Department of Psychiatry & Behavioural Neurosciences, McMaster University, Canada.
Department of Health Research Methods, Evidence and Impact, McMaster University, Canada.
Child Abuse Negl. 2021 Jun;116(Pt 1):104203. doi: 10.1016/j.chiabu.2019.104203. Epub 2019 Oct 31.
In this manuscript, we summarize the findings of a systematic review that informed the development of the World Health Organization's recommendations related to psychosocial interventions for child and adolescent sexual abuse.
Systematic searches across 14 databases were conducted to retrieve any published randomized controlled trials of psychosocial interventions addressing mental health outcomes among children and adolescents exposed to sexual abuse who have experienced symptoms. We assessed study risk of bias using the Cochrane Risk of Bias tool and certainty of the evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria.
Twenty-four articles representing fifteen studies were included in the systematic review. Only two studies were conducted in low- or middle-income countries. Few studies could be pooled together because of differences in interventions and comparators. Due to the small numbers of participants and very serious concerns with risk of bias, we are very uncertain about the benefits of interventions provided to children alone and without the involvement of their caregivers. However, cognitive behavior therapy (CBT) with a trauma focus provided to children and involving their caregivers may reduce some mental health symptoms associated with sexual abuse experiences.
The findings suggest that more and larger studies are needed to evaluate the effects of psychosocial interventions for children and adolescents exposed to sexual abuse who preside in low- and middle-income countries. PROSPERO registration number: CRD42016039656.
在本手稿中,我们总结了一项系统评价的结果,该评价为世界卫生组织制定有关儿童和青少年性虐待的心理社会干预建议提供了信息。
在 14 个数据库中进行了系统搜索,以检索任何针对已暴露于性虐待并出现症状的儿童和青少年的心理健康结果的心理社会干预的已发表随机对照试验。我们使用 Cochrane 偏倚风险工具评估研究偏倚风险,并使用 GRADE(推荐评估、制定与评价)标准评估证据确定性。
有 24 篇文章代表 15 项研究被纳入系统评价。仅有两项研究在中低收入国家进行。由于干预措施和对照措施的差异,很少有研究可以合并在一起。由于参与者人数少且偏倚风险非常严重,我们对仅为儿童提供且没有其照顾者参与的干预措施的益处非常不确定。然而,针对儿童并涉及他们的照顾者的创伤焦点认知行为疗法(CBT)可能会减轻与性虐待经历相关的一些心理健康症状。
研究结果表明,需要更多和更大规模的研究来评估针对中低收入国家中遭受性虐待的儿童和青少年的心理社会干预的效果。PROSPERO 注册号:CRD42016039656。