Asociación entre abuso sexual y distrés psicológico en adolescentes escolarizados de Santa Marta, Colombia

Autores/as

  • Adalberto Campo-Arias Universidad del Margdalena
  • Carmen Cecilia Caballero-Domínguez Universidad del Margdalena
  • Joseph Luciano Espitia-Correa Universidad del Margdalena

Palabras clave:

abuso sexual, estrés postraumático, depresión, epidemiología, Suicidio; adolescentes; jóvenes; factores de riesgo, intento de suicidio, revisión fuente DeCS.

Resumen

El abuso sexual es un estresor que incrementa el riesgo de distrés psicológico. El objetivo de la investigación fue cuantificar la asociación entre abuso sexual y distrés psicológico (estrés postraumático, depresión y riesgo suicida) en estudiantes adolescentes en Santa Marta, Colombia. Se diseñó un estudio transversal. Participaron 1.462 estudiantes entre 13 y 17 años (M = 15,98; DE = 0,83). El abuso sexual se indagó mediante un ítem único del Cuestionario de Victimización Juvenil y el distrés con la Escala Breve de Davidson para estrés postraumático, el Índice de Bienestar General y la escala de ideación suicida del Centro de Estudios Epidemiológicos y (WHO-5). La prevalencia de abuso sexual fue 17,37%; riesgo de estrés postraumático, 19,36%; riesgo de depresión, 7,05%; y alto riesgo suicida, 13,27%. La historia de abuso sexual se asoció a estrés postraumático (Ajustado OR = 2,41; IC 95% 1,77 - 3,28), depresión (AOR = 2,48; IC 95% 1,59-3,88), y riesgo suicida (AOR = 2,51; IC 95% 1,77 - 3,56). Se concluye que el abuso sexual es un estresor que incrementa significativamente el riesgo de distrés psicológicos en estudiantes adolescentes en Santa Marta, Colombia. Se necesitan estudios de cohorte para controlar posibles variables de confusión para estas asociaciones.

Citas

Alisic, E. , Zalta, A. K. , Van Wesel, F. , Larsen, S. E. , Hafstad, G. S. , Hassanpour, K. y Smid, G. E. (2014). Rates of post-traumatic stress disorder in trauma-exposed children and adolescents: meta-analysis. The British Journal of Psychiatry, 204(5), 335-340. https://doi.org/10.1177/10.1192/bjp.bp.113.131227

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5a edi) (DSM-5). American Psychiatric Association.

Arboleda, M. R. C. , Duarte, J. C. y Cantón-Cortés, D. (2011). Naturaleza de los abusos sexuales a menores y consecuencias en la salud mental de las víctimas. Gaceta Sanitaria, 25(2), 157-165. https://doi.org/10.1016/j.gaceta.2010.10.009

Barth, J. , Bermetz, L. , Heim, E. , Trelle, S. y Tonia, T. (2013). The current prevalence of child sexual abuse worldwide: a systematic review and meta-analysis. International Journal of Public Health, 58(3), 469-483. https://doi.org/10.1007/s00038-012-0426-1

Batista, Y. , Vega, Y. y Caamaño, D. (2013). Presencia del maltrato y abuso sexual en el hogar de estudiantes de secundaria en tres colegios públicos de la ciudad de Santa Marta–Magdalena-(Colombia). Duazary, 10(1), 67-72. https://doi.org/10.21676/2389783X.336

Baytunca, M. B. , Ata, E. , Ozbaran, B. , Kaya, A. , Kose, S. , Aktas, E. O. , Aydin, R. , Guney, S. , Yuncu, Z. , Erermis, S. y Bildik, T. (2016). Childhood sexual abuse and supportive factors. Pediatrics International, 59(1), 10-15.https://doi.org/10-1510.1111/ped.13065

Campo-Arias, A. , Miranda-Tapia, G. , Cogollo, Z. y Herazo, E. (2015). Reproducibilidad del Índice de Bienestar General (WHO-5 WBI) en estudiantes adolescentes. Salud Uninorte, 31(1), 18-24. https://doi.org/org/10.14482/sun.30.1.4309

Cantón-Cortés, D. , Cortés, M. R. , y Cantón, J. (2012). The role of trauma genic dynamics on the psychological adjustment of survivors of child sexual abuse. European Journal of Developmental Psychology, 9(6), 665-680. https://doi.org/org/10.1080/17405629.2012.660789

