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Órgano Oficial del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz

2001, Number 6

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Salud Mental 2001; 24 (6)

El abuso sexual y el intento suicida asociados con el malestar depresivo y la ideación suicida de los adolescentes

González-Forteza C, Ramos LL, Vignau BLE, Ramírez VC

Language: Spanish
References: 103
Page: 16-25
PDF size: 313.27 Kb.


ABSTRACT

Recent studies have showed that suicide behavior is present in students of junior and senior high school. In Mexico City, a prevalence of 4.3% in men and 12.1% in women has been reported. The motivations for suicide attempt are multiple, and sexual abuse has been recognized as one of them. This problem has been scarcely documented in students in our country. Nevertheless, a prevalence of 4.3% has been found in junior and senior high school students of both sexes. The present paper explores the association between suicide attempt and sexual abuse, and the impact that these problems can cause in the current mental health of the students, particularly in terms of depression and suicide ideation. The objective is to identify in a population of two junior high schools in the downtown area of Mexico City: 1) the frequency of sexual abuse and suicide attempt experienced once in a lifetime; 2) the frequency of current depression and suicide ideation; 3) the association between sexual abuse and suicide attempt with current depression and suicide ideation; and 4) the frequency of current depression and suicide ideation in students that reported sexual abuse or suicide attempt. A total of 936 students participated: 54% men and 46% women, with a mean age of 13.7 years. A survey was performed with the permission of the Ministry of Education and the school authorities. The instrument was self-administered. The participation was voluntary, and confidentiality and anonymity were assured. The results show that 7% of the women and 2% of the men had experienced sexual abuse, and that 11% of the women and 4% of the men had attempted to commit suicide. Among the male population, there were no cases of sexual abuse nor suicide attempt; but among the female population, from 49 girls that had attempted to commit suicide, 12% had also been victims of sexual abuse. Most of the cases reported that sexual abuse was experienced when they were around 10 years old and the suicide attempt was committed when they were around 12 years old. The fr equency of current depression and suicide attempt were 14% and 15%, respectively in men and in women, 18% in both indicators. The association between sexual abuse and suicide attempt, and the indicators of current emotional problems was statistically significant. In men with suicide attempt, 50% showed current depression and suicide ideation; in women with sexual abuse and suicide attempt, the frequency was 67%. These results are discussed with the aim of making evident the need to establish preventive strategies for the early detection and the promotion of emotional health among the school population.


REFERENCES

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  2. BORGES G, ROSOVSKY H, CABALLERO M, GOMEZ C: Evolución reciente del suicidio en México: 1970-1991.

  3. Reseña. Novena Reunión de Investigación y Enseñanza, Instituto Mexicano de Psiquiatría, 15-21, 1994.

  4. BEITCHMAN J, ZUCKER K, HOOD J, DACOSTA G, AKMAN D, CASSAVIA E: A review of the long-term effects of child sexual abuse. Child Abuse Neglect, 16:101-118, 1992.

  5. BRIERE J, EVANS D, RUNTZ M, WALL T: Symptomatology in men who were molested as children: A comparison study. Am J Orthopsychiat, 58:457-461, 1998.

  6. BROWN J, COHEN P, JOHNSON J, SMAILES E: Childhood abuse and neglect: specificity of effects on adolescent and young depression and suicidality. J Am Acad Child Adolesc Psychiatry, 38(12):1490-1496, 1999.

  7. BROWNE A, FINKELHOR D: Impact of child sexual abuse: A review of the research. Psychol Bull, 99:66-77, 1986.

  8. CANETTO SS, SAKINOFSKY I: The gender paradox in suicide. Suicide Life-Threatening Behavior, 28(1):1-23, 1998.

  9. COIE JD, WATT NF, WEST SG, HAWKINS D, ASSARNOW JR, MARKMAN HJ, RAMEY SL, SHURE MB, LONG B: The science of prevention. A conceptual framework and some directions for a National Research Program. American Psychologist, 48(10):1013-1022, 1993.

