Coping styles and disordered eating in survivors of childhood sexual abuse

Childhood sexual abuse (CSA) is a complex form of trauma that can have long-lasting effects on how an individual copes with stress and adversity in their daily life. CSA has been associated with a number of sequelae, one of them being eating disorder (ED). This thesis focuses on the coping styles of CSA survivors and explores the link between CSA and ED, through the lens of coping and trauma-related cognitions. Due to a gender imbalance in the current literature, a systematic review of studies measuring the link between ED and CSA in males was carried out. Half of the studies included in the review found support for the relationship between CSA and harmful eating patterns in males. A case study of a male CSA survivor presenting with difficulties coping with emotions, expressed as self-injury, binge eating and physical and sexual aggression towards others, revealed that a coping-focused intervention successfully reduced harmful behaviours. An empirical study (N=295) investigated coping styles and early maladaptive schema as mediating variables in the link between CSA and ED, using the EAT-26, the Young Schema Questionnaire (YSQ-S3) and the Brief COPE. The sample included participants recruited from social media platforms (n 118), as well as ED (164) and CSA support forums (13). Only early maladaptive schema were found to mediate the relationship between CSA and ED. An interpretation may be that ED itself is a coping mechanism. A psychometric review of the Brief Coping with Problems Experienced (COPE) scale, highlights difficulties in the measurement of coping and explores potential benefits of a conceptualisation focusing on flexibility in coping, rather than style of coping. It also indicates a need for more trauma-sensitive measures when assessing coping strategies in this population. Future research should focus on the specific early maladaptive schemas or schema domains that may influence the relationship between CSA and ED. Future efforts should also aim to better understand the relationships of these variables in male survivors. Clinical implications are discussed, along with limitations of the thesis