Cantón-Cortés, D. y Cortés, M. (2015). Consecuencias del abuso sexual infantil: una revisión de las variables intervinientes. Anales de Psicología, 31(2), 552-561. https://doi.org/org/10.6018/analesps.31.2.180771

Carosio, A. (2012). Feminismo y cambio social en América Latina y el Caribe. Buenos Aires: Consejo Latinoamericano de Ciencias Sociales (Clacso). http://biblioteca.clacso.edu.ar/gsdl/collect/clacso/index/assoc/D7156.dir/Feminismoycambiosocial.pdf

Carver, C. S. (1998). Resilience and thriving: Issues, models, and linkages. Journal of Social Issues, 54(2), 245-266. https://doi.org/10.1111/j.1540-4560.1998.tb01217.x

Cohen, J. A. , Mannarino, A. P. y Iyengar, S. (2011). Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence:a randomized controlled trial. Archives of Pediatrics y Adolescent Medicine, 165(1), 16-21. https://doi.org/org/10.1001/archpediatrics.2010.247

Cyr, K. , Chamberland, C. , Clément, M. E. , Lessard, G. , Wemmers, J.-A. , Collin-Vézina, D. y Damant, D. (2013). Polyvictimization and victimization of children and youth: Results from a populational survey. Child Abuse y Neglect, 37(10), 814-820. https://doi.org/10.1016/j. chiabu.2013.03.009

Da Silva, J.V. y Roncalli, A.G. (2018). Prevalence of sexual violence in Brazil: associated individual and contextual factor. International Journal of Public Health, 63(8), 933-944. https://doi.org/10.1007/s00038-018-1136-0

Drapeau, A. , Marchand, A. , y Beaulieu-Prévost, D. (2011). Epidemiology of psychological distress. En L. L’Abate (pp. 105-134), Mental illnesses-understanding, prediction and control. Rijeka: InTech.

Fatmawati, F. (2017). Post-Traumatic stress disorder among sexually abused children: The role of traumagenic dynamics model. Gender Equality: International Journal of Child and Gender Studies, 2(2), 11-22. http://dx.doi.org/10.22373/equality.v2i2.1460

Finkelhor, D. (1987). The trauma of child sexual abuse: Two models. Journal of Interpersonal Violence, 2(4), 348-366. https://doi.org/10.1177/088626058700200402

Finkelhor, D. , Hamby, S. L. , Ormrod, R. y Turner, H. (2005). The Juvenile Victimization Questionnaire: reliability, validity, and national norms. Child Abuse y Neglect, 29(4), 383-412. https://doi.org/10.5944/ap.13.2.17810

Finkelhor, D. y Browne, A. (1988). Assessing the long-term impact of child sexual abuse: A review and conceptualization. Sage Publications.

Finkelhor, D. , Shattuck, A. , Turner, H. A. y Hamby, S. L. (2014). The lifetime prevalence of child sexual abuse and sexual assault assessed in late adolescence. Journal of Adolescent Health, 55(3), 329-333. https://doi.org/10.1016/j.jadohealth.2013.12.026

Fontes, L. F. C. , Conceição, O. C. y Machado, S. (2017). Childhood and adolescent sexual abuse, victim profile and its impacts on mental health. Ciencia y Saude Coletiva, 22, 2919-2928. https://doi.org/10.1590/1413-81232017229.11042017.

Franco, A. y Ramírez, L. (2016). Abuso sexual infantil: perspectiva clínica y dilemas ético-legales. Revista Colombiana de Psiquiatría, 45(1), 51-58. https://doi.org/10.1016/j.rcp.2015.07.003

Gallego, C. , Medina, M. y Montoya, L. (2008). Historia de abuso sexual y su relación con depresión, autoestima y consumo de sustancias psicoactivas en estudiantes de media vocacional del municipio de Caldas Antioquia, Colombia. CES Medicina, 22(1), 17-27. https://doi.org/10.21615/ces%20med.v22i1.522

García, F. G. y Ortiz, M. Á. C. (2016). Evaluación del perfil psicosocial en menores víctimas de abuso sexual: diferencias por sexo y edad.Revista de Psicología Clínica con niños y adolescentes, 3(2), 87-98.

