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比较性交易儿童与三组易受人口贩运影响的高危青少年之间的心理健康障碍:双重回顾性队列研究和范围综述。

Comparing mental health disorders among sex trafficked children and three groups of youth at high-risk for trafficking: A dual retrospective cohort and scoping review.

机构信息

Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, 53213, USA.

Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, 53213, USA.

出版信息

Child Abuse Negl. 2020 Feb;100:104196. doi: 10.1016/j.chiabu.2019.104196. Epub 2019 Sep 29.

Abstract

BACKGROUND

Individuals at high-risk for trafficking are often subject to preexisting complex trauma that only intensifies during the trafficking experience. This greatly increases their risk of mental illness, although the actual prevalence of mental health disorders in children who are sex trafficked remains unclear.

OBJECTIVE

To examine the prevalence of mental health diagnoses among a sample of youth identified as being sex trafficked, and to discuss these rates in relation to other high-risk groups reported in the literature.

PARTICIPANTS AND SETTING

143 female and male child trafficking victims in Wisconsin.

METHODS

We retrospectively reviewed individual medical records, identifying mental health diagnoses and behaviors. The results were compared to summarized prevalence data for mental health disorders in sex trafficked, runaway children, juvenile offenders, and foster care children identified via a scoping review.

RESULTS

We observed significantly higher rates of ADHD (52.4%, p < 0.0001), bipolar disorder (26.6%, p < 0.0001), and PTSD (19.6%, p < 0.05 to p < 0.0001) in our sample of trafficked youth compared to all high-risk groups, as well as for depression (45.5%), anxiety (19.6%), conduct disorder (19.6%), ODD (25.9%), and psychosis (14.0%) relative to multiple groups individually.

CONCLUSIONS

The complex trauma suffered by child survivors of sex trafficking can impart numerous effects with overlapping symptomatology of many mental health disorders. Survivors' adaptive responses to complex trauma may lead to improper diagnosis and treatment of mental health disorders at the expense of prompt access to trauma-focused therapies. Alternative diagnoses and treatments of this complex dysfunction are discussed.

摘要

背景

高危人口经常受到先前存在的复杂创伤的影响,这些创伤在被贩卖期间只会加剧。这大大增加了他们患精神疾病的风险,尽管被贩卖的儿童中精神健康障碍的实际流行率仍不清楚。

目的

检查被确定为性贩卖的青少年样本中精神健康诊断的流行率,并讨论这些比率与文献中报告的其他高危群体的关系。

参与者和设置

威斯康星州的 143 名女性和男性儿童贩卖受害者。

方法

我们回顾性地审查了个人医疗记录,确定了精神健康诊断和行为。结果与通过范围审查确定的性贩卖、离家出走儿童、少年犯和寄养儿童的精神健康障碍汇总患病率数据进行了比较。

结果

与所有高危群体相比,我们在被贩卖的青少年样本中观察到 ADHD(52.4%,p<0.0001)、双相情感障碍(26.6%,p<0.0001)和 PTSD(19.6%,p<0.05 至 p<0.0001)的发生率显著更高,以及与多个群体相比,抑郁(45.5%)、焦虑(19.6%)、品行障碍(19.6%)、对立违抗性障碍(25.9%)和精神病(14.0%)的发生率也更高。

结论

性贩卖的儿童幸存者所遭受的复杂创伤会带来许多影响,这些影响与许多精神健康障碍的重叠症状有关。幸存者对复杂创伤的适应反应可能导致对精神健康障碍的不当诊断和治疗,而不是及时获得以创伤为中心的治疗。讨论了这种复杂功能障碍的替代诊断和治疗方法。

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