Postgraduate Programme, Faculty of Psychology, Institute of Health, Republic University, Tristán Narvaja Street 1674, 11200, Montevideo, Uruguay.
School of Social Sciences, Cardiff University, King Edward VII Ave, Cardiff, CF10 3NN, UK.
Child Abuse Negl. 2020 Jun;104:104463. doi: 10.1016/j.chiabu.2020.104463. Epub 2020 Mar 30.
Effects of treatment for child sexual abuse (CSA) victims have important implications. Assessing Risk of Bias (RoB) is a vital step to inform interpretations of treatment effects for these victims. The AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews) offers a comprehensive critical appraisal, allowing users to distinguish high quality reviews.
The aim of this article is two-fold: 1) to provide an up-to-date systematic review of treatment program meta-analytical reviews on interventions for CSA victims; and 2) to evaluate the quality of meta-analytical reviews using the AMSTAR-2. This is the first systematic review to examine the quality of meta-analyses on the effectiveness of CSA interventions using the AMSTAR-2.
Eight electronic databases were searched for articles published up to April 2019. Meta-analytical reviews that assessed the effectiveness of any treatment modality for sexually abused children and adolescents up to 18 years old were considered. Outcome measures included physical and mental symptoms, and disorders, measured through validated instruments. Of 2794 articles, nine meta-analyses met the eligibility criteria. There was a variety of interventions, including: trauma-focused cognitive-behavioral therapy CBT, psychodrama, play therapy, and eclectic interventions. The most common outcomes measured were post-traumatic stress disorder/trauma, externalizing, internalizing, and sexualized behaviors.
Although effect sizes were moderately significant, with treatment having a positive effect, all meta-analyses showed a high RoB.
To use the best available evidence in clinical decision-making for CSA victims, reviewers should conduct meta-analyses that employ RoB tools.
治疗儿童性虐待（CSA）受害者的效果具有重要意义。评估偏倚风险（RoB）是告知这些受害者治疗效果解释的重要步骤。AMSTAR-2（用于评估系统评价的测量工具）提供了全面的批判性评估，使用户能够区分高质量的评价。
本文的目的有两个：1）提供关于 CSA 受害者干预措施的治疗方案元分析综述的最新系统评价；2）使用 AMSTAR-2 评估元分析综述的质量。这是第一篇使用 AMSTAR-2 检查 CSA 干预措施有效性的元分析质量的系统评价。
搜索了截至 2019 年 4 月发表的文章，共涉及 8 个电子数据库。考虑了评估任何治疗模式对 18 岁以下性受虐儿童和青少年有效性的元分析综述。结局指标包括通过验证工具测量的身体和精神症状和障碍。在 2794 篇文章中，有 9 篇元分析符合入选标准。干预措施多种多样，包括：创伤焦点认知行为疗法 CBT、心理剧、游戏疗法和折衷干预。最常见的测量结局包括创伤后应激障碍/创伤、外化、内化和性化行为。
尽管效应大小适中，治疗具有积极影响，但所有元分析均显示 RoB 较高。
为了在 CSA 受害者的临床决策中使用最佳现有证据，审查员应进行使用 RoB 工具的元分析。
