Dissociation and Physical Abuse as Predictors of Bulimic Symptomatology and Impulse Dysregulation
This chapter examines the relationship among physical abuse, dissociation, bulimic symptomatology, and impulse dysregulation. In addition to a host of disorders delineated by dissociation, the contribution of dissociation to other diagnoses such as posttraumatic stress disorder, substance abuse, and eating disorders is emerging in a growing body of literature. The vehicle of trauma most frequently discussed in relation to eating disorders is that of childhood sexual abuse (CSA). Further empirical attempts to elucidate the complex relationship require variables salient to both abuse and eating disorders to be partialled out and analyzed with respect to their mediating or moderating effects. The focus within the eating disorder/abuse literature has been on CSA. Clearly the analysis of a meaningful relationship between childhood abuse and bulimia calls for greater methodological sophistication. The fact of abuse and the interpretation of it may well function separately to enhance the likelihood of abuse-related symptomatology such as bulimia and impulse dysregulation.