The relationship between eating disorders and sexual trauma

  • Jennifer Madowitz
  • Brittany E. Matheson
  • June Liang
Review

Abstract

Research aimed at understanding the causes and comorbidities of eating disorders (ED) identifies sexual trauma as one potential pathway to the development and maintenance of eating disorders. Based on current literature, there are two main etiological pathways between sexual trauma and ED—body perceptions and psychological difficulties. However, previously published reviews on this topic are outdated and have not yielded consistent findings. Therefore, authors completed a literature review covering years 2004–2014 to examine the relationship between sexual trauma and ED according to both proposed pathway models. Authors utilized PubMed, GoogleScholar, and PsychINFO as search engines. Search terms included “sexual assault”, “sexual abuse”, “sexual trauma”, and “rape” in conjunction with relevant ED terminology. Thirty-two studies met inclusion criteria for this review. Current data indicate an increased prevalence of sexual trauma for individuals with ED. Although limited, recent evidence suggests that sexual trauma precedes and contributes to the development of ED. Existing literature indicates that the body perceptions pathway may impact ED through body dissatisfaction, shame, sexual dysfunction, and fear of future sexual trauma. The psychological difficulties pathway indicates a link between ED and the desire to cope with the failure of the average expected environment, psychological diagnoses, the need for control, and the regulation of emotions. However, further research is needed to assess the potential causal role that sexual trauma may play in the etiology of ED.

Keywords

Sexual trauma Sexual assault Sexual abuse Eating disorders 

References

  1. 1.
    Stuhldreher N, Konnopka A, Wild B, Herzog W, Zipfel S, Löwe B, König H-H (2012) Cost-of-illness studies and cost-effectiveness analyses in eating disorders: a systematic review. Int J Eat Disord 45(4):476–491. doi:10.1002/eat.20977 PubMedCrossRefGoogle Scholar
  2. 2.
    Smink FE, van Hoeken D, Hoek H (2012) Epidemiology of eating disorders: incidence, prevalence and mortality rates. Curr Psychiatry Rep 14(4):406–414. doi:10.1007/s11920-012-0282-y PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Hoek HW (2006) Incidence, prevalence and mortality of anorexia nervosa and other eating disorders. Curr Opin Psychiatry 19(4):389–394. doi:10.1097/01.yco.0000228759.95237.78 PubMedCrossRefGoogle Scholar
  4. 4.
    Ingram RE, Price JM (2001) Vulnerability to psychopathology : risk across the lifespan. Guilford Press, New YorkGoogle Scholar
  5. 5.
    Ingram R, Luxton D (2005) Vulterability-stress models. In: Hankin B, Abela J (eds) Development of psychopathology: a vulnerability stress perspective. Sage Publications Inc., Thousand Oaks, pp 32–46CrossRefGoogle Scholar
  6. 6.
    Berge J, Loth K, Hanson C, Croll-Lampert J, Neumark-Sztainer D (2012) Family life cycle transitions and the onset of eating disorders: a retrospective grounded theory approach. J Clin Nurs 21(9–10):1355–1363. doi:10.1111/j.1365-2702.2011.03762.x PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Preti A, Incani E, Camboni MV, Petretto DR, Masala C (2006) Sexual abuse and eating disorder symptoms: the mediator role of bodily dissatisfaction. Compr Psychiatry 47(6):475–481. doi:10.1016/j.comppsych.2006.03.004 PubMedCrossRefGoogle Scholar
  8. 8.
    Faravelli C, Giugni A, Salvatori S, Ricca V (2004) Psychopathology after rape. Am J Psychiatry 161(8):1483–1485. doi:10.1176/appi.ajp.161.8.1483 PubMedCrossRefGoogle Scholar
  9. 9.
    Castellini G, Lo Sauro C, Lelli L, Godini L, Vignozzi L, Rellini AH, Faravelli C, Maggi M, Ricca V (2013) 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 10(9):2190–2200. doi:10.1111/jsm.12232 PubMedCrossRefGoogle Scholar
  10. 10.
