Adölesanlarda Cinsel İstismar İle İlişkili Davranışsal Problemler: Retrospektif Bir Çalışma

Year 2018, Volume: 10 Issue: 2, 188 - 193, 15.08.2018

Miraç Barış Usta Seher Akbaş Berna Aydın

https://doi.org/10.18521/ktd.382121

Cited By: 2

Abstract

Amaç: Çocuk cinsel istismarı, çocukların ve ergenlerin zihinsel
sağlığı ve gelişimini olumsuz yönde etkileyen halk sağlığı problemidir. Bu
çalışmanın amacı, ergenlik çağındaki çocuklarda cinsel istismarın psikiyatrik
sonuçlarını ve travmaya bağlı davranışsal ve duygusal
sorunları tanımlamaktır.

Gereç
ve Yöntem: 1 Aralık 2010 ile 31 Aralık 2013 tarihleri
arasında değerlendirilen 409 mağdur retrospektif arşiv çalışmasına katıldı.
DSM-IV-TR kriterlerine göre çocuk ve ergen psikiyatrları tarafından konulan ve
davranışsal ve duygusal sorunlar özbildirim ölçekleri
ile değerlendirilmiş toplam 136 mağdur çalışmaya katıldı.

Bulgular: Mağdurlarının % 86.0'ı kızdı ve % 30.1'i birden fazla
cinsel istismara maruz kalmıştır. Mağdurlarının %72.1'sinde Eksen 1'de psikiyatrik tanı mevcut bulunmuştur.
Kontrollerle karşılaştırıldığında, içe dönük sorunlar (p<0.001),
anksiyete/depresyon (p<0.001), çökkünlük (p<0.001) ve kural bozma
davranışı (p=0.002) puanlarının mağdur grubunda daha yüksek olduğu gözlenmiştir.

Sonuç: Cinsel istismar sonrası ortaya çıkabilecek spesifik
davranış problemlerini tanımak ve formüle etmek, daha sonraki travmaları
önlemek ve psikiyatrik tedavi açısından önem taşımaktadır. Cinsel istismar
mağdurlarının duygusal ve davranışsal sorunlarını
anlamak için uzunlamasına çalışmalarına ihtiyaç duyulmaktadır.

Keywords

Cinsel İstismar, Ptsd, Adolesan, Davranışsal Sorunlar

Behavioural Problems Associated with Child Sexual Abuse in Adolescents: A Retrospective Study

Abstract

Backgroud/aim: Child Sexual Abuse (CSA) is a public health problem with negative effects
on the mental health and development of children and adolescents. The aim of this study was
to identify the psychiatric outcomes of child sexual abuse and the trauma-related behavioural
and emotional problems in adolescents.

Method: 136 CSA victims and 136 age and gender-matched control group participated in the
study between 1 December 2010 and 31 December 2013. Diagnostic evaluation of the CSA
victims was applied with the criteria of the DSM-IV-TR by child and adolescent psychiatrists
and behavioral and emotional problems were assessed by the Youth Self Report.

Results: CSA victims are 86.0% were female and %30.1 expereinced multiple sexual abuse
events. %72.1 of CSA victims has psychiatric diagnosis on Axis 1. Compared to age-matched
controls Internalizing problems (p<0.001), Anxiety/depression (p<0.001), Withdrawn
(p<0.001), and Rule breaking behaviour (p=0.002) scores are higher in the CSA group.

Conclusion: Specific problems following a traumatic event may be important in respect of
treatment and a formulation to understand the psychopathology. There is a need for
longitudinal childhood studies to investigate the mediators of the psychopathology and to
understand the emotional and behavioural problems of CSA victims.  

