Behavioral assessment of child sexual abuse victims attending a child psychiatry clinic in Samsun/Turkey after a traumatic event

摘要

Objective: Child Sexual Abuse(CSA), which damages psychological and physical health and has negative effects on development, is a serious public health problem in the world. Several studies have shown that a number of psychiatric disorders may develop, such as behavioral problems, compromised interpersonal relations, sexually oriented behavior, engagement in high-risk activities, substance dependence, suicidal thoughts or behavior, personality disorders, depression, dissociation, and post-traumatic stress disorder (PTSD).Thus, there is strong evidence that CSA-related PTSD have a profound and often lasting impact that can encompass psychological health, neurobiological development, relational skills, and risk behaviors. In this study, we aimed to extend our understanding of consequences of sexual traumas and trauma-related emotional and behavioral problems with a detailed psychiatric examination and assessment with Youth Self-Report (YSR) of CSA victims after a traumatic event. Method: Victims said by judicial authorities to have been subjected to sexual abuse are referred to the Ondokuzmayis University Faculty of Medicine Forensic Medicine Department for examination and reports establish the severity of the physical and psychiatric damage resulting from such sexual abuse. 160 cases under the age of 18, referred for this purpose from several provinces of Turkey between January 01, 2007 and December 31, 2013, were included in the study and their patient files examined. We used a Turkish version of the Youth Self-Report (YSR) as screening instrument in the first stage. Results: Sociodemographic findings: CSA victims were 15.3±1.9 years old on average, and 87.5% were female. Control subjects were 15.0±1.8 years old on average and 87.0% were female. There was no significant difference regarding age, gender and education. ; YSR findings of the groups: CSA victims compared to the control subjects reported significantly higher problem scores in internalizing problems anxiety/depression, total problems and aggressive behavior subtests. There is no significant correlation between CSA victims age and problem scores and also no significant difference in problem scores between gender groups. Discussion: Child sexual abuse is associated with various psychiatric disorders and life-long behavioral problems. In our study, we found internalizing problems such as anxiety/depression and also aggressive behavior statistically significantly increased. In contrast to the literature, in our study there is no significant correlation between CSA victims’ age and problem scores, and also no significant difference in problem scores between gender groups. Prevalence of psychological pathology was raised in the male gender and when the abuse was recurrent, although the differences were not statistically significant.