监管场所中有童年期躯体情感虐待史羁押人员的心理干预效果分析

目的 改善监管场所羁押人员中有童年期躯体情感虐待史者的心理健康水平,并对心理干预的效果进行研究评估.方法 经过虐待史调查和心理评估,建立羁押人员心理团体咨询小组,同时建立19个配对对照组,由注册心理咨询师进行8次团体辅导心理,比较干预前后及干预组与对照组心理测量结果的差异.主要用症状自评量表(SCL-90)总分及因子分得分差值进行评估.结果 干预组经心理干预后,前后自身对照各因子得分差值有统计学意义;对照组前后大多数因子分差值没有统计学意义;而干预组与配对对照组比较,干预前后2次SCL-90评估中大多数因子分差值有统计学意义.结论 对监管场所中有童年期躯体情感虐待史的羁押人员进行一定的系统的心理干预是需要的,能有效地改善其心理健康水平.     

北碚区监管场所内羁押人员HIV感染情况调查

[目的]了解北碚区监管场所内羁押人员感染人类免疫缺陷病毒(HIV)的高危行为以及艾滋病病毒(HIV)感染状况,防止HIV在监管场所中传播和蔓延,为制订本地区监管场所内羁押人员中艾滋病病毒感染者的管理和干预措施提供科学依据。[方法]在2005～2008年期间,对北碚区辖区内监管场所内的羁押人员进行HIV感染情况调查。[结果]在本次监测的6888名监管场所内羁押人员中,发现HIV抗体阳性感染者374人,监管场所内羁押人员HIV感染率为5.43%;73.36%的羁押人员有吸毒史;监管场所内羁押人员HIV感染途径以单纯注射吸毒和注射吸毒兼性乱为主,分别占发现感染者的45.99%和46.52。[结论]该地区监管场所的内羁押人员HIV感染率高于本地区全人群感染率,特别在有吸毒及性乱史的羁押人员中HIV感染率高达7%。因此加强对该人群HIV抗体的检测和性病艾滋病防治的宣传教育,对预防和控制HIV传播有重要意义。     

2011年信阳市监管场所羁押人员HIV感染调查

目的了解信阳市监管场所内羁押人员的艾滋病病毒(HIV)感染状况及该人群的高危行为,防止HIV在监管场所中传播。方法对信阳市监管场所中新入所的羁押人员进行调查,按照统一调查表填写,同时采集静脉血进行HIV抗体检测。结果共检测羁押人员2 749人。有高危行为者256人,占9.35%。检出HIV抗体阳性4例,阳性率0.15%。HIV感染者经注射吸毒感染2人,经血液途径感染2人。结论信阳市监管场所羁押人群艾滋病疫情依然严重。建议加强监管场所内艾滋病防治宣传教育和行为干预工作,以防止艾滋病毒在监管场所内的传播。     

童年期虐待与初中生抑郁症状关系

目的探讨童年期虐待经历与初中生抑郁症状的关系。方法整群抽取安徽省霍邱县3所乡镇普通初级中学的1 417名初中生,采用抑郁自评量表(SDS)、自编童年期虐待经历问卷和自编一般情况调查表进行问卷调查。结果1 417名初中生中抑郁症状的检出率为61.3%,女生(66.7%)高于男生(56.6%),初二年级(64.4%)高于初一(62.4%)和初三年级(56.7%),非独生子女(63.5%)高于独生子女(54.9%),差异均有统计学意义(P<0.05或P<0.001);与父母的关系从差、一般到亲密,学习成绩从差、中等到好,初中生抑郁症状的检出率均逐渐下降,差异均有统计学意义(均P<0.001);童年期遭受各种类型反复虐待的初中生抑郁症状的检出率均高于未遭受反复虐待者,差异均有统计学意义(P<0.05或 P<0.001);多因素非条件logistic 回归分析结果显示,童年期遭受反复重度躯体虐待、反复中度躯体虐待、反复情感虐待、反复接触性性虐待和反复非接触性性虐待的初中生抑郁症状发生的危险性分别是未遭受上述虐待的1.989(OR=1.989)、1.436(OR=1.436)、1.698(OR=1.698)、2.834(OR=2.834)和2.235倍(OR=2.235)。结论童年期遭受反复虐待是青少年抑郁症状的危险因素。     

