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性虐待儿童受害者的心理评估:一份方案的制定

Psychological evaluation of children victims of sexual abuse: development of a protocol.

作者信息

Marques Natali Maia, Belizario Gabriel Okawa, Rocca Cristiana Castanho de Almeida, Saffi Fabiana, de Barros Daniel Martins, Serafim Antonio de Pádua

机构信息

Department and Institute of Psychiatry, Forensic Psychology Program, University of São Paulo School of Medicine, São Paulo, Brazil.

Department and Institute of Psychiatry, Bipolar Disorder Research Program (PROMAN), University of São Paulo Medical School, Sao Paulo, Brazil.

出版信息

Heliyon. 2020 Mar 18;6(3):e03552. doi: 10.1016/j.heliyon.2020.e03552. eCollection 2020 Mar.

Abstract

Sexual abuse (SA) is associated with significant psychological problems in childhood, making it increasingly important to develop evaluation protocols. This study examined clinical aspects and cognitive measures of 49 children (24 with SA history and 25 controls). It employed a SA assessment questionnaire, clinical evaluations of posttraumatic stress disorder, risk indicators and neuropsychological tests in order to elaborate a specific forensic psychological evaluation protocol for this population. Conflicting couples (80%), separated parents (68%) and parents' alcohol/drug abuse (76%) were revealed as major risk factors. Fathers represented the primary perpetrator (24%). The main cognitive complaint was difficulty concentrating. Regarding the association between clinical and cognitive variables, it was observed that children who were anxious or referred to having fear, difficulties with operational memory and difficulty sleeping, had more trouble performing tasks that required attention and memory (operational, immediate and late). Children with SA history demonstrated inferior performance in visual attention/task switching and memory; with an emphasis in the loss of set in the Wisconsin test. The findings suggest the possibility of a primary attention deficit in children with SA history, possibly influencing the performance of other cognitive functions.

摘要

性虐待(SA)与儿童期的重大心理问题相关,因此制定评估方案变得越来越重要。本研究调查了49名儿童(24名有性虐待史,25名作为对照)的临床情况和认知指标。研究采用了性虐待评估问卷、创伤后应激障碍的临床评估、风险指标和神经心理测试,以便为这一群体制定特定的法医心理评估方案。研究发现,关系冲突的夫妻(80%)、分居的父母(68%)以及父母的酒精/药物滥用(76%)是主要风险因素。父亲是主要施虐者(占24%)。主要的认知问题是注意力难以集中。关于临床变量和认知变量之间的关联,研究发现,焦虑或表示有恐惧情绪、操作记忆有困难以及睡眠困难的儿童,在执行需要注意力和记忆的任务(操作、即时和延迟任务)时会遇到更多困难。有性虐待史的儿童在视觉注意力/任务转换和记忆方面表现较差;在威斯康星测试中尤其表现为定势丧失。研究结果表明,有性虐待史的儿童可能存在原发性注意力缺陷,这可能会影响其他认知功能的表现。

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