Çocukluk Döneminde Cinsel İstismar Üzerine Yapılan Çalışmaların İçerik Analizi

Yıl 2020, Cilt: 1 Sayı: 1, 23 - 40, 05.10.2020

Melis Hıdır , Fatma Elif Kılınç

Öz

Amaç: Çocuk cinsel istismarı çocuğun fiziksel, zihinsel ve duygusal gelişim düzeyi göz önüne alındığında anlamlandıramayacağı, kendi rızası dışında gelişen cinsel eylemlere zorla ya da ikna edilerek dâhil edilmesidir. Çocukluk döneminde cinsel istismara maruz kalmak çocuğun tüm gelişim alanlarını uzun ve kısa vadeli olarak önemli ölçüde etkileyen küresel halk sağlığı sorunlarından biridir. Bu çalışmanın amacı çocukluk döneminde görülen cinsel istismara yönelik yapılmış çalışmaların sistematik bir şekilde değerlendirilmesidir.
Yöntem: Değerlendirmede 01.01.2019 - 05.05.2020 tarihleri arasında PubMed veri tabanına ait yayınlardan ‘child sexual abuse’ sözcük grubu kullanılarak yapılan arama ile ulaşılan çalışmalar taranmıştır. Bu anahtar kelime ile ilgili tarih aralığı sınırlandırılarak toplam 3201 çalışma görüntülenmiş olup tam metin olarak 2649 çalışmaya ulaşılmıştır. Konunun içeriği, yaş aralığı (0-18), başlık ve anahtar kelime uygunluğu, araştırma makalesi olması gibi kriterler değerlendirilerek uygun olmayan araştırmalar, derleme makaleler ve meta-analiz çalışmaları bu çalışmaya dâhil edilmemiştir. Değerlendirme kriterlerini karşılamayan çalışmalar çıkarıldığında toplam 12 makale incelenmiştir.
Bulgular: Çalışmalar incelendiğinde çalışma grubunun çoğunu ergenlerin oluşturduğu, cinsel istismar öyküsü olan çocukların, istismarcılarının çoğunun yakınlarındaki kişiler olduğu, istismarın zararlı madde kullanımı, depresyon, anksiyete, uyku bozuklukları, travma sonrası stres bozukluğu ile ilgili doğrudan ilişkisi olduğu ve intihar etme düşüncelerinin olduğu bulunmuştur.
Sonuç: Çocuk cinsel istismarı çocuğun hayatında derin izler bırakarak yetişkinliğe kadar etkisini sürdüren problemlere neden olmaktadır. Cinsel istismarın risk faktörleri ve sonuçları arasındaki ilişkiyi incelemeye yönelik araştırmalar, erken müdahale ve önleme programlarına yönelik araştırmalara göre daha fazladır. Çocuk cinsel istismarı yaygınlığını azaltmak için gelişimi bilen kişiler tarafından yapılacak değerlendirmelere, aile ve okul temelli programlara, bu değerlendirme ve programların etkililiğinin araştırılmasına ihtiyaç vardır.

