Fergusson D M, Horwood L J, Lynskey M T
Christchurch Health and Developments Study, Christchurch School of Medicine, New Zealand.
J Am Acad Child Adolesc Psychiatry. 1996 Oct;35(10):1365-74. doi: 10.1097/00004583-199610000-00024.
This is the second in a series of articles that describe the prevalence, correlates, and consequences of childhood sexual abuse (CSA) in a birth cohort of more than 1,000 New Zealand children studied to the age of 18 years. This article examines the associations between reports of CSA at age 18 and DSM-IV diagnostic classifications at age 18.
A birth cohort of New Zealand children was studied at annual intervals from birth to age 16 years. At age 18 years retrospective reports of CSA prior to age 16 and concurrently measured psychiatric symptoms were obtained.
Those reporting CSA had higher rates of major depression, anxiety disorder, conduct disorder, substance use disorder, and suicidal behaviors than those not reporting CSA (p < .002). There were consistent relationships between the extent of CSA and risk of disorder, with those reporting CSA involving intercourse having the highest risk of disorder. These results persisted when findings were adjusted for prospectively measured childhood family and related factors. Similar but less marked relationships between CSA and nonconcurrently measured disorders were found.
The findings suggest that CSA, and particularly severe CSA, was associated with increased risk of psychiatric disorder in young adults even when due allowance was made for prospectively measured confounding factors.
本文是系列文章中的第二篇,该系列文章描述了对1000多名新西兰儿童出生队列研究至18岁时儿童性虐待(CSA)的患病率、相关因素及后果。本文探讨了18岁时CSA报告与18岁时DSM-IV诊断分类之间的关联。
对新西兰儿童出生队列从出生到16岁每年进行研究。在18岁时获取16岁之前CSA的回顾性报告以及同时测量的精神症状。
报告CSA的儿童比未报告CSA的儿童患重度抑郁症、焦虑症、品行障碍、物质使用障碍和自杀行为的比率更高(p <.002)。CSA的程度与疾病风险之间存在一致的关系,报告CSA涉及性交的儿童患疾病的风险最高。当对前瞻性测量的童年家庭及相关因素进行调整后,这些结果依然存在。在CSA与非同时测量的疾病之间也发现了类似但不太明显的关系。
研究结果表明,即使对前瞻性测量的混杂因素进行了适当考虑,CSA,尤其是严重的CSA,仍与年轻人患精神疾病的风险增加有关。