Merry S N, Andrews L K
Department of Psychiatry and Behavioural Sciences, Auckland School of Medicine, New Zealand.
J Am Acad Child Adolesc Psychiatry. 1994 Sep;33(7):939-44. doi: 10.1097/00004583-199409000-00002.
The assessment of psychiatric status of sexually abused children 12 months after the disclosure of recent sexual abuse.
Ninety-five children, aged from 4 through 16 years, were recruited to the study from a variety of agencies other than psychiatric units. Sixty-six (69.5%) were assessed for psychiatric diagnosis on DSM-III-R using data from parents, teachers, and children 12 months after disclosure of abuse. Abuse was extra- and intrafamilial.
Overall 63.5% of the children warranted a diagnosis on Axis I. There was a wide range of diagnoses, with particularly high rates of oppositional defiant disorder (19.6%), post-traumatic stress disorder (18.2%), anxiety disorders (30.3%), depressive disorders (12.1%), and attention-deficit hyperactivity disorder (13.6%). Boys had a higher rate of diagnosis than girls. Abuse and social variables did not predict diagnoses but mothers' mental status rated on the General Health Questionnaire did. Subjects not located at follow-up were more often male and more likely to be socioeconomically disadvantaged. Thus the estimates of psychopathology here are likely to be conservative.
This study highlights the need of sexually abused children for skilled long-term therapy tailored to individual presentation.
评估近期性虐待事件披露12个月后受性虐待儿童的精神状态。
从精神科以外的各类机构招募了95名年龄在4至16岁之间的儿童参与该研究。其中66名（69.5%）儿童在虐待事件披露12个月后，依据父母、教师及儿童提供的数据，按照《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）进行精神疾病诊断评估。虐待事件包括家庭外和家庭内的情况。
总体而言，63.5%的儿童在轴I上符合诊断标准。诊断类型广泛，对立违抗障碍（19.6%）、创伤后应激障碍（18.2%）、焦虑症（30.3%）、抑郁症（12.1%）和注意力缺陷多动障碍（13.6%）的发生率尤其高。男孩的诊断率高于女孩。虐待情况和社会变量无法预测诊断结果，但通过一般健康问卷评估的母亲精神状态可以预测。随访时未找到的受试者男性居多，且更可能在社会经济方面处于不利地位。因此，此处对精神病理学的估计可能较为保守。
本研究强调了受性虐待儿童需要针对个体情况进行的长期专业治疗。