童年期虐待与青少年自我伤害行为关系

目的 探讨童年期不良经历与青少年自我伤害行为的关系。方法 在安徽省4个县各方便抽取4个中学,每所中学分别在初一至高三每个年级随机整群抽取1~2个班级,按照自愿参加的原则对学生进行匿名问卷调查。共获得有效问卷10 894份。结果 童年期反复重度躯体虐待报告率为8.5%;反复中度躯体虐待报告率为23.6%;反复情感虐待的报告率为20.4%。青少年总体自伤报告率为22.3%,自伤的报告率与3种童年期反复虐待的经历呈相关趋势,童年期3种虐待经历是青少年自我伤害行为发生的危险因素。结论 不同类别和程度的童年期反复躯体虐待和反复情感虐待经历对青少年自我伤害行为产生负性影响。     

珠海市监管场所羁押人员HIV监测情况分析

目的了解珠海市监管场所中羁押人员HIV感染状况,防止HIV在监管场所中传播与蔓延。方法定期对珠海市所有监管场所中的羁押人员进行调查,按照统一调查表填写,Excel录入并进行统计分析;同时采集静脉血5ml,用酶联免疫试剂初筛,初筛阳性标本用蛋白印记法(WB)进行确证。结果5350名羁押收教人员中,检出18例HIV抗体阳性者,男性17例,女性1例,总检出率为0.34%。18份HIV感染者中注射毒品者9例,阳性率2.49%,占总报告数的50%;有性乱史者4例,阳性率0.59%,占总报告数的22%;其中1例既有注射毒品史又有性乱史;有5例感染途径不详。结论珠海市监管场所中羁押人员HIV感染率较高,主要为吸毒者和性乱人群。建议加强对监管场所羁押人员HIV感染的监测,并对此类人群进行健康教育及行为干预,提高他们的自我防护意识;对HIV感染者与未感染者分监舍关押,并在监管场所中设置美沙酮替代品治疗和提供安全套,以防止HIV在监管场所中传播与蔓延。     

童年期虐待的不同形式与中学生自杀行为关联性研究

目的 探讨不同形式的童年期虐待与中学生自杀行为的关系。方法 采用分层整群抽样的方法,以广州、新乡、沈阳和重庆4个地区14221名中学生为研究对象,使用问卷调查了解一般人口统计学指标、心理问题症状、童年期虐待经历及自杀行为等信息,建立多因素logistic回归模型,分析不同形式的童年期虐待对自杀行为发生的影响。结果 中学生童年期总体虐待、躯体虐待、情感虐待、性虐待、自杀意念、自杀计划和自杀未遂的检出人数(率)分别为7246(51.0%)、5824(41.0%)、5409(38.0%)、1039(7.3%)、2042(14.4%)、1174(8.3%)和548(3.9%)。男生躯体虐待的检出率高于女生,女生情感虐待和自杀意念的检出率高于男生,组间差异有统计学意义(P<0.01);童年期性虐待、自杀计划和自杀未遂的检出率在不同性别间的差异无统计学意义(P>0.01)。控制相关混杂因素的作用后,童年期虐待经历会增加男生自杀意念(OR=2.03,95%CI:1.72~2.40)和自杀计划(OR=1.93,95%CI:1.57~2.37)的发生风险,增加女生自杀意念(OR=2.45,95%CI:2.12~2.82)、自杀计划(OR=2.46,95%CI:2.02~3.00)和自杀未遂(OR=2.12,95%CI:1.61~2.78)的发生风险。除童年期躯体虐待与男生自杀未遂外,不同类型的童年期虐待均是男女中学生自杀行为发生的危险因素(P<0.01)。随着童年期虐待种类数的增加,男女生自杀行为的发生风险亦呈增高趋势(P<0.01)。持续受虐以及施虐人为父母/其他的中学生,自杀行为的发生风险显著增加。结论 童年期虐待经历是中学生自杀行为发生的重要危险因素。     

童年期虐待经历与青春期抑郁症状的前瞻性关联

目的 探讨童年期虐待经历与青春期抑郁症状的前瞻性关联。方法 于2013年5月方便选取安徽省蚌埠市3所小学,根据知情同意原则,对参加研究的3～4年级学生进行身高、体重测量,同时开展问卷调查,其中学生问卷包括童年期受虐待经历（情感、躯体和性虐待）和抑郁症状等;父母问卷包括父母学历和家庭经济条件等信息。2017年3月进行随访。基线抑郁症状采用儿童抑郁量表评价,随访期抑郁症状采用《心境与情绪问卷》评价。建立多因素二分类非条件logistics回归模型,分析童年期虐待经历与青春期抑郁症状的前瞻性关联。结果 2013年基线调查1 172名学生,4年后随访1 021名（87.1%）。基线童年期虐待经历报告完整的学生为1 126名,其中躯体、情感和性虐待报告率分别为12.8%（144/1 126）、11.1%（125/1 126）和10.9%（123/1 126）。基线与随访期抑郁症状报告率分别为7.0%（82/1 172）和12.3%（126/1 021）。logistic回归结果表明,调整基线抑郁症状、随访时年龄、性别、独生子女、家庭经济状况、父母离婚、BMI分类后,童年期情感虐待经历（OR=1.86,95% CI：1.03～3.36;P=0.039）和躯体虐待经历（OR=2.37,95% CI：1.39～4.03;P=0.001）增加青春期抑郁症状发生风险。结论 童年期情感虐待和躯体虐待可能增加青春期抑郁症状发生的风险。     

无锡市锡山区监管场所羁押人员HIV抗体筛查分析

目的了解无锡市锡山区的监管场所羁押人员中艾滋病病毒（HIV）感染情况及其影响因素,为制定HIV控制策略和措施提供依据。方法采用HIV1＋2酶联免疫吸附试验（ELISA）试剂盒双抗原夹心法做筛查,应用免疫印迹法（WB）进行确认。结果6341人中检出HIV抗体阳性3例,占羁押人员的0．047％。其中1人有静脉吸毒史,1人有性乱史。结论HIV感染在锡山区的监管场所羁押人员中尚处于低流行阶段,但由于监管场所中吸毒及性乱人群占有一定比率,因此,加强对这类高危人群的HIV检测,进行相关知识健康教育和监管措施控制,对预防和控制HIV传播有重要意义。     

某市监管场所羁押收教人员HIV感染情况调查

[目的]了解济宁市羁押收教人员HIV感染状况,为制定防制措施提供依据.[方法]采取整群抽样的方法对羁押收教人员进行HIV感染等高危行为调查,并进行HIV血清学检测.[结果]201414名羁押、收教人员中,检出5例HIV抗体阳性者,均为男性,检出率为0.024%.其中3例有静脉吸毒史(1例还有性乱史),1例有性乱史,1例有既往卖血(浆)史.[结论]羁押收教人群不仅是违法犯罪人群,也是艾滋病病毒感染的重点人群.建议形成对新收监的人员例行HIV抗体检测的制度,加强健康教育及行为干预,确定专门的狱所收押阳性者是防止HIV在监所中传播与蔓延的有效手段.     

The Effects of Childhood Abuse on Relationship Quality: Gender Differences and Clinical Implications

This study examined the relationship between self‐reported childhood physical and sexual abuse, romantic relationship quality, possible gender differences, and clinical implications. Three hundred thirty‐eight women and 296 men who sought services at a university mental health clinic in the northeast region of the United States completed a 30‐minute self‐report assessment questionnaire before their first therapy session. Among the items in the questionnaire were measures of childhood physical and sexual abuse, relationship stability, problem areas in the relationship, and other demographic information. Results from structural equation modeling indicated that childhood physical abuse influenced relationship quality for both men and women whereas childhood sexual abuse did not have a significant impact on relationship quality for either gender. The results of the study indicated that there may be more gender similarities than differences in experiences of childhood abuse and relationship quality than previous research has shown.     

Factors Associated with Hospitalization in Confirmed Cases of Physical Child Abuse

Selected characteristics of twenty-seven confirmed cases of physical child abuse requiring hospitalization were compared with 105 confirmed cases of physical abuse not requiring hospitalization. Results indicate that there is a significant relationship between the age of the abused child and whether or not that child was hospitalized. Children under the age of three were most likely to be hospitalized as a result of abuse. Sex of child, total number of children in the family, age of the alleged perpetrator, sex of alleged perpetrator, and relationship of child to the alleged perpetrator were not found to be significantly related to hospitalization of the child. Implications are discussed for identifying children most in need of services in human service settings.     

