National Crime Victims Research and Treatment Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, United States.
Addict Behav. 2013 Apr;38(4):2074-9. doi: 10.1016/j.addbeh.2012.12.010. Epub 2012 Dec 21.
To inform intervention approaches, the current study examined prevalence and comorbidity of recent use and history of abuse of alcohol, marijuana, and other illicit drugs as well as history of substance treatment among a sample of female victims of sexual assault seeking post-assault medical care. Demographic variables and prior history of assault were also examined to further identify factors relevant to treatment or prevention approaches. Participants were 255 women and adolescent girls seeking post sexual assault medical services who completed an initial follow-up assessment on average within 3 months post-assault. The majority (72.9%) reported recent substance use prior to assault, approximately 40% reported prior substance abuse history, and 12.2% reported prior substance treatment history. Prior history of assault was associated with recent drug use and history of drug abuse as well as substance treatment. Among those with prior histories of substance abuse and assault, assault preceded substance abuse onset in the majority of cases. Almost all those with prior treatment history reported recent drug or alcohol use. A portion of sexual assault survivors seen for acute medical services may benefit from facilitated referral for substance abuse treatment in addition to counseling at the time of screening. Assessment and intervention approaches should target alcohol, marijuana, and other illicit drug use and abuse. Substance use and associated impairment may serve as a rape tactic by perpetrators of assault. Substance use at the time of assault does not imply blame on the part of assault victims. Previous findings indicate that rape poses high risk of PTSD particularly among women with prior history of assault. Screening and intervention related to substance abuse should be done with recognition of the increased vulnerability it may pose with regard to assault and the high risk of PTSD within this population.
为了提供干预措施的依据,本研究调查了在寻求性侵后医疗服务的女性受害者样本中,最近使用和滥用酒精、大麻和其他非法药物以及物质治疗史的流行情况和共病情况,以及物质治疗史。还检查了人口统计学变量和先前的攻击史,以进一步确定与治疗或预防方法相关的因素。参与者是 255 名女性和少女,她们在性侵后平均 3 个月内完成了初步随访评估。大多数人(72.9%)在性侵前报告最近有物质使用,约 40%报告有先前的物质滥用史,12.2%报告有先前的物质治疗史。先前的攻击史与最近的药物使用和药物滥用史以及物质治疗有关。在有先前物质滥用和攻击史的人中,大多数情况下攻击先于物质滥用的发生。几乎所有有先前治疗史的人都报告了最近的药物或酒精使用。在接受急性医疗服务的性侵犯幸存者中,有一部分可能需要在筛查时接受咨询之外,还需要促进转介接受物质滥用治疗。评估和干预方法应针对酒精、大麻和其他非法药物的使用和滥用。物质使用和相关的功能障碍可能是袭击者的一种强奸策略。在袭击时使用药物并不意味着袭击受害者有过错。先前的研究结果表明,性侵犯尤其对有先前袭击史的女性构成 PTSD 的高风险。应认识到物质滥用筛查和干预可能对性侵犯和该人群中 PTSD 的高风险构成更高的脆弱性。