Goldman, J. D. G. y Padayachi, U. K. (2000). Some methodological problems in estimating incidence and prevalence in child sexual abuse research. Journal of Sex Research, 37(4), 305-314. https://doi.org/10.1080/00224490009552052

González-Forteza, C. , Ramos, L. , Vignau B. y Ramírez, V. (2001). El abuso sexual y el intento suicida asociados con el malestar depresivo y la ideación suicida de los adolescentes. Mental Health, 24(6), 16-25.

Greenland, S. (1989). Modeling and variable selection in epidemiologic analysis. AmericanJournal of Public Health, 79(3), 340-349. https://doi.org/10.2105/AJPH.79.3.340

Hailes, H. P. , Yu, R. , Danese, A. y Fazel, S. (2019). Long-term outcomes of childhood sexual abuse: an umbrella review. The Lancet Psychiatry, 6(10), 830-839. https://doi.org/10.1016/S2215-0366(19)30286-X

Hernández-Avila, M. , Garrido-Latorre, F. y López-Moreno, S. (2000). Diseño de estudios epidemiológicos. Salud Pública de México, 42, 144-154. https://doi.org/10.1590/S0036-36342000000200010

Hernández, B. y Velasco-Mondragón, H. E. (2020). Encuestas transversales. Revista Cubana de Higiene Epidemiología, 42(5), 447-455.Hernández, J. (2006). Selección del tamaño de muestra en estudios clínicos. Revista Colombiana de Gastroenterología,21(2), 118-121.

Hosmer, D. W. , Taber, S. y Lemeshow, S. (1991). The importance of assessing the fit of logistic regression models: a case study. American Journal of Public Health, 81(12), 1630-1635. https://doi.org/10.2105/AJPH.81.12.1630

Instituto de Medicina Legal y Ciencias Forenses (2019). Comportamiento de la violencia doméstica. Colombia.

Instituto Nacional de Salud (2019). Violencia de género e intrafamiliar Colombia 2019. https://www.ins.gov.co/buscador-eventos/Informesdeevento/VIOLENCIA

IBM Corp (2015). IBM SPSS Statistics for Windows, Version 23.0. IBM Corp.Katz, M. N. (2006). Multivariable analysis. Second edition. Cambridge University Press.

Kilpatrick, D. , Ruggiero, K, Acierno, R. , Saunders, B. , Resnick, H. y Best, C. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence and comorbidity: Results from the national survey of adolescents. Journal of Consulting and Clinical Psychology, 71(4), 692-700. https://doi.org/10.1037/0022-006x.71.4.692

Landolt, M. , Schnyder, U. , Maier, T. , Schoenbucher y Mohler-Kuo, M. (2013). Trauma exposure and posttraumatic stress disorder in adolescents: a national Survey in Switzerland. Journal of Traumatic Stress, 26(2), 209-216. https://doi.org/10.1002/jts.21794

Lazarus, R. S. y Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.

Lee, H. , Lee, E. Y. , Greene, B. y Shin, Y. J. (2019). Psychological distress among adolescents in Laos, Mongolia, Nepal, and Sri Lanka. Asian Nursing Research, 13(2), 147-153. https://doi.org/10.1016/j.anr.2019.04.001

Lim, K. S. , Wong, C. H. , McIntyre, R. S. , Wang, J. , Zhang, Z. , Tran, B. X. , Tan, W. , Ho, C. S. y Ho, R. C. (2019). Global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents between 1989 and 2018: a meta-analysis. International Journal of Environmental Research and Public Health, 16(22), 4581. https://doi.org/10.3390/ijerph16224581

Lindert, J. , von Ehrenstein, O. S. , Grashow, R. , Gal, G. , Braehler, E. y Weisskopf, M. G. (2014). Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis. International Journal of Public Health, 59(2), 359-372. https://doi.org/10.1007/s00038-013-0519-5

López, S. Faro, C. , Lopetegui, L. , Pujol, E. , Monteagudo, M. y Cobo, J. (2017). Impacto del abuso sexual durante la infancia-adolescencia en las relaciones sexuales y afectivas de mujeres adultas. Gaceta Sanitaria, 31(3), 210-219. https://doi.org/10.1016/j.gaceta.2016.05.010

