McCreary B D, Thompson J
Department of Psychiatry, Queen's University, Kingston, Ontario.
Can J Psychiatry. 1999 May;44(4):350-5. doi: 10.1177/070674379904400404.
To consider psychiatric issues that relate to the prevention and management of sexual abuse involving persons with developmental disabilities as either abusers or victims.
Seven case descriptions illustrate the clinical challenges raised by allegations of sexual abuse.
Mental disorders and communication problems often coexist with the cognitive impairment that is primary in developmental disabilities. Pedophilic behaviour prompts allegations of abuse, and posttraumatic stress disorder often follows abuse. Difficulties communicating with others may preclude the detection of abuse or normal legal proceedings once an allegation is made.
Psychiatric expertise applied both directly and indirectly through others is relevant in the prevention of sexual abuse and the management of those with developmental disabilities who are abusers or abused.
探讨与预防和处理涉及发育障碍者作为施虐者或受害者的性虐待相关的精神科问题。
七个案例描述说明了性虐待指控所引发的临床挑战。
精神障碍和沟通问题常与发育障碍中首要的认知障碍并存。恋童癖行为引发虐待指控，而创伤后应激障碍常发生在虐待之后。与他人沟通困难可能会妨碍虐待行为的发现，或者在提出指控后妨碍正常的法律程序。
直接或通过他人间接应用的精神科专业知识在预防性虐待以及管理作为施虐者或受虐者的发育障碍者方面具有相关性。
