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Cinsel istismar maðduru olan çocuklarýn baþvuru þekilleri, klinik ve sosyodemografik özellikleri

Yıl 2010, Cilt: 17 Sayı: 4, 15 - 21, 30.12.2010

Zeynep Göker Evrim Aktepe Selma Tural Hesapcıoğlu Sema Kandil

Öz

Objective: The aim of this study is to present childhood sexual abuse (CSA) cases seen at our department and to assess the referral types and their clinic and sociodemographic features of these cases. Method: The clinical charts of all the patients seen at the Department of Child and Adolescent Psychiatry, Karadeniz Technical University Faculty of Medicine between 2005 and 2007 were screened retrospectively. Sociodemographic and clinical data of sexually abused children were analyzed. Results: Over a two-year period, patients who were referred to the Department of Child and Adolescent Psychiatry, Karadeniz Technical University Faculty of Medicine, 1.3% of those was CSA related. The mean age of the 62 cases was 10.8 ( 3.1 SD) years. Most of the victims were girls (69.4%, n=43). Sixty six and one percent (n=41) CSA cases were referred by the legal authorities, 29.1% (n=18) of patients were referred for psychiatric assessment and help because sexually abused, and 4.8% (n=3) of patients were referred for other psychiatric problems. Sixty six and seven percent (n=12) of CSA cases who referred for psychiatric assessment and want to help because sexually abused, were referred with her or him mother to our department. The offenders were generally an extra-familial acquaintance (82.3%, n=51). Incest cases were 9.7% (n=6) of all the CSA cases observed. Eighty five and five percent (n=53) of CSA cases had a psychiatric disorder. The most determined of psychiatric disorder was the post traumatic stress disorder (37.1%, n=23). Conclusion: Results is attributed raising of knowledge about childhood sexual abuse. Roughly two-thirds of cases in our study, is referred by legal ways. Whereas, approximately one-third cases, is referred to help because sexually abused, and the majority of them was attended by their mother. Individual, familial and cultural issues are effected real numbers of sexually abused children. This results show that some of the mothers with sexually abused children were seeking for cure by coming to child psychiatrist before legal process. Also, in this study, 16% of sexually abused children had mental retardation. It is important that is define risky groups and take preventive

measures for CSA by the professional.

