Overt and covert sexual abuse: relationship to body image and eating disturbance.

Abstract

To separate forms of overt and covert sexual abuse and assess their independent contribution to the development of body image and eating disturbance. A new measure was developed--the Covert-Overt Sexual Abuse Questionnaire (COSAQ)--and correlated with levels of body image, eating disturbance, social desirability, self-esteem, and depression. Factor analyses on three independent samples yielded two distinct subscales which were labelled Overt and Covert. Each scale had excellent internal consistency and test-retest reliability. Regression analyses demonstrated the ability of the Covert factor to explain variance associated with body image disturbance and eating dysfunction beyond that accounted for by levels of social desirability, self-esteem, depression, and overt sexual abuse. These findings support the importance of a more "subtle" form of early trauma--covert sexual abuse--in the development of body image and eating-related problems.