  10. COLLINGS SJ:The long-term effects of contact and noncontact forms of child sexual abuse in a sample of university men. Child Abuse Negl, 19(1):1-6, 1994.

  11. CHANDY JM, BLUM RWM, RESNICK MD: Genderespecific outcomes for sexually abused adolescents. Child Abuse Negl, 20(12):1219-1231, 1996.

  12. DENNERSTEIN L, ASTBURY J, MORSE C: Psychosocial and Mental Health Aspects of Women’s Health. World Health Organization, Génova, 1993.

  13. DESJARLAIS R, EISENBERG L, BYRON G, KLEINMAN A: World Mental Health. Problems and Priorities in Low-income Countries. Oxford University Press, Oxford, 1995.

  14. DIEKSTRA R: The epidemiology of suicide and parasuicide. Acta Psychiatr Scand, 371(supl.):9-20, 1993.

  15. ESTRADA C, HERNANDEZ MA, JUAREZ B, PEREZ L, SAMPERIO R, VAZQUEZ E: Revictimización. Psicología Iberoamericana, 3(3):37-40, 1995.

  16. FERGUSSON DM, HORWOOD J, LYNKSEY M: Childhood sexual abuse and psychiatric disorder in young adulthood, II: psychiatric outcomes of childhood sexual abuse. J Am Acad Child Adolesc Psychiatry, 35:1365-1374,1996.

  17. FINKELHOR D: Sexually Victimized Children. Free Press, Nueva York, 1979.

  18. FINKELHOR D, DZIUBA-LEATHERMAN J:. Victimization of children. Am Psychol, 49(3):173-183, 1994.

  19. GONZALEZ-FORTEZA C, ANDRADE P, JIMENEZ A: Relación entre estresores cotidianos familiares y sintomatología depresiva e ideación suicida en adolescentes mexicanos.Acta Psiquiátrica Psicológica América Latina, 43(4):319-326, 1997.

  20. GONZALEZ-FORTEZA C, BERENZON-GORN S, TELLO-GRANADOS AM, FACIO-FLORES D, MEDINA-MORA ME: Ideación suicida y características asociadas en mujeres adolescentes. Salud Pública México, 40(5):430-437, 1998.

  21. GONZALEZ-FORTEZA C, MARIÑO MC, ROJAS E, MONDRAGON L, MEDINA-MORA ME: Intento de suicidio en estudiantes de la ciudad de Pachuca, Hgo. y su relación con el uso de sustancias y el malestar depresivo. Revista Mexicana Psicología, 15(2):165-175, 1998.

  22. GONZALEZ-SERRATOS R: Informe preliminar sobre algunos aspectos de la investigación en sobrevivientes de abuso sexual en la infancia. Salud Reproductiva Sociedad, 6(7):14-17, 1995.

  23. HEISE L, PITANGUY J, GERMAIN A: Violencia Contra la Mujer: la Carga Oculta Sobre la Salud. Organización Panamericana de la Salud, Washington, 1994.

  24. HIJAR M, RASCON RA, BLANCO J, LOPEZ L: Los suicidios en México. Características sexuales y geográficas (1979- 1993). Salud Mental, 19(4):14-21, 1996.

  25. HOLMES WC, SLAP GB: Sexual abuse of boys. Definition, prevalence, correlates, sequelae, and management. JAMA, 281(21):1855-1865, 1998.

  26. KELLY L: Surviving Sexual Violence. University of Minnesota Press, Minneapolis, 1988.

  27. KIENHORST CWM, DE WILDE EJ, DIEKSTRA RFW, WOLTERS WHG: Differences between adolescent suicide attempters and depressed adolescents. Acta Psychiatr Scand, 85:222-228, 1992.

  28. KOSKY R, SILBURN S, ZUBRICK SR: Are children in adolescence who have suicidal thoughts differents from those who attempt suicide? J Nervous Mental Disease, 178:38-43, 1990.

  29. KUMAR G, STEER R: Psychosocial correlates of suicidal ideation in adolescent psychiatric inpatients. Suicide Life Threatening Behavior, 25(3):339-346, 1995.

