儿童身体虐待的代际连续性:证据有多好?
I O Ertem1, J M Leventhal, S Dobbs
1Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA. ertem@dialup.ankara.edu.tr
Lancet (London, England)
|October 7, 2000
概括
童年身体虐待可能会增加下一代遭受虐待的风险. 然而,大多数研究都缺乏严格的方法,这使人们对儿童身体虐待的代际传播产生了怀疑.
科学领域:
- 公共卫生 公共卫生
- 儿童发展 儿童发展
- 心理学 心理学 心理学
背景情况:
- 一个普遍的信念表明,童年身体虐待增加了虐待自己的孩子的可能性.
- 支持这种儿童身体虐待的代际传播的经验证据尚未得到系统审查.
- 现有研究往往缺乏方法严格性,需要对其设计进行批判性评估.
研究的目的:
- 系统地评估研究儿童身体虐待的代际传播的研究方法质量.
- 评估研究设计与来自假设随机对照试验的八个方法标准.
主要方法:
- 对1965年至2000年间以英语出版的研究进行了系统审查.
- 包括的研究报告了两代人的身体虐待,并设置了一个对照组.
- 两个独立的研究人员评估了每个研究的遵守八个预定义的方法标准.
主要成果:
- 确定了十项研究 (四个队列,一个横截面,五个病例控制).
- 四项研究显示,在有虐待史的父母中,虐待儿童的相对风险 (4.75-37.8) 显著增加.
- 然而,方法上的缺陷普遍存在:五项研究具有回忆/检测偏差,五项缺乏适当的对照组,八项没有充分的随访,六项研究没有证实父母对虐待的责任. 大多数研究都未能控制混的社会人口统计学因素.
结论:
- 只有一个符合所有八个方法标准的研究提供了强有力的证据,证明了儿童身体虐待的代际连续性 (相对风险12.6).
- 另一项符合六个标准的研究不支持这一假设 (相对风险1.05).
- 拟议的模型和方法标准可以提高未来关于代际不良结果风险因素的研究的科学质量.
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