South London and the Maudsley NHS Foundation Trust/Institute Psychiatry, Psychology and Neuroscience, King's College London, UK.
Department of Psychosis Studies, Institute Psychiatry, Psychology and Neuroscience, King's College London, UK.
Child Abuse Negl. 2018 Jun;80:9-31. doi: 10.1016/j.chiabu.2018.03.018. Epub 2018 Mar 17.
Childhood sexual abuse (CSA) is a worldwide problem with severe long-term consequences. A history of CSA can impact the childbearing experience of mothers and fathers; affecting their mental health, parenting skills and compromising infant development. Nonetheless, the perinatal period offers huge opportunity for intervention and hope. This literature review collates evidence for perinatal psychosocial interventions targeting both mothers and fathers who are survivors of CSA. Publications dating from 1970 to June 2016 were searched using Medline, Maternity and Infant Health, PsychINFO, PsychArticles, PubMed and the International Bibliography of the Social Sciences (IBSS). There were no perinatal interventions that considered the needs of survivor fathers. Sixteen publications on 9 psychosocial perinatal interventions for CSA survivors were identified. However, no sub-analyses specific to CSA survivors were reported. Trauma-specific perinatal interventions drew from a range of theoretical models and varied widely in format. Generally interventions were associated with improvements in maternal mental health, parenting competence, infant attachment security and positive public health outcomes. They were safe and feasible to implement, acceptable to parents and therapist, and therapists were able to implement protocols with adequate fidelity. Yet current data is hampered by small sample size, inconsistent reporting of CSA rates and outcome measures, scarcity of observational data and longer-term follow-up. Intervention modifications are proposed for CSA survivors in view of their unique childbearing experiences.
儿童期性虐待（CSA）是一个全球性问题，会带来严重的长期后果。 CSA 史会影响到母亲和父亲的生育经历；影响他们的心理健康、育儿技能，并损害婴儿的发育。尽管如此，围产期仍提供了巨大的干预和希望的机会。本文献综述整理了针对 CSA 幸存者的母婴围产期心理社会干预的证据。使用 Medline、Maternity and Infant Health、PsychINFO、PsychArticles、PubMed 和国际社会科学文献目录（IBSS）搜索了 1970 年至 2016 年 6 月的出版物。没有考虑到幸存者父亲需求的围产期干预措施。确定了 16 篇关于 CSA 幸存者 9 种围产期心理社会干预的出版物。然而，没有报告针对 CSA 幸存者的亚分析。特定于创伤的围产期干预措施借鉴了一系列理论模型，形式差异很大。一般来说，干预措施与改善母亲的心理健康、育儿能力、婴儿的依恋安全性和积极的公共卫生结果有关。它们是安全且可行的，父母和治疗师都能接受，并且治疗师能够以足够的忠实度实施方案。然而，由于样本量小、CSA 发生率和结果测量报告不一致、观察数据稀缺以及缺乏长期随访，目前的数据受到限制。鉴于 CSA 幸存者独特的生育经历，提出了对他们的干预措施修改建议。