Factors Associated with Hospitalization in Confirmed Cases of Physical Child Abuse

Selected characteristics of twenty‐seven confirmed cases of physical child abuse requiring hospitalization were compared with 105 confirmed cases of physical abuse not requiring hospitalization. Results indicate that there is a significant relationship between the age of the abused child and whether or not that child was hospitalized. Children under the age of three were most likely to be hospitalized as a result of abuse. Sex of child, total number of children in the family, age of the alleged perpetrator, sex of alleged perpetrator, and relationship of child to the alleged perpetrator were not found to be significantly related to hospitalization of the child. Implications are discussed for identifying children most in need of services in human service settings.     

Sexual Abuse in Childhood and Physical and Mental Health in Adulthood: An Australian Population Study

Although childhood sexual abuse (CSA) is associated with a wide range of health problems later in life, there is also evidence of substantial individual differences. This study describes the mental and physical health of a population sample of Australians, randomly selected from the Commonwealth electoral roll, who have reported their CSA histories. Some 58% of those located from the electoral roll agreed to a telephone interview (n=1,784). Health status was measured using the Short Form 36 questionnaire. Men who had experienced non-penetrative and penetrative sexual abuse in childhood had 2.25 (95% CI=1.32-3.82) and 5.93 (95% CI=2.72-12.95) times respectively the rate of impaired mental health, but no higher rates of impaired physical health. Women who had experienced non-penetrative and penetrative sexual abuse in childhood had 1.87 (95% CI=1.19-2.95) and 3.15 (95% CI=1.87-5.33) times respectively the rate of impaired mental health and 1.87 (95% CI=1.19-2.92) and 2.31 (95% CI=1.34-3.97) times respectively the rate of impaired physical health. However, participants who had experienced CSA were no less likely than those who had not experienced CSA to be in optimum physical and mental health. None of the possible confounding or moderating variables tested appeared to mitigate the impact of CSA on health outcomes. Those with the highest levels of mental and physical health appear to be unaffected by the experience of CSA.     

Psychosocial Predictors of Sexual HIV Transmission Risk Behavior among HIV-Positive Adults with a Sexual Abuse History in Childhood

Childhood sexual abuse (CSA) is associated with HIV sexual risk behavior. Although many psychosocial correlates of sexual risk among HIV-positive persons have been identified, studies predicting continued risk among HIV-positive adults with histories of CSA are limited. This cross-sectional study identified variables predictive of sexual transmission risk behavior among an ethnically diverse sample of 256 HIV-positive adults (women and men who have sex with men; MSM) with CSA histories. Participants were assessed for trauma symptoms, shame related to HIV and sexual trauma, substance use, coping style, and sexual risk behavior. Logistic regression analyses were conducted to identify variables predictive of unprotected sexual behavior in the past 4 months. Unprotected sex was significantly associated with substance use and trauma-related behavioral difficulties among women and men, and less spiritual coping among men. Unprotected sex with HIV negative or serostatus unknown partners was significantly associated with greater trauma-related behavioral difficulties, more HIV-related shame, and fewer active coping strategies. Thus, trauma symptoms, shame, coping style, and substance use were significantly associated with sexual risk behavior among HIV-positive adults with histories of CSA, with models of prediction differing by gender and partner serostatus. HIV prevention intervention for persons with HIV and CSA histories should address trauma-related behavioral difficulties and enhance coping skills to reduce sexual transmission risk behavior.     

Childhood Sexual Abuse and Cannabis Use in Early Adulthood: Findings from an Australian Birth Cohort Study

Childhood sexual abuse (CSA) is associated with a wide range of health problems later in life. The impact of CSA on young adults’ use of cannabis remains under-studied. We examined the extent to which exposure to CSA was associated with increased rates of use of cannabis in early adulthood in a birth cohort of 3,285 Australian children followed-up to the age of 21 years, when retrospective reports of CSA were obtained from sample participants along with information on their use of cannabis at 21 years. Young adult men and women who reported experiencing CSA had significantly higher rates of frequent use of cannabis in early adulthood, defined as use of cannabis at least “every few days.” In multivariate analyses, men who reported a history of CSA had an odds ratio (OR) of 2.1 (95% CI = 1.1–3.9) for frequent use of cannabis at the age of 21 years. For women, there was an OR of 3.9 (95% CI = 2.4–6.3). Family and individual factors measured earlier in the study did not confound these associations. The findings suggest that children experiencing CSA have a substantially greater risk of use of cannabis and, in particular, its frequent use in early adulthood. Further research is required to explore factors that explain the pathway linking CSA and use of cannabis in early adulthood.     

