ÇİĞDEM YEKTAŞ, Ali Evren TUFAN, BORA BÜKEN, NİHAL YURTERİ ÇETİN, Merve YAZICI

Cinsel istismar mağduru çocuk ve ergenlerde istismar ve istismarcıya ilişkin özelliklerin ve psikopataloji ile ilişkili risk etkenlerinin değerlendirilmesi

Amaç: Bu çalışmada, bir çocuk ve ergen ruh sağlığı ve hastalıkları kliniğine adli mercilerce yönlendirilen istismar mağduru çocuk ve ergen olguların sosyodemografik özelliklerinin, istismar ve istismarcıların niteliğinin ve istismar sonrası klinik tanılarının değerlendirilmesi ile psikopatoloji gelişimini yordayan etkenlerin belirlenmesi amaçlan-mıştır. Yöntem: Adli mercilerce yönlendirilen 3-18 yaşları arasındaki 106 çocuk ve ergenin (83 kız, 23 erkek) sosyo-demografik ve klinik bilgileri dosyaları ve adli raporları incelenerek geriye dönük olarak değerlendirilmiştir. Bulgular: Örneklemin %63.2’si ergenlik dönemindeki kızlardan oluşuyordu. En sık bildirilen cinsel istismar tipi cinsel uyarılma için bedene dokunmaydı (%47.2). Çocukların %10.4’ünün birden fazla yolla cinsel istismara uğradığı belirlendi. Olguların %32.1’i cinsel istismar sırasında fiziksel şiddet görmüştü. Örneklemin %17.0’si başka istismar türlerine de uğramıştı. Tüm örneklemde yineleyen cinsel istismar oranı %69.8 olarak saptandı. Cinsel istismar edilen olgula-rın %50.0’ının aile içinde farklı tipte istismarlara da uğradığı bildiriliyordu. Cinsel istismara maruz kalan çocuklara en sık konulan klinik tanılar sırasıyla travma sonrası stres bozukluğu (%24.5), uyum bozukluğu (%16.0) ve akut stres bozu kluğu (%11.3) oldu. Sonuç: Çalışmamızdaki olguların önemli bir bölümünün kızlardan oluşması kız çocukların daha fazla istismara maruz kaldığı bilgisini desteklemektedir. İstismarcıların hepsi erkek cinsiyette olup çoğunlukla çocuğun tanıdığı kişilerdir. Zeka geriliği olan ve istismar sırasında fiziksel şiddet gören çocuk ve ergen-lerde ruhsal sorun gelişme riski daha yüksek bulunmuştur. (Anadolu Psikiyatri Derg 2018; 19(5):501-508)

Evaluation of abuse and abuser’s features and risk factors associated with psychopathology in children and adolescents victimized by sexual abuse

Objective: The aim of this study to determine sociodemographic variables, characteristics of abuses and abusers, clinical diagnosis after abuse and factors associated with the psychopathology of sexually abused children and adolescents who referred to the department of child and adolescent psychiatry with the request of criminal report. Methods: Sexually abused 106 children and adolescents (83 girls and 23 boys) aged 3-18 years who referred for criminal reports were evaluated. Case files and criminal reports were examined retrospectively. Results: Great majority of the group was consisted of adolescent girls (63.2%). Touching to the body for sexual arousal was the most reported type of the sexual abuse (47.2%). 10.4% of the children reported multiway abuse. 32.1% of the cases experienced physical violence during sexual abuse. Other victims were also present in 17.0% (n=18) of the sample. Recurrent sexual abuse was found in 69.8% of cases. 50.0% of sexually abused cases were also exposed to different types of abuse within the family. The most common clinical diagnoses were post-traumatic stress disorder (24. 5%) adjustment disorder (16.0%) and acute stress disorder (11.3%). Conclusion: Consistent with the literature, our finding, in which a significant proporiton of the cases were girls, shows that the girls are exposed to the sexual abuse more than boys. All abusers are male who were mostly familiar to the victims. Children and adolescents with mental retardation and experienced physical violence during abuse had a higher risk of developing psycho-pathology. (Anatolian Journal of Psychiatry 2018; 19(5):501-508)

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