Department of Clinical and Health Psychology, Autonomous University of Barcelona, Spain.
Centre for Psychiatry, Imperial College, UK.
Clin Child Psychol Psychiatry. 2020 Oct;25(4):847-859. doi: 10.1177/1359104520920332. Epub 2020 Jun 1.
Sexual assault of adolescents is associated with negative mental health outcomes, including self-harm. Little is known about correlates and predictors of self-harm after sexual assault. We hypothesized that pre-assault vulnerabilities and post-assault psychological distress would be associated with self-harm after experiencing a recent sexual assault.
The sample was recruited from adolescents aged 13 to 17 years accessing sexual assault centers and it included 98 females. Longitudinal data were collected at (3.9 weeks on average post-assault) and (21.8 weeks on average post-assault). Bivariate analysis and hierarchical binary logistic regressions were performed.
The rate of self-harm was 38.1% before the assault and 37.8% after the assault (). History of family dysfunction ( 3.60 (1.30, 10.01)), depressive symptoms at ( 5.83 (2.35, 14.43)) or ( 2.79 (1.20, 6.50), and posttraumatic stress symptoms at ( 3.21 (1.36, 7.58)) predicted self-harm at . These effects were attenuated when adjusting for confounders, except for depressive symptoms at ( 4.21 (1.57, 11.28)).
Clinical implications for the prevention of onset or continuation of self-harm following adolescent sexual assault are discussed. Future studies should replicate these findings in a larger sample and consider different trajectories of self-harm.
青少年遭受性侵犯与负面心理健康结果有关，包括自伤。对于性侵犯后自伤的相关因素和预测因素知之甚少。我们假设，在经历最近的性侵犯之前的脆弱性和事后的心理困扰与自伤有关。
该样本是从 13 至 17 岁的青少年性侵犯中心招募的，包括 98 名女性。在（平均性侵后 3.9 周）和（平均性侵后 21.8 周）收集纵向数据。进行了双变量分析和分层二元逻辑回归。
性侵犯前的自伤率为 38.1%，性侵犯后的自伤率为 37.8%（）。家庭功能障碍史（优势比[OR]3.60，95%置信区间[CI]1.30 至 10.01）、就诊时（OR5.83，95%CI2.35 至 14.43）或（OR2.79，95%CI1.20 至 6.50）的抑郁症状，以及就诊时（OR3.21，95%CI1.36 至 7.58）的创伤后应激症状预测就诊时的自伤（）。调整混杂因素后，除了就诊时的抑郁症状（OR4.21，95%CI1.57 至 11.28）外，这些影响减弱。
讨论了预防青少年性侵犯后自伤发作或持续的临床意义。未来的研究应在更大的样本中复制这些发现，并考虑不同的自伤轨迹。
