Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB #8120, Carolina Population Center, Chapel Hill, NC, 27599-8120, USA,
Matern Child Health J. 2013 Dec;17(10):1951-60. doi: 10.1007/s10995-013-1221-1.
The objective of this study is to examine the association between physical and sexual violence exposure and somatic symptoms among female adolescents. We studied a nationally representative sample of 8,531 females, aged 11-21 years, who participated in the 1994-1995 Wave I of the National Longitudinal Study of Adolescent Health (Add Health). Female adolescents were asked how often they had experienced 16 specific somatic symptoms during the past 12 months. Two summary categorical measures were constructed based on tertiles of the distributions for the entire female sample: (a) total number of different types of symptoms experienced, and (b) number of frequent (once a week or more often) different symptoms experienced. Groups were mutually exclusive. We examined associations between adolescents' violence exposure and somatic symptoms using multinomial logistic regression analyses. About 5 % of adolescent females reported both sexual and non-sexual violence, 3 % reported sexual violence only, 36 % reported non-sexual violence only, and 57 % reported no violence. Adolescents who experienced both sexual and non-sexual violence were the most likely to report many different symptoms and to experience very frequent or chronic symptoms. Likelihood of high symptomatology was next highest among adolescents who experienced sexual violence only, followed by females who experienced non-sexual violence only. Findings support an exposure-response association between violence exposure and somatic symptoms, suggesting that symptoms can be markers of victimization. Treating symptoms alone, without addressing the potential violence experienced, may not adequately improve adolescents' somatic complaints and well-being.
本研究旨在探讨身体暴力和性暴力暴露与女性青少年躯体症状之间的关联。我们研究了一个具有全国代表性的样本,该样本包括 8531 名年龄在 11 至 21 岁之间的女性,她们参加了 1994-1995 年全国青少年健康纵向研究(Add Health)的第一波调查。研究人员询问女性青少年在过去 12 个月中经历过 16 种特定躯体症状的频率。基于整个女性样本分布的三分位数,构建了两个综合分类指标:(a)经历过的不同类型症状的总数,以及(b)经历过的频繁(每周一次或更频繁)不同症状的数量。这些分组是互斥的。我们使用多项逻辑回归分析来研究青少年暴力暴露与躯体症状之间的关系。约 5%的青春期女性报告同时经历过性暴力和非性暴力,3%的女性报告只经历过性暴力,36%的女性报告只经历过非性暴力,57%的女性报告没有经历过暴力。同时经历过性暴力和非性暴力的青少年最有可能报告许多不同的症状,并经历非常频繁或慢性的症状。其次,只经历过性暴力的青少年也有较高的出现高症状的可能性,其次是只经历过非性暴力的女性。这些发现支持了暴力暴露与躯体症状之间的暴露-反应关系,表明症状可以作为受害的标志物。仅仅治疗症状而不解决潜在的暴力经历,可能无法充分改善青少年的躯体抱怨和幸福感。