Avaliação de psicoterapia em adolescentes sobreviventes de abuso sexual: uma revisão sistemática

Bruna Ribeiro Cavalcante; Maria Cristina Antunes; Carlos Aznar Blefari

doi:10.19135/revista.consinter.00019.39

Autores

Bruna Ribeiro Cavalcante Universidade Tuiuti do Paraná https://orcid.org/0009-0001-7462-2422
Maria Cristina Antunes Universidade Tuiuti do Paraná https://orcid.org/0000-0002-6767-518X
Carlos Aznar Blefari Universidade Tuiuti do Paraná https://orcid.org/0000-0001-8665-5304

DOI:

https://doi.org/10.19135/revista.consinter.00019.39

Palavras-chave:

psicoterapia, efetividade, abuso sexual infantil, adolescentes

Resumo

O objetivo deste estudo foi avaliar evidências de efetividade disponíveis na literatura referente a psicoterapia em adolescentes sobreviventes de abuso sexual infantil. Para tanto, foi conduzida uma revisão sistemática da literatura publicada entre 2018 e 2024, nas bases Science Direct, Sage Journals, PsycNet, Pubmed, Scielo, Pepsic, Lilacs, Periódicos Capes e EBSCO. Foram adotados os seguintes critérios de inclusão: 1) pesquisas cuja clientela estudada foi de indivíduos entre 11 e 19 anos de idade; 2) estudos que examinaram o desfecho das intervenções na saúde mental dos clientes; 3) ter um delineamento experimental ou quase-experimental. Dentre 6006 estudos identificados, foram incluídos nesta revisão seis estudos. Os resultados demonstraram diversidade nas abordagens de tratamento utilizadas, contudo todos apresentaram efetividade na redução dos sintomas no decorrer da intervenção psicológica, mantendo essa evolução mesmo após o término do tratamento. Sugere-se que em estudos futuros aspectos como instrumentos utilizados, tempo entre as avaliações e sintomas avaliados sejam minuciosamente detalhados, afim de dirimir eventuais inconsistências observadas nas comparações. A Psicologia tem muito a contribuir para a elaboração de tratamentos específicos eficazes por meio de intervenções baseadas em evidências aos sobreviventes de abuso sexual, dadas as suas especificidades, concomitantemente, auxiliando na elaboração de políticas públicas de saúde que possam ser aplicadas visando a melhor qualidade de vida desta população.

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Biografia do Autor

Bruna Ribeiro Cavalcante, Universidade Tuiuti do Paraná

Mestranda em Psicologia Forense pela Universidade Tuiuti do Paraná, Curitiba, Brasil.

Maria Cristina Antunes, Universidade Tuiuti do Paraná

Doutorado em Psicologia Social pela Universidade de São Paulo, Universidade Tuiuti do Paraná, Curitiba, Brasil.

Carlos Aznar Blefari, Universidade Tuiuti do Paraná

Doutorado em Psicologia Clínica pela PUC-RS, Universidade Tuiuti do Paraná, Curitiba, Brasil.

Referências

ACHENBACH, T. M., RESCORLA, L. A. “Manual for the ASEBA school-age forms & profiles.” Burlington: University of Vermont Press, 2001.

ARMSTRONG, J., PUTNAM, F., CARLSON, E., LIBERO, D., SMITH, S. “Development and validation of a measure of adolescent dissociation: the Adolescent Dissociative Experiences Scale”. J Nerv Ment Dis, v.185, n. 8, p. 491-497, 2017. https:doi.org/10.1097/00005053-199708000-00003 DOI: https://doi.org/10.1097/00005053-199708000-00003

ARNOUD, T. C. J, FREITAS, C. P. P, KOLLER, S. H., HABIGZANG, L. F. “Relationships Between CSA Characteristics, Waiting Time, and Psychotherapy Treatment Response”. Journal of Cognitive Psychotherapy: An International Quarterly, v.34, n.4., p.358–375, 2020. https://doi.org/10.1891/JCPSY-D-20-00017 DOI: https://doi.org/10.1891/JCPSY-D-20-00017

