissociation and physical abuse as predictors of bulimic symptomatology and impulse dysregulation. Eat Disord. 1993;1:226–39.

    Article  Google Scholar 

  38. Vanderlinden J, Van Dyck R, Vandereycken W, Vertommen H. Dissociative experiences and trauma in eating disorders. Int J Eat Disord. 1993;13:187–93.

    Article  CAS  Google Scholar 

  39. Higgins ET. Self-discrepancy: a theory relating self to affect. Psychol Rev. 1987;94:319–40.

    Article  CAS  Google Scholar 

  40. Vallacher RR, Wegner DM. A theory of action identification. Hillsdale, NJ: Erlbaum; 1985.

    Google Scholar 

  41. Castellini G, Lo Sauro C, Ricca V, Rellini AH. Body esteem as a common factor of tendency toward binge eating and sexual dissatisfaction among women: the role of dissociation and stress response during sex. J Sex Med. 2017;14(8):1036–45.

    Article  Google Scholar 

  42. Rellini AH, Hamilton LD, Delville Y, Meston CM. The cortisol response during physiological sexual arousal in adult women with a history of childhood sexual abuse. J Trauma Stress. 2009;22(6):557–65.

    PubMed  PubMed Central  Google Scholar 

  43. Castellini G, Lelli L, Lo Sauro C, Vignozzi L, Maggi M, Faravelli C, Ricca V. Childhood abuse, sexual function and cortisol levels in eating disorders. Psychother Psychosom. 2012;81(6):380–2.

    Article  Google Scholar 

  44. Pinheiro AP, Raney TJ, Thornton LM, Fichter MM, Berrettini WH, Goldman D, et al. Sexual functioning in women with eating disorders. Int J Eat Dis. 2010;43:123–9.

    Google Scholar 

  45. Castellini G, Lelli L, Ricca V, Maggi M. Sexuality in eating disorders patients: etiological factors, sexual dysfunction and identity issues. A systematic review. Horm Mol Biol Clin Investig. 2016;25(2):71–90.

    CAS  PubMed  Google Scholar 

  46. Reissing ED, Laliberté M, Davis J. Young women’s sexual adjustment: the role of sexual self-schema, sexual self-efficacy, sexual aversion and body attitudes. Can J Hum Sex. 2005;14:77–85.

    Google Scholar 

  47. La Rocque CI, Cioe J. An evaluation of the relationship between body image and sexual avoidance. J Sex Res 2010;47: 1–12.

    Google Scholar 

  48. Chivers M, Seto M, Lalumiere M, Laan E, Grimbos T. Agreement of genital and subjective measures of sexual arousal: preliminary results of a meta-analysis. Paper presented at the annual meeting of the International Academy of Sex Research, Ottawa, Canada, 2005.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Psychiatric Unit, Department of Health Sciences, Florence University School of Medicine, Florence, Italy

    Giovanni Castellini & Valdo Ricca

Authors
  1. Giovanni Castellini
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Valdo Ricca
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Valdo Ricca .

Editor information

Editors and Affiliations

  1. Formerly University Sapienza of Rome, Editor-in-Chief of Eating and Weight Disorders, Campiglia Marittima (LI), Italy

    Massimo Cuzzolaro

  2. Department of Neuroscience, University of Turin, Torino, Italy

    Secondo Fassino

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Castellini, G., Ricca, V. (2018). Sexual Abuse and Body Image in Eating and Weight Disorders. In: Cuzzolaro, M., Fassino, S. (eds) Body Image, Eating, and Weight. Springer, Cham. https://doi.org/10.1007/978-3-319-90817-5_20

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-90817-5_20

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-90816-8

  • Online ISBN: 978-3-319-90817-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation