Adult Sexual Abuse, Disordered Eating Behaviors, and Substance Abuse: The Role of Internalized Shame and Maladaptive Coping Strategies

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Yilmaz, Bilgé Özgé
Old Dominion University Libraries
Adult; Sexual abuse; Disordered eating behaviors; Substance abuse; Young adults; Revictimization; Experimental Analysis of Behavior
thesis / dissertation description
The prevalence of sexual abuse and disordered eating in young adulthood is increasing in the United States, with as many as one-quarter of women reporting unwanted sexual contact and two-thirds reporting extreme dieting. Among the numerous deleterious effects of sexual abuse are a greater risk of problematic eating, drinking and drug use among women, making this population at particular risk for co-occurrence of sexual abuse, disordered eating and substance use. Despite these statistics, the impact of adult sexual abuse (ASA) on disordered eating and substance use is largely unknown for this population. Shame and avoidance-focused coping have been identified as shared responses among sexual abuse survivors and are well-known contributors to the maintenance and development of disordered eating and substance abuse, though it is unclear how these might influence the relationship between ASA contact, disordered eating, and problematic substance use. This study aimed to 1) examine the association of history (i.e., ASA only, no history, revictimization) and 2) type (i.e., contact, non-contact) of ASA on health-risk behaviors among college women and 3) assess two potential mediators (i.e., internalized shame, maladaptive coping) influencing the relationship between ASA contact and disordered eating, problematic drinking, and problematic drug use. Participants were 420 undergraduate female students who completed an online survey. Results indicated that women who endorsed a history of ASA only (i.e., contact, non-contact) reported significantly greater problematic drinking as compared to women who did not endorse ASA history. Further, endorsed revictimization (i.e., multiple instances of sexual abuse across lifespan) history was associated with significantly greater reported disordered eating and problematic substance use as compared to women with no reported ASA history. Results of mediation analyses revealed that internalized shame fully mediated the relationship between ASA contact, disordered eating and problematic drug use, and partially mediated the relationship between ASA contact and problematic drinking. Maladaptive coping did not mediate the relationship between ASA contact and the outcome variables. Overall, internalized shame explained the greatest amount of variance in the association between ASA contact, disordered eating, and substance use. Future research may benefit from replicating this study among larger, more diverse clinical samples.