Reported sexual abuse and eating psychopathology: a review of the evidence for a causal link.

It has been claimed that there is no specific link between a reported history of sexual abuse and the eating disorders. In particular, studies and reviews investigating the relationship between reported sexual abuse and the eating disorders have concluded that the prevalence rate of abuse among eating-disordered women is similar to the rates found in other psychiatric groups and in the general population. However, it is argued in this review that such a conclusion is based on an inappropriate level of analysis of the phenomena of sexual abuse and diagnosable eating disorders. When these two relatively blunt constructs are considered in finer detail, there appears to be a complex link between the nature of sexual abuse and specific bulimic symptomatology. This relationship is discussed with particular reference to important mediating factors (including dissociation, self-denigration, borderline personality disorder, and disclosure experiences), the functions of the bulimic behaviors, and the particular cognitive schemata that the victims of abuse may develop. The clinical implications of this relationship are considered, and suggestions are made for further research.