BECK, A. T., STEER, R. A., BROWN, G. K. “Manual for the Beck Depression Inventory–II.” San Antonio, TX: Psychological Corporation; 1996. DOI: https://doi.org/10.1037/t00742-000

BOHUS, M., KLEINDIENST, N., LIMBERGER, M., STIEGLITZ, R., DOMSALLA, M., CHAPMAN, A., STEIL, R., PHILIPSEN, A., WOLF , M. “The short version of the Borderline Symptom List (BSL-23): development and initial data on psychometric Properties”. Psychopathology, v.42, n.1, p.32-39, 2009. https://doi.org/10.1159/000173701 DOI: https://doi.org/10.1159/000173701

CAPELLA, C., GUTIÉRREZ, C., RODRÍGUEZ, L., GÓMEZ, C. “Change during psychotherapy: The perspective of children and adolescents who have been sexually abused”. Research in Psychotherapy: Psychopathology, Process and Outcome, v.21, n.1, p.24-39. 2018. http://doi.org/10.4081/ripppo.2018.288 DOI: https://doi.org/10.4081/ripppo.2018.288

CHOULIARA, Z., NARANG, J., QUAYLE, E., SCHWANNAUER, M. “Therapeutic Interventions with Child and Adolescent Survivors of Sexual Abuse: A Critical Narrative Review”. Children and Youth Services Review, v.107, 2019. https://doi.org/10.1016/j.childyouth.2019.104559

CHUKU, B. A., OBI, N., ANATS, C., HAMBOLU, O., ADERIBIGBE, F., AKPABIO, N., ODION-OMONHIMIN, L. “The relationship between childhood sexual abuse and eating disorders among African American adolescents in the United States”. Journal list Cureus, v.15, n.(4), p.1-9, 2023. https://doi.org/10.7759/cureus.37949 DOI: https://doi.org/10.7759/cureus.37949

EDWARDS, D., COLLIN-VÉZINA, D., DANBROOK, M.,WEKERLE, C. “Longitudinal trajectories of depressive symptoms among sexually abused adolescents involved in child protection services”. Child Abuse & Neglect, v.131, p.105742, 2022. https://doi.org/10.1016/j.chiabu.2022.105742 DOI: https://doi.org/10.1016/j.chiabu.2022.105742

FISCHER, A., ROSNER, R., RENNEBERG, B., STEIL, R. “Suicidal ideation, self-injury, aggressive behavior and substance use during intensive trauma-focused treatment with exposure-based components in adolescente and young adult PTSD patients”. Borderline Personality Disorder and Emotion Dysregulation, v.9, n.1, p.1-13, 2022. https://doi.org/10.1186/s40479-021-00172-8 DOI: https://doi.org/10.1186/s40479-021-00172-8

GOMES, R. A. B., ANTUNES, M. C., CORTEZ, P. A. “Sintomas de transtorno de estresse pós-traumático, depressão e ansiedade em mães de vítimas de abuso sexual”. Estudos Contemporâneos, v.9, n.17, p.1-20, 2023. https://doi.org/10.19135/revista.consinter.00017.35 DOI: https://doi.org/10.14393/Hygeia2070400

GO-UN, K., MI-YOUNG, K. “The Effectiveness of Psychological Interventions for Women Traumatized by Sexual Abuse: A Systematic Review and Meta-Analysis”. Issues in mental health nursing, 2020, v. 41, n.5, 385–394. https://doi.org/10.1080/01612840.2019.1677830 DOI: https://doi.org/10.1080/01612840.2019.1677830

GREENSPAN, F., MORETZSOHN, A., SILVERSTONE, P. “What treatments are available for childhood sexual abuse, and how do they compare?” International Journal of Advances in Psychology, v.2, n.4, p. 232–241, 2013. https://doi.org/10.14355/ijap.2013.0204.07 DOI: https://doi.org/10.14355/ijap.2013.0204.07

HAUTZINGER, M., KELLER, F., KUHNER, C. “Beck Depressions-Inventar (BDI-II) Revision”. Frankfurt, Germany: Harcourt Test Services, 2006.

