Langeland Willemien, Smit Jan H, Merckelbach Harald, de Vries Gerard, Hoogendoorn Adriaan W, Draijer Nel
Department of Psychiatry and EMGO+ Institute, Vrije University Medical Center/GZZinGeest, A. J. Ernststraat 1187, 1081 HL, Amsterdam, The Netherlands.
Soc Psychiatry Psychiatr Epidemiol. 2015 Apr;50(4):603-12. doi: 10.1007/s00127-014-0986-x. Epub 2014 Nov 22.
Epidemiological research on childhood sexual abuse (CSA) and its consequences in adult life mainly relies on retrospective reports. This study explores their consistency and the correlates of inconsistent CSA self-reports in a random population sample.
A stratified subsample of 2,462 subjects (selected from a large-scale (N = 34,267) representative sample of Dutch adults aged 40 and beyond) participated in a two-phase online questionnaire survey on extra-familial CSA which was conducted on a four- to six-week interval. Subjects reporting CSA were overrepresented. Participants with consistent and inconsistent responses were compared with regard to demographics, family background, abuse severity, and clinical characteristics. Potential correlates of inconsistency were identified using logistic regression analysis. An additional questionnaire (Phase III) administered to inconsistent respondents explored possible reasons for their inconsistency.
Of the 1,992 respondents who had reported extra-familial CSA during Phase I, 707 (35.5%) denied this in Phase II. Of the 2,462 respondents in Phase II, 727 (29.5%; 9.2% when considering sample stratification) gave a discrepant answer to the extra-familial sexual abuse item compared to their answers given in Phase I. Reports of less severe abuse, intra-familial CSA, and early parental separation predicted inconsistency. Reasons provided for inconsistency varied from misunderstanding (e.g., reporting intra-familial CSA rather than extra-familial CSA) to emotional motives (e.g., embarrassment, being overwhelmed) or practical considerations (e.g., lack of privacy while filling out the questionnaire).
Inconsistent self-reports of extra-familial sexual abuse occur on a substantial scale and are associated with less severe forms of abuse (lack of salience) or classification difficulties (perpetrator being a family member or not). Consistency tests and probing for clarifications or corrections should be routinely conducted in order to increase the quality of CSA epidemiological research.
关于儿童性虐待(CSA)及其对成年生活影响的流行病学研究主要依赖回顾性报告。本研究探讨了在随机人群样本中,这些报告的一致性以及CSA自我报告不一致的相关因素。
从荷兰40岁及以上成年人的大规模代表性样本(N = 34,267)中选取2462名受试者组成分层子样本,参与了一项关于家庭外CSA的两阶段在线问卷调查,两阶段间隔四至六周。报告CSA的受试者比例过高。对回答一致和不一致的参与者在人口统计学、家庭背景、虐待严重程度和临床特征方面进行了比较。使用逻辑回归分析确定不一致的潜在相关因素。向回答不一致的受访者发放了一份补充问卷(第三阶段),以探究其回答不一致的可能原因。
在第一阶段报告过家庭外CSA的1992名受访者中,707人(35.5%)在第二阶段否认了这一点。在第二阶段的2462名受访者中,727人(29.5%;考虑样本分层时为9.2%)对家庭外性虐待问题的回答与他们在第一阶段给出的答案不一致。虐待程度较轻、家庭内CSA以及早期父母离异的报告预示着回答不一致。回答不一致的原因多种多样,从误解(例如,报告的是家庭内CSA而非家庭外CSA)到情感动机(例如,尴尬、不知所措)或实际考虑因素(例如,填写问卷时缺乏隐私)。
家庭外性虐待的自我报告不一致现象相当普遍,且与虐待形式较轻(缺乏显著性)或分类困难(施虐者是否为家庭成员)有关。应常规进行一致性测试并探究澄清或修正,以提高CSA流行病学研究的质量。