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Biomedical subjects

R Dickey

Publications and source records attributed to R Dickey.

At least 19 recordsLinked to original sources
PubMed2001

Sensitivity and specificity of the phallometric test for pedophilia in nonadmitting sex offenders.

The specificity of phallometric testing for pedophilia has been calculated using sex offenders against adult women. Does the offender's actual number of prior sexual contacts with women affect such estimates? To answer this, the authors' studied 82 male sex offenders against adult women, 172 offenders against unrelated children, and 70 offenders against their own biological children or stepchildren. Phallometric testing included visual and auditory depictions of prepubescent, pubescent, and adult males and females. The results for offenders against women showed that those who had had sexual contact with the greatest number of women (consenting or nonconsenting) had the lowest probability of being diagnosed as pedophilic. Specificity, calculated for those who had sexual contact with the most women and thus the most evidence of attraction to them, was 96%. Sensitivity, calculated analogously for men with the most offenses against children, was 61%.

Adolescent↗
PubMed2000

Fraternal birth order and sexual orientation in pedophiles.

Whether homosexual pedophiles have more older brothers (a higher fraternal birth order) than do heterosexual pedophiles was investigated. Subjects were 260 sex offenders (against children age 14 or younger) and 260 matched volunteer controls. The subject's relative attraction to male and female children was assessed by phallometric testing in one analysis, and by his offense history in another. Both methods showed that fraternal birth order correlates with homosexuality in pedophiles, just as it does in men attracted to physically mature partners. Results suggest that fraternal birth order (or the underlying variable it represents) may prove the first identified universal factor in homosexual development. Results also argue against a previous explanation of the high prevalence of homosexuality in pedophiles (25% in this study), namely, that the factors that determine sexual preference in pedophiles are different from those that determine sexual preference in men attracted to adults. An alternative explanation in terms of canalization of development is suggested.

Adolescent↗
PubMed1999

Monitoring brevetoxins during a Gymnodinium breve red tide: comparison of sodium channel specific cytotoxicity assay and mouse bioassay for determination of neurotoxic shellfish toxins in shellfish extracts.

In October of 1996, a Gymnodinium breve bloom occurred in shellfish harvesting waters of Alabama, Mississippi and Louisiana, Gulf of Mexico, USA. Bloom densities reached 5.6x10(5) cells liter(-1) and bloom residence at shellfish sampling stations ranged from 3 to 28 days. Brevetoxin-2 dominated G. breve toxin profiles in bloom seawater extracts. Shellfish toxicity, assessed by mouse bioassay, exceeded the guidance level for up to 75 days after the bloom had dissipated. Cytotoxicity assays and mouse bioassays showed similar temporal patterns of shellfish toxicity, but the two methods differed in estimations of brevetoxin-3 equivalent toxicity by a factor of 93 to 1. LC-ESI-MS showed the temporal patterns in shellfish toxicity reflected metabolism of G. breve toxins. The molecular ions m/z 1004, 1017 and 1033 dominated LC-ESI-MS spectra of toxic chromatographic fractions from the extracts and were identified as brevetoxin metabolites on the basis of LC-APCI-MS-MS. The discrepancy between cytotoxicity and mouse bioassay estimates of brevetoxin-3 equivalent toxicity resulted from the difference in extraction efficiency of solvents used in the respective methods and the relative sensitivity of the assays to toxin metabolite mixtures present in the extracts. The normalized cytotoxicity assay showed 75% agreement with mouse bioassay positive test samples and 64% agreement with mouse bioassay negative test samples. Published in 1999 by John Wiley & Sons, Ltd.

Animals↗
PubMed1999

Pedophiles: mental retardation, maternal age, and sexual orientation.

Intellectual functioning, parental age, and sexual orientation in 991 male sexual offenders were investigated. Sources of data included semistructured interviews, clinical charts, phallometric tests, and self-administered questionnaires. The results suggest two main conclusions: (i) Among pedophiles in general, erotic preference moves away from adult women along two dimensions: age and sex. The extent of this movement is greater, along both dimensions, for pedophiles with lower levels of intellectual functioning. (ii) High maternal age (or some factor it represents) increases the likelihood of exclusive sexual interest in boys. Intellectual deficiency (or some factor it represents) decreases the likelihood of exclusive sexual interest in girls. These two factors summate, so that a pedophile with both factors is more likely to be sexually interested in boys than a pedophile with only one.