    Dworkin E, Javdani S, Verona E, Campbell R (2014) Child sexual abuse and disordered eating: the mediating role of impulsive and compulsive tendencies. Psychol Violence 4(1):21–36CrossRefGoogle Scholar
  11. 11.
    Hepp U, Spindler A, Schnyder U, Kraemer B, Milos G (2007) Post-traumatic stress disorder in women with eating disorders. Eating Weight Disord 12(1):e24–e27CrossRefGoogle Scholar
  12. 12.
    Hund AR, Espelage DL (2005) Childhood emotional abuse and disordered eating among undergraduate females: mediating influence of alexithymia and distress. Child Abuse Negl 30(4):393–407. doi:10.1016/j.chiabu.2005.11.003 CrossRefGoogle Scholar
  13. 13.
    Pawlowska B, Masiak M (2007) Comparison of socio-demographic data of female patients with purging and restricting types of anorexia nervosa hospitalised at the Psychiatry Department of the Medical University of Lublin in the years 1993–2003. Psychiatr Pol 41(3):350–364PubMedGoogle Scholar
  14. 14.
    Reyes-Rodriguez ML, Von Holle A, Ulman TF, Thornton LM, Klump KL, Brandt H, Crawford S, Fichter MM, Halmi KA, Huber T, Johnson C, Jones I, Kaplan AS, Mitchell JE, Strober M, Treasure J, Woodside DB, Berrettini WH, Kaye WH, Bulik CM (2011) Posttraumatic stress disorder in anorexia nervosa. Psychosom Med 73(6):491–497. doi:10.1097/PSY.0b013e31822232bb PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Chen LP, Murad MH, Paras ML, Colbenson KM, Sattler AL, Goranson EN, Elamin MB, Seime RJ, Shinozaki G, Prokop LJ, Zirakzadeh A (2010) Sexual abuse and lifetime diagnosis of psychiatric disorders: systematic review and meta-analysis. Mayo Clin Proc 85(7):618–629. doi:10.4065/mcp.2009.0583 PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Stice E (2002) Risk and maintenance factors for eating pathology: a meta-analytic review. Psychol Bull 128(5):825–848PubMedCrossRefGoogle Scholar
  17. 17.
    Connors ME, Morse W (1993) Sexual abuse and eating disorders: a review. Int J Eat Disord 13(1):1–11PubMedCrossRefGoogle Scholar
  18. 18.
    Smolak L, Murnen S (2002) A meta-analytic examination of the relationship between child sexual abuse and eating disorders. Int J Eat Disord 31(2):136–150PubMedCrossRefGoogle Scholar
  19. 19.
    Zhang J, Wang Z (2008) Factors associated with smoking in Asian American adults: a systematic review. Nicotine Tob Res Off J Soc Res Nicotine Tob 10(5):791–801. doi:10.1080/14622200802027230 CrossRefGoogle Scholar
  20. 20.
    Gustafson TB, Sarwer DB (2004) Childhood sexual abuse and obesity. Obes Rev 5(3):129–135. doi:10.1111/j.1467-789X.2004.00145.x PubMedCrossRefGoogle Scholar
  21. 21.
    Boynton-Jarrett R, Rosenberg L, Palmer JR, Boggs DA, Wise LA (2012) Child and adolescent abuse in relation to obesity in adulthood: the Black Women’s Health Study. Pediatrics 130(2):245–253. doi:10.1542/peds.2011-1554 PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Carter JC, Bewell C, Blackmore E, Woodside DB (2006) The impact of childhood sexual abuse in anorexia nervosa. Child Abuse Negl 30(3):257–269. doi:10.1016/j.chiabu.2005.09.004 PubMedCrossRefGoogle Scholar
  23. 23.
    Stoltenborgh M, van Ijzendoorn MH, Euser EM, Bakermans-Kranenburg MJ (2011) A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreat 16(2):79–101. doi:10.1177/1077559511403920 PubMedCrossRefGoogle Scholar
  24. 24.
