Adams J A, Harper K, Knudson S, Revilla J
University of California, San Francisco.
Pediatrics. 1994 Sep;94(3):310-7.
Studies of alleged victims of child sexual abuse vary greatly in the reported frequency of physical findings based on differences in definition of abuse and of "findings." This study was designed to determine the frequency of abnormal findings in a population of children with legal confirmation of sexual abuse, using a standardized classification system for colposcopic photographic findings.
Case files and colposcopic photographs of 236 children with perpetrator conviction for sexual abuse, were reviewed. The photos were reviewed blindly by a team member other than the examiner, and specific anatomical findings were noted and classified as normal to abnormal on a scale of 1 to 5. Historical and behavioral information, as well as legal outcome was recorded, and all data entered into a dBase III program. Correlations were sought between abnormal findings and other variables.
The mean age of the patients was 9.0 years (range 8 months to 17 years, 11 months), with 63% reporting penile-genital contact. Genital examination findings in girls were normal in 28%, nonspecific in 49%, suspicious in 9%, and abnormal in 14% of cases. Abnormal anal findings were found in only 1% of patients. Using discriminant analysis, the two factors which significantly correlated with the presence of abnormal genital findings in girls were the time since the last incident, and a history of blood being reported at the time of the molest.
Abnormal genital findings are not common in sexually abused girls, based on a standardized classification system. More emphasis should be placed on documenting the child's description of the molestation, and educating prosecutors that, for children alleging abuse: "It's normal to be normal."
关于儿童性虐待据称受害者的研究，由于对虐待及“检查结果”定义的不同，所报告的身体检查结果出现频率差异极大。本研究旨在使用阴道镜摄影检查结果的标准化分类系统，确定经法律确认遭受性虐待儿童群体中异常检查结果的出现频率。
回顾了236名性虐待犯罪者被定罪的儿童的病例档案和阴道镜照片。由检查者以外的一名团队成员对照片进行盲法审查，记录特定的解剖学检查结果，并按1至5的等级将其从正常到异常进行分类。记录历史和行为信息以及法律结果，并将所有数据输入dBase III程序。寻找异常检查结果与其他变量之间的相关性。
患者的平均年龄为9.0岁（范围为8个月至17岁11个月），63%报告有阴茎与生殖器接触。女童的生殖器检查结果中，28%为正常，49%为非特异性，9%为可疑，14%为异常。仅1%的患者肛门检查结果异常。使用判别分析，与女童生殖器异常检查结果显著相关的两个因素是距上次事件的时间以及骚扰发生时报告有出血的病史。
根据标准化分类系统，性虐待女童中生殖器异常检查结果并不常见。应更加重视记录儿童对骚扰情况的描述，并向检察官宣传，对于声称遭受虐待的儿童：“正常是正常的”。
