New York University School of Medicine, New York, NY, USA.
Child Maltreat. 2020 Feb;25(1):106-116. doi: 10.1177/1077559519848489. Epub 2019 May 13.
Child sexual abuse (CSA) is associated with a range of negative consequences for victims that are compounded when it recurs. We used the National Child Abuse and Neglect Data System to study a cohort of 42,036 children in 45 U.S. states with sexual abuse reports first confirmed by child protective services (CPS) during 2010 in order to identify children with increased risk for recurrence. A small proportion (3.6%) had a second confirmed sexual abuse report through 2015. In multivariate models, female gender, family hearing and vision problems, other child maltreatment, and other family violence were associated with increased risk of recurrence, while younger children, Hispanic families, and those with substance abuse tended to have less risk. One fourth of recurrence involved the same offender, usually a parent or caretaker. One fourth of cases were referred for any CPS services, which were more likely to be provided for families with poverty, drug or alcohol problems, or other violence. Only substance abuse services significantly reduced recurrence in multivariable models. Those trying to reduce CSA recurrence should recognize that certain case characteristics are associated with greater recurrence, and most CPS services do not significantly reduce CSA recurrence.
儿童性虐待（CSA）与受害者的一系列负面后果有关，而当这种虐待再次发生时，后果会更加严重。我们使用美国全国儿童虐待和忽视数据系统，对 2010 年期间儿童保护服务部门首次确认的 45 个州的 42036 名儿童进行了一项队列研究，以确定具有更高复发风险的儿童。一小部分（3.6%）在 2015 年之前有第二份经确认的性虐待报告。在多变量模型中，女性性别、家庭听力和视力问题、其他儿童虐待和其他家庭暴力与复发风险增加有关，而年龄较小的儿童、西班牙裔家庭和有药物滥用问题的家庭则风险较低。四分之一的复发涉及同一施虐者，通常是父母或看护人。四分之一的病例被转介给儿童保护服务部门，这些家庭更有可能面临贫困、药物或酒精问题或其他暴力问题。只有药物滥用服务在多变量模型中显著降低了复发率。那些试图减少 CSA 复发的人应该认识到，某些病例特征与更高的复发率有关，而且大多数儿童保护服务部门并没有显著降低 CSA 的复发率。
