Muram D, Speck P M, Gold S S
Department of Obstetrics and Gynecology, University of Tennessee, Memphis 38103.
Child Abuse Negl. 1991;15(1-2):105-10. doi: 10.1016/0145-2134(91)90095-u.
We evaluated the merit of a directive issued by The Tennessee Department of Human Services (TDHS) requesting a medical evaluation for all children who were closely associated with a victim of sexual assault, even if these children denied being victims themselves. In a 6-month period, 247 girls, age 12 and under, were referred for medical evaluation. Of these, 188 were primary victims of sexual abuse, and 59 girls were secondary victims, associates of victims of abuse. All examinations were performed in an office setting. A colposcope was used to magnify the findings. Of these 59 girls, 45 girls were found to have abnormal genital findings. Nonspecific findings were present in 5 girls (8%), and findings considered specific for sexual abuse were observed in 40 girls (68%). When compared with 5 girls (8%), and findings considered specific for sexual abuse were observed in 40 girls (68%). When compared with primary victims, secondary victims were more likely to demonstrate genital abnormalities suggestive of sexual abuse. (chi 2 = 13.7, p = .0011). Of the 50 secondary victims who were later interviewed by TDHS, 24 girls (48%) reported that they were also victims of assault. We strongly recommend that siblings of sexual abuse victims, as well as other children who are closely associated with them and exposed to the perpetrator, be evaluated to determine whether they have abnormalities suggestive of sexual assault.
我们评估了田纳西州人类服务部（TDHS）发布的一项指令的价值，该指令要求对所有与性侵犯受害者密切相关的儿童进行医学评估，即使这些儿童否认自己是受害者。在6个月的时间里，有247名12岁及以下的女孩被转介进行医学评估。其中，188名是性虐待的主要受害者，59名女孩是二级受害者，即虐待受害者的关联者。所有检查均在办公室环境中进行。使用阴道镜放大检查结果。在这59名女孩中，发现45名女孩有生殖器异常。5名女孩（8%）有非特异性发现，40名女孩（68%）有被认为是性虐待特异性的发现。与主要受害者相比，二级受害者更有可能表现出提示性虐待的生殖器异常（卡方=13.7，p=.0011）。在后来接受TDHS采访的50名二级受害者中，24名女孩（48%）报告称她们也是袭击的受害者。我们强烈建议对性虐待受害者的兄弟姐妹以及其他与他们密切相关且接触过犯罪者的儿童进行评估，以确定他们是否有提示性侵犯的异常情况。
