文章基本信息

标题：Adolescents’ and Adults’ Experiences of Being Surveyed About Violence and Abuse: A Systematic Review of Harms, Benefits, and Regrets
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作者：Tracy McClinton Appollis ; Crick Lund ; Petrus J. de Vries 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2015
卷号：105
期号：2
页码：e31-e45
DOI：10.2105/AJPH.2014.302293
语种：English
出版社：American Public Health Association
摘要：The neuroscience and psychological literatures suggest that talking about previous violence and abuse may not only be beneficial, as previously believed, but may also be associated with risks. Thus, studies on such topics introduce ethical questions regarding the risk–benefit ratio of sensitive research. We performed a systematic review of participants’ experiences related to sensitive research and compared consequent harms, benefits, and regrets among victims and nonvictims of abuse. Thirty studies were included (4 adolescent and 26 adult studies). In adolescent studies, 3% to 37% of participants (median: 6%) reported harms, but none of these studies measured benefits or regrets. Among adults, 4% to 50% (median: 25%) reported harms, 23% to 100% (median: 92%) reported benefits, and 1% to 6% (median: 2%) reported regrets. Our results suggest that the risk–benefit ratio related to sensitive research is not unfavorable, but there are gaps in the evidence among adolescents. Sensitive research topics include those that are highly private and potentially psychologically traumatic. Substance use, sexual practices, violence and abuse, death, accidents, combat (including war), and natural disasters might all be considered sensitive research topics. Since the 1930s and 1940s, research has increasingly focused on sensitive topics, predominantly owing to the epidemics of illicit drug use, AIDS, and teenage pregnancies. 1,2 There is a clear scientific rationale for research on sensitive topics to generate accurate information about prevalence, risk and protective factors, and intervention strategies. The self-reports of research participants are one of the most efficient data collection methods to gather such information. In the clinical arena of trauma-related disorders, including posttraumatic stress disorder (PTSD), earlier approaches of debriefing and “talking through” traumatic experiences were thought to be helpful intervention strategies to manage trauma and reduce risk. More recent evidence, however, suggests that such approaches may be harmful and may lead to retraumatization. 3 The past decade has also seen an emerging neuroscience literature focusing on memory consolidation and reconsolidation; this literature suggests that reliving a memory might strengthen the memory trace. 4 Taken together, psychological and neuroscience evidence suggests that there may be both risks and benefits of trauma-based clinical work. There has also been a debate in research settings as to whether recalling and answering questions about past trauma or abuse has negative or positive consequences for study participants. 5–10 Some argue that asking about abuse might be upsetting, harmful, and stigmatizing and may lead to retraumatization; that survivors might not be emotionally stable enough to assess risk or seek help; and that researchers have an obligation to protect survivors from questions about their experiences. In contrast, others suggest that disclosure in the context of research participation may be followed by emotional relief, that participants identify such disclosure as beneficial, and that most participants do not regret or negatively appraise their research experience. 11–18 Furthermore, it has been suggested that the emotional distress experienced by participants involved in sensitive research is an indicator of emotional engagement with a research project rather than an indicator of harm. 5 Given this debate, it is important to examine the literature regarding harms, benefits, and regrets in the context of sensitive research. A key consideration is differences between those with previous exposure to violence and abuse (victimization or perpetration) and those who have not been exposed. Another consideration is whether responses to research differ by gender. Females might be more vulnerable to the harms of research participation because prevailing norms supporting gender power inequities and male violence against women and girls may limit the accessibility of support during and after participation. Responses to participation may also be age dependent. In particular, adolescents who are exposed to abuse might be particularly vulnerable because they may need more support than adults during and after the research, and such support may be less accessible to them. Given the uncertainty regarding the risks, benefits, and risk-to-benefit ratio of participating in sensitive research, we conducted a systematic review of quantitative and qualitative studies investigating adolescents’ and adults’ experiences of participating in studies that included sensitive questions regarding violence and abuse (including intimate partner violence [IPV]) victimization and perpetration. We compared the consequent harms, benefits, and regrets among individuals who had been victims and perpetrators of violence or abuse with those of individuals who had not been victims or perpetrators. Furthermore, we investigated whether there were gender and age differences in the reporting of harms and benefits of research experience. Our goal was to produce evidence to guide researchers and ethics committees in avoiding underprotection or overprotection of human participants in research on violence and abuse.