Anahtar Kelimeler

Cinsel istismar, çocuk cinsel istismarı, sistematik derleme

Kaynakça

• Referans1 David N, Ezechi O, Wapmuk A, Gbajabiamila T, Ohihoin A, Herbertson E, et al. Child sexual abuse and disclosure in South Western Nigeria: a community based study. African Health Sciences. 2018;18(2):199–208.
• Referans2 Martyniuk H, Dworkin E. Child Sexual Abuse Prevention: Programs for children. J Nurs UFPE online. 2011. Available from: www.nsvrc.org
• Referans3 Haugaard JJ. The Challenge of Defining Child Sexual Abuse. American Psychologist. 2000;55(9):1036.
• Referans4 Slep AMS, Heyman RE, Foran HM. Child Maltreatment in DSM-5 and ICD-11. Family Process. 2015;54(1):17–32.
• Referans5 Mathews B, Collin-Vézina D. Child Sexual Abuse: Toward a Conceptual Model and Definition. Trauma, Violence & Abuse. 2019;20(2):131–148.
• Referans6 Kloppen K, Haugland S, Svedin CG, Mæhle M, Breivik K. Prevalence of Child Sexual Abuse in the Nordic Countries: A Literature Review. Journal of Child Sexual Abuse 2016;25(1):37–55.
• Referans7 Polat O. Tüm Boyutlarıyla Çocuk İstismarı-1. 1.baskı. Ankara: Seçkin Yayıncılık; 2007. 93–158 p.
• Referans8 Sedlak AJ, Broadhurst DD. Third National Incidence Study of Child Abuse and Neglect. Washington; 1996.
• Referans9 Jones LM, Finkelhor D, Kopiec K. Why is sexual abuse declining? A survey of state child protection administrators. Child Abus Negl. 2001;25:1139–58.
• Referans10 Martin EK, Silverstone PH. How much child sexual abuse is “below the surface,” and can we help adults identify it early? Front Psychiatry. 2013;4(58):1–10.
• Referans11 Russell D, Higgins D, Posso A. Preventing child sexual abuse: A systematic review of interventions and their efficacy in developing countries. Child Abus Negl. 2020;102(January).
• Referans12 Blanco L, Nydegger LA, Camarillo G, Trinidad DR, Schramm E, Ames SL. Neurological changes in brain structure and functions among individuals with a history of childhood sexual abuse: A review. Neurosci Biobehav Rev.
• Referans13 Chen LP, Murad MH, Paras ML, Colbenson KM, Sattler AL, Goranson EN, et al. Sexual Abuse and Lifetime Diagnosis of Psychiatric Disorders: Systematic Review and Meta-analysis. Mayo Clin Proc. 2010;85(7):618–29.
• Referans14 Homma Y, Wang N, Saewyc E, Kishor N. The Relationship Between Sexual Abuse and Risky Sexual Behavior Among Adolescent Boys: A Meta-Analysis. J Adolesc Heal. 2012;51(1):18–24.
• Referans15 Senn TE, Braksmajer A, Urban MA, Coury-Doniger P, Carey MP. Pilot Test of an Integrated Sexual Risk Reduction Intervention for Women with a History of Childhood Sexual Abuse. AIDS Behav. 2017;21(11):3247–59.
• Referans16 Marques NM, Belizario GO, Rocca CC de A, Saffi F, de Barros DM, Serafim, et al. Psychological evaluation of children victims of sexual abuse: development of a protocol. Heliyon. 2020;6(3).
• Referans17 Rinne-Albers MA, Boateng CP, van der Werff SJ, Lamers-Winkelman F, Rombouts SA, Vermeiren RR, et al. Preserved cortical thickness, surface area and volume in adolescents with PTSD after childhood sexual abuse. Sci Rep. 2020;10(1):1–9.
• Referans18 Rajan G, Ljunggren G, Wändell P, Wahlström L, Svedin CG, Carlsson AC. Health care consumption among adolescent girls prior to diagnoses of sexual abuse, a case–control study in the Stockholm Region. Eur Child Adolesc Psychiatry. 2019;1–7.
• Referans19 Do HN, Nguyen HQT, Nguyen LTT, Nguyen HD, Bui TP, Phan NT, et al. Perception and Attitude about Child Sexual Abuse among Vietnamese School-Age Children. Int J Environ Res Public Health. 2019;16(20).
• Referans20 Wong WHS, Kuo WH, Sobolewski C, Bhatia I, Ip P. The Association Between Child Abuse and Attempted Suicide: A Retrospective Cohort Study. Crisis. 2019;41(3):196–204.
• Referans21 Jonsson LS, Fredlund C, Priebe G, Wadsby M, Svedin CG. Online sexual abuse of adolescents by a perpetrator met online: a cross-sectional study. Child Adolesc Psychiatry Ment Health. 2019;13(32):1–10.