  30. LEBLANC JB, BRABANT S, FORSYTH CJ: The meaning of college for survivors of sexual abuse: Higher education and the older female college student. Am J Orthopsychiat, 66(3):468-473, 1996.

  31. LEVITON LC, SNELL E, MSGINNIS M: Urban issues in health promotion strategies. American J Public Health, 90(6):863-866, 2000.

  32. LIPSCHITZ DS, KAPLAN ML, SORKENN J, CHORNEY P, ASNIS GM: Childhood abuse, adult assault, and dissociation. Compr Psychiatry, 37(4):261-266, 1996.

  33. LIPSCHITZ DS, WINEGAR RK, HARTNICK E, FOOTE B, SOUTHWICK S: Posttraumatic stress disorder in hospitalized adolescents; Psychiatric comorbidity and clinical correlates. J Am Acad Chil Adolesc Psychiatry, 38(4): 385-392, 1999.

  34. MARIÑO MC, MEDINA-MORA ME, CHAPARRO JJ, GONZALEZ-FORTEZA C: Confiabilidad y estructura factorial del CES-D en adolescentes mexicanos. Revista Mexicana Psicología, 10(2):141-145, 1993.

  35. MOYER DM, DIPIETRO L, BERKOWITZ RI, STUNKARD AJ: Childhood sexual abuse and precursors of binge eating in an adolescent female population. Int J Eat Disord, 21(1):23-30, 1997.

  36. PEDERSEN W, SKRONDAL A: Alcohol and sexual victimization: A longitudinal stof Norwegian girls. Addiction, 91(4):565-581, 1996.

  37. PETERS DK, RANGE LM: Childhood sexual abuse and current suicidality in college women and men. Child Abuse Negl, 19(3):335-341, 1995.

  38. PETERS SD, WYATT GE, FINKELHOR D: Prevalence. En: Finkelhor D (ed.). A Sourcebook on Child Sexual Abuse. Sage, 15-59, Beverly Hills, 1986.

  39. RADLOFF L: The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Meas, 1:385-401, 1977.

  40. RAMOS-LIRA L, SALDIVAR-HERNANDEZ G,MEDINA-MORA ME, ROJAS-GUIOT E, VILLATOROVELAZQUEZ J: Prevalencia de abuso sexual en estudiantes y su relación con el consumo de drogas. Salud Pública México, 40(3):221-233, 1998.

  41. ROBERTS E:Reliability of the CES-D: Scale in different ethnic contexts. Psychiatry Research, 2:125-134, 1980.

  42. ROTHERAM-BORUS MJ, MAHLER KA, KOOPMAN C, LANGABEER K: Sexual abuse history and associated multiple risk behavior in adolescent runaways. Am J Orthopsychiat, 66(3):390-400, 1996.

  43. SANTANA-TAVIRA R, SANCHEZ-AHEDO R, HERRERA-BASTO E: El maltrato infantil: un problema mundial. Salud Pública México, 40(1):58-65, 1998.

  44. SHAUNESEY K, COHEN JL, PLUMMER B, BERMAN A: Suicidality in hospitalized adolescents: relationship to prior abuse. Amer J Orthopsychiat, 63(1):113-119, 1993.

  45. SINGER KI: Group work with men who experienced incest in chilhood. Am J Orthopsychiat, 59:468-472, 1989.

  46. SINGER MI, ANGLIN TM, SONG L, LUNGHOFER L: Adolescents exposure to violence and associated symptoms of psychological trauma. JAMA, 273(6):477-482, 1995.

  47. SOTO F: La violencia sexual en la mujer y el trauma silenciado. Psicología Iberoamericana, 4(3):31-36, 1996.

  48. TEBBUT J, SWANSTON H, OATES RK, O’TOOLE BI: Five years after child sexual abuse: Persisting dysfunction and problems of prediction. J Am Acad Child Adolesc Psychiatry, 36(3):303-339, 1997.

