Abstract
Objective: Eating disorder (ED) and trauma have often been associated, and there is evidence that early experiences of traumatic events are associated with subsequent ED. Research results point toward an increased prevalence of sexual trauma in individuals with ED, and it has been suggested that sexual trauma precedes and contributes to the development of ED. The aim of this study was to assess the prevalence of sexual trauma as well as other types of traumatic life events in a clinical sample of children, adolescents, and adults with ED.Method: Patients (N = 329), median age 16.9 [Interquartile Range (IQR):4.5], diagnosed with various EDs in a specialized ED unit were included.Results: The majority (67%) of patients with ED reported at least one traumatic life event at time of assessment such as bullying (32%), loss (24%), or accidents (11%). Nineteen per cent of the patients reported having been the victim of a sexual trauma or another sexual traumatic event distributed as follows in terms of severity: 13% had been the victim of a negative experience associated with sex; 57% reported having experienced sexual assault other than rape; and 30% had been the victim of severe forms of sexual assault. The median time between the sexual trauma and the ED diagnosis was 3.4 years (IQR: 6.6). The median time between the sexual trauma and the onset of ED symptoms was 0 years (IQR: 5). The study results imply that the sexual trauma could be experienced either prior to or after onset of ED symptoms.Conclusions: Sixty-seven per cent of the patients with an ED reported traumatic life events at time of assessment, whereby 19% reporting negative sexual experiences or sexual abuse. However, sexual trauma does not necessarily play a causal role in the development of EDs.
Highlights
AIM OF THE STUDYStressors are often believed to play a crucial role as risk factors in the onset of eating disorders (ED) (Smyth et al, 2008)
In a systematic review and meta-analysis focusing on the association between these distinct types of abuse during childhood and different ED subtypes, the authors concluded that while bulimia nervosa (BN) and binge eating disorder (BED) were associated with childhood abuse, anorexia nervosa (AN) showed mixed results (Caslini et al, 2016)
Trauma is more common in the bulimic ED subtypes compared to the non-bulimic ED subtypes and the findings linking EDs with trauma have been extended to children/adolescents and boys/men with EDs as well
Summary
AIM OF THE STUDYStressors are often believed to play a crucial role as risk factors in the onset of eating disorders (ED) (Smyth et al, 2008). Traumatic events (TEs) are one type of stressors associated with risk for an ED (Molendijk et al, 2017). One example of severe TE could be multiple experiences of victimization in connection with extended childhood neglect disrupting the parent-child attachment system and/or abuse (Zlotnick et al, 1996; Ford and Kidd, 1998) including sexual trauma. Studies including meta-analyses and reviews have concluded that a strong association between childhood maltreatment and ED exists (Smolak and Murnen, 2002; Stice, 2002; Madowitz et al, 2015; Caslini et al, 2016; Molendijk et al, 2017). According to Brewerton (2007), childhood sexual abuse is a non-specific risk factor for ED. Most studies have focused on AN or BN, and only a limited number of studies have included less specific categories of ED, including other specified feeding or eating disorders (OSFED), atypical AN, and atypical BN (Molendijk et al, 2017)
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