    Cumella EJ, Kally Z (2008) Profile of 50 women with midlife-onset eating disorders. Eat Disord 16(3):193–203. doi:10.1080/10640260802016670 PubMedCrossRefGoogle Scholar
  25. 25.
    Cachelin FM, Monreal TK, Juarez LC (2006) Body image and size perceptions of Mexican American women. Body Image 3(1):67–75. doi:10.1016/j.bodyim.2005.10.006 PubMedCrossRefGoogle Scholar
  26. 26.
    Sanci L, Coffey C, Olsson C, Reid S, Carlin JB, Patton G (2008) Childhood sexual abuse and eating disorders in females: findings from the Victorian Adolescent Health Cohort Study. Arch Pediatr Adolesc Med 162(3):261–267. doi:10.1001/archpediatrics.2007.58 PubMedCrossRefGoogle Scholar
  27. 27.
    Ng IS, Cheung KC, Chou KL (2013) Correlates of eating disorder in middle-aged and older adults: evidence from 2007 British National Psychiatric Morbidity Survey. J Aging Health 25(7):1106–1120. doi:10.1177/0898264313494798 PubMedCrossRefGoogle Scholar
  28. 28.
    Fischer S, Stojek M, Hartzell E (2010) Effects of multiple forms of childhood abuse and adult sexual assault on current eating disorder symptoms. Eat Behav 11(3):190–192. doi:10.1016/j.eatbeh.2010.01.001 PubMedCrossRefGoogle Scholar
  29. 29.
    Jacobi C, Hayward C, de Zwaan M, Kraemer HC, Agras WS (2004) Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for a general taxonomy. Psychol Bull 130(1):19PubMedCrossRefGoogle Scholar
  30. 30.
    Mitchell KS, Mazzeo SE, Schlesinger MR, Brewerton TD, Smith BN (2012) Comorbidity of partial and subthreshold ptsd among men and women with eating disorders in the national comorbidity survey-replication study. Int J Eat Disord 45(3):307–315. doi:10.1002/eat.20965 PubMedCentralPubMedCrossRefGoogle Scholar
  31. 31.
    Krug I, Fuller-Tyszkiewscz M, Micali N, Taborelli E, Anderluh M, Fernandez-Aranda F, Tchanturia K, Karwautz A, Wagner G, Collier D, Treasure J (2013) Dissecting the relationship between childhood abuse, personality treats and genetic markers in eating disorders using a discordant sister-pair design. J Eat Disord 1:069. doi:10.1186/2050-2974-1-S1-O69 CrossRefGoogle Scholar
  32. 32.
    Rayworth BB, Wise LA, Harlow BL (2004) Childhood abuse and risk of eating disorders in women. Epidemiology 15(3):271–278PubMedCrossRefGoogle Scholar
  33. 33.
    Cumella EJ, Kally Z (2008) Comparison of middle-age and young women inpatients with eating disorders. Eat Weight Disord 13(4):183–190PubMedCrossRefGoogle Scholar
  34. 34.
    Pike KM, Hilbert A, Wilfley DE, Fairburn CG, Dohm FA, Walsh BT, Striegel-Moore R (2008) Toward an understanding of risk factors for anorexia nervosa: a case-control study. Psychol Med 38(10):1443–1453. doi:10.1017/S0033291707002310 PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    Jaite C, Schneider N, Hilbert A, Pfeiffer E, Lehmkuhl U, Salbach-Andrae H (2012) Etiological role of childhood emotional trauma and neglect in adolescent anorexia nervosa: a cross-sectional questionnaire analysis. Psychopathology 45(1):61–66. doi:10.1159/000328580 PubMedCrossRefGoogle Scholar
  36. 36.
    Eubanks JR, Kenkel MY, Gardner RM (2006) Body-size perception, body-esteem, and parenting history in college women reporting a history of child abuse. Percept Mot Skills 102(2):485–497. doi:10.2466/pms.102.2.485-497 PubMedCrossRefGoogle Scholar
  37. 37.
