Child Sexual Abuse and Eating Disorders

Abstract

Since the mid-1990s, a number of investigators have examined whether child sexual abuse might play a role as a risk factor for eating disorders. Indeed, sufficient attention had been paid to this association to facilitate a meta-analytic review in 2002. While this attention suggests that researchers are no longer ignoring this nexus, we continue to need more specific and sensitive information about the processes that mediate and moderate this association. To that end, we review what we know about the association between child sexual abuse (CSA) and eating disorders, propose conceptual models that can be tested, and delineate ideas for future directions in this area. We restrict our review to the impact of CSA on eating disorders as they affect females for several reasons. First, while some researchers recognize that males may experience similar sexual victimization rates in childhood, males tend to manifest traits of a more externalizing nature (such as aggression) because of such abuse. Second, the earlier ages for sexual abuse among boys' hamper reliable reporting of these incidents. Third, it may be more difficult for boys than girls to disclose acts of sexual abuse to a survey interviewer or social service investigator because of cultural roles that reduce the admission of vulnerability characteristics in males. Nevertheless, we believe that future research needs to address the CSA-eating disorder nexus for males if some of these measurement obstacles can be overcome.