McKay, M. T. , Cannon, M. , Chambers, D. , Conroy, R. M. , Coughlan, H. , Dodd, P. , Healy, C. , O ?Donell, L. y Clarke, M. C. (2021). Childhood trauma and adult mental disorder: A systematic review and meta?analysis of longitudinal cohort studies. Acta Psychiatrica Scandinavica, 143(3), 189-205. https://doi.org/10.1111/acps.13268

Makhija, N. J. (2014). The relationship between trauma genic Dynamic responses towards childhood sexual abuse, ethnic identity, social support, trauma severity, and attitudes towards interpersonal relationships in adolescent females. Seton Hall University Dissertations and Theses.

Mann, R. E. , Hanson, R. K. y Thornton, D. (2010). Evaluar el riesgo de reincidencia sexual: Algunas propuestas sobre la naturaleza de los factores de riesgo psicológicamente significativos. Sexual Abuse: A Journal of Research and Treatment, 22(2), 191-217. https://doi.org/10.1177/1079063210366039

Martins, C. y Alencastro, L. (2015). Characteristics of violence suffered by high school adolescents in a Brazilian state capital. Revista Eletrônica de Enfermagem, 17(3),1-10. https://doi.org/10.5216/ree.v17i3.29684.

Meltzer-Brody, S. , Churchill, E. y Davidson, J. R. (1999). Derivation of the SPAN, a brief diagnostic screening test for post-traumatic stress disorder. Psychiatry Research, 88(1), 63-70. https://doi.org/10.1016/S0165-1781(99)00070-0

Ministerio de Salud de Colombia (1993). Resolución 008430 por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Santa fé de Bogotá.

Miranda-Mendizábal, A. , Castellví, P. , Parés-Badell, O. , Alayo, I. , Almenara, J. , Alonso, I. , Blasco, M. J. , Cebria, A. , Gabilondo, A. , Gili, M. , Lagares, C. , Piqueras, J. A. , Rodríguez-Jiménez, T. , Rodríguez-Marín, J. , Roca, M. , Soto-Sanz, V. , Vilagut, G. y Alonso, J. (2019). Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies. International Journal of Public Health, 64(2), 265-283. https://doi.org/10.1007/s00038-018-1196-1012345678

WaldropNg, Q. X. , Yong, B. Z. J. , Ho, C. Y. X. , Lim, D. Y. y Yeo, W. S. (2018). Early life sexual abuse is associated with increased suicide attempts: an update meta-analysis. Journal of Psychiatric Research, 99, 129-141. https://doi.org/10.1016/j.jpsychires.2018.02.001

Nöthling, J. , Simmons, C. , Suliman, S. y Seedat, S. (2017). Trauma type as a conditional risk factor for posttraumatic stress disorder in a referred clinic sample of adolescents. Comprehensive Psychiatry, 76, 138-146. https://doi.org/10.1016/j.comppsych.2017.05.001

O’Connor, R. C. y Nock, M. K. (2014). The psychology of suicidal behaviour. The Lancet Psychiatry, 1(1), 73-85. https://doi.org/10.1016/S2215-0366(14)70222-6

Orozco, R. , Borges, G. , Benjet, C. , Medina, M. y López, L. (2008). Traumatic life events and posttraumatic stress disorder among Mexican adolescents results from a survey. Salud Pública de México, 50(1), 529-537. https://doi.org/100.1590/S0036-36342008000700006

Patel, V. , Lund, C. , Hatherill, S. , Plagerson, S. , Corrigall, J. , Funk, M. y Flisher, A. J. (2010). Mental disorders: equity and social determinants. En E. Blas y A. S. Kurup, Equity, social determinants and public health programmes (pp. 114-134). Geneva: World Health Organization.

