Verelst A, De Schryver M, De Haene L, Broekaert E, Derluyn I
Department of Social Welfare Studies, Centre for Children in Vulnerable Situations, Ghent University, Henri Dunantlaan 2, 9000 Gent, Belgium.
Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000 Gent, Belgium.
Child Abuse Negl. 2014 Jul;38(7):1139-46. doi: 10.1016/j.chiabu.2014.04.003. Epub 2014 Jun 2.
This study aims to explore the factors that explain the mental sequelae of war-related sexual violence and focuses in particular on the role of stigmatization. Drawing on a large-scale quantitative survey undertaken in the war-affected region of eastern Democratic Republic of the Congo, we analyze how stigmatization mediates the mental health impact of sexual violence on adolescent girls who were victims of rape. Twenty-two secondary schools were randomly selected out of a stratified sample in Bunia, Eastern Congo. In a cross-sectional, population-based survey, 1,305 school-going adolescent girls aged 11-23 completed self-report measures assessing war-related traumatic events, experiences of sexual violence, stigmatization, and mental health symptoms. Of the 1,305 participants, 38.2% (n=499) reported experiences of sexual violence. Victims of sexual violence reported more war-related traumatic events and more stigmatization experiences. Several hierarchical regression analyses examined the mediating impact of stigmatization on the relationship between sexual violence and mental health outcomes, thereby controlling for sociodemographics (age, parental availability, and socioeconomic status) and war-related traumatic exposure. Our findings show that this stigmatization largely explains the mental health impact of sexual violence, in particular, on adolescent girls' reported symptoms of depression (full mediation) and posttraumatic stress (avoidance and total PTSD: full mediation; hyperarousal: partial (40%) mediation). No evidence of mediation by stigmatization was found for symptoms of anxiety and intrusion. Stigmatization plays thus an important role in shaping the mental sequelae of sexual violence, a finding with major consequences for clinical practice.
本研究旨在探究导致与战争相关的性暴力所致心理后遗症的因素，尤其关注污名化的作用。基于在刚果民主共和国东部受战争影响地区开展的大规模定量调查，我们分析了污名化如何介导性暴力对遭受强奸的青春期女孩心理健康的影响。从刚果东部布尼亚的分层样本中随机选取了22所中学。在一项基于人群的横断面调查中，1305名年龄在11至23岁的在校青春期女孩完成了自我报告测量，评估与战争相关的创伤事件、性暴力经历、污名化及心理健康症状。在1305名参与者中，38.2%（n = 499）报告有性暴力经历。性暴力受害者报告了更多与战争相关的创伤事件和更多的污名化经历。几项分层回归分析检验了污名化在性暴力与心理健康结果之间关系中的中介作用，从而控制了社会人口统计学因素（年龄、父母陪伴情况和社会经济地位）以及与战争相关的创伤暴露。我们的研究结果表明，这种污名化在很大程度上解释了性暴力对心理健康的影响，特别是对青春期女孩报告的抑郁症状（完全中介）和创伤后应激症状（回避和总体创伤后应激障碍：完全中介；过度警觉：部分（40%）中介）。未发现污名化对焦虑和闯入症状有中介作用的证据。因此，污名化在塑造性暴力的心理后遗症方面起着重要作用，这一发现对临床实践具有重大影响。
