Trinity Centre for Global Health, School of Psychology, Trinity College Dublin, Dublin, Ireland; The Danish Children Centre for the Capital Region, Copenhagen, Denmark.
Institute of Psychiatry, Psychology, and Neuroscience, Kings College London, London, United Kingdom.
Child Abuse Negl. 2020 Sep;107:104589. doi: 10.1016/j.chiabu.2020.104589. Epub 2020 Jun 17.
Exposure to child abuse can lead to lasting mental health problems. Extant research has found that different types of child abuse tend to co-occur and overlap, which merits the investigation of the effects of exposure to multiple types of childhood mistreatment.
The aim of this study was to systematically review the evidence on the associations between multiple different types of interpersonal victimization or polyvictimization, and indicators of psychopathology among children ages 0-17.
The review included studies across all economic strata and research on nationally representative, community, and at-risk samples, using the same standardized assessment tool (i.e. the Juvenile Victimization Questionnaire or JVQ). The review was conducted using peer-reviewed evidence published up until August 2019 from Scopus, EMBASE, PsycINFO, Medline, CINAHL, and ERIC. Out of 4998 relevant references screened, 255 met the inclusion criteria, 22 of which aimed to address childhood polyvictimization and psychopathology.
A total of 21 of the 22 included studies identified a significant positive association between polyvictimization and various indicators of psychopathology comprising both externalizing (e.g. anger), internalizing problems (e.g. depression) and total psychological distress. A range of studies demonstrated that polyvictimization was a stronger risk factor for psychopathology than individual (sub)types of victimization. Based on the study findings, we provide a set of recommendations for future research on polyvictimization and psychopathology.
The present systematic review was the first to review the evidence on the associations between polyvictimization (as measured by the JVQ) and child and adolescent psychopathology in the global research literature. As a novel approach, the present review included both normative and high-risk samples. The results showed that polyvictimization is a substantial risk factor for mental health problems spanning both inner-directed and outer-directed mental health difficulties. However, the inconsistency in methods of defining and measuring polyvictimization severely undermines the scientific impact of this body of work. Additional well-designed, longitudinal studies that take account of the context-specific nature of polyvictimization are required to better establish the causal relationships between childhood polyvictimization and psychopathology so as to improve prevention and intervention efforts.
遭受儿童虐待会导致持久的心理健康问题。现有研究发现，不同类型的儿童虐待往往同时发生且相互重叠，这值得研究多种类型的儿童期虐待的影响。
本研究旨在系统地回顾有关 0-17 岁儿童遭受多种人际伤害或多重重创与精神病理学指标之间关联的证据。
本综述包括所有经济阶层的研究以及针对全国代表性、社区和高危样本的研究，使用相同的标准化评估工具（即少年受害问卷或 JVQ）。该综述使用 Scopus、EMBASE、PsycINFO、Medline、CINAHL 和 ERIC 中截至 2019 年 8 月发表的同行评审证据进行。在筛选出的 4998 篇相关参考文献中，有 255 篇符合纳入标准，其中 22 篇旨在探讨儿童多重重创与精神病理学。
22 项纳入研究中的 21 项研究表明，多重重创与各种精神病理学指标之间存在显著的正相关，包括外化问题（如愤怒）、内化问题（如抑郁）和总心理困扰。一系列研究表明，多重重创是精神病理学的一个更强的风险因素，而不是单一（亚）类型的受害。基于研究结果，我们为多重重创与精神病理学的未来研究提供了一系列建议。
本系统综述是首次在全球研究文献中综述了少年受害问卷（JVQ）测量的多重重创与儿童和青少年精神病理学之间的关联证据。作为一种新颖的方法，本综述同时纳入了正常和高危样本。结果表明，多重重创是心理健康问题的一个重要风险因素，涵盖了内导向和外导向的心理健康困难。然而，定义和衡量多重重创的方法不一致，严重削弱了这方面工作的科学影响力。需要进行更多设计良好、纵向的研究，考虑多重重创的具体情况，以更好地确定儿童多重重创与精神病理学之间的因果关系，从而改进预防和干预措施。
