Allen Brian
Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA.
Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, PA, USA.
Clin Child Fam Psychol Rev. 2023 Mar;26(1):50-64. doi: 10.1007/s10567-022-00412-5. Epub 2022 Sep 12.
Problematic sexual behavior (PSB) among preteen children is a poorly understood clinical phenomenon that may leave even the most skilled and knowledgeable of clinicians at a loss when attempting to develop an evidence-based treatment approach. Much of this lack of practical direction can be credited to the relatively scarce clinical trial research examining this outcome. Nonetheless, the etiological research on PSB provides clearer directions and suggests the implementation of already well-established interventions may be effective. This paper reviews the current state of the etiological research pertaining to PSB and places these findings within developmental psychopathology, social learning theory, and post-traumatic stress disorder symptomatology frameworks. Specific treatment directives derived from these three viewpoints are then reviewed, including a review of the current evidence base for the treatment of PSB. Finally, a treatment planning algorithm is specified to help clinicians identify the most beneficial approach to treating PSB in a given case.
青春期前儿童的问题性行为(PSB)是一种临床现象,人们对其了解甚少。即便经验最丰富、知识最渊博的临床医生在试图制定循证治疗方案时,也可能会感到不知所措。这种缺乏实用指导方法的情况,很大程度上可归因于针对这一结果的临床试验研究相对较少。尽管如此,关于PSB的病因学研究提供了更清晰的方向,并表明实施已成熟的干预措施可能会有效。本文回顾了与PSB相关的病因学研究现状,并将这些发现置于发展性心理病理学、社会学习理论和创伤后应激障碍症状学框架内进行探讨。然后,我们将审视从这三个观点衍生出的具体治疗指导方法,包括对PSB治疗当前证据基础的回顾。最后,制定了一个治疗规划算法,以帮助临床医生在特定病例中确定治疗PSB的最有益方法。