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Sexual Abuse, Disordered Personality and Eating Disorders

Published online by Cambridge University Press:  06 August 2018

Lisa McClelland
Affiliation:
Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
Lawrence Mynors-Wallis*
Affiliation:
University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford
Tom Fahy
Affiliation:
Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
Jane Treasure
Affiliation:
Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF
*
Correspondence

Abstract

Standardised personality assessments were administered to 50 consecutive referrals to an Eating Disorders Clinic. A history of childhood sexual abuse was identified in 30% of patients using a modified version of the SLEI. This rate is comparable with those from other studies. Overall, 52% of the patients were rated as having a personality disorder but a significantly higher proportion of women with a personality disorder had a history of childhood sexual abuse compared with those without a personality disorder (13/26 v. 2/24, Fisher P < 0.001). Although in patients with eating disorders no clear causal link between CSA and personality disorder was demonstrated, our findings emphasise the need to inquire sensitively into the sexual history of such patients.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1991 

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References

American Psychiatric Association (1980). Diagnostic and Statistical Manual for Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual for Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Baker, A. W. & Duncan, S. P. (1985) Child sexual abuse: a study of prevalence in Great Britain. Child Abuse Neglect, 9, 457467.Google Scholar
Briere, J. (1984) The effects of childhood sexual abuse on later psychological functioning. Defining a ‘post sexual abuse syndrome”. Paper presented at the Third National Conference on Sexual Victimisation of Children, Washington, DC.Google Scholar
Browne, A. & Finkelhor, D. (1986) Impact of child sexual abuse: a review of the research. Psychological Bulletin, 99, 106, 77. 1Google Scholar
Bruch, H. (1973) Eating Disorders: Obesity, Anorexia and the Person Within. New York: Basic Books.Google Scholar
Bryer, J. B., Nelson, B. A., Miller, J. B., et al (1987) Childhood sexual and physical abuse as factors in adult psychiatric illness. American Journal of Psychiatry, 144, 14261430.Google Scholar
Bulik, C. M., Sullivan, P. F. & Rorty, M. (1989) Childhood sexual abuse in women with bulimia. Journal of Clinical Psychiatry, 50, 460464.Google Scholar
Burnam, M. A., Stein, J. A., Golding, J. M., et al (1988) Sexual assault and mental disorders in a community population. Journal of Consultation and Clinical Psychology, 56, 843850.Google Scholar
Calam, P. M. & Slade, P. D. (1989) Sexual experience and eating problems in female undergraduates. International Journal of Eating Disorders, 8, 391397.Google Scholar
Casper, R. C., Eckert, E. D., Halmi, K. A., et al (1980) Bulimia: its incidence and clinical importance in patients with anorexia nervosa. Archives of General Psychiatry, 37, 10301035.CrossRefGoogle ScholarPubMed
Cooper, P. J., Taylor, M. J., Cooper, Z., et al (1987) The development and validation of the Body Shape Questionnaire. International Journal of Eating Disorders, 6, 485494.Google Scholar
Craine, L. S., Herson, C. E., Collwer, J. A., et al (1988) Prevalence of a history of sexual abuse among female psychiatric patients in a State Hospital system. Hospital and Community Psychiatry, 39, 300304.Google Scholar
Freud, S. (1895) In The Aetiology of Hysteria. Complete Psychological Works of Sigmund Freud. Vol. 3. London: Hogarth Press.Google Scholar
Garner, D. M. & Garfinkel, P. E. (1979) The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychological Medicine, 9, 273279.Google Scholar
Garfinkel, P. E., Moldofsky, H. & Garner, D. M. (1980) The heterogeneity of anorexia nervosa: bulimia as a distinct subtype. Archives of General Psychiatry, 37, 10361040.CrossRefGoogle Scholar
Gartner, A., Marcus, R., Halmi, K. & Loranger, A. (1989) DSM–III–R personality disorders in patients with eating disorders. American Journal of Psychiatry, 146, 15851591.Google ScholarPubMed
Hall, R. C. W., Tice, L., Beresford, T. P., et al (1989) Sexual abuse in patients with anorexia nervosa and bulimia. Psychosomatics, 30, 7379.CrossRefGoogle ScholarPubMed