Adult↗
PubMed1998

The relation of birth order to sexual orientation in men and women.

Homosexual men have a higher mean birth order than do heterosexual men, primarily because they have a greater number of older brothers. The purpose of this study was to determine whether the same difference occurs in homosexual vs heterosexual women. The probands were 964 homosexual and heterosexual, male and female volunteers, from whom birth order data were collected with self-administered questionnaires. The homosexual men had more older brothers than the heterosexual men, but they did not have more older sisters, younger brothers, or younger sisters. The homosexual women did not differ from the heterosexual women with regard to any class of sibling. These results are consistent with the hypothesis that the high birth order of homosexual men reflects the progressive immunization of certain mothers to H-Y antigen by succeeding male fetuses, and the increasing effects of H-Y antibodies on sexual differentiation of the brain in succeeding male fetuses.

Adult↗
PubMed1995

Surgical sex reassignment: a comparative survey of international centers.

The Harry Benjamin International Gender Dysphoria Association's Standards of Care (Walker et al., 1985) set out minimum standards for the selection of patients for sex reassignment surgery. This survey reports on the standard and policies actually used by clinics in Europe and North America, including their areas of agreement and disagreement with the Standards. To our knowledge, there has been only one prior survey of gender clinic policies, and that was restricted to European treatment facilities. The present survey is aimed at primary caregivers in the medical community; however, it may also be of use to administrators in responding to increasing demands for accountability from special interest groups and from government, with their often divergent agendas. It is our hope that this survey will begin the process of developing more uniform standards of care.

Data Collection↗
PubMed1995

Comparison of height and weight in homosexual versus nonhomosexual male gender dysphorics.

The authors' clinical impression that homosexual gender-dysphoric males are physically smaller than nonhomosexual gender-dysphoric males was tested. Subjects were 176 homosexual and 246 nonhomosexual male outpatients, ages 16 to 65, who complained of discontent with their biological sex. Compared with the nonhomosexual male gender dysphorics, the homosexual gender dysphorics were shorter, lighter, and lighter in proportion to their height. The homosexual gender dysphorics were also shorter than men in the general population, whereas the nonhomosexual gender dysphorics were not. The smaller physiques of homosexual gender-dysphoric men may partly explain the clinical observation that these patients are somewhat more successful in passing as women.

Adolescent↗
PubMed1995

Female-to-male transsexualism, heterosexual type: two cases.

Two cases of gender-dysphoric genetic females who describe a sexual attraction to phenotypic males are reported. After outlining their individual histories, the authors note common clinical features of this subtype of transsexualism. Similar characteristics have also been found in the few cases of heterosexual transsexualism in genetic females reported by others. Familiarity with the distinguishing features of this subgroup could assist clinicians in diagnosing and treating such patients.

Adult↗
PubMed1992

The management of a case of treatment-resistant paraphilia with a long-acting LHRH agonist.

A patient with multiple paraphilias who had been treated for several years with sex drive reducing agents (cyproterone acetate and medroxyprogesterone acetate) with little effect on sexual activity or fantasy was offered treatment with long-acting leuprolide acetate, on LHRH agonist. This produced a marked decrease in all reported sexual thoughts and activities with no significant side-effects.

Adult↗
PubMed1991

Erotic gender differentiation in pedophilia.

Five groups of males were compared on penile volume changes elicited from viewing short movie strips and slides of nude children and adults of both genders. Subject groups were sex offenders against adult females, volunteer controls who erotically preferred adult females, volunteer controls who erotically preferred adult males, heterosexual pedophiles, and homosexual pedophiles. Pedophiles differentiated erotically between females and males less than males who erotically preferred physically mature partners.

Choice Behavior↗
PubMed1991

Group therapy for gender-dysphoric heterosexual men.

The treatment and clinical management of gender dysphoric heterosexual men often poses a challenge to the clinician. Gender dysphoric patients pursuing various lifestyle options may seek psychotherapy to deal with some of their conflicts. This paper describes one form of counseling--group therapy--which has been helpful to gender dysphoric heterosexual men and outlines the group psychotherapy program at the Gender Clinic of the Clarke Institute of Psychiatry.

