Relationship of Childhood Abuse to Psychiatric Distress, Social Adjustment, and Eating Disorder Severity in Japanese Bulimics

The aim of this study was to investigate the childhood abuse histories of bulimic patients in order to characterize the effect of these histories, on their later social adjustment, psychiatric distress, and bulimic severity. Fifty Japanese female bulimic outpatients filled out a 28-item version of the General Health Questionnaire, the Dissociative Disorders Interview Schedule, the Bulimic Inventory Test, and a clinical database questionnaire. Among 50 bulimic patients, 16 reported a history of physical abuse, and 20 a history of sexual abuse. The nature of the sexual abuse reported was relatively mild compared to Western reports. Although the age of onset of dieting, anorexia, binge eating, vomiting, and severity of bulimia had no relationship to abuse history, the patients with sexual abuse histories had more absenteeism in junior high school and reported more sexual activity than those without such histories. The patients who reported physical abuse histories scored higher on the somatic symptom section of the General Health Questionnaire. The findings of this study suggest that, while abuse experiences themselves do not seem to be a cause of bulimia, these experiences may affect the style and level of adaptive functioning in later life, and the type of abuse may influence the nature of future psychological difficulties. Differences in the severity of child abuse between Japan and Western countries requires further study.