Speculations on the Role of Childhood Abuse in the Development of Eating Disorders Among Women
Clearly, child abuse is neither a necessary nor sufficient precursor for the development of eating disorders or other psychopathology. Childhood abuse of all kinds—sexual, physical and psychological, both subtle and dramatic—represents a form of boundary violation in which the separateness and integrity of the child’s physical and/or psychological self are treated with gross disregard. Abusive experiences, of which child sexual and physical abuse are the main forms studied, constitute major stressors and predisposing factors for the development of psychopathology, including eating pathology. In an effort to provide a preliminary model, we propose that both the immediate trauma and the negative developmental consequences of childhood abuse provide setting conditions for numerous forms of psy-chopathology, including eating disturbance. Deficits in affect regulation, which may arise from a combination of constitutional insufficiencies and early experience, constitute an additional risk factor for eating disorders among women abused in childhood. Clinical work with eating-disordered women abused in childhood presents a number of challenges.