Thyen U, Kirchhofer F, Wattam C
Klinik für Pädiatrie, Medizinische Universität zu Lübeck.
Gesundheitswesen. 2000 Jun;62(6):311-9. doi: 10.1055/s-2000-11468.
Descriptive study on health outcomes, co-morbidity, severity and social context in child abuse and neglect.
Cross-sectional study of consecutively incoming cases in eleven German Child Protection Centres between January and July 1997 using a standardised survey instrument.
We report on 263 children from 251 families. The majority of children was less than ten years old, 63% were girls, 37% boys. Of all children, 134 had suffered sexual abuse with physical contact, 20 sexual abuse without contact, 77 physical abuse, 62 emotional abuse and 99 neglect (multiple responses were allowed). The overlap between various types of abuse was considerable: many children had suffered more than one, a quarter more than two types of abuse. The majority of cases was classified as either severe and/or chronic. Most children and youngsters suffered emotional distress or posttraumatic stress, long-term consequences of physical injuries were less common. Intra-familiar relationship problems and emotional distress of the care-giver had greater impact on the risk for abuse or neglect compared to socioeconomic risk factors. In 55% child protection workers documented a disability in social and emotional development, in a quarter of children developmental retardation.
The current, exclusive classification of types of abuse and neglect does not adequately describe the complexity of childrens' experiences of intra-familiar violence. Future research should be oriented towards the physical, emotional and social consequences of child maltreatment and use multifactorial designs to capture the complex aetiology and multiple acts and omissions responsible for the distress and injuries. Prospective studies are important to assess specific effects of child abuse and neglect on child development.
对虐待和忽视儿童的健康结果、合并症、严重程度及社会背景进行描述性研究。
使用标准化调查工具，对1997年1月至7月间德国11个儿童保护中心连续接收的病例进行横断面研究。
我们报告了来自251个家庭的263名儿童。大多数儿童年龄小于10岁，63%为女孩，37%为男孩。在所有儿童中，134人遭受过伴有身体接触的性虐待，20人遭受过无身体接触的性虐待，77人遭受过身体虐待，62人遭受过情感虐待，99人遭受过忽视（允许有多项回答）。各类虐待之间的重叠情况相当严重：许多儿童遭受过不止一种虐待，四分之一的儿童遭受过两种以上虐待。大多数病例被归类为严重和/或慢性。大多数儿童和青少年遭受过情绪困扰或创伤后应激障碍，身体伤害的长期后果则不太常见。与社会经济风险因素相比，家庭内部关系问题和照顾者的情绪困扰对虐待或忽视风险的影响更大。55%的儿童保护工作者记录了儿童在社会和情感发展方面存在障碍，四分之一的儿童存在发育迟缓问题。
目前对虐待和忽视类型的单一分类不足以描述儿童在家庭内部暴力经历的复杂性。未来的研究应着眼于儿童虐待的身体、情感和社会后果，并采用多因素设计来把握导致痛苦和伤害的复杂病因以及多种行为和疏忽。前瞻性研究对于评估儿童虐待和忽视对儿童发育的具体影响很重要。
