双重诊断患者身体和性侵害特征中的性别差异：一项横断面研究。
Gender differences in characteristics of physical and sexual victimization in patients with dual diagnosis: a cross-sectional study.
作者信息
de Waal Marleen M, Dekker Jack J M, Kikkert Martijn J, Kleinhesselink Maaike D, Goudriaan Anna E
机构信息
Department of Research, Arkin Mental Health Care, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
Academic Medical Center, Department of Psychiatry, Amsterdam Institute for Addiction Research, University of Amsterdam, Amsterdam, The Netherlands.
出版信息
BMC Psychiatry. 2017 Jul 25;17(1):270. doi: 10.1186/s12888-017-1413-0.
BACKGROUND
Patients with substance use disorders and co-occurring mental health disorders are vulnerable to violent victimization. However, no evidence-based interventions are available to reduce patients' vulnerability. An exploration of the characteristics of physical and sexual violence can provide valuable information to support the development of interventions for these patients. This study aimed to examine gender differences in characteristics of violent victimization in patients with dual diagnosis.
METHODS
In this cross-sectional survey study recent incidents of physical and sexual assault were examined with the Safety Monitor in 243 patients with dual diagnosis. Chi-square tests were used to examine gender differences in the prevalence of physical and sexual victimization. Fisher's exact tests and Fisher-Freeman-Halton exact tests were used to determine whether there were significant differences between victimized men and women with regard to perpetrators, locations, reporting to the police and speaking about the assault with others.
RESULTS
There was no significant difference in the prevalence of physical violence in men (35%) and women (47%) with dual diagnosis. There was a significant association between gender of the victim and type of perpetrator (P < .001). Men were most often physically abused by a stranger or an acquaintance, whereas women were most frequently abused by an (ex)partner. Sexual violence was more prevalent in women (29%) compared to men (4%) (P < .001). Patients with dual diagnosis were unlikely to report incidents of physical abuse and sexual assault to the police and to speak about it with caregivers.
CONCLUSIONS
Characteristics of physical violence are different for men and women with dual diagnosis. Women with dual diagnosis are more often victims of sexual violence compared to men. Interventions aimed at reducing patients' vulnerability for victimization should take gender differences into account.
背景
患有物质使用障碍和并发精神健康障碍的患者容易遭受暴力侵害。然而，目前尚无基于证据的干预措施可降低患者的易受伤害性。对身体暴力和性暴力特征的探索可为开发针对这些患者的干预措施提供有价值的信息。本研究旨在探讨双重诊断患者暴力受害特征中的性别差异。
方法
在这项横断面调查研究中，使用安全监测器对243例双重诊断患者近期发生的身体和性侵犯事件进行了调查。采用卡方检验来检验身体和性受害发生率的性别差异。使用费舍尔精确检验和费舍尔-弗里曼-哈尔顿精确检验来确定受害男性和女性在犯罪者、地点、向警方报案以及与他人谈论袭击事件方面是否存在显著差异。
结果
双重诊断的男性（35%）和女性（47%）身体暴力发生率无显著差异。受害者性别与犯罪者类型之间存在显著关联（P <.001）。男性最常受到陌生人或熟人的身体虐待，而女性最常受到（前）伴侣的虐待。与男性（4%）相比，女性（29%）的性暴力更为普遍（P <.001）。双重诊断患者不太可能向警方报告身体虐待和性侵犯事件，也不太可能与护理人员谈论此事。
结论
双重诊断的男性和女性身体暴力特征不同。与男性相比，双重诊断的女性更常成为性暴力的受害者。旨在降低患者受害易感性的干预措施应考虑性别差异。
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