Oates R K, O'Toole B I, Lynch D L, Stern A, Cooney G
Department of Paediatrics and Child Health, University of Sydney, Camperdown, NSW, Australia.
J Am Acad Child Adolesc Psychiatry. 1994 Sep;33(7):945-53. doi: 10.1097/00004583-199409000-00003.
To evaluate sexually abused children and their families at intake and 18 months later, in comparison with a control group.
Eighty-four sexually abused children aged 5 to 15 years were assessed at intake, with 64 being able to be reassessed at 18 months, the assessment using measures of self-esteem relevant to their age; the Children's Depression Inventory, and the Achenbach Child Behavior Checklist. Parents were assessed with the McMaster Family Assessment Device and the General Health Questionnaire. Control children and families were similarly assessed. Additional measures at follow-up were a structured interview with the parents, the Indices of Coping Responses, and the Newcastle Child and Family Life Events Schedule. Therapists were contacted to obtain information on type and duration of therapy.
While the control children's self-esteem, depression, and behavior scores showed little change over time, the abused children's scores were more likely to move toward the normal range although 56% remained in the dysfunctional range for self-esteem, 48% for behavior, and 35% for depression. Improvement in child behavior was related to improvement in family function. While there was no direct relationship between child outcome and the relationship of the abuser to the child, family dysfunction, which was related to child outcome, did correlate with the closeness of the abuser to the child. Sixty-five percent of abused children had received therapy for an average of 9 months. No relationship was found between therapy and outcome.
The major variable relating to improvement in sexually abused children appears to be adequacy of family functioning. There is a need for increased emphasis on the evaluation of treatment.
与对照组相比，在初次接诊时及18个月后对遭受性虐待的儿童及其家庭进行评估。
对84名年龄在5至15岁的遭受性虐待儿童在初次接诊时进行评估，其中64名儿童在18个月后能够接受再次评估，评估采用与其年龄相关的自尊量表、儿童抑郁量表和阿肯巴克儿童行为量表。对家长采用麦克马斯特家庭评估工具和一般健康问卷进行评估。对对照儿童及其家庭进行类似评估。随访时的其他评估措施包括与家长进行结构化访谈、应对反应指标和纽卡斯尔儿童及家庭生活事件量表。联系治疗师以获取治疗类型和持续时间的信息。
虽然对照儿童的自尊、抑郁和行为得分随时间变化不大，但受虐儿童的得分更有可能朝着正常范围变化，尽管56%的儿童自尊仍处于功能失调范围，48%的儿童行为处于该范围，35%的儿童抑郁处于该范围。儿童行为的改善与家庭功能的改善相关。虽然儿童的结局与施虐者和儿童的关系没有直接关系，但与儿童结局相关的家庭功能失调确实与施虐者与儿童的亲密程度相关。65%的受虐儿童接受了平均9个月的治疗。未发现治疗与结局之间存在关联。
与遭受性虐待儿童改善情况相关的主要变量似乎是家庭功能的充分性。有必要更加重视治疗评估。