    Walsh JM, Wheat ME, Freund K (2000) Detection, evaluation, and treatment of eating disorders the role of the primary care physician. J Gen Intern Med 15(8):577–590PubMedCentralPubMedCrossRefGoogle Scholar
  38. 38.
    Treuer T, Koperdák M, Rózsa S, Füredi J (2005) The impact of physical and sexual abuse on body image in eating disorders. Eur Eat Disord Rev 13(2):106–111. doi:10.1002/erv.616 CrossRefGoogle Scholar
  39. 39.
    Troop NA, Allan S, Serpell L, Treasure JL (2008) Shame in women with a history of eating disorders. Eur Eat Disord Rev J Eat Disord Assoc 16(6):480–488. doi:10.1002/erv.858 CrossRefGoogle Scholar
  40. 40.
    Feiring C, Taska LS (2005) The persistence of shame following sexual abuse: a longitudinal look at risk and recovery. Child Maltreat 10(4):337–349. doi:10.1177/1077559505276686 PubMedCrossRefGoogle Scholar
  41. 41.
    Negrao C, Bonanno GA, Noll JG, Putnam FW, Trickett PK (2005) Shame, humiliation, and childhood sexual abuse: distinct contributions and emotional coherence. Child Maltreat 10(4):350–363PubMedCrossRefGoogle Scholar
  42. 42.
    Sable MR, Danis F, Mauzy DL, Gallagher SK (2006) Barriers to reporting sexual assault for women and men: perspectives of college students. J Am Coll Health 55(3):157–162PubMedCrossRefGoogle Scholar
  43. 43.
    Troop NA, Allan S, Serpell L, Treasure JL (2008) Shame in women with a history of eating disorders. Eur Eat Disord Rev 16(6):480–488. doi:10.1002/erv.858 PubMedCrossRefGoogle Scholar
  44. 44.
    Goss K, Allan S (2009) Shame, pride and eating disorders. Clinical Psychol Psychother 16(4):303–316. doi:10.1002/cpp.627 CrossRefGoogle Scholar
  45. 45.
    Grabhorn R, Stenner H, Kaufbold J, Overbeck G, Stangier U (2005) Shame and social anxiety in anorexia and bulimia nervosa. Zeitschrift fur Psychosomatische Medizin und Psychotherapie 51(2):179–193PubMedCrossRefGoogle Scholar
  46. 46.
    Clarke LH, Griffith M (2008) Body image and aging: older women and the embodiment of trauma. Women’s Stud Int Forum 31:200–208CrossRefGoogle Scholar
  47. 47.
    Williamson DA, White MA, York-Crowe E, Stewart TM (2004) Cognitive-behavioral theories of eating disorders. Behav Modif 28(6):711–738. doi:10.1177/0145445503259853 PubMedCrossRefGoogle Scholar
  48. 48.
    Smith DW, Letourneau EJ, Saunders BE, Kilpatrick DG, Resnick HS, Best CL (2000) Delay in disclosure of childhood rape: results from a national survey. Child Abuse Negl 24(2):273–287. doi:10.1016/S0145-2134(99)00130-1 PubMedCrossRefGoogle Scholar
  49. 49.
    Ullman SE (2007) Relationship to perpetrator, disclosure, social reactions, and PTSD symptoms in child sexual abuse survivors. J Child Sex Abuse 16(1):19–36. doi:10.1300/J070v16n01_02 CrossRefGoogle Scholar
  50. 50.
    Putnam FW (2003) Ten-year research update review: child sexual abuse. J Am Acad Child Adolesc Psychiatry 42(3):269–278. doi:10.1097/00004583-200303000-00006 PubMedCrossRefGoogle Scholar
  51. 51.
    Jenkins PE, Meyer C, Blissett JM (2013) Childhood abuse and eating psychopathology: the mediating role of core beliefs. J Aggress Maltreat Trauma 22(3):248–261. doi:10.1080/10926771.2013.741665 CrossRefGoogle Scholar
  52. 52.
    Armstrong D, Shakespeare-Finch J (2011) Relationship to the bereaved and perceptions of severity of trauma differentiate elements of posttraumatic growth. Omega 63(2):125–140PubMedGoogle Scholar
  53. 53.