KOVACS, M. “Children’s Depression Inventory”. Canada: Multi-Health Systems, 1992.

LU, J. Y., TUNG, T. H., SHEN, S. A., HUANG, C., & CHEN, P. S. (2020). “The effects of psychotherapy for depressed or posttraumatic stress disorder women with childhood sexual abuse history Meta-analysis of randomized controlled trials”. Medicine, v.99, n.17, p. 1-7. https://doi.org/10.1097/MD.http://dx.doi.org/10.1097/MD.0000000000019776 DOI: https://doi.org/10.1097/MD.0000000000019776

MacDONALD, G., HIGGINS, J., RAMCHANDANI, P., VALENTINE, J., BRONGER, L., KLEIN, P., O’DANIEL, R., PICKERING, M., RADEMAKER, B., RICHARDSON, G., TAYLOR, M. “Cognitive-Behavioural Interventions for Children Who Have Been Sexually Abused: A Systematic Review”. v.8, n.1, p. 1-111, 2012. https://doi.org/10.1002/14651858.CD001930.pub3 DOI: https://doi.org/10.4073/csr.2012.14

MANNARINO, A., COHEN, J., BERMAN, S. “The children's attributions and perceptions scale: A new measure of sexual abuse-related factors”. Journal of Clinical Child Psychology, v.23, n. 2, p.204-211, 1994. https://doi.org/10.1207/s15374424jccp2302_9 DOI: https://doi.org/10.1207/s15374424jccp2302_9

MATHEWS, B., COLLIN-VEZINA, D. “Child sexual abuse: Toward a conceptual model and definition.” Trauma, Violence, & Abuse, v.20. n. 2, p.131–148, 2019. https://doi.org/10.1177/1524838017738726 DOI: https://doi.org/10.1177/1524838017738726

MC TAVISH, J., SANTESSO, N., AMIN, A., REIJNDERS, M., ALI, M. U., FITZPATRICK-LEWIS, D., MACMILAN, H. “Psychosocial interventions for responding to child sexual abuse: A systematic review”. Child Abuse &Neglect. v.116, part 1, p.104203, 2021. https://doi.org/10.1016/j.chiabu.2019.104203 DOI: https://doi.org/10.1016/j.chiabu.2019.104203

MILES, L., VALENTINE, J., MABEY, L., HOPKINS, E., STODTMEISTER, P., ROCKWOOD, R., MOXLEY, A. “Uma revisão sistemática de tratamentos baseados em evidências para vítimas de violência sexual em adolescentes e adultos”. Jornal da Associação Americana de Enfermeiras Psiquiátricas, 10783903231216138, p1-23, 2023. https://doi.org/10.1177/10783903231216138 DOI: https://doi.org/10.1177/10783903231216138

NARANG, J., SCHWANNAUER, M., QUAYLE, E. CHOULIARA, Z. “Therapeutic interventions with child and adolescent survivors of sexual abuse: A critical narrative review.” Children and Youth Services Review, v. 107, p. 104559, 2019. https://doi.org/10.1016/j.childyouth.2019.104559 DOI: https://doi.org/10.1016/j.childyouth.2019.104559

O’KEEFFE, N., McELVANEY, R. “Forensic medical examinations: The body as gateway to healing after child sexual abuse”. Child Abuse Review, v., n. 4, p.1-10, 2022. https://doi.org/10.1002/car.2750 DOI: https://doi.org/10.1002/car.2750

OSMEÑA, N. M. E., BARRERA, D. J. “Filipino children and adolescents’s stories of sexual abuse: Narrative types and consequences”. Journal of Child & Adolescent Trauma, v.14, n.2, p.249-259, 2021. https://doi.org/10.1007/s40653-020-00336-8 DOI: https://doi.org/10.1007/s40653-020-00336-8

