Evaluation of the psychiatric examination findings of victims decided to have sexual abuse occurred as a result of trial

In the study; it is aimed to examine the personal, environmental, and incident factors that may affect the mental health of the victims of sexual abuse and to discuss the data in the light of the literature. Total 449 (8.7%) cases that were sent with a history of sexual abuse in 5157 cases, which were reported between 2005 and 2012 in the Department of Forensic Medicine, Faculty of Medicine, Düzce University, were examined. Among these cases, 68 (15.1%) cases, which were judged to have committed sexual abuse, were included in the study. Of the cases, 44 (64.7%) were female and 24 (35.3%) were male. In their second mental examination, which was made six months after the date of the incident; there were no psychiatric pictures in 43 (63.2%) cases, Post Traumatic Stress Disorder (PTSD) in 14 (20.6%) cases, depression in three (4.4%) cases, PTSD in three (4.4%) cases, and depression, anxiety disorder in one (1.5%) case, depression, and anxiety disorder in one (1.5%) case. Three (4.4%) cases were referred to another center without a diagnosis. The risk of being affected of mental health in the late period was found increased by 11.32 times in the cases which have psychiatric findings during the first examination, by 12.52 times if the action took place in the form of anal penetration, by 6.9 times if deprived of liberty and by 15.88 times if the attacker was a foreigner. Long-term follow-up of victims of sexual abuse by the psychiatry clinic is important in terms of continuing their normal social life as healthy individuals

___

1. Polat O, Inanıcı MA, Aksoy ME. Sexual Crimes. In; Textbook of Forensic Medicine. First edition. Nobel Medical Bookstore, Istanbul,1997;340-60.

2. Turkish Penal Code No.5237. T.C. Official Newspaper, September 26, 2004; No:25611.

3. Karbeyaz K. “The concept of disorder in body or mental health” in victims of sexual crimes, the effectiveness of forensic reports on this issue on judicial decision. Master thesis, Osmangazi University, Eskisehir, 2009.

4. Law on Amendment of The Turkish Penal Code and Some Laws No.6545. T. C. Official Newspaper, June 28, 2014; No:29044.

5. Banyard VL, Williams LM, Siegel JA. Childhood Sexual abuse: a gender perspective on context and consequences. Child Maltreat. 2004;9:223-38.

6. Martin G, Bergen HA, Richardson AS, et al. Sexual abuse and suicidality: gender differences in a large community sample of adolescents. Child Abuse Negl. 2004;28:491-503.

7. Grossin C, Sibille I, Lorin de la Granmaison G, et. al. Analysis of 418 cases of sexual assault. Forensic Sci Int. 2003;131:125-30.

8. Peterson ZD, Voller EK, Polusny MA, et. al. Prevalence and consequences of adult sexual assault of men: Review of empirical findings and state of the literature. Clin Psychol Rev. 2011;31:1-24.

9. Hapke U, Schumann A, Rumpf H, et. al. Post-traumatic stress disorder: the role of trauma, pre-existing psychiatric disorders, and gender. Eur Arch Psychiatry Clin Neurosci. 2006;256:299-306.

10. Ruch LO, Chandler SM. Sexual assault trauma during the acute phase: An exploratory model and multivariate analysis. J Health Soc Behav. 1983;24:174- 85.

11. Elliott DM, Mok DS, Briere J. Adult sexual assault: Prevalence, symptomatology, and sex differences in the general population. J Trauma Stress 2004;17:203-11.

12. Karakaya I, Coskun A, Agaoğlu B, et. al. Mental evaluation results of cases reported to have been exposed to sexual abuse. Bulletin Forensic Med. 2006;11:53-8.

13. Dogangun B. Psychiatric conditions requiring special education, common psychiatric disorders in Turkey. IU Cerrahpaşa Medical Faculty Continuous Medical Education Activities, Symposium Series, N:62, March 2008;157-74.

14. Aylott J. Preventing rape and sexual assault of people with learning disabilities. Br J Nurs 199921;8:871-6.

15. Korkut S, Tuzun B. Evaluation of incest cases in terms of child’s position and legal rights. J Forensic Med. 2001:15:30-6.

16. Kar H, Gamsız Bilgin N, Dokgoz H, et. al. Forensic psychiatric evaluation of cases of sexual abuse victims with mental retardation. Turkey Clinics J Clin Forensic Med Forensic Sci. 2011;8:1-5.

