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Abstract(s)
Introdução: O abuso sexual infantil trata-se de um grave problema de saúde pública.
Segundo o DSM-5, o abuso sexual infantil inclui qualquer ato envolvendo uma criança
cuja intenção é a obtenção de satisfação sexual por parte dos pais, cuidador, ou outro
indivíduo responsável pela criança. Apresenta consequências a curto e longo prazo,
podendo ter um impacto duradouro na vida da vítima.
Segundo um relatório da OMS, uma em cada oito crianças já sofreu de abuso ou
exploração sexual. Na Europa, de acordo com o Conselho Europeu, uma em cada cinco
crianças é vítima de violência sexual.
Materiais e métodos: A pesquisa bibliográfica foi baseada nas bases de dados Pubmed,
Science Direct, Cochrane Library, Scopus, Psychiatry Online e Access Medicine. Os
artigos selecionados são maioritariamente de revisão, estudos observacionais, relatórios
e guidelines, em inglês, português e espanhol. Foram consultados dois livros e websites.
A pesquisa foi restringida aos últimos 5 anos, incluindo outros artigos menos recentes
sempre que o conteúdo fosse considerado relevante para a compreensão do tema.
Resultados: O abuso sexual ocorrido durante a infância está associado a um aumento de
comorbilidades na idade adulta. Por um lado, relaciona-se com maior prevalência de
patologia orgânica, tornando o indivíduo mais suscetível a infeções recorrentes e,
consequentemente, a desenvolver condições inflamatórias crónicas. A obesidade é mais
prevalente, existe um incremento do risco cardiovascular e a saúde oral pode ser
comprometida.
Por outro lado, as consequências psicológicas são vastas e com grande potencial de afetar
a funcionalidade do indivíduo, ao aumentar a probabilidade de desenvolver uma
perturbação psiquiátrica, como a depressão, perturbações de ansiedade e de stress pós
traumático, e aquando da adoção de comportamentos de coping desadaptativos,
nomeadamente os comportamentos auto lesivos, abuso de álcool e substâncias. Verificase, ainda, uma maior prevalência de pensamentos suicidas e tentativas de suicídio.
A sexualidade pode ser afetada, resultando em disfunção sexual, compulsividade sexual
e comportamentos sexuais de risco.
Por fim, o impacto socioeconómico não deve ser negligenciado, devendo ser reconhecido.
A literatura descreve o declínio da performance académica de sobreviventes, dificuldade
na continuação dos estudos após a conclusão do secundário, decréscimo na remuneração
e aumento das despesas associadas ao tratamento das comorbilidades. Conclusão: O abuso sexual na infância acarreta consequências duradouras, podendo
surgir ou apresentar maior impacto na vida adulta.
Os profissionais de saúde têm um papel fundamental na prevenção e identificação dos
casos de abuso sexual infantil, possuindo a responsabilidade ética e legal de os reportar.
Quanto a intervenções terapêuticas, a terapia cognitivo comportamental demonstra-se a
mais eficaz, podendo recorrer-se a outras opções como terapias baseadas em
mindfulness, escrita expressiva e terapia em grupo.
Investigações futuras acerca deste tema devem ter amostras representativas da
população do género masculino e da comunidade LGBTQIA+ que se encontram sub
representadas na literatura. Apela-se, também, aos investigadores portugueses para
enriquecerem a literatura científica com dados referentes à população portuguesa, dado
a escassez do contributo nacional para a área.
