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介导性虐待学龄前儿童治疗结果的因素:6个月和12个月随访

Factors that mediate treatment outcome of sexually abused preschool children: six- and 12-month follow-up.

作者信息

Cohen J A, Mannarino A P

机构信息

Allegheny University of the Health Sciences, Pittsburgh, PA, USA.

出版信息

J Am Acad Child Adolesc Psychiatry. 1998 Jan;37(1):44-51. doi: 10.1097/00004583-199801000-00016.

Abstract

OBJECTIVE

The role of familial, demographic, developmental, and treatment-mediating factors on treatment outcome of sexually abused preschool children was evaluated 6 and 12 months after treatment.

METHOD

Forty-three sexually abused preschool children and their parents who were evaluated shortly after disclosure of sexual abuse and then were provided with one of two treatment interventions were reevaluated at the completion of treatment and 6 and 12 months after treatment. Parents completed the Child Behavior Checklist, the Child Sexual Behavior Inventory, and the Weekly Behavior Report to measure a variety of emotional and behavioral symptoms in children. Parents also completed the Beck Depression Inventory, the Family Adaptability and Cohesion Evaluation Scales-III, the Parent Emotional Reaction Questionnaire, the Parental Support Questionnaire, and the Maternal Social Support Index. Children completed the Battelle Developmental Inventory and the Peabody Picture Vocabulary Test at pretreatment to assess developmental levels.

RESULTS

Correlational and stepwise multiple regression analyses were conducted to analyze the role of the hypothesized mediating variables in predicting scores on outcome measures across the two treatment groups. While the Parent Emotional Reaction Questionnaire was the strongest familial predictor of treatment outcome at posttreatment, parental support became a stronger predictor of outcome at the 6- and 12-month follow-up points. Treatment group was the strongest overall predictor of outcome at posttreatment and at 12-month follow-up. Demographic and developmental factors did not strongly predict outcome.

CONCLUSIONS

Findings indicate the strong impact of parental support on treatment outcome in sexually abused preschool children over the course of a 12-month follow-up and emphasize the importance of including parental interventions in treating sexually abused preschool children. They also support the superior effectiveness of cognitive-behavioral therapy over supportive counseling for this population.

摘要

目的

在治疗后6个月和12个月时,评估家庭、人口统计学、发育及治疗调节因素对遭受性虐待的学龄前儿童治疗结果的作用。

方法

43名遭受性虐待的学龄前儿童及其父母在性虐待披露后不久接受了评估,随后接受了两种治疗干预措施之一,在治疗结束时以及治疗后6个月和12个月时再次接受评估。父母完成了儿童行为清单、儿童性行为量表和每周行为报告,以测量儿童的各种情绪和行为症状。父母还完成了贝克抑郁量表、家庭适应性和凝聚力评估量表-III、父母情绪反应问卷、父母支持问卷和母亲社会支持指数。儿童在治疗前完成了巴特尔发育量表和皮博迪图片词汇测试,以评估发育水平。

结果

进行了相关性和逐步多元回归分析,以分析假设的调节变量在预测两个治疗组结果测量得分方面的作用。虽然父母情绪反应问卷是治疗后治疗结果最强的家庭预测因素,但在6个月和12个月的随访点,父母支持成为结果更强的预测因素。治疗组是治疗后和12个月随访时结果最强的总体预测因素。人口统计学和发育因素对结果的预测作用不强。

结论

研究结果表明,在12个月的随访过程中,父母支持对遭受性虐待的学龄前儿童的治疗结果有强烈影响,并强调在治疗遭受性虐待的学龄前儿童时纳入父母干预措施的重要性。它们还支持认知行为疗法相对于支持性咨询对该人群具有更高的有效性。

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