  49. TERROBA G, HEMAN A, SALTIJERAL MT, MARTINEZ P: Factores clínicos y sociales asociados con el parasuicidio y el suicidio consumado. Salud Mental, 9(1):74- 80, 1986.

  50. VILLATORO J, MEDINA-MORA ME, CARDIEL H, VILLA G, ALCANTAR E, VAZQUEZ L, FLEIZ C, NAVARRO C, BLANCO J, NEQUIZ G: Consumo de Drogas, Alcohol y Tabaco en Estudiantes del Distrito Federal: Medición Otoño 1997.Reporte Global de Escuelas de Secundaria, Bachillerato y Técnicas. SEP, IMP, México, 1999.

  51. WONDERLICH SA, WILSNACK RW, WILSNACK SC, HARRIS TR: Childhood sexual abuse and bulimic behavior in a nationally representative sample. Am J Public Health, 86(8):1082-1086, 1996.

  52. YODER KA: Comparing suicide attempters, suicide ideators, and nonsuicidal homeless and runaway adolescents. Suicide Life-Threatening Behavior, 29(1):25-36, 1999.

  53. BENJET C, HERNANDEZ-GUZMAN L, TERCEROQUINTANILLA M, HERNANDEZ-ROQUE S, CHARTT-LEON M: Validez del CES-D en púberes y peripúberes. Revista Mexicana Psicología, 16(1):175-185, 1999.

  54. BORGES G, ROSOVSKY H, CABALLERO M, GOMEZ C: Evolución reciente del suicidio en México: 1970-1991. Reseña. Novena Reunión de Investigación y Enseñanza, Instituto Mexicano de Psiquiatría, 15-21, 1994.

  55. BEITCHMAN J, ZUCKER K, HOOD J, DACOSTA G, AKMAN D, CASSAVIA E: A review of the long-term effects of child sexual abuse. Child Abuse Neglect, 16:101-118, 1992.

  56. BRIERE J, EVANS D, RUNTZ M, WALL T: Symptomatology in men who were molested as children: A comparison study. Am J Orthopsychiat, 58:457-461, 1998.

  57. BROWN J, COHEN P, JOHNSON J, SMAILES E: Childhood abuse and neglect: specificity of effects on adolescent and young depression and suicidality. J Am Acad Child Adolesc Psychiatry, 38(12):1490-1496, 1999.

  58. BROWNE A, FINKELHOR D: Impact of child sexual abuse: A review of the research. Psychol Bull, 99:66-77, 1986.

  59. CANETTO SS, SAKINOFSKY I: The gender paradox in suicide. Suicide Life-Threatening Behavior, 28(1):1-23, 1998.

  60. COIE JD, WATT NF, WEST SG, HAWKINS D, ASSARNOW JR, MARKMAN HJ, RAMEY SL, SHURE MB, LONG B: The science of prevention. A conceptual framework and some directions for a National Research Program. American Psychologist, 48(10):1013-1022, 1993.

  61. COLLINGS SJ:The long-term effects of contact and noncontact forms of child sexual abuse in a sample of university men. Child Abuse Negl, 19(1):1-6, 1994.

  62. CHANDY JM, BLUM RWM, RESNICK MD: Genderespecific outcomes for sexually abused adolescents. Child Abuse Negl, 20(12):1219-1231, 1996.

  63. DENNERSTEIN L, ASTBURY J, MORSE C: Psychosocial and Mental Health Aspects of Women’s Health. World Health Organization, Génova, 1993.

  64. DESJARLAIS R, EISENBERG L, BYRON G, KLEINMAN A: World Mental Health. Problems and Priorities in Low-income Countries. Oxford University Press, Oxford, 1995.

  65. DIEKSTRA R: The epidemiology of suicide and parasuicide. Acta Psychiatr Scand, 371(supl.):9-20, 1993.

  66. ESTRADA C, HERNANDEZ MA, JUAREZ B, PEREZ L, SAMPERIO R, VAZQUEZ E: Revictimización. Psicología Iberoamericana, 3(3):37-40, 1995.

