Abrams M E
Semin Adolesc Med. 1987 Mar;3(1):67-78.
Adolescent sexual abuse is an overwhelming issue for society and the medical community. Adolescent medicine has only begun to emerge in the mainstream of medical practice. Sexual medicine, adolescent chemical dependency, and abusive medicine are emerging subspecialties of mainstream medicine, with victimization syndromes just beginning to be explored. Adolescent sexual abuse, sexual addiction disorders, family incest, eating disorders, depression, and suicide in adolescents all need to be viewed from epidemiologically regarding family and community orientation. I refer to physician and troubled adolescent relations as the quadruple passivity syndrome. The ego-centered, troubled adolescent denies he or she has problems but no desire for treatment; the physician denies that the adolescent has health problems and has no desire to evaluate them. Physicians need to take an aggressive role in identifying, treating, and preventing the victimization process in children, adolescents, adults, spouses, families, and geriatric patients. Physicians need to be trained to identify these patients and to develop treatment protocols. The victimization syndrome needs more research, publication, and surveillance by all medical associations, but primarily by family physicians and pediatricians. In conclusion this clinical discussion describes four main points: Sexually abused adolescents can be successfully treated by a multidisciplinary advocacy team. A community multidisciplinary team can work in a unified approach for the good of the community by putting an end to future generations of victimized adolescents and families. The medical community has the greatest challenge in training, educating, and becoming more aware about adolescent sexual abuse. The community must provide support for victims of sexual abuse.
青少年性虐待对社会和医学界来说是一个极其严重的问题。青少年医学才刚刚开始在医学实践主流中崭露头角。性医学、青少年药物依赖和虐待医学是主流医学中新兴的亚专业领域,而受害综合征才刚刚开始被探索。青少年性虐待、性成瘾障碍、家庭乱伦、饮食失调、青少年抑郁症和自杀等问题,都需要从以家庭和社区为导向的流行病学角度来审视。我将医生与问题青少年的关系称为四重被动综合征。以自我为中心的问题青少年否认自己有问题且不想接受治疗;医生则否认青少年存在健康问题,也不想对其进行评估。医生需要在识别、治疗和预防儿童、青少年、成年人、配偶、家庭及老年患者的受害过程中发挥积极作用。医生需要接受培训,以识别这些患者并制定治疗方案。受害综合征需要所有医学协会,尤其是家庭医生和儿科医生进行更多的研究、发表成果和监测。总之,本次临床讨论阐述了四个要点:受性虐待的青少年可以通过多学科宣传团队得到成功治疗。社区多学科团队可以通过杜绝后代青少年和家庭成为受害者,以统一的方式为社区的利益而努力。医学界在培训、教育以及提高对青少年性虐待的认识方面面临着最大的挑战。社区必须为性虐待受害者提供支持。