Pengpid, S. y Peltzer, K. (2020). Psychological distress and its associated factors among school-going adolescents in Tanzania. Psychological Studies, 65(2), 174-181. https://doi.org/10.1007/s12646-020-00550-2

Pengpid, S. , Peltzer, K. , Laosee, O. y Suthissukon, K. (2018). Intimate partner sexual violence and risk for femicide, suicidality and substance use among women in antenatal care and general out-patients in Thailand. BMC Women ?s Health, 18(1), 37. https://doi.org/10.1186 /s12905-018-0526-z

Pereda, N. , Abad, J. y Guilera, G. (2015). Victimization and Polyvictimization Among Spanish Adolescent Outpatients. Journal of Aggression, Maltreatment y Trauma, 24(9), 1044-1066. https://doi.org/10.1080/10926771.2015.1072121

Pereda, N. , Abad, J. y Guilera, G. (2016). Lifetime prevalence and characteristics of child sexual victimization in a community sample of Spanish adolescents. Journal of Child Sexual Abuse, 25(2), 142-158.https://doi.org/10.1080/10538712.2016.1123791

Pineda, D. A. , Guerrero, O. L. , Pinilla, M. L. y Estupiñán, M. (2002). Utilidad de un cuestionario para rastreo del estrés postraumático en una población

colombiana. Acta Neurológica Colombiana, 18(3), 132-138. https://doi.org/10.33588/rn.3410.2002009

Pineda-Roa, C. A. , Martínez-Chía, Á. P. , Corredor-González, D. Y. , Herazo, E. y Campo-Arias, A. (2018). Hallazgos psicométricos de la escala para ideación suicida del centro de estudios epidemiológicos en adolescentes escolarizados de Samacá, Boyacá. Biosalud, 17(2), 47-55. https://doi.org/10.17151/biosa.2018.17.2.4.

Polanczyk, G. V. , Salum, G. A. , Sugaya, L. S. , Caye, A. y Rohde, L. A. (2015). Annual Research Review: A meta?analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56(3), 345-365. https://doi.org/10.1111/jcpp.12381

Quarshie, E. N. , Waterman, M. G. y House, A. O. (2020). Self-harm with suicidal and non-suicidal intent in young people in sub-Saharan Africa: a systematic review. BMC Psychiatry, 20, 234. https://doi.org/10.1186/s12888-020-02587-z

Quintero?Aguado, A. , Bonilla?Escobar, F. J. , Otero?Ospina, A. , Campo-Cabal, G. y Valencia?Upegui, H. (2013). Abuso sexual infantil: ¿un ámbito omitido o desapercibido en Colombia? Revista Colombiana de Psiquiatría, 42(2), 234-235. https://doi.org 10.1016/S0034-7450(13)70012-X

Radford, L. , Corral, S. , Bradley, C. y Fisher, H. L. (2013). The prevalence and impact of child maltreatment and other types of victimization in the UK: Findings from a population survey of caregivers, children and young people and young adults. Child Abuse y Neglect, 37, 801-813. https://doi.org/10.1016/j.chiabu.2013.02.004

Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385-401. https://doi.org/10.1177/014662167700100306

Ridner, S. H. (2004). Psychological distress: concept analysis. Journal of Advanced Nursing, 45(5), 536-545. https://doi.org/10.1046/j.1365-2648.2003.02938.x

Saxena, S. , Jané-Llopis, E. V. A. y Hosman, C. (2006). Prevention of mental and behavioural disorders: implications for policy and practice. World Psychiatry, 5(1), 5-14.

Shapiro, D. N. , Kaplow, J.B. , Amaya Jackson, L. y Dodge, K. A. (2012). Marcadores conductuales de afrontamiento y síntomas psiquiátricos entre los abusados sexualmente niños. Journal of Traumatic Stress, 25(2), 157-163. https://doi.org/10.1002/jts.21674

Sheppard, R. , Deane, F. P. y Ciarrochi, J. (2018). Unmet need for professional mental health care among adolescents with high psychological distress. Australian y New Zealand Journal of Psychiatry, 52(1), 59-67. https://doi.org/10.1177%2F0004867417707818

Singer, M. , Bulled, N. , Ostrach, B. y Mendenhall, E. (2017). Syndemics and the biosocial conception of health. The Lancet, 389(10072), 941-950. https://doi.org/10.1186/s12889-020-09352-7

Solakoglu, O. , Driver, N. , y Belshaw, S. H. (2018). The effect of sexual abuse on deviant behaviors among Turkish adolescents: the mediating role of emotions. International Journal of Offender Therapy and Comparative Criminology, 62(1), 24-49. https://doi.org/10.1177/0306624X16642810

Solano, C. , Guiliana, C. , Chauca, C. , Gonzales, N. , Hernández, E. , Huamán, G. , ... Oyola, A. (2019). Factores asociados a la violencia familiar en estudiantes universitarios de ciencias de la salud. Revista Cubana de Salud Pública, 45(2), e1239.

