Mandell David S, Walrath Christine M, Manteuffel Brigitte, Sgro Gina, Pinto-Martin Jennifer A
Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Child Abuse Negl. 2005 Dec;29(12):1359-72. doi: 10.1016/j.chiabu.2005.06.006. Epub 2005 Nov 15.
To determine the demographic and psychosocial correlates of physical and sexual abuse among children with autism.
Data collected from 1997 to 2000 through the national evaluation of the Comprehensive Community Mental Health Services for Children and their Families Program on 156 children with autism were used. Data included a baseline assessment of child and family psychosocial experiences and presenting problems associated with referral into system-of-care service, demographic information, and a clinical record review to obtain psychiatric diagnosis. Binary and multinomial logistic regression was used to determine the association of different characteristics of children who were abused compared with those who were not abused.
Caregivers reported that 18.5% of children with autism had been physically abused and 16.6% had been sexually abused. Physically abused children more likely had engaged in sexual acting out or abusive behavior, had made a suicide attempt, or had conduct-related or academic problems. Sexually abused children more likely had engaged in sexual acting out or abusive behavior, suicidal or other self-injurious behavior, had run away from home, or had a psychiatric hospitalization. In adjusted multivariate models, the relationship between sexual abuse and sexual acting out, running away from home and suicidal attempts persisted.
Based on the prevalence of abuse and its association with various behaviors, clinicians should be as attuned to the psychosocial histories of children with autism as they are for other children, and consider the potential of abuse when these behaviors are observed.
确定自闭症儿童身体虐待和性虐待的人口统计学及心理社会相关因素。
使用1997年至2000年通过全国儿童及其家庭综合社区心理健康服务项目评估收集的156名自闭症儿童的数据。数据包括对儿童和家庭心理社会经历的基线评估以及与转入护理系统服务相关的呈现问题、人口统计学信息,以及用于获取精神科诊断的临床记录审查。采用二元和多项逻辑回归来确定受虐待儿童与未受虐待儿童不同特征之间的关联。
照料者报告称,18.5%的自闭症儿童曾遭受身体虐待,16.6%曾遭受性虐待。遭受身体虐待的儿童更有可能表现出性相关行为或虐待行为、曾尝试自杀,或存在与行为或学业相关的问题。遭受性虐待的儿童更有可能表现出性相关行为或虐待行为、自杀或其他自我伤害行为、离家出走,或曾有过精神科住院治疗。在调整后的多变量模型中,性虐待与性相关行为、离家出走和自杀企图之间的关系依然存在。
基于虐待的发生率及其与各种行为的关联,临床医生应像关注其他儿童一样关注自闭症儿童的心理社会病史,并在观察到这些行为时考虑虐待的可能性。