• Referans22 Hébert M, Amédée LM, Blais M, Gauthier-Duchesne A. Child Sexual Abuse among a Representative Sample of Quebec High School Students: Prevalence and Association with Mental Health Problems and Health-Risk Behaviors. Can J Psychiatry. 2019;64(12):846–54.
• Referans23 Borelli JL, Cohen C, Pettit C, Normandin L, Target M, Fonagy P, et al. Maternal and Child Sexual Abuse History: An Intergenerational Exploration of Children’s Adjustment and Maternal Trauma-Reflective Functioning. Front Psychol. 2019;10(May):1–11.
• Referans24 Runarsdottir E, Smith E, Arnarsson A. The Effects of Gender and Family Wealth on Sexual Abuse of Adolescents. Int J Environ Res Public Health. 2019;16(10).
• Referans25 Wing Lo T, Tse JWL, Cheng CHK, Chan GHY. The Association between Substance Abuse and Sexual Misconduct among Macau Youths. Int J Environ Res Public Health. 2019;16(9).
• Referans26 Miragoli S, Camisasca E, Di Blasio P. Investigating linguistic coherence relations in child sexual abuse: A comparison of PTSD and non-PTSD children. Heliyon. 2019;5(2).
• Referans27 Vrolijk-Bosschaart TF, Brilleslijper-Kater SN, Verlinden E, Widdershoven GAM, Teeuw AH, Voskes Y, et al. A Descriptive Mixed-Methods Analysis of Sexual Behavior and Knowledge in Very Young Children Assessed for Sexual Abuse: The ASAC Study. Front Psychol. 2019;9:1–13.
• Referans28 Topçu S. Çocuk ve Gençlerin Cinsel İstismarı. Ankara: Doruk Yayıncılık; 1997.
• Referans29 Finkelhor D. Child Sexual Abuse. Challenges Facing Child Protection and Mental Health Professionals. In: Childhood and Trauma Separation, Abuse, War. 1984. p. 101–15.
• Referans30 Hauer D, Weis F, Papassotiropoulos A, Schmoeckel M, Beiras-Fernandez A, Lieke J, et al. Relationship of a common polymorphism of the glucocorticoid receptor gene to traumatic memories and posttraumatic stress disorder in patients after intensive care therapy. Crit Care Med. 2011;39(4):643–50.
• Referans31 Paolucci EO, Genuis ML, Violato C. A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse. J Psychol Interdiscip Appl. 2001;135(1):17–36.
• Referans32 Jumper SA. A meta-analysis of the relationship of child sexual abuse to adult psychological adjustment. Child Abus Negl. 1995;19(6):715–28.
• Referans33 Molnar BE, Berkman LF, Buka SL. Psychopathology, childhood sexual abuse and other childhood adversities: relative links to subsequent suicidal behaviour in the US. Psychol Med. 2001;31(6):965–77.
• Referans34 Gökçe İmren S, Ayaz AB, Yusufoǧlu C, Rodopman Arman A. Cinsel istismara uǧrayan çocuk ve ergenlerde klinik özellikler ve intihar girişimi ile ilişkili risk etmenleri. Marmara Med J. 2013;26(1):11–6.
• Referans35 Watkins B, Bentovim A. The Sexual Abuse of Male Children and Adolescents: A Review of Current Research. J Child Psychol Psychiatry. 1992;33(1):197–248.
• Referans36 Stoltenborgh M, van IJzendoorn MH, Euser EM, Bakermans-Kranenburg MJ. A Global Perspective on Child Sexual Abuse: Meta-Analysis of Prevalence Around the World. Child Maltreat. 2011;16(2):79–101.
• Referans37 Finkelhor D, Lewis IA. An Epidemiologic Approach to the Study of Child Molestation. Ann N Y Acad Sci. 1988;528:64–78.
• Referans38 Ceylan A, Tuncer O, Melek M, Akgün C, Gülmehmet F, Erden Ö. Van Bölgesindeki Çocuklarda Cinsel İstismar. Van Tıp Derg. 2009;16(4):131–4.
• Referans39 Back SE, Jackson JL, Fitzgerald M, Shaffer A, Salstrom S, Osman MM. Child sexual and physical abuse among college students in Singapore and the United States. Child Abus Negl. 2003;27(11):1259–75.
• Referans40 Wells M, Mitchell KJ. How Do High-Risk Youth Use the Internet? Characteristics and Implications for Prevention. Child Maltreat. 2008;13(3):227–34.