Stoltenborgh, M. , van IJzendoorn, M. H. , Euser, E.M. y Bakermans-Kranenburg, M. J. (2011). A global perspective on child sexual abuse: Meta-analysis of prevalence around the world. Maltrato infantil, 16(2), 79-101. https://doi.org/10.1177/1077559511403920

Tran, Q. A. , Le, V. T. H. y Nguyen, T. H. D. (2020). Depressive symptoms and suicidal ideation among Vietnamese students aged 13–17: Results from a cross-sectional study throughout four geographical regions of Vietnam. Health Psychology Open, 7(2), 2055102920973253. https://doi.org/10.1177/2055102920973253

Turner, H. A. , Finkelhor, D. , Shattuck, A. y Hamby, S. (2012). Recent victimization exposure and suicidal ideation in adolescents. Archives of Pediatrics y Adolescent Medicine, 166(12), 1149-1154. https://doi.org/10.1001/archpediatrics.2012.1549

Uddin, R. , Burton, N. W. , Maple, M. , Khan, S. R. y Khan, A. (2019). Suicidal ideation, suicide planning, and suicide attempts among adolescents in 59 low-income and middle-income countries: a population-based study. The Lancet Child y Adolescent Health, 3(4), 223-233. https://doi.org/10.1016/S2352-4642(18)30403-6

Vélez, C. M. , Henao, P. A. , Ordoñez, F. y Gómez, L. E. (2015). Evaluación de un programa de promoción de conductas de autoprotección para la prevención del abuso sexual, Medellín. Revista Médica de Risaralda, 21(1), 3- 8. https://doi.org/10.22517/25395203.8855

Ventura-León, J. y Valencia, P. D. (2020). Intervalos de confianza: Aclaraciones e interpretaciones en el ámbito de salud. Revista Chilena de Pediatría, 91(6), 991-992. https://doi.org/10.22517/10.32641/rchped.vi91i6.2972

Waldrop, A. E. , Hanson, R. F. , Resnick, H. S. , Kilpatrick, D. G. , Naugle, A. E. y Saunders, B. E. (2007). Risk factors for suicidal behavior among a national sample of adolescents: Implications for prevention. Journal of traumatic Stress, 20(5), 869-879. https://doi.org/10.1002/jts.20291

Wilson, H. W. y Widom, C. S. (2009). A prospective examination of the path from child abuse and neglect to illicit drug use in middle adulthood: The potential mediating role of four risk factors. Journal of Youth Adolescence, 38(3), 340-354. https://doi.org/10.1007 /s10964-008-9331-6

World Health Organization (2014). Global status report on violence prevention. Geneva. World Health Organization.

World Health Organization Regional Office for Europe (1998). Well-being measures in primary health care: The DepCare project. Consensus meeting. Stockholm: WHO Regional Office.

World Medical Association (2018). WMA Declaration of Helsinki – Ethical principles for medical research involving human subjects. The World Medical Association. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/

Xu, D. D. , Rao, W. W. , Cao, X. L. , Wen, S. Y. , An, F. R. , Che, W. I. , Bressintong, D. T. , Cheung, T. , Ungvari, G. S. y Xiang, Y. T. (2020). Prevalence of depressive symptoms in primary school students in China: A systematic review and meta-analysis. Journal of Affective Disorders, 268, 20-27. https://doi.org/10.1016/j.jad.2020.02.034

Xu, D. D. , Rao, W. W. , Cao, X. L. , Wen, S. Y. , Che, W. I. , Ng, C. H. , Gabor, S. U. , Du, Y. , Zhang, L. y Xiang, Y. T. (2018). Prevalence of major depressive disorder in children and adolescents in China: a systematic review and meta-analysis. Journal of Affective Disorders, 241, 592-598. https://doi.org/10.1016/j.jad.2018.07.083

Yoon, Y. , Cederbaum, J. y Schwartz, A. (2018). Childhood sexual abuse and current suicidal ideation among adolescents: Problem-focused and emotion-focused coping skills. Journal of Adolescence, 67, 120-128. https://doi.org/10.1016/j.adolescence.2018.06.009

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