Bergen Helen A, Martin Graham, Richardson Angela S, Allison Stephen, Roeger Leigh
The University of Queensland, Mental Health Centre, K floor, Royal Brisbane Hospital, Herston, Queensland 4029, Australia.
Aust N Z J Psychiatry. 2004 Jan-Feb;38(1-2):34-41. doi: 10.1111/j.1440-1614.2004.01295.x.
To investigate gender-specific relationships between self-reported sexual abuse, antisocial behaviour and substance use in a large community sample of adolescents.
A cross-sectional study of students aged, on average, 13 (n = 2596), 14 (n = 2475) and 15 years (n = 2290), from 27 schools in South Australia with a questionnaire including sexual abuse, frequency and severity of substance use, depressive symptomatology (CES-D), family functioning (McMaster Family Assessment Device), and antisocial behaviour (an adapted 22-item Self-Report Delinquency Scale). Logistic regression analyses using HLM V5.05 with a population-average model were conducted.
In the model considered, reported sexual abuse is significantly independently associated with antisocial behaviour, controlling for confounding factors of depressive symptomatology and family dysfunction, with increased risks of three- to eightfold for sexually abused boys, and two- to threefold for sexually abused girls, compared to nonabused. Increased risks of extreme substance use in sexually abused girls (age 13) and boys (ages 13-15) are more than fourfold, compared to nonabused. Age differences were not statistically significant.
Childhood sexual abuse is a risk factor for the development of antisocial behaviour and substance use in young adolescents. Clinicians should be aware of gender differences.
在一个大型青少年社区样本中，研究自我报告的性虐待、反社会行为和物质使用之间的性别特异性关系。
对南澳大利亚27所学校平均年龄为13岁（n = 2596）、14岁（n = 2475）和15岁（n = 2290）的学生进行横断面研究，采用一份包含性虐待、物质使用频率和严重程度、抑郁症状（流调中心用抑郁量表）、家庭功能（麦克马斯特家庭评估工具）以及反社会行为（一个改编的22项自我报告犯罪量表）的问卷。使用HLM V5.05软件，采用总体平均模型进行逻辑回归分析。
在该模型中，在控制抑郁症状和家庭功能障碍等混杂因素后，报告的性虐待与反社会行为显著独立相关。与未受虐待者相比，受性虐待的男孩出现反社会行为的风险增加三至八倍，受性虐待的女孩增加两至三倍。与未受虐待者相比，受性虐待的女孩（13岁）和男孩（13 - 15岁）出现极端物质使用的风险增加四倍多。年龄差异无统计学意义。
童年期性虐待是青少年反社会行为和物质使用发展的一个风险因素。临床医生应意识到性别差异。
