Welch S L, Fairburn C G
Institute of Psychiatry, DeCrespigny Park, London, England.
Child Abuse Negl. 1996 Jul;20(7):633-42. doi: 10.1016/0145-2134(96)00051-8.
There were two aims: First, to determine whether sexual or physical abuse in childhood or adolescence increases the risk of developing bulimia nervosa, and second, to see whether any increase in risk is specific to bulimia nervosa rather than being common to psychiatric disorders in general.
A case control design with individual matching was used. There were two related case control comparisons based on community samples. One hundred and two young adult women with bulimia nervosa were compared with 204 control subjects without an eating disorder, and with 102 control subjects with other psychiatric disorders, all recruited from the same community source. An investigator-based interview was used to assess sexual and physical abuse.
Sexual abuse involving physical contact was reported by 35% of the cases of bulimia nervosa. It was more common among this group than among the normal controls. Physical abuse was also reported by a minority of the cases of bulimia nervosa, and was more common among this group than among the normal controls. However, there were no significant differences between the cases of bulimia nervosa and the controls with general psychiatric disorder, except in the category of repeated severe sexual abuse: this was more common among the cases of bulimia nervosa although present only in small numbers within these two groups.
The findings indicate that sexual and physical abuse are both risk factors for the development of bulimia nervosa. However, they are not present in the majority of cases. This indicates that other risk factors must operate in these cases. Sexual and physical abuse do not appear to be risk factors specific to bulimia nervosa; rather, they appear to be risk factors for psychiatric disorder in general in young adult women.
本研究有两个目标：其一，确定童年期或青春期遭受性虐待或身体虐待是否会增加患神经性贪食症的风险；其二，探究这种风险增加是否特定于神经性贪食症，而非普遍适用于一般精神疾病。
采用个体匹配的病例对照设计。基于社区样本进行了两项相关的病例对照比较。102名患有神经性贪食症的年轻成年女性与204名无饮食失调的对照对象以及102名患有其他精神疾病的对照对象进行比较，所有对象均来自同一社区。通过基于研究者的访谈来评估性虐待和身体虐待情况。
35%的神经性贪食症病例报告了涉及身体接触的性虐待。在该组中比正常对照组更为常见。少数神经性贪食症病例也报告了身体虐待，且在该组中比正常对照组更常见。然而，神经性贪食症病例与患有一般精神疾病的对照组之间没有显著差异，除了在反复严重性虐待类别中：这在神经性贪食症病例中更为常见，尽管在这两组中数量都很少。
研究结果表明，性虐待和身体虐待都是神经性贪食症发病的风险因素。然而，大多数病例中并不存在这些因素。这表明在这些病例中必定还有其他风险因素起作用。性虐待和身体虐待似乎并非神经性贪食症特有的风险因素；相反，它们似乎是年轻成年女性一般精神疾病的风险因素。
