University of Montreal , Montreal, Canada.
Sainte-Justine Université Hospital center , Montreal, Canada.
J Child Sex Abus. 2020 Oct;29(7):749-768. doi: 10.1080/10538712.2019.1709242. Epub 2020 Feb 11.
Child sexual abuse (CSA) has been strongly associated with a range of psychological and physical problems in childhood and adulthood, such as anxiety, post-traumatic stress disorder (PTSD), and infectious diseases. Despite the strength of these associations, no studies to date have investigated psychobiological processes that might underlie the relationship between CSA and physical health problems occurring during childhood, such as infectious diseases. The goal of the current study is to evaluate PTSD as a potential mediator between CSA and the occurrence of infectious diseases among children and adolescents. Furthermore, we postulate that PTSD plays a specific role as an indicator of chronic stress during childhood, in comparison to other mental disorders, such as anxious and non-anxious disorders (e.g., depression). Via a prospective matched-cohort design, administrative data were used to document PTSD, anxious and non-anxious disorders, and infectious diseases. The sample size was 882 persons with a substantiated report of sexual abuse and 882 matched controls. Negative binomial regressions revealed that CSA is associated with a greater number of anxious diseases diagnoses that, in turn, predict more infectious diseases diagnoses. These findings highlight the importance of preventing and intervening among sexually abused youth with anxious disorder symptoms to limit negative outcomes on physical health.
儿童性虐待（CSA）与儿童期和成年期的一系列心理和生理问题密切相关，例如焦虑、创伤后应激障碍（PTSD）和传染病。尽管这些关联很强烈，但迄今为止，没有研究调查过可能潜在地解释 CSA 与儿童期发生的身体健康问题（例如传染病）之间关系的心理生物学过程。本研究的目的是评估 PTSD 是否可以作为 CSA 和儿童青少年传染病发生之间的潜在中介。此外，我们假设 PTSD 在儿童期慢性应激方面比其他精神障碍（例如焦虑和非焦虑障碍（例如抑郁））具有特定作用。通过前瞻性匹配队列设计，使用行政数据记录 PTSD、焦虑和非焦虑障碍以及传染病。样本量为 882 名有性虐待报告且得到证实的人和 882 名匹配对照者。负二项式回归显示，CSA 与更多焦虑疾病的诊断有关，而这些疾病又反过来预示着更多的传染病诊断。这些发现强调了预防和干预有焦虑障碍症状的性虐待青少年的重要性，以限制对身体健康的负面影响。