  67. FERGUSSON DM, HORWOOD J, LYNKSEY M: Childhood sexual abuse and psychiatric disorder in young adulthood, II: psychiatric outcomes of childhood sexual abuse. J Am Acad Child Adolesc Psychiatry, 35:1365-1374, 1996.

  68. FINKELHOR D: Sexually Victimized Children. Free Press, Nueva York, 1979.

  69. FINKELHOR D, DZIUBA-LEATHERMAN J:. Victimization of children. Am Psychol, 49(3):173-183, 1994.

  70. GONZALEZ-FORTEZA C, ANDRADE P, JIMENEZ A: Relación entre estresores cotidianos familiares y sintomatología depresiva e ideación suicida en adolescentes mexicanos. Acta Psiquiátrica Psicológica América Latina, 43(4): 319-326, 1997.

  71. GONZALEZ-FORTEZA C, BERENZON-GORN S, TELLO-GRANADOS AM, FACIO-FLORES D, MEDINA-MORA ME: Ideación suicida y características asociadas en mujeres adolescentes. Salud Pública México, 40(5):430-437, 1998.

  72. GONZALEZ-FORTEZA C, MARIÑO MC, ROJAS E, MONDRAGON L, MEDINA-MORA ME: Intento de suicidio en estudiantes de la ciudad de Pachuca, Hgo. y su relación con el uso de sustancias y el malestar depresivo. Revista Mexicana Psicología, 15(2):165-175, 1998.

  73. GONZALEZ-SERRATOS R: Informe preliminar sobre algunos aspectos de la investigación en sobrevivientes de abuso sexual en la infancia. Salud Reproductiva Sociedad, 6(7):14-17, 1995.

  74. HEISE L, PITANGUY J, GERMAIN A: Violencia Contra la Mujer: la Carga Oculta Sobre la Salud. Organización Panamericana de la Salud, Washington, 1994.

  75. HIJAR M, RASCON RA, BLANCO J, LOPEZ L: Los suicidios en México. Características sexuales y geográficas (1979-1993). Salud Mental, 19(4):14-21, 1996.

  76. HOLMES WC, SLAP GB: Sexual abuse of boys. Definition, prevalence, correlates, sequelae, and management. JAMA, 281(21):1855-1865, 1998.

  77. KELLY L: Surviving Sexual Violence. University of Minnesota Press, Minneapolis, 1988.

  78. KIENHORST CWM, DE WILDE EJ, DIEKSTRA RFW, WOLTERS WHG: Differences between adolescent suicide attempters and depressed adolescents. Acta Psychiatr Scand, 85:222-228, 1992.

  79. KOSKY R, SILBURN S, ZUBRICK SR: Are children in adolescence who have suicidal thoughts differents from those who attempt suicide? J Nervous Mental Disease, 178:38-43, 1990.

  80. KUMAR G, STEER R: Psychosocial correlates of suicidal ideation in adolescent psychiatric inpatients. Suicide Life Threatening Behavior, 25(3):339-346, 1995.

  81. LEBLANC JB, BRABANT S, FORSYTH CJ: The meaning of college for survivors of sexual abuse: Higher education and the older female college student. Am J Orthopsychiat, 66(3):468-473, 1996.

  82. LEVITON LC, SNELL E, MSGINNIS M: Urban issues in health promotion strategies. American J Public Health, 90(6):863-866, 2000.

  83. LIPSCHITZ DS, KAPLAN ML, SORKENN J, CHORNEY P, ASNIS GM: Childhood abuse, adult assault, and dissociation. Compr Psychiatry, 37(4):261-266, 1996.

  84. LIPSCHITZ DS, WINEGAR RK, HARTNICK E, FOOTE B, SOUTHWICK S: Posttraumatic stress disorder in hospitalized adolescents; Psychiatric comorbidity and clinical correlates. J Am Acad Chil Adolesc Psychiatry, 38(4): 385-392, 1999.