17. Horozgil D. The simple form of children’s sexual abuse crime (Article 103/1 of the Turkish criminal code). J TBB. 2011;93:108-46.

18. Werner J, Milanez Werner MC. Child sexual abuse in clinical and forensic psychiatry: a review of recent literature. Curr Opin Psychiatry 2008;21:499-504.

19. Cloitre M, Scarvalone P, Difede JA. Posttraumatic stres disorder, self and interpersonal dysfunction among sexually retraumatized women. J Trauma Stress 1997;10:437-52.

20. Colangelo JJ, Keefe-Cooperman K. Understanding the impact of childhood sexual abuse on women’s sexuality, J Ment Health Couns. 2012;34:14-37.

21. Çaylı E. Problems faced at the evaluation of the sexual assault and abuse cases that are nation wide and are observed in the cases which apply to the Forensic Medicine Branch of the Medical Faculty of Süleyman Demirel University in terms of mental health and solution offers (2006-2010). Master thesis, Süleyman Demirel University, Isparta, 2011.

22. Dube SR, Anda RF, Whitfield CL, et. al. Long-term consequences of childhood sexual abuse by gender of victim. Am J Prev Med. 2005;28:430-8.

23. Baytunca MB, Ata E, Ozbaran B, et. al. Childhood sexual abuse and supportive factors. Pediatr Int. 2017;59:10-15.

24. Leserman J. Sexual Abuse History: Prevalence, Health Effects, Mediators, and Psychological Treatment. Psychosom Med Nov-Dec. 2005;67:906-15.

25. Topal Ş, Küçük YE. Aile İçi şiddet ve i̇slam hukukundaki önleyici tedbirler. Recep Tayyip Erdoğan Üniversitesi İlahiyat Fakültesi Dergisi. 2012;:11-41.

26. Kilpatrick DG, Saunders BE, Smith DW. Youth victimization: prevalence and implications. washington DC: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice; 2003.

27. Tutar Güven Ş, İşler Dalgiç A, Erkol Z. Emotional and psychosocial problems encountered by children who have been sexually abused. J Psychosoc Nurs Ment Health Serv. 2018;56:37-43.

28. Morais HB, Alexander AA, Fix RL, et. al. Childhood sexual abuse in adolescents adjudicated for sexual offenses: mental health consequences and sexual offending behaviors. Sex Abuse. 2018;30:23-42.

29. Hofmann A. Psychotraumatologie–der Standdes Wissensunddie Versorgungslage. Psychotherapie im Dialog. 2006;4:351-7.

30. Kaya B, Travma Sonrası Stres Bozukluğunda Komorbidite. Psikiyatri Dünyası 2000;4:37-43.

31. Polat O. Child sexual abuse. In: Forensic Medicine. First edition, Der Publication, Istanbul, 2000;207-31.

32. Celal Butun, Ali Yildirim, Erdal Ozer, et. al. A Nonrandom Sample of 55 Sexual Abuse Cases in Sivas. Med Sci Monit. 2017;23:4360-5.

33. Campbell R, Dworkin E, Cabral G. An ecological model of the impact of sexual assault on women’s mental health. Trauma, Violence Abuse 2009;10:225-46.

34. Eckert OL, Sugar N, Fine D. Characteristics of sexual assault in women with a major psychiatric diagnosis. Am J Obstet Gynecol. 2002;186:1284-91.

35. Ullman SE, Filipas HH. Predictors of PTSD symptom severity and social reactions in sexual assault victims. J Trauma Stress 2001;14:369-89.

36. Ellis EM, Atkeson BM, Calhoun KS. An assessment of long-term reaction to rape. J Abnorm Psychol. 1981;90:263-6.

37. Girdler SS, Klatzkin R. Neurosteroids in the context of stress: Implications for depressive disorders. Pharmacol Ther. 2007;116:125-39.

38. Zhang L, Zhou R, Xing G, et. al. Identification of gene markers based on well validated and subcategorized stressed animals for potential clinical applications in PTSD. Med Hypotheses. 2006;66:309-14.

39. Marshall RD, Garakani A. Psycho biology of the acute stress response and its relationship to the psychobiology of post-traumatic stress disorder. Psychiatr Clin North Am. 2002;25:385-95.

40. Heim C, Ehlert U, Hanker JP, et. al. Abuse-related posttraumatic stress disorder and alterations of the hypothalamic-pituitary-adrenal axis in women with chronic pelvic pain. Psychosom Med. 1998;60:309-18.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )