Department of Psychology, University of Botswana.
National Center for Psychotraumatology, University of Southern Denmark.
Psychol Trauma. 2018 May;10(3):282-289. doi: 10.1037/tra0000295. Epub 2017 Jul 31.
Previous studies have mainly considered war-affected youth as a homogenous group yet several subpopulations of war-affected youth, such as survivors of sexual violence, exist with unique mental health problems and treatment needs. This study aimed to assess posttraumatic stress disorder (PTSD), perceptions and meaning of mental illness, and access and barriers to mental health care among survivors of sexual violence.
Data were collected from survivors of sexual violence during war (N = 181) who are participants in the longitudinal War-Affected Youth Survey (WAYS) study in Northern Uganda. Chi-square tests of independence and binary logistic regression were used to compute participants' characteristics and assess relations between exposure to sexual violence and PTSD.
Sixty-six (n = 119, 66%) reported sexual abuse: 35% (n = 63) of whom returned from captivity with at least 1 child, and 43% (n = 78) met the criteria for PTSD (Impact of Events Scale-Revised score [IES-R] ≥33). Those who reported sexual abuse scored significantly higher on PTSD (OR = 3.23; 95% CI [2.09, 6.93]), perceived more stigma, reported more barriers to seeking care, and viewed mental illness as futile and fatal compared with their peers without a history of sexual abuse.
Survivors of sexual violence are at risk of PTSD and report major obstacles to treatment and care. More resources should be allocated for interventions to improve access to care for survivors of sexual violence. Psychoeducation to create awareness, demystify myths and public stigma about mental illness, and trauma-focused cognitive-behavioral therapies to reduce PTSD among survivors are recommended. (PsycINFO Database Record
之前的研究主要将受战争影响的青年视为一个同质群体，但实际上存在一些不同的受战争影响的青年亚群体，如性暴力幸存者，他们存在着独特的心理健康问题和治疗需求。本研究旨在评估性暴力幸存者的创伤后应激障碍（PTSD）、对精神疾病的看法和意义，以及获得和获得精神保健的机会和障碍。
数据来自于正在参与乌干达北部纵向受战争影响青年调查（WAYS）研究的性暴力幸存者（N=181）。使用独立性卡方检验和二元逻辑回归来计算参与者的特征，并评估性暴力暴露与 PTSD 之间的关系。
66 人（n=119，66%）报告遭受性虐待：其中 35%（n=63）从囚禁中返回时至少带着 1 个孩子，43%（n=78）符合 PTSD 标准（事件影响量表修订版[IES-R]得分≥33）。那些报告遭受性虐待的人在 PTSD 上的得分显著更高（OR=3.23；95%CI[2.09,6.93]），对精神疾病的污名化程度更高，寻求治疗的障碍更多，并且认为精神疾病是徒劳和致命的，与没有性虐待史的同龄人相比。
性暴力幸存者有患 PTSD 的风险，并报告了治疗和护理方面的重大障碍。应分配更多资源用于干预措施，以改善性暴力幸存者获得护理的机会。建议进行心理教育以提高对精神疾病的认识、消除对精神疾病的误解和公众污名化，以及实施以创伤为中心的认知行为疗法来减少幸存者的 PTSD。
