RESUMO
Eating disorders, characterized by abnormal eating behaviors, are among a wide variety of psychiatric conditions that mainly affect children and adolescents. These disorders have a multifactorial origin and can be associated with restrictive diets, negative feelings, harmful family relationships, and post-traumatic stress. Thus, this study's objective was to evaluate the association between indicators of eating disorders and family and school contexts in Brazilian adolescents who previously experienced sexual abuse and examine the findings based on sex. National School Health Survey data were utilized. Among 102,301 students between 11 and 19 years of age, 4124 reported having experienced sexual abuse and were included in this study. Self-report questionnaires were used to assess participants' health status and the presence of risk behaviors, which were examined through multivariate analysis using a Poisson regression model. The results indicated positive relationships between self-induced vomiting, laxative misuse, and other purgative methods and infrequent meals with family, hunger, and the presence of violence in students' daily lives, regardless of sex (p < 0.05). In addition, body dissatisfaction and negative feelings about one's body were associated with having been bullied or teased by schoolmates for both sexes (p < 0.05). Distant relationships with parents were associated with purgative methods and body dissatisfaction among female students (p < 0.05). In conclusion, body dissatisfaction, negative feelings about one's body, laxative misuse, self-induced vomiting, and purgative methods were found to be associated with factors in family and school contexts such as hunger, infrequent meals with family, family violence, distant relationships with parents, and bullying at school in adolescents who have previously experienced sexual abuse.
RESUMO
BACKGROUND: Analysis of sexual abuse has usually been neglected in research at developing countries despite its everlasting consequences. This study examined the prevalence of sexual abuse among Brazilian adolescents according to data from the National School Health Survey (PeNSE) and analyzed it based on Brazilian regions, sociodemographic aspects, health information, and health-risk behaviors among Brazilian adolescents who reported having experienced sexual abuse previously. PARTICIPANTS AND SETTING: The PeNSE data were utilized, and the sample included 102,072 students from all over Brazil, aged between 11 and 19 years. METHODS: Data were collected by questionnaires and were analyzed by multivariate analysis using the Poisson regression model. RESULTS: The results denoted a relation between sexual abuse, social determinants of health variables (i.e., black, indigenous, and mixed skin color/ethnicity; Brazilian region public school, age between 15 and 18 years, and low education level of the mother), and health-risk behaviors (i.e., early sexual intercourse, having multiple sexual partners, unprotected sexual intercourse, use of tobacco, alcohol, and illicit drugs). CONCLUSION: Therefore, reports of sexual abuse are associated with risky behaviors. Given these findings, targeted interventions on sexual abuse are essential for the health of adolescents and the prevention of risky behaviors, and can also facilitate programs to prevent sexual abuse.
