Resnick M D, Blum R W
Division of Health Management and Policy, General Pediatrics, University of Minnesota, Minneapolis.
Pediatrics. 1994 Dec;94(6 Pt 1):907-13.
The association of childhood sexual intercourse, excluding sexual abuse, with adolescent health and risk behaviors was examined using the urban component of a statewide study on adolescent health, risky behaviors, and resiliency factors.
A specialized cohort design was used to derive a two-group sample. Index cases consisted of all adolescents who indicated that they had first intercourse at or before age 10 years, and controls were adolescents who either had not yet had intercourse or had done so at age 16 years or older. To avoid confounding with issues of sexual abuse, all adolescents who also indicated a history of sexual abuse on the survey were removed from the analysis, so that the comparison could focus on health and behavioral correlates of respondents who did not define their childhood sexual intercourse as constituting abuse. Comparisons were conducted separately for girls and boys.
A significantly greater proportion of index cases than controls indicated problem substance use by parents, poor school performance, gang involvement, frequent and unprotected sexual intercourse, history of pregnancy involvement, desire to leave the home, history of mental health treatment, emotional distress, and suicidal involvement. Logistic regression revealed significant group differences including academic risk, gang involvement, frequency of sexual intercourse, and history of mental health treatment. Correct group classification with the logit model was approximately 90% for both girls and boys.
The results underscore the importance of childhood sexual intercourse as an indicator of other health-compromising behaviors and risk factors. Clinicians should be alert to this clustering of risk behaviors in their psychosocial assessment of young people.
利用一项关于青少年健康、危险行为和复原力因素的全州性研究的城市部分,研究排除性虐待的童年性交与青少年健康及危险行为之间的关联。
采用专门的队列设计来获取两组样本。索引病例包括所有表示在10岁及以前首次性交的青少年,对照组为尚未性交或在16岁及以后性交的青少年。为避免与性虐待问题产生混淆,所有在调查中也表示有性虐待史的青少年都被排除在分析之外,以便比较能够聚焦于那些不将童年性交定义为虐待的受访者的健康和行为关联因素。对女孩和男孩分别进行比较。
索引病例中表示父母有物质使用问题、学业成绩差、参与帮派、频繁且无保护措施的性交、有怀孕史、想离家、有心理健康治疗史、情绪困扰和有自杀行为的比例显著高于对照组。逻辑回归显示出显著的组间差异,包括学业风险、参与帮派、性交频率和心理健康治疗史。逻辑模型对女孩和男孩的正确组分类率约为90%。
结果强调了童年性交作为其他损害健康行为和风险因素指标的重要性。临床医生在对年轻人进行社会心理评估时应警惕这种风险行为的聚集情况。