儿童虐待和夫妻性健康：一项系统评价

Child Maltreatment and Couples’ Sexual Health: A Systematic Review

——原载美国《性医学评论》2022年第10卷第4期——

USA <Sexual Medicine Reviews> 2022, 10 (4)

【关键词】儿童虐待，儿童性虐待，夫妻，性健康

[Abstract] Introduction: Childhood maltreatment (CM) is an interpersonal trauma reported by 35% to 40% of individuals in population-based studies in North America. It refers to physical, sexual, and emotional abuse, as well as physical and emotional neglect. Although there is a growing body of cross-sectional work focusing on associations between CM and sexual health, most studies have ignored the broader relationship context in which sexuality is experienced. Objectives: The current review sought to systematically and critically appraise all studies that reported on the association between CM and couples’ sexual health, to inform clinical care and recommendations for research. Methods: The electronic literature search was conducted using PubMed, PsycNET (PsycINFO, PsychArticles), Medline, CINAHL, and Eric for peer-reviewed journal articles published before September 2021. Eligible studies had to report on the association between any form of CM and any dimension of sexual health in couples or individuals in a romantic relationship. Results: In total, 13 studies (18 articles) were included in this systematic review: 4 studies pertained to clinical couples and 9, to community couples; 2 studies used a longitudinal design and 11, a cross-sectional design; 3 studies examined CM as a whole, 2 studies examined multiple subtypes of CM separately, 1 study examined both CM as a whole and its subtypes separately, whereas the other 7 studies focused on childhood sexual abuse. Results indicated that studies using valid measures of sexual health outcomes found significant associations between CM and worse outcomes – including declines over time – in both clinical and community samples. Mediators and moderators of these associations were also identified. Conclusions: Findings provide preliminary support for the role of CM in couples’ sexual health. There is a need for future longitudinal studies involving both members of the couple, valid and multidimensional measures of sexual health, and potential mediators and moderators.