Childhood sexual abuse and adolescent anorexia nervosa: A case report

Neslim Güvendeğer Doksat

doi:10.26809/joa.2886

Authors

Neslim Güvendeğer Doksat İstanbul Beykent University / Türkiye 0000-0002-5896-0165

10.26809/joa.2886

Abstract

Objective: Childhood sexual abuse (CSA) has been consistently identified as a significant risk factor for the development of eating disorders, particularly anorexia nervosa (AN), in adolescence and adulthood.

Methods: In this case report, a sixteen year old girl with a late childhood history of CSA by her brother-in-law, exhibiting AN-binge-eating/purging type will be evaluated.

Findings: This case report presents the clinical evaluation and four-month psychiatric follow-up of a sixteen-year-old female diagnosed with anorexia nervosa-binge-eating/purging type, comorbid with major depressive disorder with anxiety and post-traumatic stress disorder (PTSD) symptoms. The patient reported persistent food restriction, distorted body image, binge eating, and purging behaviors. Her symptoms intensified over the past three months, and her body mass index (BMI) at admission was 15.8 kg/m². The patient's developmental history revealed CSA by her brother-in-law between the ages of nine and eleven, which she disclosed to her mother at age thirteen but was not believed. Clinically, she exhibited intense internal and external body-related shame, avoidance of femininity, social withdrawal, and distrust of men. Treatment included fluoxetine, olanzapine, and supportive psychotherapy. Although her weight increased during treatment, persistent body image disturbances and fear of femininity led to voluntary treatment discontinuation at four months.

In conclusion; this case highlights the complex interplay between CSA, depressive disorders, and maladaptive coping mechanisms manifesting as disordered eating behaviors. The findings align with literature identifying emotional dysregulation, depression, shame, and anxiety as mediating factors in CSA and eating disorders relationship. Early identification of CSA and integration of well designed appropiate psychoterapy models into eating disorder treatment protocols are essential for optimizing therapeutic outcomes and preventing premature treatment termination.

Keywords:

childhood sexual abuse anorexia nervoza

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Childhood sexual abuse and adolescent anorexia nervosa: A case report

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