Berg K L, Shiu C-S, Msall M E, Acharya K
The College of Public Health, Temple University, Philadelphia, PA, USA.
Social Work, University of Washington, Seattle, WA, USA.
Child Care Health Dev. 2015 Nov;41(6):989-99. doi: 10.1111/cch.12233. Epub 2015 Mar 12.
This study aimed to examine the prevalence of victimization among a United States-wide cohort of youth with disabilities (YWD) investigated for maltreatment in the child welfare system (CWS) and their correlation with mental health.
Data were drawn from baseline interviews in the second National Survey of Child and Adolescent Well-Being, a national representative survey of youth involved in the CWS. Interviews took place between 2008 and 2009 and included 675 youth, 11-17 years old and residing with biological families across 83 counties nationwide. The sample consisted of 405 females (60.1%) and 270 males (39.9%), mean age = 13.5 years. We identified YWD if they reported one or more physical or neurodevelopmental health condition (n = 247). Reported victimization experiences and Children's Depression Inventory (CDI) scores were analysed using weighted regression analyses.
One-quarter of YWD in the CWS reported three or more victimizations during the prior year compared with 19% of youth without disabilities. The odds of YWD reporting a one-unit increase in level of victimization was 75% higher (P < 0.05) than youth without disabilities. Prevalence of clinical depression was significantly higher among YWD (14 vs. 5.5%; P < 0.05). Unlike youth without disabilities, the odds of clinical depression were 92% higher for every one-unit increase in victimization among YWD, controlling for covariates (P < 0.05). Of CWS-involved youth who reported three or more victimizations, 24.4% of YWD and 2.2% of non-disabled youth had CDI scores in the clinical range.
YWDs in the US CWS are at high risk of experiencing victimization and clinical depression. Our findings suggest that health professionals need to screen CWS-involved YWD for multiple forms of victimization, and develop and implement trauma-informed services that target the mental health sequelae that may jeopardize their independence in adulthood.
本研究旨在调查美国范围内儿童福利系统(CWS)中因遭受虐待而接受调查的残疾青年(YWD)群体中的受害情况及其与心理健康的相关性。
数据取自第二次全国儿童和青少年福祉调查的基线访谈,这是一项针对参与儿童福利系统的青年的全国代表性调查。访谈于2008年至2009年期间进行,包括675名年龄在11至17岁之间、与亲生家庭居住在全国83个县的青年。样本包括405名女性(60.1%)和270名男性(39.9%),平均年龄为13.5岁。如果他们报告有一种或多种身体或神经发育健康状况,我们就将其确定为残疾青年(n = 247)。使用加权回归分析对报告的受害经历和儿童抑郁量表(CDI)得分进行分析。
儿童福利系统中的残疾青年中有四分之一报告在前一年遭受过三次或更多次侵害,而无残疾青年的这一比例为19%。残疾青年报告受害程度每增加一个单位的几率比无残疾青年高75%(P < 0.05)。残疾青年中临床抑郁症的患病率显著更高(14%对5.5%;P < 0.05)。与无残疾青年不同,在控制协变量的情况下,残疾青年中受害程度每增加一个单位,临床抑郁症的几率就高92%(P < 0.05)。在报告遭受三次或更多次侵害的参与儿童福利系统的青年中,24.4%的残疾青年和2.2%的非残疾青年的儿童抑郁量表得分处于临床范围内。
美国儿童福利系统中的残疾青年遭受侵害和患临床抑郁症的风险很高。我们的研究结果表明,卫生专业人员需要对参与儿童福利系统的残疾青年进行多种形式侵害的筛查,并制定和实施针对可能危及他们成年后独立性的心理健康后遗症的创伤知情服务。