Anahtar Kelimeler

Sexual abuse child adolescent referral types

Kaynakça

  • Aktepe E. Çocukluk çaðý cinsel istismarý. Psikiyatride Güncel Yaklaþýmlar. 2009;1:95-119.
  • Child sexual abuse. Facts for families. J Am Acad Child Adolesc Psychiatry, No:9, May 2008. http://www.aacap.org/cs/root/facts_for_families/child_ sexual_abuse.
  • Oral R, Can D, Kaplan S, Polat S, Ates N, Cetin G, Miral S, Hanci H, Ersahin Y, Tepeli N, Bulguc G, Tiras B. Child abuse in Turkey: an experience in overcoming denial and a description of 50 cases. Child Abuse Negl. 2001;25(2):279-290.
  • Koten Y, Tuðlu C, Abay E. Üniversite öðrencileri arasýnda ensest bildirimi. XXXII. Ulusal Psikiyatri Kongresi, 25-28 Eylül 1996 Ankara, Türkiye. Kongre Özet Kitabý sayfa:154.
  • Zoroðlu SS, Tüzün U, ?ar V, Öztürk O, Kara ME, Alyanak B. Çocukluk döneminde ihmal ve istismarýn olasý sonuçlarýnýn incelenmesi. Anadolu Psikiyatri Dergisi 2001;2:69-78.
  • Tahiroðlu AY, Avcý A, Çekin N. Çocuk istismarý, ruh saðlýðý ve adli bildirim zorunluluðu. Anadolu Psikiyatri Dergisi 2008;9:1-7.
  • Finkelhor D, Wolak J, Berliner L. Police reporting and professional help seeking for child crime victims: A review. Child Maltreat. 2001;6(1):17-30.
  • Freidrich WN, Fisher J, Dittner C, Acton R, Berliner L, Butler J et al. Child sexual behavior inventory: normative, psychiatric and sexual abuse comparisons. Child Maltreatment 2001;6:347-349.
  • Glaser D. Child Sexual Abuse. In: Rutter M, Taylor T, eds. Child and Adolescent Psychiatry, 4nd ed., Massachusetts, Blackwell Publishing Company. 2002; 340- 358.
  • Alaggia R. Many ways of telling: expanding conceptualizations of child sexual abuse disclosure. Child Abuse Negl. 2004;28(11):1213-1227.
  • Lovett BB. Child Sexual Abuse Disclosure: Maternal Response and other Variables Impacting the Victim. Child and Adolescent Social Work Journal. 2004;21(4):355-371.
  • Cengel-Kültür E, Cuhadaroðlu-Cetin F, Gökler B. Demographic and clinical features of child abuse and neglect cases. Turkish J Pediatr. 2007;49(3):256-262.
  • Amerikan Psikiyatri Birliði: Ruhsal Bozukluklarýn Tanýsal ve Sayýmsal El Kitabý, Dördüncü Baský, Yeniden Gözden Geçirilmiþ Tam Metin (DSM-IV-TR), Amerikan Psikiyatri Birliði, Washington DC, 2000, Köroðlu E (çeviri ed.), Hekimler Yayýn Birliði, Ankara, 2007.
  • Özen NE, Þener Þ. Çocuk ve ergende cinsel istismar. Ege Psikiyatri Sürekli Yayýnlarý 1997; 2:473-491.
  • Akbaþ S, Turla A, Karabekiroðlu K, Senses A, Karakurt MN, Taþdemir GN ve ark. Cinsel istismara uðramýþ çocuklar. Adli Bilimler Dergisi 2009; 8:24-32.
  • Bahali K, Akçan R, Tahiroglu AY, Avci A. Child sexual abuse: Seven years in practice. J Forensic Sci. 2010;55(3):633-636.
  • Pereda N, Guilera G, Forns M, Gomez-Benito J. The international epidemiology of child sexual abuse: a continuation of Finkelhor. Child Abuse Negl 2009; 33:331-342.
  • DeVoe ER, Coulborn-Faller K. The characteristics of disclosure among children who may have been sexually abused. Child Maltreat. 1999;4(3):217-227.
  • Gries LT, Goh DS, Cavanaugh J. Factors associated with disclosure during child sexual abuse assessment. J Child Sex Abuse. 1996;5(3):1-20.
  • Lamb S, Edgar-Smith S. Aspects of disclosure: Mediators of outcome of childhood sexual abuse. J Interpers Violence. 1994;9(3):307-326.
  • Walrath C, Ybarra M, Holden EW. Children with reported histories of sexual abuse: Utilizing multiple perspectives to understand clinical and psychosocial profiles. Child Abuse Negl. 2003;27(5):509-524.
  • Pinera-Lucatero AG, Trujillo-Hernandez B, Millan- Guerrero RO, Vasquez C. Prevalence of childhood sexual abuse among Mexican adolescents. Child Care Health Dev 2008; 35:184-189.
  • Nickel MK, Tritt K, Mitterlehner FO, Leiberich P, Nickel C, Lahmann C et al. Sexual abuse in childhood and youth as psychopathology relevant life occurrence: cross-sectional survey. Croat Med J 2004; 45:483-489.
  • Syengo-Mutisya CM, Kathuku DM, Ndetei DM. Psychiatric morbidity among sexually abused children and adolescents. East Afr Med J 2008; 85:85-91.
  • Kaplan SJ, Pelcovitz D, Labruna V. Child and adolescent abuse and neglect research: a review of the past 10 years. Part I: Physical and emotional abuse and neglect. J Am Acad Child Adolesc Psychiatry.1999;38(10):1214-1222.
  • Webster RE. Symptoms and long-term outcomes for children who have been sexually assaulted. Psychol Schs.2001;38(6): 533-547.
  • Abramowitz JS, Talin DF, Street GP. Paradoxical effects of thought supression: a meta-analysis of controlled studies. Clin Psychol Rev 2001;21:683-703.
  • Hibbard RA, Zollinger TW. Medical evaluation referral patterns for sexual abuse victims. Child Abuse Negl.1992;16(4):533-540.

