Dissociation, comorbidity of dissociative disorders, and childhood abuse in a community sample of women with current and past bulimia

Dissociation and childhood sexual abuse were examined in a community sample of current, past, and non-bulimic controls. All respondents completed questionnaires requesting information relating to bulimia, dissociation, and incidence and severity of childhood sexual abuse. Participants scoring high on the measure of dissociation were further assessed with a structured clinical interview to determine the proportion who would fulfill the formal criteria for a DSM-IV dissociative disorder. Results indicated that dissociation was highest among current bulimics, and that past bulimics had lower levels of dissociation than current bulimics (although higher than non-bulimic controls). However, there was no association between level of dissociation and incidence of reported childhood sexual abuse. In addition, the incidence of childhood sexual abuse was no higher among bulimics than among the general population – although the severity of the abuse was reported to have been higher. The severity of self-reported childhood sexual abuse was also found to be higher among current bulimics than among past bulimics. Comorbidity of DSM-IV dissociative disorders among current bulimics was found to be 10%.