Introduction: Child sexual abuse is a serious public health problem. According to the DSM-5, child sexual abuse includes any act involving a child whose intent is to obtain sexual gratification from the child's parent, caregiver, or other individual responsible for the child. It has short- and long-term consequences and can have a lasting impact on the victim's life. According to a WHO report, one in eight children has suffered from sexual abuse or exploitation. In Europe, according to the European Council, one out of five children is a victim of sexual violence. Materials and methods: The literature search was based on Pubmed, Science Direct, Cochrane Library, Scopus, Psychiatry Online and Access Medicine databases. The articles selected are mostly reviews, observational studies, reports and guidelines, in English, Portuguese and Spanish. A master's thesis was included, two books and websites were consulted. The search was restricted to the last 5 years, including other less recent articles whenever the content was considered relevant in order to understand the topic. Results: Sexual abuse occurring during childhood is associated with an increase in comorbidities in adulthood. On one hand, it’s related to a higher prevalence of organic pathology, making the individual more susceptible to recurrent infections and, consequently, to developing chronic inflammatory conditions. Obesity is more prevalent, there is an increase in cardiovascular risk and oral health can be compromised. On the other hand, the psychological consequences are vast and have great potential to affect the individual's functionality, by increasing the probability of developing a psychiatric disorder, such as depression, anxiety disorders and post-traumatic stress, as well as when adopt behaviors of maladaptive coping, namely self-harm behaviors, alcohol and substance abuse. There is also a higher prevalence of suicidal thoughts and suicide attempts. Sexuality can be affected, resulting in sexual dysfunction, sexual compulsivity and risky sexual behaviors. Finally, the socioeconomic impact must not be neglected and must be recognized. The literature describes the decline in the academic performance of survivors, difficulty in continuing studies after completing high school, a decrease in remuneration and an increase in expenses associated with the treatment of comorbidities. Conclusion: Child sexual abuse has lasting consequences, which may emerge or have a greater impact in adult life. Health professionals have a fundamental role in preventing and identifying cases of child sexual abuse, having the ethical and legal responsibility to report them. As for therapeutic interventions, cognitive behavioral therapy proves to be the most effective, and other options such as therapies based on mindfulness, expressive writing and group therapy can be used. Future studies must have representative samples of the male population and the LGBTQIA+ community, which are underrepresented in the literature. Portuguese researchers are also called upon to enrich the scientific literature with data relating to the Portuguese population, given the scarcity of national contribution to the area.
Introduction: Child sexual abuse is a serious public health problem. According to the DSM-5, child sexual abuse includes any act involving a child whose intent is to obtain sexual gratification from the child's parent, caregiver, or other individual responsible for the child. It has short- and long-term consequences and can have a lasting impact on the victim's life. According to a WHO report, one in eight children has suffered from sexual abuse or exploitation. In Europe, according to the European Council, one out of five children is a victim of sexual violence. Materials and methods: The literature search was based on Pubmed, Science Direct, Cochrane Library, Scopus, Psychiatry Online and Access Medicine databases. The articles selected are mostly reviews, observational studies, reports and guidelines, in English, Portuguese and Spanish. A master's thesis was included, two books and websites were consulted. The search was restricted to the last 5 years, including other less recent articles whenever the content was considered relevant in order to understand the topic. Results: Sexual abuse occurring during childhood is associated with an increase in comorbidities in adulthood. On one hand, it’s related to a higher prevalence of organic pathology, making the individual more susceptible to recurrent infections and, consequently, to developing chronic inflammatory conditions. Obesity is more prevalent, there is an increase in cardiovascular risk and oral health can be compromised. On the other hand, the psychological consequences are vast and have great potential to affect the individual's functionality, by increasing the probability of developing a psychiatric disorder, such as depression, anxiety disorders and post-traumatic stress, as well as when adopt behaviors of maladaptive coping, namely self-harm behaviors, alcohol and substance abuse. There is also a higher prevalence of suicidal thoughts and suicide attempts. Sexuality can be affected, resulting in sexual dysfunction, sexual compulsivity and risky sexual behaviors. Finally, the socioeconomic impact must not be neglected and must be recognized. The literature describes the decline in the academic performance of survivors, difficulty in continuing studies after completing high school, a decrease in remuneration and an increase in expenses associated with the treatment of comorbidities. Conclusion: Child sexual abuse has lasting consequences, which may emerge or have a greater impact in adult life. Health professionals have a fundamental role in preventing and identifying cases of child sexual abuse, having the ethical and legal responsibility to report them. As for therapeutic interventions, cognitive behavioral therapy proves to be the most effective, and other options such as therapies based on mindfulness, expressive writing and group therapy can be used. Future studies must have representative samples of the male population and the LGBTQIA+ community, which are underrepresented in the literature. Portuguese researchers are also called upon to enrich the scientific literature with data relating to the Portuguese population, given the scarcity of national contribution to the area.
Description
Keywords
Abuso Sexual Infância Psicotrauma Saúde Mental Vida Adulta