Group work with female survivors of childhood sexual abuse: evidence of poorer outcomes among those with eating disorders.

OBJECTIVE: This study explored levels of depression and self-esteem after childhood sexual abuse (CSA) group treatment for survivors with and without histories of eating disorders (ED).

METHODS: Fifty adult female survivors completed a 15-week CSA group treatment program and were assessed at intake, pre-group treatment, discharge, and six months follow-up using the Beck Depression Inventory, the Generalized Contentment Scale and the Index of Self-Esteem. They were also asked to report on their CSA histories and comorbid psychiatric issues including histories of ED.

RESULTS: Survivors with reported histories of anorexia nervosa or bulimia nervosa were significantly more depressed (minimum p<.05) and tended to have significantly less self-esteem (minimum p<.10) at discharge and six-month follow-up than those without ED. The size of these effects suggested their potential clinical significance as well. Seven to nine of every ten clients with histories of ED were more depressed and had lower self-esteem than the typical client without ED at discharge and at six-month follow-up.

CONCLUSION: The findings suggest that CSA treatment programs should assess survivors for ED as they might benefit from a more specialized focus on their emotional responses to the abuse.