Relationship of childhood sexual, physical, and combined sexual and physical abuse to adult victimization and posttraumatic stress disorder.

OBJECTIVE: Prior research has suggested that women who experience childhood sexual abuse are at increased risk for sexual victimization and Posttraumatic Stress Disorder (PTSD) in adulthood. However, previous studies have paid insufficient attention to the overlap of childhood sexual and physical abuse. In the present study we disentangled the separate and combined effects of childhood sexual and physical abuse by comparing groups of participants who reported contact childhood sexual abuse only (SA), sequelae of childhood physical abuse only (PA), combined childhood sexual and physical abuse (CA), or no child abuse (NA). METHOD: A sample of 475 female college students completed measures of sexual and physical abuse in childhood (before age 15) and adulthood (after age 15), PTSD and trauma symptoms, and demographic variables. Of these participants, 27 were assigned to the SA group, 53 to the PA group, 31 to the CA group, and 211 to the NA group. RESULTS: The highest rate of adult sexual and/or physical victimization was reported by the CA group, followed by the PA group, with lower rates reported by the SA and NA groups. Using adult victimization as a covariate, the analyses revealed that the CA group reported significantly higher rates of PTSD and trauma symptoms compared to the NA group. CONCLUSIONS: The results suggest that prior reports of differences in rates of adult victimization and PTSD between women who experienced childhood sexual abuse and women who did not may be attributable to the inclusion of participants with a history of combined childhood sexual and physical abuse in childhood sexual abuse groups. The importance of separating physical and combined forms of victimization from sexual abuse is discussed.

Childhood abuse, body image disturbance, and eating disorders.

Studies have suggested that women who experience child sexual abuse are at risk for developing symptoms related to anorexia nervosa and bulimia. The purpose of the present study was to examine the relationships among childhood sexual and physical abuse, body image disturbance, and eating disorder symptomatology. Of 670 female college students screened for childhood abuse, 29 sexually abused, 32 physically abused, and 29 nonabused women completed measures of eating disorder symptoms, psychological factors thought to be related to eating disorders, and body image distortion. Contrary to previous reports, there was no evidence that child sexual or physical abuse was associated with the development of body image disturbance. Furthermore, the results did not support the hypothesis that child sexual and physical abuse are related to eating disorder symptomatology. It is suggested that subjects who are victims of child sexual abuse and who are receiving psychotherapy manifest higher rates of a number of different types of psychopathology, including eating disorders.