作者：鄭詩穎、沈瓊桃、黃菁瑜、馮瑞鶯、謝意苹、魏希聖、華筱玲
題目：Forms and contexts of child sexual abuse in Taiwan: Associations with adverse childhood experiences, mental health outcomes, and revictimization.
摘要：
Child sexual abuse (CSA) in non-Western contexts remains understudied, particularly with respect to how different forms and perpetrator–victim relationships are connected to other adverse childhood experiences (ACEs) and how they shape mental health and revictimization risk over time. This study examines the prevalence of CSA among Taiwanese children and its associations with other ACEs, psychiatric symptoms, and subsequent revictimization, with attention to both the form of sexual abuse and the perpetrator–victim relationship. Data were drawn from a nationally representative, longitudinal survey of children in the 4th and 8th grades (n = 2,599). CSA was assessed across contact (unwanted sexual touching or being forced to touch another person’s private parts) and non-contact forms (forced exposure to sexual images or videos), as well as by perpetrator relationship (parent/caregiver, sibling, or peer). Results indicated that 9.81% of 4th-grade children reported experiencing at least one form of CSA in the past 12 months. Distinct ACEs were differentially associated with specific CSA forms and perpetrator relationships, revealing patterned pathways of interpersonal risk. Parental physical violence was associated with a higher likelihood of parent/caregiver-facilitated CSA, whereas parental psychological neglect and bullying victimization were linked to increased risk of peer-facilitated CSA. All forms of CSA were associated with elevated concurrent psychiatric symptoms. Longitudinal analyses further demonstrated that sibling- and peer-facilitated contact CSA predicted greater psychiatric symptoms four years later. Additionally, parent/caregiver- and sibling-facilitated non-contact CSA, as well as peer-facilitated contact CSA, were associated with increased risk of revictimization at follow-up. These findings highlight the importance of distinguishing CSA by both form and perpetrator relationship to better understand the interpersonal contexts in which sexual abuse occurs and its lasting consequences. Implications for targeted prevention, early identification, and intervention strategies are discussed.
主要發現：9.81%的四年級兒童表示，在過去12個月內曾經歷至少一種形式的兒童性虐待。父母身體虐待與遭受父母／照顧者施加之性虐待的風險增加有關；而父母心理忽視及霸凌受害，則與遭受同儕施加之性虐待的風險增加有關。所有形式的性虐待皆與較嚴重的精神症狀相關。此外，由手足與同儕施加的接觸型性虐待，可預測四年後較嚴重的精神症狀。另一方面，由父母／照顧者與手足施加的非接觸型性虐待，以及由同儕施加的接觸型性虐待，皆與後續再度受害風險增加有關。
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