Eating Disorders and Sexual Trauma: Does One Experience Cause the Other?, Research Paper Example

Eating Disorders and Sexual Trauma: Does One Experience Cause the Other?

One of the most complex mental illnesses in the world is disordered eating. And what complicates this disorder even more is comorbidity issues that accompany it, such as sexual trauma. Millions of people all around the world are controlled by eating disorders and many of these people will die from this illness (EDC, 2012). However, EDC (2012) reports that at least 60% of people with eating disorders are successfully treated and fully recover. It is true, though, that health outcomes are different for different individuals for various reasons.

Studies show the existence of a correlation between eating disorders and sexual trauma. This correlation is related to the question of whether people who suffer traumatic experiences, such as sexual abuse, develop eating disorders as a result or vise versa. The  purpose of this paper is to analyze and evaluate the connection between eating disorders and sexual trauma, and to answer the questions of whether one of these experiences causes the other.

To understand the correlation between the two, it is first necessary to understand what defines eating disorders. According to the National Institute of Mental Health, an eating disorder is a serious illness which causes critical disturbances to one’s diet, which can lead to dietary deficiencies, which can lead to adverse health conditions. Eating disorders are characterized by a person severely overeating or binging (whether they purge or not) or consuming an extremely small amount of food, depriving themselves of nourishment (NIH, n.d.).The Eating Disorder Coalition (EDC) (2012) reports that approximately half of the population in America has knowledge of someone suffering from an eating disorder. Research shows that more than 25 million Americans suffer from eating disorders, which ranks as the third most common chronic disease among adolescents (EDC, 2012). According to the National Eating Disorder Association (NEDA), about 10 million men and 20 million women in the United States will suffer from an eating disorder at some point in their lives. Furthermore, the EDC reports that, among all mental illnesses, eating disorder illness has the highest mortality rate, due mainly to the increased suicide rates among this group (EDC, 2012).

The correlation between eating disorders and sexual trauma  is relatively prevalent. Based on research, measuring the actual number of victims of sexual abuse among those who also have eating disorders is difficult because people’s circumstances differ so much . However, this correlation is mainly reported in females which is approximately 30% of females who have suffered sexual abuse also have experienced eating disorders of some sort (Woodside, Garfinkel et al., 2001). This is a disturbing estimate in itself, but it is even more disturbing to imagine that the percentage is likely higher, due to unreported incidences of sexual abuse because of its highly personal nature. Victims of this type of abuse often cling to secrecy, are embarrassed, and feel a sense of guilt (Wonderlich, et al., 2001).  This is significant to this thesis in that unreported incidences of sexual abuse, among people with eating disorders, may make determining whether the sexual abuse is a factor in causing the eating disorders.

Another significant finding regarding the link between eating disorders and sexual trauma is the victim perceiving that she lacks control. Peterson and Seligman (1983) report that, as humans, people need to feel like they have control over their own lives, especially when it concerns bad situations or experiences. Otherwise, they may feel quite distressed. Those who may survive sexual trauma may have feelings after the fact of having no control over their own bodies. This is because sexual abuse has a coercive nature about it. This is related to why people with eating disorders have a strong desire for self-control, especially with a sexual trauma history. One type of eating disorder is anorexia, which is to eat very little or no food at all, and by restricting food intake, the abused victim may get a sense of control over her own body, if only for a limited time (Peterson & Seligman, 1983 ). This behavior can be a way of coping with the effects of sexual trauma, which suggests that the sexual trauma is the cause of the eating disorder in this case, which relates to the thesis question.

