Pope H G, Mangweth B, Negrão A B, Hudson J I, Cordás T A
Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA 02178.
Am J Psychiatry. 1994 May;151(5):732-7. doi: 10.1176/ajp.151.5.732.
This study was designed to assess the prevalence of childhood sexual abuse among women with bulimia nervosa in three countries: the United States, Austria, and Brazil. In addition, it assessed whether bulimic subjects might have experienced more severe sexual abuse than women in the general population and whether bulimic subjects who report abuse might display greater psychopathology than those who do not report abuse.
Thirty-three university students in Innsbruck, Austria, 33 university students in Boston, and 25 women in São Paulo, Brazil, all meeting DSM-III-R criteria for bulimia nervosa, were recruited by advertisement. Detailed histories of sexual abuse, obtained at the conclusion of a comprehensive evaluation interview, were prepared, translated into English, and rated by an investigator who was blind to the nationality of the subject. Subjects were compared on frequency of eating binges, history of major depression, body mass index, and satisfaction with body image.
Narrowly defined childhood sexual abuse was reported by 24%-36% of women in the three countries, although only 15%-32% of women reported abuse before the onset of bulimia nervosa. There were no significant differences between countries in rates of abuse. Overall, these rates appear no greater than those reported in comparable studies of women in the general population. The data also did not support the hypothesis that bulimic subjects had endured more severe sexual abuse than other women, nor was there a significant association between history of childhood sexual abuse and severity of bulimic symptoms.
These findings add to the weight of evidence suggesting that childhood sexual abuse is not a risk factor for bulimia nervosa.
本研究旨在评估美国、奥地利及巴西三国神经性贪食症女性中儿童期性虐待的发生率。此外，还评估了贪食症患者是否比普通人群中的女性经历过更严重的性虐待，以及报告遭受过性虐待的贪食症患者是否比未报告者表现出更严重的精神病理学症状。
通过广告招募了奥地利因斯布鲁克的33名大学生、波士顿的33名大学生以及巴西圣保罗的25名女性，她们均符合神经性贪食症的DSM-III-R标准。在全面评估访谈结束时获取详细的性虐待史，整理后翻译成英文，由一名对受试者国籍不知情的研究者进行评分。对受试者在暴饮暴食频率、重度抑郁病史、体重指数及身体形象满意度方面进行比较。
三个国家中24%-36%的女性报告有狭义的儿童期性虐待，不过只有15%-32%的女性报告在神经性贪食症发病前遭受过性虐待。各国间的虐待发生率无显著差异。总体而言，这些发生率似乎并不高于普通人群中女性的类似研究报告。数据也不支持贪食症患者比其他女性遭受更严重性虐待的假设，儿童期性虐待史与贪食症症状严重程度之间也无显著关联。
这些发现进一步证明儿童期性虐待并非神经性贪食症的危险因素。