PAGE, M., McKENZIE, J., BOSSUYT, P., BOUTRON, I., HOFFMANN, T., MULROW, C., SHAMSEER, L., TETZLAFF, J., Akl, E., BRENNAN, S., CHOU, R., GLANVILLE, J., GRIMSHAW, J., HRÓBJARTSSON, A., LALU, M., LI, T., LODER, E., MAYO-WILSON, E., McDONALD, S., McGUINNESS, L., STEWART, L., THOMAS, J., TRICCO, A., WELCH, V., WHITING, P., MOHER, D. “The PRISMA 2020 statement: an updated guideline for reporting systematic reviews”. BMJ, v. 372, n. 71, p. 1-9, 2021. https://doi.org/10.1136/bmj.n71 DOI: https://doi.org/10.1136/bmj.n71

PASSARELA, C. M., MENDES, D. D., MARI, J. J. “Revisão sistemática para estudar a eficácia de terapia cognitivo-comportamental para crianças e adolescentes abusadas sexualmente com transtorno de estresse pós-traumático”. Rev Psiq Clín., v.37, n. 2, p. 60-65, 2010. https://doi.org/10.1590/S0101-60832010000200006 DOI: https://doi.org/10.1590/S0101-60832010000200006

PEUKER, A. C., HABIGZANG, L. F., KOLLER, S. H., ARAUJO, L. B. “Avaliação de processo e resultado em psicoterapias: uma revisão.” Psicologia em Estudo, v. 14, n. 3, p. 439–445, 2009. Available from: https://www.scielo.br/j/pe/a/M3QtZ8GGYzPTmbLZNzwvjZs/ DOI: https://doi.org/10.1590/S1413-73722009000300004

PITTENGER, S., SCHREIER, A., MEIDLINGER, K., POGUE, J., THEIMER, K., FLOOD, M. F., HANSEN, D. “Psychological Distress and Revictimization Risk in Youth Victims of Sexual Abuse”. Journal of Interpersonal Violence, v.34, n. 9, p.1930–1960, 2019. https://doi.org/10.1177/0886260516658755 DOI: https://doi.org/10.1177/0886260516658755

PRASAD, V., VANDROSS, A., TOOMEY, C., CHEUNG, M., RHO, J., QUINN, S., CHACKO, S.J., BORKAR, D., GALL, V., SELVARAJ, S., HO, N., CIFU, A. “A decade of reversal: an analysis of 146 contradicted medical practices.” Mayo Clinic Proceedings, v. 88, n. 8, p.790-798, 2013. https://doi.org/10.1016/j.mayocp.2013.05.012 DOI: https://doi.org/10.1016/j.mayocp.2013.05.012

ROSNER, R., RIMANE, E., FRICK, U., GUTERMANN, J., HAGL, M., RENNEBERG, B., SCHREIBER, F., VOGEL, A.,STEIL, R. “Effect of developmentally adapted cognitive processing therapy for youth with symptoms of posttraumatic stress disorder after childhood sexual and physical abuse: A randomized clinical trial”. JAMA Psychiatry, v.76, n. 5, p.484-491, 2019. https://doi.org/10.1001/jamapsychiatry.2018.4349 DOI: https://doi.org/10.1001/jamapsychiatry.2018.4349

SAWYER, G., HANSEN, D. “Heterogeneous symptom patterns of sexually abused children in treatment: Understanding the complexity of the problem”. Journal of Child Sexual Abuse, v.23, n.8, p.900-917, 2014. https://doi.org/10.1080/10538712.2014.964439 DOI: https://doi.org/10.1080/10538712.2014.964439

SAWYER, G., TSAO, E., HANSEN, D., FLOOD, M. F. “Weekly problems scales: Instruments for sexually abused youth and their nonoffending parents in treatment”. Child Maltreatment . v.11, n.1, p.34-48. 2006. https://doi.org/10.1177/1077559505283550 DOI: https://doi.org/10.1177/1077559505283550