Cinsel istismar maðduru olan çocuklarýn baþvuru þekilleri, klinik ve sosyodemografik özellikleri

Yıl 2010, Cilt: 17 Sayı: 4, 15 - 21, 30.12.2010

Zeynep Göker Evrim Aktepe Selma Tural Hesapcıoğlu Sema Kandil

Öz

Amaç: Bu çalışmada cinsel istismar mağduru olan çocuk ve ergenlerin klinik ve sosyodemografik özelliklerini, bölümümüze başvuru şekillerini saptamak amaçlandı.
Yöntem: Karadeniz Teknik Üniversitesi Tıp Fakültesi Çocuk-Ergen Ruh Sağlığı ve Hastalıkları Anabilim Dalına 2005 ve 2007 yılları arasındaki süre içinde başvurmuş olan çocuk-ergenlerin kişisel kartları geriye dönük incelendi. Cinsel istismar olgusu olarak değerlendirilen çocukların sosyodemografik ve klinik bilgileri toplanarak analiz edildi.
Sonuçlar: İki yıllık süreçte polikliniğimize başvuran cinsel istismar olgularının yüzdesi %1.3'dür. Toplam 62 olgunun yaş ortalaması 10.8 yaştır. Mağdurların %69.4'ü (n=43) kızdır. Olguların %66.1'i (n=41) adli olarak, %29.1'i (n=18) cinsel istismar nedeniyle yardım almak için, %4.8'i (n=3) psikiyatrik belirtileri nedeniyle polikiliniğimize başvurmuşlardır. İstismar yakınması olarak başvuran olguların %66.7'sinin (n=12) anneleri tarafından polikliniğe başvurdukları saptanmıştır. Suçluların çoğunun aile dışındaki kişilerden oluştuğu belirlenmiştir (%82.3, n=51). Tüm olguların %9.7'si (n=6) ensest mağdurudur. Olguların %85.5'i (n=53) psikiyatrik tanı almıştır. En sık saptanan psikiyatrik tanı travma sonrası stres bozukluğudur (%37.1, n=23).
Tartışma: Çalışmamızda saptanan bulgular, çocuk cinsel istismarının özellikleri ile ilgili bilgilerimizi arttırıcı niteliktedir. Cinsel istismarda bildirimde bulunulmamış olguların sayısal boyutu ürkütücü düzeyde olup çalışmamızdaki olguların çoğunluğu adli makamlara intikal etmiş olgulardır. Çalışmamızda ayrıca istismar edilen vakaların %16'sı mental retarde bireylerdir. Konuyla ilgili profesyonellerin riskli grupların tanımlanması ve koruyucu önlemlerin alınabilmesi için yol gösterici olacak çalışmalara yer vermeleri önemli olacaktır. Çalışmamızın sonuçları, mağdurların durumlarının anneleri tarafından değerlendirilip olayın adli boyutundan önce çocuk psikiyatristlerinden yardım arayışına girdiklerini de göstermektedir.
Anahtar kelimeler: Cinsel istismar, çocuk, ergen, başvuru şekilleri.
ABSTRACT
Objective: The aim of this study is to present childhood sexual abuse (CSA) cases seen at our department and to assess the referral types and their clinic and sociodemographic features of these cases.
Method: The clinical charts of all the patients seen at the Department of Child and Adolescent Psychiatry, Karadeniz Technical University Faculty of Medicine between 2005 and 2007 were screened retrospectively. Sociodemographic and clinical data of sexually abused children were analyzed.
Results: Over a two-year period, patients who were referred to the Department of Child and Adolescent Psychiatry, Karadeniz Technical University Faculty of Medicine, 1.3% of those was CSA related. The mean age of the 62 cases was 10.8 years. Most of the victims were girls (69.4%, n=43). Sixty six and one percent (n=41) CSA cases were referred by the legal authorities, 29.1% (n=18) of patients were referred for psychiatric assessment and help because sexually abused, and 4.8% (n=3) of patients were referred for other psychiatric problems. Sixty six and seven percent (n=12) of CSA cases who referred for psychiatric assessment and help because sexually abused, were referred with her or him mother to our department. The offenders were generally an extra-familial acquaintance (82.3%, n=51). Incest cases were 9.7% (n=6) of all the CSA cases observed. Eighty five and five percent (n=53) of CSA cases had a psychiatric disorder. The most determined of psychiatric disorder was the post traumatic stress disorder (37.1%, n=23).
Conclusion: Results is attributed raising of knowledge about childhood sexual abuse. The numbers of sexually abused chidren which unannounced is very forbidding and, in our study, the most cases is referred by legal ways. In this study, 16% of sexually abused children had mental retardation, also. It is important that is define risky groups and take preventive measures for CSA by the professional. This results show that some of the mothers with sexually abused children were seeking for cure by coming to child psychiatrist before legal process.
Key words: Sexual abuse, child, adolescent, referral types.

