Springs F E, Friedrich W N
Mayo Medical School, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1992 Jun;67(6):527-32. doi: 10.1016/s0025-6196(12)60458-3.
The relationship between childhood sexual abuse and subsequent health risk behaviors and medical problems was examined in 511 women who had used a family practice clinic in a rural midwestern community during a 2-year period (1988 and 1989). These women completed a questionnaire that assessed various health risk behaviors--smoking, drinking, drug abuse, number of sexual partners, and age at first intercourse--and a medical symptom checklist that assessed 38 medical problems related to major systems of body function, the somatization scale from the SCL-90, a screen for sexual abuse, and a brief measure of social support. The results indicated that sexually abused women, who represented 22.1% of the sample, reported significantly more medical problems, greater levels of somatization, and more health risk behaviors than did the nonabused women. More severe abuse (for example, penetration or multiple abusers) correlated with more severe problems. Extent of social support correlated inversely with the number of gynecologic problems reported in the sexually abused group. Fewer than 2% of the sexually abused women had discussed the abuse with a physician. To identify and assist victims of sexual abuse, physicians should become experienced with nonthreatening methods of eliciting such information when the medical history is obtained.
对511名在1988年和1989年这两年间就诊于中西部农村社区一家家庭诊所的女性进行了研究，以探讨儿童期性虐待与后续健康风险行为及医疗问题之间的关系。这些女性完成了一份问卷，该问卷评估了各种健康风险行为——吸烟、饮酒、药物滥用、性伴侣数量以及首次性交年龄——以及一份医疗症状清单，该清单评估了38种与身体主要功能系统相关的医疗问题、SCL-90中的躯体化量表、性虐待筛查以及一份简短的社会支持测量表。结果表明，占样本22.1%的曾遭受性虐待的女性，比起未受虐待的女性，报告了更多的医疗问题、更高水平的躯体化以及更多的健康风险行为。更严重的虐待（例如，性侵或多名施虐者）与更严重的问题相关。社会支持程度与曾遭受性虐待组报告的妇科问题数量呈负相关。不到2%的曾遭受性虐待的女性与医生讨论过她们所遭受的虐待。为了识别和帮助性虐待受害者，医生在获取病史时应熟练掌握用无威胁性的方法引出此类信息。
