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儿童期性虐待和身体虐待的频率及其对使用 IAPT 服务人群的影响。

Frequency and impact of childhood sexual and physical abuse on people using IAPT services.

机构信息

Greater Manchester Mental Health NHS Foundation Trust, UK.

Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, UK.

出版信息

Br J Clin Psychol. 2021 Nov;60(4):504-512. doi: 10.1111/bjc.12310. Epub 2021 Jun 3.

Abstract

OBJECTIVES

This study explored the prevalence of childhood sexual/physical abuse (CSA/CPA) as identified by practitioners in Improving Access to Psychological Therapies (IAPT) services and clarified differences in clients' characteristics with and without a history of CSA/CPA.

METHODS

A retrospective analysis of a large dataset comprised of IAPT routine data and data from a local service evaluation reporting on clients' presenting problems.

RESULTS

14% of IAPT clients (n = 1,315) were identified with a record of CSA/CPA. CSA/CPA history was associated with longer duration and earlier age of onset of condition(s), greater number of presenting problems and post-traumatic stress disorder co-occurrence, higher intensity treatment delivery, and lower recovery rates.

CONCLUSIONS

CSA/CPA history appears as an important feature in a sizable minority of IAPT clients; further work is required to meet clients' trauma-related needs.

PRACTITIONER POINTS

A sizable minority of IAPT clients (14%) present with a history of CSA/CPA as recorded in clinical notes. CSA/CPA history is associated with more complex and enduring presentations in IAPT clients. The reported CSA/CPA frequency is likely to be underestimates of the actual prevalence and impact of adverse childhood experiences in IAPT clients. Trauma-informed inquiry and trauma-specific screening tools would help practitioners to meet clients' trauma-related needs.

摘要

目的

本研究旨在探讨改善心理治疗获取途径(IAPT)服务中从业者所识别的儿童期性/身体虐待(CSA/CPA)的流行情况,并阐明有和没有 CSA/CPA 病史的患者特征的差异。

方法

对包含 IAPT 常规数据和当地服务评估报告中患者就诊问题的数据的大型数据集进行回顾性分析。

结果

14%的 IAPT 患者(n=1315)有 CSA/CPA 的记录。CSA/CPA 病史与疾病持续时间较长、发病年龄较早、就诊问题较多、创伤后应激障碍共病、治疗强度较高以及康复率较低有关。

结论

CSA/CPA 病史似乎是 IAPT 患者中相当一部分患者的重要特征;需要进一步工作来满足患者的创伤相关需求。

从业者要点

相当一部分 IAPT 患者(14%)在临床记录中报告有 CSA/CPA 病史。CSA/CPA 病史与 IAPT 患者更复杂和持久的表现有关。报告的 CSA/CPA 频率可能低估了 IAPT 患者中不良童年经历的实际发生率和影响。以创伤为中心的问询和创伤特异性筛查工具将有助于从业者满足患者的创伤相关需求。

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