某中学高中女生儿童期性虐待发生情况调查

目的 了解高中女生儿童期性虐待发生情况，为卫生及教育部门制定预防儿童期性虐待对策提供参考依据。方法 用自填式问卷，于2000年12月对某高中学校985名女生就有关儿童期受性虐待经历进行不记名的回顾性调查。结果 在被调查的985名女生中，有251人（25．5％）16岁前曾经历过非身体接触或身体接触的性虐待；其中18人经历过被试图性交，5人经历过被强行性交。儿童期性虐待首次发生年龄58％在13岁及以前。性交行为的发生率在有儿童期性虐待经历的女生中（2．6％）高于没有性虐待经历的女生（0．4％），差异有显性(x^2=6.48,P=0.011)。在不同的父母化程度间，儿童期性虐待发生率差异未发现有显性。结论 儿童期性虐待问题在我国女童中可能并非少见，有必要对这一问题开展研究，并重视在小学生中开展预防性虐待教育工作。     

Risk Reduction for HIV-Positive African American and Latino Men with Histories of Childhood Sexual Abuse

While the HIV epidemic has disproportionately affected African American and Latino men who have sex with men (MSM), few HIV prevention interventions have focused on African American and Latino men who have sex with both men and women (MSMW). Even fewer interventions target HIV-positive African American and Latino MSM and MSMW with histories of childhood sexual abuse (CSA), a population that may be vulnerable to high-risk sexual behaviors, having multiple sexual partners, and depression. The Men's Health Project, a small randomized clinical trial, compared the effects of two 6-session interventions, the Sexual Health Intervention for Men (S-HIM), guided by social learning theory and aimed at decreasing high-risk sexual behaviors, number of sexual partners, and depressive symptoms, and a standard health promotion control (SHP). A community sample of 137 HIV-positive gay and non-gay identifying African American and Latino MSM and MSMW with histories of CSA was recruited. Results were based on an "intent to treat" analyses of baseline to post, 3 and 6 month follow-ups. The sample as a whole reported reductions in sexual risk behaviors and number of sexual partners from baseline to post-test, and from the 3 to 6 month follow-ups, although the decrease in sexual risk behavior from baseline to post-test was significant only for S-HIM participants. No significant differences between conditions were reported for depressive symptoms, but the total sample reported a significant decrease at 6 months. These findings highlight the importance of addressing sexual decision-making and psychological adjustment for ethnic men, while being sensitive to CSA histories and sexual minority status, and suggest the need to develop additional strategies to heighten HIV risk reduction over time.     

Childhood physical and sexual abuse experiences associated with post-traumatic stress disorder among pregnant women

PurposeWe sought to evaluate the extent to which childhood physical and/or sexual abuse history is associated with post-traumatic stress disorder (PTSD) during early pregnancy and to explore the extent to which the childhood abuse-PTSD association is mediated through, or modified by, adult experiences of intimate partner violence (IPV).MethodsIn-person interviews collected information regarding history of childhood abuse and IPV from 2,928 women aged 18-49 years old prior to 16 weeks of gestation. PTSD was assessed using the PTSD Checklist-Civilian Version. Multivariate logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsCompared to women with no childhood abuse, the odds of PTSD were increased 4.31-fold for those who reported physical abuse only (95% CI, 2.18–8.49), 5.33-fold for sexual abuse only (95% CI, 2.38–11.98), and 8.03-fold for those who reported physical and sexual abuse (95% CI, 4.10–15.74). Mediation analysis showed 13% of the childhood abuse-PTSD association was mediated by IPV. Furthermore, high odds of PTSD were noted among women with histories of childhood abuse and IPV compared with women who were not exposed to either (OR = 20.20; 95% CI, 8.18–49.85).ConclusionsChildhood abuse is associated with increased odds of PTSD during early pregnancy. The odds of PTSD were particularly elevated among women with a history of childhood abuse and IPV. Efforts should be made to prevent childhood abuse and mitigate its effects on women's mental health.