• Referans41 Baumgartner SE, Valkenburg PM, Peter J. Unwanted online sexual solicitation and risky sexual online behavior across the lifespan. J Appl Dev Psychol. 2010;31:439–47.
• Referans42 Wolak J, Finkelhor D, Mitchell KJ, Ybarra ML. Online “Predators” and Their Victims: Myths, Realities, and Implications for Prevention and Treatment. Am Psychol. 2008;63(2):111–28.
• Referans43 Livingstone S, Haddon L, Görzig A, Ólafsson K. Risks and safety on the internet: the perspective of European children: full findings and policy implications from the EU Kids Online survey of 9-16 year olds and their parents in 25 countries. EU Kids Online. 2011.
• Referans44 Whittle H, Hamilton-Giachritsis C, Beech A, Collings G. A review of young people’s vulnerabilities to online grooming. Aggress Violent Behav. 2013;18(1):135–46.
• Referans45 McKee JR, Payne BK. Witnessing Domestic Violence as a Child and Adulthood Emotionality: Do Adults “Feel” the Consequences of Exposure to Partner Abuse Later in the Life Course? J Aggress Maltreatment Trauma. 2014;23(3):318–31.
• Referans46 McCloskey LA. The Intergenerational Transfer of Mother– Daughter Risk for Gender-Based Abuse. Psychodyn Psychiatry. 2013;41(2):303–28.
• Referans47 Sumner SA, Mercy JA, Saul J, Motsa-Nzuza N, Kwesigabo G, Buluma R, et al. Prevalence of Sexual Violence Against Children and Use of Social Services — Seven Countries, 2007–2013. Vol. 64, Morbidity and Mortality Weekly Report. 2015.
• Referans48 Turchik JA, Garske JP, Probst DR, Irvin CR. Personality, Sexuality, and Substance Use as Predictors of Sexual Risk Taking in College Students. J Sex Res. 2010;47(5):411–9.
• Referans49 Graves KL, Leigh BC. The relationship of substance use to sexual activity among young adults in the United States. Fam Plann Perspect. 1995;27(1):18–33.
• Referans50 Mckeganey N, Neale J, Robertson M. Physical and sexual abuse among drug users contacting drug treatment services in Scotland. Drugs Educ Prev Policy. 2005;12(3):223–32.
• Referans51 Grossman M, Kaestner R, Markowitz S. Get High and Get Stupid: The Effect of Alcohol and Marijuana Use on Teen Sexual Behavior. Rev Econ Househ. 2004;2(4):413–41.
• Referans52 Tausczik YR, Pennebaker JW. The Psychological Meaning of Words: LIWC and Computerized Text Analysis Methods. J Lang Soc Psychol. 2010;29(1):24–54.
• Referans53 Cordón IM, Pipe ME, Sayfan L, Melinder A, Goodman GS. Memory for traumatic experiences in early childhood. Dev Rev. 2004;24(1):101–32.
• Referans54 Manheim M, Felicetti R, Moloney G. Child Sexual Abuse Victimization Prevention Programs in Preschool and Kindergarten: Implications for Practice. J Child Sex Abus. 2019;28(6):745–57.
• Referans55 Brilleslijper-Kater SN, Friedrich WN, Corwin DL. Sexual knowledge and emotional reaction as indicators of sexual abuse in young children: theory and research challenges. Child Abus Negl. 2004;28:1007–17.
• Referans56 Putnam FW. Ten-Year Research Update Review: Child Sexual Abuse. J Am Acad Child Adolesc Psychiatry. 2003;42(3):269–78.
• Referans57 Davis MK, Gidycz CA. Child Sexual Abuse Prevention Programs: A Meta- Analysis. J Clin Child Psychol. 2000;29(2):257–65.
• Referans58 Edwards VJ, Freyd JJ, Dube SR, Anda RF, Felitti VJ. Health Outcomes by Closeness of Sexual Abuse Perpetrator: A Test of Betrayal Trauma Theory. J Aggress Maltreatment Trauma. 2012;21(2):133–48.
• Referans59 Anderson GD, Anderson JN, Gilgun JF. The Influence of Narrative Practice Techniques on Child Behaviors in Forensic Interviews. J Child Sex Abus. 2014;23(6):615–34.
• Referans60 Andrews SJ, Lamb ME. The Effects of Age and Delay on Responses to Repeated Questions in Forensic Interviews With Children Alleging Sexual Abuse. Law Hum Behav. 2014;38(2):171–80.
• Referans61 Jones LM, Atoro KE, Walsh WA, Cross TP, Shadoin AL. Nonoffending Caregiver and Youth Experiences With Child Sexual Abuse Investigations. J Interpers Violence. 2010;25(2):291–314.