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监禁环境中精神疾病患者的创伤暴露风险:我们究竟了解多少?

Risk of trauma exposure among persons with mental illness in jails and prisons: what do we really know?

机构信息

Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque, New Mexico 87106, USA.

出版信息

Curr Opin Psychiatry. 2011 Sep;24(5):431-5. doi: 10.1097/YCO.0b013e328349bbb8.

Abstract

PURPOSE OF REVIEW

Traumatic victimization, particularly sexual abuse, is a serious problem in correctional facilities and those suffering from mental illnesses are especially vulnerable. This review examines our current knowledge regarding trauma victimization among persons with mental illness serving time in jails/prisons, considers methodological challenges, and provides recommendations for future research.

RECENT FINDINGS

Traumatic victimization, particularly sexual abuse, has consistently been identified as a high-frequency problem within jails and prisons. Lifetime, 6-month, and 12-month prevalence rates of physical and sexual violence among incarcerated people are quite high relative to nonincarcerated populations, and women report much higher rates of most traumatic events than men. Moreover, data show that inmates with mental illnesses are up to eight times more likely to be victims of sexual abuse than nonmentally ill inmates.

SUMMARY

Additional research is needed to improve our understanding of this issue and inform change efforts. Future research should include: epidemiological studies to improve our knowledge of risk factors and correlates of victimization; prospective studies to determine causality between trauma victimization and mental illness or other adverse outcome; and intervention studies to examine strategies for reducing violence and traumatic victimization inside correctional facilities, effective treatments for posttraumatic psychopathology, and improved re-entry outcomes.

摘要

目的综述:创伤性受害,特别是性虐待,在惩教设施中是一个严重的问题,而患有精神疾病的人尤其容易受到伤害。这篇综述审查了我们目前对在监狱中服刑的精神疾病患者的创伤性受害的了解,考虑了方法学方面的挑战,并为未来的研究提供了建议。

最新发现:创伤性受害,特别是性虐待,在监狱中一直是一个高频问题。与非监禁人群相比,监禁人群的身体和性暴力的终身、6 个月和 12 个月的患病率相当高,而且女性报告的大多数创伤性事件的发生率远高于男性。此外,数据表明,患有精神疾病的囚犯遭受性虐待的可能性是非精神病囚犯的八倍以上。

总结:需要进一步的研究来增进我们对这一问题的理解,并为改革努力提供信息。未来的研究应包括:进行流行病学研究,以增进我们对受害风险因素和相关因素的了解;进行前瞻性研究,以确定创伤性受害与精神疾病或其他不良后果之间的因果关系;以及进行干预性研究,以检验减少惩教设施内暴力和创伤性受害的策略、创伤后精神病理学的有效治疗方法以及改善重新进入社会的结果。

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