SILVA, F. C., MONGE, A., LANDI, C. A., ZENARDI, G. A., SUZUKI, D.C.,VITALLE, M. S. S. “Os impactos da violência sexual vivida na infância e adolescência em universitários”. Rev Saude Publica, v.54, n.134, p.1-11, 2020. https://doi.org/10.11606/s1518-8787.2020054002576 DOI: https://doi.org/10.11606/s1518-8787.2020054002576

SMITH, P., DALGLEISH, T., MEISER-STEDMAN, R. “Practitioner Review: Posttraumatic stress disorder and its treatment in children and adolescents”. Journal of Child Psychology and Psychiatry, v.60, n. 5 , p.500–515. 2019.https://doi.org/10.1111/jcpp.12983 DOI: https://doi.org/10.1111/jcpp.12983

STAVROU, P. D. “The consequences of childhood sexual abuse on the conjugal life of a young woman and the effects of the psychoanalytic psychotherapy as a method of treatment”. J Psychol Clin Psychiatry, v.9, n. 6, p.567‒577, 2018. https://doi.org/10.15406/jpcpy.2018.09.00590 DOI: https://doi.org/10.15406/jpcpy.2018.09.00590

TACKETT, J. L., BRANDES, C. M., KING, K. M., MARKON, K. E. Psychology's replication crisis and clinical psychological science. Annual review of clinical psychology, v. 15, p. 579-604, 2019. https://doi.org/10.1146/annurev-clinpsy-050718-095710 DOI: https://doi.org/10.1146/annurev-clinpsy-050718-095710

TASK, E., WALSH, K., DiLILLO, D. “Treatment effects for common outcomes of child sexual abuse: A current meta-analysis”. Aggression and violent behavior, v.16, n. 1, p.6–19. https://doi.org/10.1016/j.avb.2010.10.001 DOI: https://doi.org/10.1016/j.avb.2010.10.001

TISSIANI, A. A., et. al AZEVEDO, N. O., MENDONÇA, G. J. M. G., RAMOS, A. L. B. M., OLIVEIRA, M. C. C., ALVES, I. F. R. D., PECORELLI, D. G., DANTAS, P. E. B. DEININGER, L. S. C. “Análise das principais consequências do abuso sexual infanto-juvenil”. Revista Eletrônica Acervo Saúde, v. 13, n. 7, p.1-10, 2021. https://doi.org/10.25248/reas.e8194.2021 DOI: https://doi.org/10.25248/reas.e8194.2021

TICHELAAR, H., DEKOVIĆ, M., ENDENDIJK, J. “Exploring effectiveness of psychotherapy options for sexually abused children and adolescents: A systematic review of randomized controlled trials”. Children and Youth Services Review, v.119, 105519, p.1-19, 2020. https://doi.org/10.1016/j.childyouth.2020.105519 DOI: https://doi.org/10.1016/j.childyouth.2020.105519

UNTERHITZENBERGER, J., SACHSER, C., ROSNER, R. “Posttraumatic Stress Disorder and Childhood Traumatic Loss: A Secondary Analysis of Symptom Severity and Treatment Outcome”. Journal of Traumatic Stress, v.33, n.3, p.208–217, https://doi.org/10.1002/jts.22499 DOI: https://doi.org/10.1002/jts.22499

WOLFE, V., GENTILE, C., MICHIENZI, T., SAS, L., WOLFE, D. A. “The Children’s Impact of Traumatic Events Scale: A measure of post-sexual abuse PTSD symptoms”. Behavioral Assessment, v.13, n.4, p.359-383, 1991. DOI: https://doi.org/10.1037/t02083-000

WORLD HEALTH ORGANIZATION (WHO). “Inspire: seven strategies for ending violence against children”. Switzerland: WHO, 2016. Disponível em: https://resourcecentre.savethechildren.net/pdf/inspire-ending-violence-against-children-2016.pdf/