Coping with sexual trauma through disordered eating is not the only effect that can arise, as other negative effects, such as body dissatisfaction, is also linked to this issue, according to Peterson and Seligman.  Research reveals that women with a history of both eating disorders and sexual trauma often do not accept their own femininity and sexuality or their own bodies. This is a catalyst to their believing that their bodies were too seductive, which was the reason their abuser was drawn to them. They actually blame themselves and their bodies for causing their traumatic experience, causing them to associate being feminine with negative consequences. This is a reason why they think of starving their bodies, through anorexia, as a way to punish their bodies and express their anger toward their own bodies. Furthermore, anorexia may be a way of escaping the responsibility of dealing with being a woman, because this disease results in low sex drive and lack of menses. This way, she can regress back to being child-like and not have to handle being sexual or feminine because it causes psychological and emotional distress, as well as bad memories of being violated (Peterson & Seligman, 1983 ). This is what is known as learned helplessness, and is used by the victim when coping with an event out of his or her control, such as sexual abuse. In this, the victim learn that their behaviors are not necessarily related to situational outcomes; therefore, the victim learns a “response-outcome independence” (Peterson & Seligman, 1983, p. 103) that causes them to think that how that future attempts to change a situation by actions may not be successful.

Bulimia is another eating disorder that is often seen in women who have been sexually traumatized. This eating disorder has a very strong association with sexual abuse on a deeper level. This is because purging, which is the hallmark of bulimia, may help the victim feel like she is purifying or cleansing herself of feeling “dirty” and having a dirty body (Deep, Lilenfeld, Plotnicov, Pollice, & Kaye, 1999). However, “the question of whether sexual abuse causes the development of an eating disorder remains unclear” (Deep, Lilenfeld, Plotnicov, Pollice, & Kaye, 1999, p. 8).The National Eating Disorders Association reports that bulimia is used as a means of self-protection among victims of sexual trauma. This is due to the binge/purge cycle of bulimia being a way to lessen awareness of the emotions and thoughts of traumatic experiences to escape. Additionally, bulimia is seen in those sexual abuse survivors that experience a lot of stress, guilt and anger and the need to refocus and regain their personal space, control, and predictability in life (NEDA, 2012).  This may suggest that the bulimia developed as a consequence of sexual abuse as a way to gain control.

Similarities of Symptoms and Research on the Cause of Eating Disorders

People with eating disorders and people who have experienced sexual trauma may often exhibit similar symptoms . As mentioned, two of the most prevalent and popular eating disorders are anorexia and bulimia. However, another eating disorder called binge eating disorder is also prevalent. This disorder is characterized by binge eating without the weight control obsession seen with bulimia. Consequently, this category of eating disorder presents with similar symptoms as the others, such as body dissatisfaction, self-criticism, low self-esteem, need for approval, self-harm, and depression. Other symptoms include physical and mental health issues (Dunkley, Masheb, & Grilo, 2010).  The similarity of symptoms among people who engage in disordered eating and who have also been sexually abused suggests that one can indeed cause the other. This is significant to note here, as it relates to the thesis and research question.

According to Hall and Hall (2011), symptoms of eating disorders associated with sexual trauma include long-term effects from the experience, particularly when the abuse occurs in childhood. These symptoms include “depression, guilt, shame, self-blame, eating disorders, somatic concerns, anxiety, dissociative patterns, repression, denial, sexual problems, and relationship problems” (p. 2). Additionally, it is noted that depression is the most common symptom among survivors, particularly long-term. This is because they often have a difficult time externalizing the abuse. This makes them think about themselves in a negative way. Consequently, after thinking this way in the long-term, these people feel worthless and feel like they do not have anything to offer in life, so they shy away from others (Van Velsor & Cox, 2001).  This, in turn, could lead to looking for a way to cope or an escape, such as, developing an eating disorder.

The views offered by Carter, Bewell, Blackmore, and Woodside (2006) indicate that research findings show that prevalence of child sexual abuse among patients diagnosed with the anorexia nervosa disease showed more psychiatric disturbance and obsessive-compulsive symptoms than eating disorder patients with no history of child sexual abuse. Additionally, those who were survivors of child sexual abuse also had more severe levels of the psychopathology of their eating disorders. This includes higher incidences of purging behaviors, such as laxative misuse and self-induced vomiting, among the patients who suffer from eating disorders and a history of child sexual abuse.

Kong and Bernstein (2009) add that previous research shows that sexual trauma survivors are predisoposed to higher risks for developing eating disorders. This is due to victims of sexual trauma attempting to “avoid intrusive memories and situations associated with the trauma. In order to do so, individuals develop coping mechanisms which often include food abuse” (p. 6). This allows the person to focus their attention on the food instead of reliving the sexual trauma experiences.

