Epidemiology Commons^™

Secular Trends In The Incidence Of Anorexia Nervosa: Integrative Review Of Population-Based Studies, Kevin M. Gorey

Social Work Publications

OBJECTIVE AND METHOD: Aggregating across retrospective cohort samples, this integrative review synthesizes the findings of 12 cumulative incidence studies (45 hypotheses) on anorexia nervosa secular trends.

RESULTS: (1) The female/male anorexia incidence rate ratio was estimated to be 8.20, 18.46 versus 2.25 cases per 100,000 per year, p < .05; (2) female teenagers experienced anorexia at a rate fivefold greater than other women, 50.82 versus 10.37 incident cases per 100,000 per year, p < .001; (3) no secular trend or change in the incidence of anorexia was observed among teenagers, while a near threefold increase was observed over the past 40 years among women in their 20s and 30s, 6.28 (1950-1964) versus 17.70 (1980-1992) cases per 100,000 per year, p < .05; and (4) the two cohort characteristics of age, and the age by year interaction accounted for nearly two thirds of the variability among anorexia incidence estimates, R2 = .614, F(2,27) = 21.49, p < .001. After the two factors of age and the Age x Year interaction were accounted for, none of the other study characteristics, including study year(s), were found to be significantly associated with anorexia incidence, that is, a main effect of time was not observed.

DISCUSSION: The integrative evidence across the population-based epidemiologic studies covering 40 years in this field suggests strongly that, overall, the incidence of anorexia nervosa, particularly among those very young women at greatest risk of experiencing it, has not increased significantly. However, the risk does seem to have increased significantly among women in …

The Prevalence Of Child Sexual Abuse: Integrative Review Adjustment For Potential Response And Measurement Biases, Kevin M. Gorey

Social Work Publications

This integrative review synthesizes the finding of 16 cross-sectional surveys (25 hypotheses) on the prevalence of child abuse among nonclinical, North American samples. It is essentially a research literature on sexual abuse; only one of the studies assessed physical abuse, and there has not yet been a single study of prevalent child emotional abuse nor neglect. The following summative inferences were made: (1) response rates diminished significantly over time, M = 68% prior to 1985 and M = 49% for more recent surveys, p < .05; (2) unadjusted estimates of the prevalent experience among women and men of childhood sexual abuse was 22.3% and 8.5%, respectively; (3) study response rates and child abuse operational definitions together accounted for half of the observed variability in their abuse prevalence estimates, R2 = .500, p < .05; (4) female and male child sexual abuse prevalence estimates adjusted for response rates (60% or more) were respectively, 16.8% and 7.9%, and adjusted for operational definitions (excluding the broadest, noncontact category) they were 14.5% and 7.2%; (5) after adjustment for response rates and definitions, the prevalence of child sexual abuse was not found to vary significantly over the three decades reviewed. Given the large human costs, both personal and social, of child abuse, and the identified gap in the requisite knowledge needed to steer effective preventive and treatment interventions, it is time to invest in a large, methodologically rigorous, population-based study of child abuse which, if it does nothing else, spares no expense in ensuring very high participation.