精神发育迟滞患者性自我防卫能力的多元分析

Multivariant Analysis of Sexual Self-defense Capacity in Patients with Mental Retardation

目的探讨影响精神发育迟滞患者的性自我防卫能力评定的相关因素及社会功能水平对性防卫能力的影响。方法采用1：1的病例对照研究方法,对性侵害案中87例精神发育迟滞患者和同期87例非精神发育迟滞精神障碍患者使用自编法医精神病学鉴定案例登记表收集一般资料,韦氏智力测试量表测定智商,成人智残评定量表和功能大体评定量表进行社会功能的评定。结果除文化、职业、性知识、索要财物与性自我防卫能力密切相关外,成人智残评定量表和功能大体评定量表评分对性自我防卫能力评定也有重要意义。多种因子对有性自我防卫能力、性自我防卫能力削弱和无性自我防卫能力的患者的判别正确率分别为73．1%、66．9%和87．2%,总判别正确率为78．1%。结论精神发育迟滞患者性防卫能力评定受诸多因素的影响,在性自我防卫能力评定时除充分考虑社会学、法学因素外,还要考虑其社会功能的水平。多元判别分析模型为精神发育迟滞患者性防卫能力评定提供了有价值的工具。

Objective To explore relevant factors that affect the assessment of sexual self-defense capacity and to evaluate the effect of social functions on sexual self-defense capacity in patients with mental retardation. Methods A1 ： 1 matched case-control study was carried out, which included 174 sexual assault cases, 87 with mental retardation and 87 without mental retardation. The record of forensic psychiatry assessment designed by ourselves was used to collect the general characteristics. Wechsler Adult Intelligence-Rerisedin China （WAIS-RC） was used to determine the intelligence quoctient. Rating Scale of Intellectual Disability （RSID） and Global Assessment Function （GAF） were used to assess the social functions. Results Besides, factors such as culture, occupation, knowledge about sex and payment claim, the scores of GAF and RSID were also related to the assessment of sexual self-defense capacity. Moreover, the correct ratio of discrimination was 73.1% （yes）, 66.9% （impaired） and 87.2% （no）, respectively, and the general correct ratio of discrimination was 78.1%. Conclusion Not only social and legal factors but also the level of social functions should be adequately considered in the assessment of sexual self-defense capacity. Therefore, it might be concluded that multiple discriminant analysis model can be a useful tool when the sexual self-defense capacity in patients with mental retardation is assessed.