McCrae Julie S, Chapman Mimi V, Christ Sharon L
School of Social Work, University of North Carolina, Chapel Hill, NC, USA.
Am J Orthopsychiatry. 2006 Oct;76(4):468-81. doi: 10.1037/0002-9432.76.4.468.
Sexually abused children may have poor mental health because of their victimization as well as preexisting or co-occurring family problems. However, few studies consider psychopathology in relation to both abuse and other family experiences. This study uses data from the National Survey of Child and Adolescent Well-Being (NSCAW) to create latent subgroups of 553 children investigated for sexual abuse. The study investigates children's psychological symptoms and child welfare service (CWS) patterns to understand how children's needs relate to mental health services. Analyses were conducted by child age: 3-7, 8-11, and 12-14. Factor mixture modeling and regression analyses were used. Results show meaningful subgroups of children that relate to different symptom patterns. Among 3- to 7-year-olds, behavioral symptoms are associated with caregiver domestic violence and mental illness. Among 8- to 11-year-olds, depressive symptoms are associated with severe abuse and multiple family problems, whereas posttraumatic stress is associated with chronic, unresolved abuse. Although many children received mental health services, services are not well matched to children's needs--the substantiation status of the abuse explains services. Implications for CWS and mental health services are discussed.
遭受性虐待的儿童可能由于其受侵害经历以及既存的或同时出现的家庭问题而心理健康状况不佳。然而,很少有研究考虑到与虐待及其他家庭经历相关的精神病理学问题。本研究使用来自全国儿童和青少年福利调查(NSCAW)的数据,对553名接受性虐待调查的儿童创建潜在亚组。该研究调查儿童的心理症状和儿童福利服务(CWS)模式,以了解儿童的需求与心理健康服务之间的关系。按儿童年龄进行分析:3至7岁、8至11岁和12至14岁。使用了因子混合模型和回归分析。结果显示与不同症状模式相关的有意义的儿童亚组。在3至7岁的儿童中,行为症状与照顾者家庭暴力和精神疾病有关。在8至11岁的儿童中,抑郁症状与严重虐待和多种家庭问题有关,而创伤后应激与长期未解决的虐待有关。尽管许多儿童接受了心理健康服务,但服务与儿童需求的匹配度不佳——虐待的证实状态解释了服务情况。讨论了对儿童福利服务和心理健康服务的启示。