Anova, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Sciences/Psychiatry, Umeå University, Umeå, Sweden.
Center for Epidemiology and Community Medicine, Stockholm, Sweden.
J Sex Med. 2021 Sep;18(9):1571-1581. doi: 10.1016/j.jsxm.2021.06.008. Epub 2021 Jul 22.
BACKGROUND: In 2012 the Swedish Helpline project PrevenTell, targeting men and women with self-identified out-of-control and paraphilic sexual behavior, was launched by ANOVA, Karolinska University Hospital. The overall purpose was to reach the target group and via a telephone-contact encourage further on-site assessment and treatment. AIM: To describe men and women contacting PrevenTell during the first 7 years by delineate sexuality-related risk-factors for sexual violence, gender differences, and age- and gender-preferences when reporting a pedophilic interest. METHOD: A 52-item semi-structured telephone interview was conducted by experts in sexual medicine with individuals who contacted the helpline. The interview covered sociodemographic characteristics, problematic sexual behavior(s), and mental health and based on the information reported, interventions included recommending an appointment at ANOVA, supporting other appropriate healthcare, or motivation of individuals still ambivalent to treatment. RESULTS: Data collection took place between March 2012 and October 2019. A total of 1573 respondents in the main target group (1454 men and 119 women) gave informed consent for participation. Compulsive sexual behavior was reported by 69% of respondents and 56% described at least one paraphilic interest. The prevalence of concomitant compulsive sexual behavior and a paraphilic interest was high, varying between 65% and 83%. Significant gender differences were found in socioeconomic and mental health variables, in which women showed fewer positive and stable life factors compared to men. A sexual preference for minors was reported by 24% of respondents. In this group, 63% reported use of child sexual exploitation material and 15% committed child sexual abuse. Respondents were offered anonymity, however 55% disclosed their identity and were enrolled for further assessment and treatment at ANOVA. CLINICAL IMPLICATIONS: The result of this study is of substantial relevance when developing secondary preventive initiatives targeting sexual violence in the community. STRENGTHS AND LIMITATIONS: This is the first study to present data from a national helpline targeting both men and women with a wide range of self-identified problematic sexual behaviors. Limitations include the lack of diagnostic confirmation on-site, hence, presented data provides only an indication of clinical conditions. Furthermore, the main objective of the interview was to motivate participants to seek further treatment, sometimes necessary to prioritize this over adherence to the semi-structured questionnaire, explaining the relatively high absence rate in some variables. CONCLUSION: Men and women at risk of committing sexual crimes can be reached through a national helpline service and motivated to undergo further assessment and treatment. Adebahr R, Söderström EZ, Arver S, et al. Reaching Men and Women at Risk of Committing Sexual Offences - Findings From the National Swedish Telephone Helpline PrevenTell. J Sex Med 2021;18:1571-1581.
背景:2012 年,瑞典 ANOVA、卡罗林斯卡大学医院启动了 PrevenTell 项目,旨在针对自我认同的失控和性癖好性行为的男性和女性提供服务。该项目的总体目标是接触目标群体,并通过电话联系鼓励进一步进行现场评估和治疗。
目的:通过描述联系 PrevenTell 的男性和女性,阐明与性暴力相关的风险因素,包括性别差异,以及报告恋童癖时的年龄和性别偏好。
方法:通过性医学专家对通过电话联系热线的个人进行了 52 项半结构化电话访谈。访谈涵盖了社会人口特征、问题性行为以及心理健康等方面的信息。根据报告的信息,干预措施包括推荐在 ANOVA 就诊,提供其他适当的医疗保健支持,或鼓励那些对治疗仍持犹豫态度的个人。
结果:数据收集于 2012 年 3 月至 2019 年 10 月进行。主要目标群体(1454 名男性和 119 名女性)中的 1573 名受访者同意参与研究并提供了知情同意书。69%的受访者报告存在强迫性性行为,56%的受访者描述了至少一种性癖好。同时存在强迫性性行为和性癖好的比例较高,介于 65%至 83%之间。在社会经济和心理健康变量方面存在显著的性别差异,女性的积极和稳定的生活因素明显少于男性。24%的受访者报告了对未成年人的性偏好。在这个群体中,63%的人报告使用儿童性剥削材料,15%的人实施了儿童性虐待。受访者被提供了匿名保护,但仍有 55%的人透露了自己的身份,并被安排在 ANOVA 进行进一步的评估和治疗。
临床意义:本研究的结果对于制定针对社区性暴力的二级预防措施具有重要意义。
优势和局限性:这是第一项针对具有广泛自我认同的问题性行为的男性和女性的全国性热线提供数据的研究。局限性包括现场诊断确认的缺乏,因此,呈现的数据仅提供了临床状况的指示。此外,访谈的主要目的是激励参与者寻求进一步的治疗,有时需要优先考虑这一点,而不是遵守半结构化问卷,这解释了一些变量中相对较高的缺失率。
结论:通过国家性热线服务可以接触到有性犯罪风险的男性和女性,并激励他们接受进一步的评估和治疗。
Trauma Violence Abuse. 2024-4