Anahtar Kelimeler

Cinsel istismar çocuk ergen baþvuru þekilleri

Kaynakça

  • Aktepe E. Çocukluk çaðý cinsel istismarý. Psikiyatride Güncel Yaklaþýmlar. 2009;1:95-119.
  • Child sexual abuse. Facts for families. J Am Acad Child Adolesc Psychiatry, No:9, May 2008. http://www.aacap.org/cs/root/facts_for_families/child_ sexual_abuse.
  • Oral R, Can D, Kaplan S, Polat S, Ates N, Cetin G, Miral S, Hanci H, Ersahin Y, Tepeli N, Bulguc G, Tiras B. Child abuse in Turkey: an experience in overcoming denial and a description of 50 cases. Child Abuse Negl. 2001;25(2):279-290.
  • Koten Y, Tuðlu C, Abay E. Üniversite öðrencileri arasýnda ensest bildirimi. XXXII. Ulusal Psikiyatri Kongresi, 25-28 Eylül 1996 Ankara, Türkiye. Kongre Özet Kitabý sayfa:154.
  • Zoroðlu SS, Tüzün U, ?ar V, Öztürk O, Kara ME, Alyanak B. Çocukluk döneminde ihmal ve istismarýn olasý sonuçlarýnýn incelenmesi. Anadolu Psikiyatri Dergisi 2001;2:69-78.
  • Tahiroðlu AY, Avcý A, Çekin N. Çocuk istismarý, ruh saðlýðý ve adli bildirim zorunluluðu. Anadolu Psikiyatri Dergisi 2008;9:1-7.
  • Finkelhor D, Wolak J, Berliner L. Police reporting and professional help seeking for child crime victims: A review. Child Maltreat. 2001;6(1):17-30.
  • Freidrich WN, Fisher J, Dittner C, Acton R, Berliner L, Butler J et al. Child sexual behavior inventory: normative, psychiatric and sexual abuse comparisons. Child Maltreatment 2001;6:347-349.
  • Glaser D. Child Sexual Abuse. In: Rutter M, Taylor T, eds. Child and Adolescent Psychiatry, 4nd ed., Massachusetts, Blackwell Publishing Company. 2002; 340- 358.
  • Alaggia R. Many ways of telling: expanding conceptualizations of child sexual abuse disclosure. Child Abuse Negl. 2004;28(11):1213-1227.
  • Lovett BB. Child Sexual Abuse Disclosure: Maternal Response and other Variables Impacting the Victim. Child and Adolescent Social Work Journal. 2004;21(4):355-371.
  • Cengel-Kültür E, Cuhadaroðlu-Cetin F, Gökler B. Demographic and clinical features of child abuse and neglect cases. Turkish J Pediatr. 2007;49(3):256-262.
  • Amerikan Psikiyatri Birliði: Ruhsal Bozukluklarýn Tanýsal ve Sayýmsal El Kitabý, Dördüncü Baský, Yeniden Gözden Geçirilmiþ Tam Metin (DSM-IV-TR), Amerikan Psikiyatri Birliði, Washington DC, 2000, Köroðlu E (çeviri ed.), Hekimler Yayýn Birliði, Ankara, 2007.
  • Özen NE, Þener Þ. Çocuk ve ergende cinsel istismar. Ege Psikiyatri Sürekli Yayýnlarý 1997; 2:473-491.
  • Akbaþ S, Turla A, Karabekiroðlu K, Senses A, Karakurt MN, Taþdemir GN ve ark. Cinsel istismara uðramýþ çocuklar. Adli Bilimler Dergisi 2009; 8:24-32.
  • Bahali K, Akçan R, Tahiroglu AY, Avci A. Child sexual abuse: Seven years in practice. J Forensic Sci. 2010;55(3):633-636.