Harter, S., Alexander, P. C. & Neimeyer, R. A. (1988) Long-term effects of incestuous child abuse in college women: social adjustment, social cognition and family characteristics. Journal of Consulting and Clinical Psychology, 56, 58.CrossRefGoogle ScholarPubMed
Henderson, M. & Freeman, C. L. P. (1987) A self-rating scale for bulimia: the BITE. British Journal of Psychiatry, 150, 1824.Google Scholar
Herman, J. L., Perry, J. C. & Van Der Kolk, B. A. (1989) Childhood trauma in borderline personality disorder. American Journal of Psychiatry, 146, 490495.Google ScholarPubMed
Hudson, J., Pope, H., Jonas, J., et al (1983) Phenomenologic relationship of eating disorders to major affective disorder. Psychiatric Research, 9, 341354.Google Scholar
Jacobson, A. & Richardson, B. (1987) Assault evidence of 100 psychiatric inpatients. Evidence of the need for routine inquiry. American Journal of Psychiatry, 144, 908913.Google Scholar
Lacey, J. H. & Evans, C. D. H. (1986) The impulsivist: a multi-impulse personality disorder. British Journal of Addiction, 81, 641649.Google Scholar
Leon, G. R., Lucas, A. R., Colligan, R. C., et al (1985) Sexual, body image and personality attitudes in anorexia nervosa. Journal of Abnormal Child Psychology, 13, 245258.Google Scholar
Levine, A. P. & Hyler, S. E. (1986) DSM–III personality diagnosis in bulimia. Comprehensive Psychiatry, 27, 4753.Google Scholar
Markowe, H. L. J. (1988) The frequency of childhood sexual abuse in UK. Health Trends, 20, 26.Google Scholar
Miller, J., Moeller, D., Kaufman, A., et al (1978) Recidivism among sex assault victims. American Journal of Psychiatry, 135, 11031105.Google ScholarPubMed
Morrison, J. (1989) Childhood sexual histories of women with somatization disorder. American Journal of Psychiatry, 146, 239241.Google Scholar
Mullen, P. E., Romans-Clarkson, S. E., Walton, V. A., et al (1988) Impact of sexual and physical abuse on women's health. Lancet, i, 841845.Google Scholar
Oppenheimer, R., Howells, K., Palmer, R. L. et al (1985) Adverse sexual experiences in childhood and clinical eating disorders: a preliminary description. Journal of Psychiatric Research, 19, 357361.Google Scholar
Piran, N., Lerner, P., Garfinkel, P. E., et al (1988) Personality disorder in anorexic patients. International Journal of Eating Disorders, 7, 589599.3.0.CO;2-H>CrossRefGoogle Scholar
Pope, H. G. & Hudson, J. I. (1989) Are eating disorders associated with borderline personality disorder? A critical review. International Journal of Eating Disorders, 8, 19.Google Scholar
Russell, D. E. H. (1986) The Secret Trauma: Incest in the Lives of Girls and Women. New York: Basic Books.Google Scholar
Sheldon, H. (1988) Childhood sexual abuse in adult female psychotherapy referrals: incidence and implications for treatment. British Journal of Psychiatry, 152, 107112.Google Scholar
Sloan, G. & Leichner, P. (1986) Is there a relationship between sexual abuse or incest and eating disorders? Canadian Journal of Psychiatry, 31, 656660.Google Scholar
Smart, D. E., Beumont, P. J. V. & George, G. C. W. (1976) Some personality characteristics of patients with anorexia nervosa. British Journal of Psychiatry, 128, 5760.Google Scholar
Snaith, R. P., Ahmed, S. N., Mehta, S., et al (1971) Assessment of the severity of primary depressive illness. The Wakefield self-assessment depression inventory. Psychological Medicine, 1, 143149.Google Scholar
Strober, M. (1985) Personality factors in anorexia nervosa. Pediatrician, 12, 134138.Google Scholar
Tyrer, P., Alexander, M. S., Cicchetti, D., et al (1979) Reliability of a schedule for rating personality disorders. British Journal of Psychiatry, 135, 168174.Google Scholar
Tyrer, P., Strauss, J. & Cicchetti, D., (1983) Temporal reliability of personality in psychiatric patients. Psychological Medicine, 13, 393398.Google Scholar
Walker, E., Katon, W., Harrop Griffiths, J., et al. (1988) Relationship of chronic pelvic pain to psychiatric diagnoses and childhood sexual abuse. American Journal of Psychiatry, 145, 7580.Google Scholar
West, D. J. (1988) Incest in childhood and adolescence; long term effects and therapy. British Journal of Hospital Medicine, 40, 343360.Google Scholar
Zanarini, M. C., Gunderson, J. G., Marino, M. F., et al (1989) Childhood experiences of borderline patients. Comprehensive Psychiatry, 30, 1825.CrossRefGoogle ScholarPubMed
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