The role of general family environment and sexual and physical abuse in the origins of eating disorders

Abstract

This paper reviews the role of childhood family functioning and of sexual and physical abuse in eating disorders. Bearing in mind the huge methodological differences across studies the following tentative conclusions can be reached: there is evidence of more family pathology in eating disorder families than in normal control families. Those with bulimic disorders seem to have poorer family functioning than restrictors. Different eating disorder subgroups show less or comparable levels of family pathology compared to psychiatric or other medical controls depending on the comparison group. In bulimia nervosa high levels of family disturbance seem to be associated with greater severity and chronicity of bulimic symptomatology. There is some suggestion that family functioning may have more of an effect on Axis II than on Axis I disorders. Rates of sexual abuse appear to be higher in bulimia nervosa than in normal controls. Depending on which psychiatric control groups are chosen, eating disorder patients may have similar, higher or lower rates of contact sexual abuse. The majority of studies fails to ®nd differences between eating disorder subtypes in terms of rates of sexual abuse. The evidence on whether there is any link between abuse characteristics and the severity of eating disorder is inconclusive. On balance, childhood sexual abuse does not seem to be a speci®c risk factor for eating disorders. Physical abuse is more common in bulimic than in restricting disorders and usually occurs in the context of a disturbed family environment. The clinical implications of these ®ndings are discussed. Future research in the area of family factors or childhood trauma in eating disorders needs to get away from mere`head

Impulsivity and Personality Variables in Adolescents With Eating Disorders

“…As with prior studies, family and childhood developmental variables demonstrated important relationships with impulsivity (Corstorphine et al, 2007; Schmidt et al, 1997). The presence of externalizing pathology (such as substance abuse disorder or criminality) in a parent showed positive relation to Acting Out and Destructiveness in the adolescents in our sample, suggesting a possible genetic predisposition to impulsivity in this population.…”

“…While childhood trauma appears to be an independent risk factor for later self-destructive, impulsive behavior (Wonderlich, Crosby, & Mitchell, 2001), some researchers have demonstrated that parents with externalizing symptoms may place their children at higher risk for childhood abuse (Verona & Sachs-Ericsson, 2005). Findings from observational studies also suggest that the manifestations of personality disturbances, such as heightened emotionality and impulsivity, in EDs may be moderated by family dysfunction or environments lacking warmth and stability (Steiger & Bruce, 2007; Schmidt, Humfress & Treasure, 1997). …”

The role of gendered constructions of eating disorders in delayed help-seeking in men: a qualitative interview study

“…Environmental and genetic factors impact the risk of developing an ED. Up to 70% of cases of AN and BN have been estimated to be triggered by an adverse life event, such as abuse 2 5 6. Existing psychiatric conditions7 or substance abuse in the family,8 9 certain personality traits (such as perfectionism and low self-esteem),8–10 and complex sociocultural factors around body image are also risk factors 2 11.…”

Parental Loss and Eating-Related Cognitions and Behaviors in College-Age Women

“…Speci¢cally, research has indicated that a history of violent physical abuse is associated with the development of eating disorders (Rorty & Yager, 1993;Schmidt, Humfress, & Treasure, 1997). The relationship between the experience of sexual abuse and disordered eating patterns=eating disorders has been explored well in the literature (Moyer, 1997;Neumark-Sztainer, Story, Hannan, Beuhring, & Resnick, 2000;Tobin & Gri⁄ng, 1996).…”