  • Pereda N, Guilera G, Forns M, Gomez-Benito J. The international epidemiology of child sexual abuse: a continuation of Finkelhor. Child Abuse Negl 2009; 33:331-342.
  • DeVoe ER, Coulborn-Faller K. The characteristics of disclosure among children who may have been sexually abused. Child Maltreat. 1999;4(3):217-227.
  • Gries LT, Goh DS, Cavanaugh J. Factors associated with disclosure during child sexual abuse assessment. J Child Sex Abuse. 1996;5(3):1-20.
  • Lamb S, Edgar-Smith S. Aspects of disclosure: Mediators of outcome of childhood sexual abuse. J Interpers Violence. 1994;9(3):307-326.
  • Walrath C, Ybarra M, Holden EW. Children with reported histories of sexual abuse: Utilizing multiple perspectives to understand clinical and psychosocial profiles. Child Abuse Negl. 2003;27(5):509-524.
  • Pinera-Lucatero AG, Trujillo-Hernandez B, Millan- Guerrero RO, Vasquez C. Prevalence of childhood sexual abuse among Mexican adolescents. Child Care Health Dev 2008; 35:184-189.
  • Nickel MK, Tritt K, Mitterlehner FO, Leiberich P, Nickel C, Lahmann C et al. Sexual abuse in childhood and youth as psychopathology relevant life occurrence: cross-sectional survey. Croat Med J 2004; 45:483-489.
  • Syengo-Mutisya CM, Kathuku DM, Ndetei DM. Psychiatric morbidity among sexually abused children and adolescents. East Afr Med J 2008; 85:85-91.
  • Kaplan SJ, Pelcovitz D, Labruna V. Child and adolescent abuse and neglect research: a review of the past 10 years. Part I: Physical and emotional abuse and neglect. J Am Acad Child Adolesc Psychiatry.1999;38(10):1214-1222.
  • Webster RE. Symptoms and long-term outcomes for children who have been sexually assaulted. Psychol Schs.2001;38(6): 533-547.
  • Abramowitz JS, Talin DF, Street GP. Paradoxical effects of thought supression: a meta-analysis of controlled studies. Clin Psychol Rev 2001;21:683-703.
  • Hibbard RA, Zollinger TW. Medical evaluation referral patterns for sexual abuse victims. Child Abuse Negl.1992;16(4):533-540.
Toplam 28 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Diş Hekimliği
Bölüm Araştırma Makaleleri
Yazarlar

Zeynep Göker Bu kişi benim

Evrim Aktepe

Selma Tural Hesapcıoğlu

Sema Kandil Bu kişi benim

Yayımlanma Tarihi 30 Aralık 2010
Gönderilme Tarihi 25 Haziran 2010
Yayımlandığı Sayı Yıl 2010 Cilt: 17 Sayı: 4

Kaynak Göster

Vancouver Göker Z, Aktepe E, Tural Hesapcıoğlu S, Kandil S. Cinsel istismar maðduru olan çocuklarýn baþvuru þekilleri, klinik ve sosyodemografik özellikleri. SDÜ Tıp Fak Derg. 2010;17(4):15-21.

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