1 Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
2 Centre for Research on Children and Families, School of Social Work, McGill University, Montreal, Qubec, Canada.
Trauma Violence Abuse. 2019 Apr;20(2):260-283. doi: 10.1177/1524838017697312. Epub 2017 Mar 23.
Identifying and understanding factors that promote or inhibit child sexual abuse (CSA) disclosures has the potential to facilitate earlier disclosures, assist survivors to receive services without delay, and prevent further sexual victimization. Timely access to therapeutic services can mitigate risk to the mental health of survivors of all ages. This review of the research focuses on CSA disclosures with children, youth, and adults across the life course. Using Kiteley and Stogdon's literature review framework, 33 studies since 2000 were identified and analyzed to extrapolate the most convincing findings to be considered for practice and future research. The centering question asked: What is the state of CSA disclosure research and what can be learned to apply to practice and future research? Using Braun and Clarke's guidelines for thematic analysis, five themes emerged: (1) Disclosure is an iterative, interactive process rather than a discrete event best done within a relational context; (2) contemporary disclosure models reflect a social-ecological, person-in-environment orientation for understanding the complex interplay of individual, familial, contextual, and cultural factors involved in CSA disclosure; (3) age and gender significantly influence disclosure; (4) there is a lack of a life-course perspective; and (5) barriers to disclosure continue to outweigh facilitators. Although solid strides have been made in understanding CSA disclosures, the current state of knowledge does not fully capture a cohesive picture of disclosure processes and pathways over the life course. More research is needed on environmental, contextual, and cultural factors. Barriers continue to be identified more frequently than facilitators, although dialogical forums are emerging as important facilitators of CSA disclosure. Implications for practice in facilitating CSA disclosures are discussed with recommendations for future research.
识别和了解促进或阻碍儿童性虐待（CSA）披露的因素有可能促进更早的披露，帮助幸存者及时获得服务，并防止进一步的性侵害。及时获得治疗服务可以减轻所有年龄段幸存者的心理健康风险。本研究综述重点关注整个生命周期中儿童、青少年和成年人的 CSA 披露。使用 Kiteley 和 Stogdon 的文献综述框架，确定并分析了自 2000 年以来的 33 项研究，以推断出最有说服力的发现，以供实践和未来研究考虑。提出的中心问题是：CSA 披露研究的现状如何，有哪些可以借鉴应用于实践和未来研究？使用 Braun 和 Clarke 的主题分析指南，出现了五个主题：（1）披露是一个迭代的、互动的过程，而不是一个离散的事件，最好在关系背景下进行；（2）当代披露模型反映了一种社会生态、人与环境的取向，用于理解 CSA 披露中涉及的个人、家庭、环境和文化因素的复杂相互作用；（3）年龄和性别对披露有重大影响；（4）缺乏生命历程的视角；（5）披露障碍继续超过促进因素。尽管在理解 CSA 披露方面已经取得了坚实的进展，但目前的知识状况并没有完全捕捉到整个生命周期中披露过程和途径的连贯图景。需要更多关于环境、背景和文化因素的研究。障碍继续被更频繁地识别出来，而促进因素则较少被识别，尽管对话论坛正在成为 CSA 披露的重要促进因素。讨论了促进 CSA 披露的实践意义，并为未来的研究提出了建议。