Kendall-Tackett (2002) found that childhood sexual abuse can lead to adverse behavioral pathways, meaning that victims often engage in harmful or at-risk activities such as substance abuse, eating disorders, suicide, high-risk sexual behavior, and smoking. This can also lead them to negative social pathways, revitimization, and homelessness. They can also develop post-traumatic stress disorder (PTSD), which can also have negative health effects.

NEDA (2012) also discusses other reasons why people develop eating disorders, which include being victims of not only sexual abuse but of domestic violence or observers of domestic violence, and sufferers of PTSD. Additionally, Dunkley, Masheb, and Grilo (2010) state that those who suffer a lot of childhood maltreatment are at-risk for developing eating disorders, due to developing body dissatisfaction from excessive criticism or repeated insults, as well as physical or sexual abuse in childhood . One can only imagine what a child goes through mentally, emotionally and physically when experiencing sexual trauma as well as other forms of maltreatment. The need for survival could lead to developing later issues such as eating disorders.

Eating Disorders without Sexual Trauma

The research above may not show the full picture about eating disorders or sexual trauma, as there are some people who suffer from eating disorders who have not been sexually abused. Similarly, there are people who have experienced sexual trauma that do not have eating disorders. Regarding eating disorder risk factors, not including sexual trauma, NEDA (2012) notes that anyone can develop an eating disorder, as the disease does not discriminate. Therefore, there could be issues concerning one’s ethnicity, gender, sexual orientation, or socio-economic status that lead to eating disorders . This factors are significant because they could be the catalyst to maltreatment and abuse in various forms, including sexual abuse. This is why the risk factors associated with eating disorders are so diverse because people’s issues are diverse. A common eating disorder risk factor for women includes pressure from society, peers, and the media to have a certain body image. A common risk factor for men includes something similar as that for women. Men are pressured by sports figures and their careers to have a certain body size and body type (NEDA, 2012).  One only need to turn on the television or pick up a magazine to see all of the stereotypical body images imposed on both men and women that can create pressure to look a certain way, and this is something that could certainly lead to someone feeling negatively about the way they look, which could lead to disordered eating.

According to NIH, research findings indicate that eating disorders not associated with sexual abuse are caused by complex factors. These factors include an interaction among genetics, behavioral, psychological, and biological factors . Every person is different and grows up and lives in different circumstances that are related to these factors. For example, a poor child growing up in an urban environment, as opposed to a child growing up in an affluent family, will have different perspectives and may experience or cope with issues differently, particularly if they are related to abuse. Researchers are studying human genes to gain a better understanding of the disease. In addition, researchers are studying to find a way to better understand eating disorders and possible treatments. For example, a study showed different brain activity patterns between women with bulimia and women without eating disorder illness . This suggests that the correlation between sexual trauma and eating disorders may or may not exist, however.

Conclusion

As seen mentioned by Deep, Lilenfeld, Plotnicov, Pollice, and Kaye (1999), it is unclear that a definite connection  between eating disorders and history of sexual abuse exists. Therefore, it remains that one is not necessarily true of the other. This is why it is important for researchers and clinicians to analyze each patient individually because each patient is unique. It is not wise to generalize diagnoses or treatment options because everyone’s situation has differences.

As mentioned, the correlation between eating disorders and sexual trauma cannot be denied, nor can be their prevalence. As well sexual abuse among people who also suffer from eating disorders is difficult to measure. However, this paper has shown the importance of clinicians uncovering the underlying issues associated with a person’s eating disorder, even though most victims of this type of abuse want to keep it a secret of they are embarrassed and feel guilty (Wonderlich, et al., 2001).

The purpose of this paper was to analyze and evaluate the connection between eating disorders and sexual trauma, and the paper has given an understanding of the correlation between the two. The National Institute of Mental Health has defined disordered eating as a serious illness, which causes disturbances to the healthy diet, which leads to dietary insufficiencies, which in turn lead to bad health conditions. As shown, eating disorders are highlighted by severe binging, purging, or consuming extremely small amounts of food, depriving nourishment (NIH, n.d.). Treatments are available to help those who suffer from this disease. However, further research is necessary to lead to more effective treatments that can help those who suffer from this illness, specifically comorbid eating disorder populations. More knowledge of this disease and how to care for patients who struggle with this disorder will save lives that are lost every day to eating disorders.

