Department of Pedagogic, Psychological, and Didactic Sciences, University of Salento, Via Stampacchia 45/47, Lecce, Italy.
Acta Psychiatr Scand. 2011 Jul;124(1):30-41. doi: 10.1111/j.1600-0447.2010.01612.x. Epub 2010 Oct 11.
To address the best available scientific evidence on the role of child sexual abuse in the etiology of suicide and non-suicidal self-injury.
Seven databases were searched, supplemented with hand-search of reference lists from retrieved papers. The author and a psychiatrist independently evaluated the eligibility of all studies identified, abstracted data, and assessed study quality. Disagreements were resolved by consensus.
Four reviews, including about 65,851 subjects from 177 studies, were analyzed. There is evidence that child sexual abuse is a statistically significant, although general and non-specific, risk factor for suicide and non-suicidal self-injury. The relationship ranges from small to medium in magnitude and is moderated by sample source and size. Certain biological and psychosocial variables, such as serotonin hypoactivity and genes, family dysfunction, other forms of maltreatment, and some personality traits and psychiatric disorders, may either act independently or interact with child sexual abuse to promote suicide and non-suicidal self-injury in abuse victims, with child sexual abuse conferring additional risk, either as a 'distal' and indirect cause or as a 'proximal' and direct cause.
Child sexual abuse should be considered one of the several risk factors for suicide and non-suicidal self-injury and included in multifactorial etiological models.
探讨儿童性虐待在自杀和非自杀性自伤病因学中的作用的最佳现有科学证据。
检索了 7 个数据库，并对检索到的论文的参考文献进行了手工检索。作者和一名精神科医生独立评估了所有确定研究的资格，提取数据，并评估了研究质量。通过共识解决了分歧。
对包括来自 177 项研究的约 65851 名受试者的 4 项综述进行了分析。有证据表明，儿童性虐待是自杀和非自杀性自伤的一个具有统计学意义的、尽管是普遍的和非特异性的风险因素。这种关系的程度从小到中等，并且受到样本来源和大小的调节。某些生物和心理社会变量，如 5-羟色胺活性低下和基因、家庭功能障碍、其他形式的虐待以及某些人格特质和精神障碍，可能独立作用或与儿童性虐待相互作用，促进虐待受害者的自杀和非自杀性自伤，而儿童性虐待则赋予了额外的风险，无论是作为“远端”和间接原因还是作为“近端”和直接原因。
儿童性虐待应被视为自杀和非自杀性自伤的几个风险因素之一，并纳入多因素病因学模型。