Keywords

sexual abuse, ptsd, adolescent, behavioural problems

References

• Gilbert R, Widom CS, Browne K, Fergusson D, Webb E,Janson, S. Burden and consequences of child maltreatment in high-income countries. Lancet 2009;373:68- 81.
• Beitchman JH, Zucker KJ, Hood JE, DaCosta GA, Akman D,Cassavia E. A review of the long-term effects of child sexual abuse. Child Abuse Negl 1992;16:101-118.
• Fang X, Brown DS, Florence CS, Mercy JA. The economic burden of child maltreatment in the United States and implications for prevention. Child Abuse Neg 2012;36:156-165.
• Mongillo EA, Briggs-Gowan M, Ford JD, Carter AS. Impact of traumatic life events in a community sample of toddlers. J Abnorm Child Psychol 2009;37:455-468.
• Ackerman PT, Newton JE, McPherson WB, Jones JG, Dykman RA. Prevalence of post traumatic stress disorder and other psychiatric diagnoses in three groups of abused children (sexual, physical, and both). Child Abuse Negl 1998;22:759-774.
• Sesar K, Zivcic-Becirevic I, Sesar D. Multi-type maltreatment in childhood and psychological adjustment in adolescence: questionnaire study among adolescents in Western Herzegovina Canton. Croat Med J 2008;49:243-256.
• Mills R, Scott J, Alati R, O’Callaghan M, Najman JM, Strathearn L. Child maltreatment and adolescent mental health problems in a large birth cohort. Child Abuse Negl 2013;37: 292-302.
• Godinet MT, F Li, T Berg. Early childhood maltreatment and trajectories of behavioral problems: Exploring gender and racial differences. Child Abuse Negl 2014;38:544- 556.
• Ullman SE, Filipas HH. Gender differences in social reactions to abuse disclosures, post-abuse coping, and PTSD of child sexual abuse survivors. Child Abuse Negl 2005;29:767-782.
• Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, Dube SR, Giles WH. The enduring effects of abuse and related adverse experiences in childhood. Eur Arch Psychiatry Clin Neurosci 2006;256:174-86.
• Deblinger E, Mannarino AP, Cohen JA, Steer RA. A follow-up study of a multisite, randomized, controlled trial for children with sexual abuse-related PTSD symptoms. J Am Acad Child Adolesc Psychiatry 2006;45:1474-1484 Putnam FW. Ten-year research update review: Child sexual abuse. J Am Acad Child Adolesc Psychiatry 2003;42:269-278.
• Brown J, Cohen P, Johnson JG, Smailes EM. Childhood abuse and neglect: specificity of effects on adolescent and young adult depression and suicidality. J Am Acad Child Adolesc Psychiatry 1999;38:1490-1496.
• Achenbach TM. Manual for the youth self-report. University of Vermont Burlington Department of Psychiatry 1991.
• Erol N, ZT Simsek. Mental Health of Turkish Children: Behavioral and Emotional Problems Reported By Parents, Teachers, and Adolescents. International Perspectives on Child and Adolescent Mental Health 2000:223-247.
• Pereda N, Guilera G, Forns M, Gómez-Benito J. The prevalence of child sexual abuse in community and student samples: A meta-analysis. Clin Psychol Rev 2009;29:328- 38.
• EA Davies, AC Jones. Risk factors in child sexual abuse. J Forensic Leg Med 2013;20:146-150.
• Aydin B, Akbas S, Turla A, Dundar C, Yuce M, Karabekiroglu K. Child sexual abuse in Turkey: an analysis of 1002 cases. J Forensic Sci 2015;60:61-65.
• Pintello D, Zuravin S. Intrafamilial child sexual abuse: Predictors of postdisclosure maternal belief and protective action. Child Maltreat 2001;6:344-52.
• Ungar M1, Tutty LM, McConnell S, Barter K, Fairholm J. What Canadian youth tell us about disclosing abuse. Child Abuse Negl 2009;33:699-708.
• Hébert M, Collin-Vézina D, Daigneault I, Parent N, Tremblay C. Factors linked to outcomes in sexually abused girls: a regression tree analysis. Compr Psychiatry 2006;47:443-55.
• Fergusson DM, GF McLeod, LJ Horwood. Childhood sexual abuse and adult developmental outcomes: Findings from a 30-year longitudinal study in New Zealand. Child Abuse Negl 2013;37:664-674.
• Finkelhor D, L Berliner. Research on the treatment of sexually abused children: A review and recommendations. J Am Acad Child Adolesc Psychiatry 1995;34:1408- 1423.
• Sher L. The concept of post-traumatic mood disorder and its implications for adolescent suicidal behavior. Minerva Pediatrica 2008; 60:1393-1399.
• McLeer SV, Dixon JF, Henry D, Ruggiero K, Escovitz K, Niedda T, Scholle R. Psychopathology in non—clinically referred sexually abused children. Am Acad Child Adolesc Psychiatry 1998;37:1326-1333.
• Saigh PA, Yasik AE, Oberfield RA, Halamandaris PV, McHugh M. An analysis of the internalizing and externalizing behaviors of traumatized urban youth with and without PTSD. J Abnorm Psychol 2002;111:462-70.
• Rind B, Tromovitch P, Bauserman R. A meta-analytic examination of assumed properties of child sexual abuse using college samples. Psychol Bull 1998;124:22-53.
• Wahlstrom LC, Scott JP, Tuliao AP, DiLillo D, McChargue DE. Posttraumatic stress disorder symptoms, emotion dysregulation, and aggressive behavior among incarcerated methamphetamine users. J Dual Diagn 2015;11:118-27.