  85. MARIÑO MC, MEDINA-MORA ME, CHAPARRO JJ, GONZALEZ-FORTEZA C: Confiabilidad y estructura factorial del CES-D en adolescentes mexicanos. Revista Mexicana Psicología, 10(2):141-145, 1993.

  86. MOYER DM, DIPIETRO L, BERKOWITZ RI, STUNKARD AJ: Childhood sexual abuse and precursors of binge eating in an adolescent female population. Int J Eat Disord, 21(1):23-30, 1997.

  87. PEDERSEN W, SKRONDAL A: Alcohol and sexual victimization: A longitudinal study of Norwegian girls. Addiction, 91(4):565-581, 1996.

  88. PETERS DK, RANGE LM: Childhood sexual abuse and current suicidality in college women and men. Child Abuse Negl, 19(3):335-341, 1995.

  89. PETERS SD, WYATT GE, FINKELHOR D: Prevalence. En: Finkelhor D (ed.). A Sourcebook on Child Sexual Abuse. Sage, 15-59, Beverly Hills, 1986.

  90. RADLOFF L: The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Meas, 1:385-401, 1977.

  91. RAMOS-LIRA L, SALDIVAR-HERNANDEZ G, MEDINA-MORA ME, ROJAS-GUIOT E, VILLATOROVELAZQUEZ J: Prevalencia de abuso sexual en estudiantes y su relación con el consumo de drogas. Salud Pública México, 40(3):221-233, 1998.

  92. ROBERTS E:Reliability of the CES-D: Scale in different ethnic contexts. Psychiatry Research, 2:125-134, 1980.

  93. ROTHERAM-BORUS MJ, MAHLER KA, KOOPMAN C, LANGABEER K: Sexual abuse history and associated multiple risk behavior in adolescent runaways. Am J Orthopsychiat, 66(3):390-400, 1996.

  94. SANTANA-TAVIRA R, SANCHEZ-AHEDO R, HERRERA-BASTO E: El maltrato infantil: un problema mundial. Salud Pública México, 40(1):58-65, 1998.

  95. SHAUNESEY K, COHEN JL, PLUMMER B, BERMAN A: Suicidality in hospitalized adolescents: relationship to prior abuse. Amer J Orthopsychiat, 63(1):113-119, 1993.

  96. SINGER KI: Group work with men who experienced incest in chilhood. Am J Orthopsychiat, 59:468-472, 1989.

  97. SINGER MI, ANGLIN TM, SONG L, LUNGHOFER L: Adolescents exposure to violence and associated symptoms of psychological trauma. JAMA, 273(6):477-482, 1995.

  98. SOTO F: La violencia sexual en la mujer y el trauma silenciado. Psicología Iberoamericana, 4(3):31-36, 1996.

  99. TEBBUT J, SWANSTON H, OATES RK, O’TOOLE BI: Five years after child sexual abuse: Persisting dysfunction and problems of prediction. J Am Acad Child Adolesc Psychiatry, 36(3):303-339, 1997.

  100. TERROBA G, HEMAN A, SALTIJERAL MT, MARTINEZ P: Factores clínicos y sociales asociados con el parasuicidio y el suicidio consumado. Salud Mental, 9(1):74-80, 1986.

  101. VILLATORO J, MEDINA-MORA ME, CARDIEL H, VILLA G, ALCANTAR E, VAZQUEZ L, FLEIZ C, NAVARRO C, BLANCO J, NEQUIZ G: Consumo de Drogas, Alcohol y Tabaco en Estudiantes del Distrito Federal: Medición Otoño 1997. Reporte Global de Escuelas de Secundaria, Bachillerato y Técnicas. SEP, IMP, México, 1999.

  102. WONDERLICH SA, WILSNACK RW, WILSNACK SC, HARRIS TR: Childhood sexual abuse and bulimic behavior in a nationally representative sample. Am J Public Health, 86(8):1082-1086, 1996.

  103. YODER KA: Comparing suicide attempters, suicide ideators, and nonsuicidal homeless and runaway adolescents. Suicide Life-Threatening Behavior, 29(1):25-36, 1999.




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