892名卫校女生儿童期性虐待经历及其对心理健康的影响

Child sexual abuse: a study among 892 female students of a medical school

目的 了解卫校女生儿童时期性虐待发生情况 ,探讨性虐待经历对学生心理健康的影响 ,为卫生、教育及其他相关部门制定预防儿童性虐待对策提供参考依据。方法 用自填式问卷 ,对一所卫校 892名女生就有关儿童时期受性虐待经历进行不记名回顾性调查。结果 在被调查的 892名女生中 ,有 2 5 6 % (2 2 8/ 892 )报告 16岁以前经历过或非身体接触或身体接触的性虐待 (身体接触的性虐待中包括被试图性交和被强行性交 )。其中 12 9人经历过身体接触的性虐待 ,占 14 5 %。 5 2 6 %的儿童首次性虐待经历发生在 12岁及以下。与没有儿童期性虐待经历的女生比较 ,有儿童期性虐待经历的女生抑郁情绪量表得分高 ;健康状况自我感觉评价得分低 ;有性交行为比例高 ;在调查的近 12个月里有自杀意念或自杀企图、参与或卷入斗殴、以及在调查近 30天里曾吸烟饮酒的发生率均明显偏高。结论 儿童性虐待问题在我国并非少见。

Objective This study was designed to ascertain the prevalence of child sexual abuse (CSA) among female students of a medical school and to explore the impact of CSA on the mental health and health related risk behaviors of the victims being sexually abused and to provide useful reference for CSA prevention Methods A cross sectional survey was carried out among 892 female students from a medical school by anonymous self administered questionnaire during Oct 2002 The questionnaire used for this study mainly included (1) general demographic information; (2) sexual experiences; (3) 12 forms of CSA In this study, cases of CSA were defined as those who answered positively to one or more of the 12 questions relating to childhood sexual experiences (including non physical contact CSA and physical contact CSA) occurring before age 16 with a person when a child did not want to (4) Center for Epidemiologic Studies (CES) Depression Scale; (5) Self Esteem Scale; (6) Risk Behaviors; (7) Health status′ self evaluation Survey procedures were designed to protect students′ privacy by allowing anonymous and voluntary participation Students were seated separately, completed the self administered questionnaire in their classrooms during a regular class period Respondents were encouraged to participate in this survey, but given the sensitive nature of the subject, they could skip portion of the questionnaire if they were not comfortable with the questions The completed questionnaires were sealed in envelopes by students themselves (the envelope was distributed with questionnaire at the same time), and then collected together Data were analysed by using the Statistical Package for the Social Sciences software Frequency, percentage, Chi square test and t test of statistics were used to analyze the CSA prevalence and explore the influence of CSA on mental health of students Results Among 892 female students, 25 6% reported having experienced CSA (any one of 12 forms non physical contact and physical contact CSA) before the age of 16 years The median age at first episode was 12 years Comparing the rates of CSA of female students in different parents′ education level, between one child in a family and more than one child in a family, among rural area, county and city, there were no significant differences Compared to the students who had not experienced CSA, the students who had experienced CSA reported higher levels of depression (CES D score 18 78 vs 16 68, t =2 81, P =0 005), lower levels of health status self evaluation (score 3 53 vs 3 78, t =2 94, P =0 003); higher proportion of subjects who reported drinking alcohol and having ever smoked during the past 30 days (drinking 32 7% vs 22 9%, χ 2=8 51, P =0 004; smoking 8 8% vs 4 4%, χ 2=6 17, P =0 013); a higher percentage engaged in sexual intercourse (19 3% vs 5 9%, χ 2=33 48, P =0 000); ever seriously considered attempting suicide (23 7% vs 15 4%, χ 2=8 09, P =0 004), making a plan about how would attempt suicide (17 9% vs 9 7%, χ 2=10 62, P =0 001), being threatened or injured by someone with a weapon such as a knife, or club on school property (3 5% vs 1 1%, χ 2 =6 17, P =0 013), being involved in physical fight (16 7% vs 5 6%, χ 2=27 05, P =0 000) during the 12 months preceding the survey Conclusions The results further showed that the CSA of girls in our country is not uncommon, as reported before in our country and in the other countries and is associated with poor mental health and risky behaviors The findings highlight the urgent need for the further research into CSA epidemiological characteristics, health services for the victims abused sexually, sexual abuse prevention programs in schools and the general community in China