    Santonastaso P, Favaro A, Olivotto MC, Friederici S (1997) Dissociative experiences and eating disorders in a female college sample. Psychopathology 30(3):170–176PubMedCrossRefGoogle Scholar
  54. 54.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders (4th ed., text rev.). American Psychological Association, Washington DC. doi:10.1176/appi.books.9780890423349
  55. 55.
    Grilo CM, White MA, Masheb RM (2009) DSM-IV psychiatric disorder comorbidity and its correlates in binge eating disorder. Int J Eat Disord 42(3):228–234. doi:10.1002/eat.20599 PubMedCentralPubMedCrossRefGoogle Scholar
  56. 56.
    Swinbourne J, Hunt C, Abbott M, Russell J, St Clare T, Touyz S (2012) The comorbidity between eating disorders and anxiety disorders: prevalence in an eating disorder sample and anxiety disorder sample. Aust N Z J Psychiatry 46(2):118–131. doi:10.1177/0004867411432071 PubMedCrossRefGoogle Scholar
  57. 57.
    Aglan A, Kerfoot M, Pickles A (2008) Pathways from adolescent deliberate self-poisoning to early adult outcomes: a six-year follow-up. J Child Psychol Psychiatry 49(5):508–515. doi:10.1111/j.1469-7610.2007.01856.x PubMedCrossRefGoogle Scholar
  58. 58.
    Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR (2011) Prevalence and correlates of eating disorders in adolescents: results from the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatry 68(7):714–723. doi:10.1001/archgenpsychiatry.2011.22 PubMedCrossRefGoogle Scholar
  59. 59.
    Dubosc A, Capitaine M, Franko DL, Bui E, Brunet A, Chabrol H, Rodgers RF (2012) Early adult sexual assault and disordered eating: the mediating role of posttraumatic stress symptoms. J Trauma Stress 25(1):50–56. doi:10.1002/jts.21664 PubMedCrossRefGoogle Scholar
  60. 60.
    Strickler HL (2013) The interaction between post-traumatic stress disorders and eating disorders: a review of relevant literature. J Trauma Treat 3:183. doi:10.4172/2167-1222.1000183
  61. 61.
    Holzer SR, Uppala S, Wonderlich SA, Crosby RD, Simonich H (2008) Mediational significance of PTSD in the relationship of sexual trauma and eating disorders. Child Abuse Negl 32(5):561–566. doi:10.1016/j.chiabu.2007.07.011 PubMedCrossRefGoogle Scholar
  62. 62.
    Schmidt U, Treasure J (2006) Anorexia nervosa: valued and visible. A cognitive-interpersonal maintenance model and its implications for research and practice. Br J Clin Psychol/Br Psychol Soc 45(Pt 3):343–366CrossRefGoogle Scholar
  63. 63.
    Marsh R, Steinglass JE, Gerber AJ et al (2009) DEficient activity in the neural systems that mediate self-regulatory control in bulimia nervosa. Arch Gen Psychiatry 66(1):51–63. doi:10.1001/archgenpsychiatry.2008.504 PubMedCentralPubMedCrossRefGoogle Scholar
  64. 64.
    Proulx K (2008) Experiences of women with bulimia nervosa in a mindfulness-based eating disorder treatment group. Eat Disord 16(1):52–72. doi:10.1080/10640260701773496 PubMedCrossRefGoogle Scholar
  65. 65.
    Kaye W (2008) Neurobiology of anorexia and bulimia nervosa. Physiol Behav 94(1):121–135. doi:10.1016/j.physbeh.2007.11.037 PubMedCentralPubMedCrossRefGoogle Scholar
  66. 66.
    Hawkins RCI, Clement PF (1984) Binge eating: measurement problems and conceptual model. In: Hawkins RCI, Fremouw WJ, Clement PF (eds) The binge purge syndrome: diagnosis, treatment, and research. Springer, New YorkGoogle Scholar
  67. 67.
