Tebbutt J, Swanston H, Oates R K, O'Toole B I
Department of Paediatrics and Child Health, University of Sydney, Westmead, NSW, Australia.
J Am Acad Child Adolesc Psychiatry. 1997 Mar;36(3):330-9. doi: 10.1097/00004583-199703000-00011.
To assess change in behavior, depression, and self-esteem in sexually abused children after 5 years and to determine which factors predict later functioning.
Sixty-eight of 84 children and their nonoffending parents were reassessed after 5 years for depression, self-esteem, and behavior problems in the children; parental mental health; and family functioning.
There were no significant changes in depression, self-esteem, or behavior over 5 years. Forty-three percent of the children were now sad or depressed, 43% had low self-esteem, and 46% had behavioral dysfunction. While some children improved, a nearly equal number deteriorated, with no clear pattern of change. The only abuse-related variables associated with 5-year functioning were further contact with the abuser, which was significantly associated with depression and self-esteem, and sexual abuse prior to intake, which was related to an increased incidence of behavior problems. Older children showed more depression and lower self-esteem but less behavioral dysfunction. Poor family functioning at 5 years was associated with low self-esteem and behavior problems. Treatment had no effect on depression, self-esteem, or behavior. Multivariate analysis showed that depression and self-esteem at intake were prognostic indicators of 5-year outcome.
Many sexually abused children have continuing problems with behavior, self-esteem, and depression. Family and abuse-related variables do not appear to be good predictors of outcome, although sexually abused children who are sad or depressed and have low self-esteem at intake are likely to have continuing problems in these areas.
评估遭受性虐待儿童5年后的行为、抑郁及自尊方面的变化，并确定哪些因素可预测其后期功能状况。
84名儿童及其未犯罪的父母中有68人在5年后接受了重新评估，内容包括儿童的抑郁、自尊及行为问题；父母的心理健康状况；以及家庭功能。
5年间，抑郁、自尊或行为方面均无显著变化。43%的儿童目前悲伤或抑郁，43%的儿童自尊较低，46%的儿童存在行为功能障碍。虽然有些儿童有所改善，但恶化的儿童数量几乎与之相当，且无明显的变化模式。与5年功能状况相关的唯一虐待相关变量是与施虐者的进一步接触，这与抑郁和自尊显著相关，以及入院前的性虐待，这与行为问题发生率增加有关。年龄较大的儿童表现出更多的抑郁和更低的自尊，但行为功能障碍较少。5岁时家庭功能不良与自尊较低和行为问题有关。治疗对抑郁、自尊或行为没有影响。多变量分析表明，入院时的抑郁和自尊是5年结果的预后指标。
许多遭受性虐待的儿童在行为、自尊和抑郁方面持续存在问题。家庭和与虐待相关的变量似乎不是结果的良好预测指标，尽管入院时悲伤或抑郁且自尊较低的遭受性虐待儿童在这些方面可能会持续存在问题。