Adult↗
PubMed1990

Does sexual abuse in childhood cause pedophilia: an exploratory study.

The reliability of the notion that pedophilia is caused by sexual abuse in childhood was explored by examining retrospective self-reports of 344 males. Included in the study were 77 heterosexual pedophiles, 54 homosexual pedophiles, 51 nonpedophilic sex offenders against children, 36 sex offenders against physically mature females, 75 heterosexual paid volunteers who erotically preferred mature females, and 51 homosexual clients who preferred mature males. For each sex offender the differential diagnosis of an erotic preference for minors vs. a preference for physically mature partners was made by means of the phallometric test of erotic gender and age preferences. The analysis of self-reports confirmed that the proportion of pedophiles who report having been sexually abused in childhood by mature persons is larger than that of men who were not charged for or accused of a sex offense against a child though the difference is relatively small (28.6 vs. 13.9 and 10.7% for the heterosexual pedophiles and the two groups of gynephiles, respectively, and 25.9 vs. 11.8% for the homosexual pedophiles and androphiles, respectively). Further analysis demonstrated, however, that pedophiles who admitted having an erotic interest in children significantly more often claimed that they had been sexually abused as children than pedophiles who did not admit having such feelings. This interdependence renders the reliability of these self-reports questionable.

Adult↗
PubMed1989

Prediction of regrets in postoperative transsexuals.

This study investigated whether heterosexual males are more likely to regret sex reassignment surgery than homosexual males or females. Subjects were 111 postoperative transsexuals who had been surgically reassigned for at least one year, representing a follow-up rate of 84.1%. Subjects' feelings about surgery were assessed with self-administered questionnaires. None of the 61 homosexual females or 36 homosexual males consciously regretted surgery, compared to 4 of the 14 heterosexual males: a significant difference. This finding suggests that heterosexual applicants for sex reassignment should be evaluated with particular caution, although a heterosexual preference is not an absolute contraindication for surgery.

Adaptation, Psychological↗
PubMed1988

Sexual sadism: brain, blood, and behavior.

The behavior of sadists is bizarre and poorly understood. There are gross endocrine and brain abnormalities in a small number of these men. Approximately two-fifths show subtle temporal lobe brain abnormalities that are logically linked to sexual behavior and require further exploration. It would be interesting to explore the interface of the endocrine system and the brain--that is, to determine if there are interactive processes that may be related to the development of sexual anomalies, perhaps early in life as suggested by Kolarsky et al. Certainly, biological factors cannot determine whether an individual will act on his sexual impulses. Many psychological factors, such as family background and substance abuse, play a significant role in the dangerousness of the individual. However, it appears that biological factors are noteworthy in sexual sadism. Brain pathology, especially, shows some correlation with force used in offences and likelihood of recidivism, and for this reason alone it merits further study.

Aggression↗
PubMed1987

Using technology to control the environment.

Over the last 5 years, technological advances have resulted in specialized technical aids, such as electronic communication devices, computer input devices, and environmental control systems, which have made it possible for many persons who are severely physically disabled to enjoy greater functional independence within the home, school, workplace, and the community. This paper focuses on environmental control systems and discusses how occupational therapists match environmental control systems with clients' needs.

Adult↗
PubMed1984

Total hip arthroplasty with a low-modulus porous-coated femoral component.

Fifty-seven patients had sixty-three total hip replacements, performed using a femoral stem with a soft, low-modulus porous coating of Proplast and a conventional acrylic-cemented acetabular component. Forty-seven of the hips were followed for an average of thirty-seven months. Seventeen (36 per cent) of the forty-seven hips were judged to be clinical failures, and five of the failures were revised by inserting a new femoral component and fixing it with acrylic cement. The prostheses were thought to have failed because they had inadequate support, due to deficiencies in the design of the stem and in the fit of the implant in the femur. The five retrieved prostheses were found to have fibrous-tissue ingrowth into the coating, which had failed by shear within its substance. Therefore, we concluded that the coating had insufficient strength to withstand normal weight-bearing loads. To improve performance, a more stable prosthesis with a stronger porous coating is needed. In addition, a posterior surgical approach through a transtrochanteric osteotomy may give better exposure of the femoral canal and facilitate the use of longer-stem (140 to 153-millimeter) designs, which are less likely to be inserted in a varus position.

Biocompatible Materials↗