    Dawe S, Loxton NJ (2004) The role of impulsivity in the development of substance use and eating disorders. Neurosci Biobehav Rev 28(3):343–351PubMedCrossRefGoogle Scholar
  68. 68.
    Cassin SE, von Ranson KM (2005) Personality and eating disorders: a decade in review. Clin Psychol Rev 25(7):895–916. doi:10.1016/j.cpr.2005.04.012 PubMedCrossRefGoogle Scholar
  69. 69.
    Waxman SE (2009) A systematic review of impulsivity in eating disorders. Eur Eat Disord Rev J Eat Disord Assoc 17(6):408–425. doi:10.1002/erv.952 CrossRefGoogle Scholar
  70. 70.
    Cloitre M, Miranda R, Stovall-McClough KC, Han H (2005) Beyond PTSD: emotion regulation and interpersonal problems as predictors of functional impairment in survivors of childhood abuse. Behav Ther 36(2):119–124. doi:10.1016/S0005-7894(05)80060-7 CrossRefGoogle Scholar
  71. 71.
    Roy A (2005) Childhood trauma and impulsivity. Possible relevance to suicidal behavior. Arch Suicide Res 9(2):147–151. doi:10.1080/13811110590903990 PubMedCrossRefGoogle Scholar
  72. 72.
    Corstorphine E, Waller G, Lawson R, Ganis C (2007) Trauma and multi-impulsivity in the eating disorders. Eat Behav 8(1):23–30. doi:10.1016/j.eatbeh.2004.08.009 PubMedCrossRefGoogle Scholar
  73. 73.
    Kim J, Cicchetti D (2010) Longitudinal pathways linking child maltreatment, emotion regulation, peer relations, and psychopathology. J Child Psychol Psychiatry 51(6):706–716. doi:10.1111/j.1469-7610.2009.02202.x PubMedCentralPubMedCrossRefGoogle Scholar
  74. 74.
    Potter SJ, Laflamme DJ (2011) An assessment of state level sexual assault prevalence estimates. Matern Child Health J 15(1):77–86. doi:10.1007/s10995-010-0565-z PubMedCrossRefGoogle Scholar
  75. 75.
    Hardt J, Rutter M (2004) Validity of adult retrospective reports of adverse childhood experiences: review of the evidence. J Child Psychol Psychiatry 45(2):260–273. doi:10.1111/j.1469-7610.2004.00218.x PubMedCrossRefGoogle Scholar
  76. 76.
    Brewerton TD (2007) Eating disorders, trauma, and comorbidity: focus on PTSD. Eat Disord 15(4):285–304PubMedCrossRefGoogle Scholar
  77. 77.
    Vrabel KR, Hoffart A, Ro O, Martinsen EW, Rosenvinge JH (2010) Co-occurrence of avoidant personality disorder and child sexual abuse predicts poor outcome in long-standing eating disorder. J Abnorm Psychol 119(3):623–629. doi:10.1037/a0019857 PubMedCrossRefGoogle Scholar
  78. 78.
    Harper K, Richter NL, Gorey KM (2009) Group work with female survivors of childhood sexual abuse: evidence of poorer outcomes among those with eating disorders. Eat Behav 10(1):45–48. doi:10.1016/j.eatbeh.2008.08.001 PubMedCrossRefGoogle Scholar
  79. 79.
    Hart LM, Granillo MT, Jorm AF, Paxton SJ (2011) Unmet need for treatment in the eating disorders: a systematic review of eating disorder specific treatment seeking among community cases. Clin Psychol Rev 31(5):727–735. doi:10.1016/j.cpr.2011.03.004 PubMedCrossRefGoogle Scholar
  80. 80.
    Hudson JI, Hiripi E, Pope HG Jr, Kessler RC (2007) The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry 61(3):348–358. doi:10.1016/j.biopsych.2006.03.040 PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.San Diego Joint Doctoral Program in Clinical PsychologySan Diego State University / University of CaliforniaSan DiegoUSA
  2. 2.Department of PediatricsUniversity of California, San DiegoSan DiegoUSA

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