This has come a long way, but you still need to do the work of clearly framing your project with your big question and your thesis. We don’t really get a gist of the argument you’re trying to make until the conclusion. You need to lay all of this out, what you are arguing, how you will prove your point, in the intro. Then, you need to make sure that you are tying everything into this argument, your perspective, throughout the paper. Also, I’d like to see some of your ideas developed further, and some direct quotes from some of your sources. This is really getting close, but the most essential thing to work on is articulating what your project is, what your big question is, what your thesis is, and how you are going about this—then show how all of your information informs your thesis throughout.

OA: 3/5.  This needs the most work, as stated throughout my notes.

IL: 4/5—you need to make connections between your sources and your thesis. It’s all very disjointed right now.

Research: 4/5. You need to dig deeper when it comes to making connections. You also need to do some direct quoting.

AA: 4/5. This goes back to how it all ties into your original thesis—YOUR argument/perspective/thesis is unclear– and you need to put this analysis to work for your argument instead of just presenting the research of others without the context of your ideas.

SJ: 5/5

Rubric Average: 4.0

Score: 90/100

References

Carter, J. C., Bewell, C., Blackmore, E., & Woodside, D. B. (2006). The impact of childhood sexual abuse in anorexia nervosa. Child Abuse & Neglect, 30(1), 257-269.

Deep, A. L., Lilenfeld, L. R., Plotnicov, K. H., Pollice, C., & Kaye, W. H. (1999). Sexual abuse in eating disorder subtypes and control women: The role of comorbid substance dependence in bulimia nervosa. The International Journal of Eating Disorders, 25(1), 1-10.

Dunkley, D. M., Masheb, R. M., & Grilo, C. M. (2010, April). Childhood maltreatment, depressive symptoms, and body dissatisfaction in patients with binge eating disorder: The mediating role of self-criticism. International Journal of Eating Disorders, 43(3), 274-281. Retrieved from International Journal of Eating Disorders.

EDC. (2012). Facts about eating disorders. Retrieved from Eating Disorders Coalition for Research, Policy & Action: http://www.eatingdisorderscoalition.org/documents/EatingDisorderFacts.pdf

Hall, M., & Hall, J. (2011). The Long-Term Effects of Childhood Sexual Abuse: Counseling Implications. VISTAS, 1-7. Retrieved from https://www.counseling.org/docs/disaster-and-trauma_sexual-abuse/long-term-effects-of-childhood-sexual-abuse.pdf?sfvrsn=2

Kendall-Tackett, K. (2002). The Health Effects of Childhood Abuse: Four Pathways by which Abuse Can Influence Health. Child Abuse and Neglect, 6(7), 715-730.

NEDA. (2012). Trauma and Eating Disorders. Retrieved from National Eating Disorders Association: https://www.nationaleatingdisorders.org/sites/default/files/ResourceHandouts/TraumaandEatingDisorders.pdf

NIH. (n.d.). Eating Disorders. Retrieved from National Institute of Mental Health: http://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml

Peterson, C., & Seligman, M. E. (1983). Learned helplessness and victimization. Journal of Social Issues, 39(1), 103-116.

Van Velsor, P., & Cox, D. (2001). Anger as a vehicle in the treatment of women who are sexual abuse survivors: Reattributing responsibility and accessing personal power. Professional Psychology: Research and Practice, 32(6), 618-625.

Wonderlich, S. A., Crosby, R. D., Mitchell, J. E., Thompson, K. M., Redlin, J., Demuth, G., . . . Haseltine, B. (2001). Eating disturbance and sexual trauma in childhood and adulthood. International Journal of Eating Disorders, 30(1), 401-412.

Woodside, B. D., Garfinkel, P. E., Lin, E., Goering, P., Kaplan, A. S., Goldbloom, D. S., & Kennedy, S. H. (2001). Comparisons of men with full or partial eating disorders, men without eating disorders, and women with eating disorders in the community. Journal of Psychiatry, 158(1), 570-574.