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Results for “Psychosexual Development”

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PubMed1994

Role of 5 alpha-reductase in health and disease.

The mechanism of androgen action varies in different tissues, but in the majority of androgen target tissues either testosterone or 5 alpha-dihydrotestosterone (DHT) binds to a specific androgen receptor to form a complex that can regulate gene expression. Testosterone is metabolized to DHT by the enzyme 5 alpha-reductase. The autosomal recessive genetic disorder of 5 alpha-reductase deficiency has clearly shown that the requirement for DHT formation varies with different tissues. In this syndrome genetic males contain normal male internal structures including testes, but exhibit ambiguous or female external genitalia at birth; at puberty they undergo partial virilization which includes development of a male gender identity even if brought up as females. Their development suggests that testosterone itself is able to stimulate psychosexual behaviour, development of the embryonic wolffian duct, muscle development, voice deepening, spermatogenesis, and axillary and pubic hair growth; DHT seems to be essential for prostate development and growth, the development of the external genitalia and male patterns of facial and body hair growth or male-pattern baldness. How different hormones operate to regulate genes via the same receptor is currently unknown, but appears to involve cell-specific factors. The 5-alpha-reductase enzyme has proved difficult to isolate biochemically, but recently at least two human isoenzymes have been identified using molecular biological methods. All the various 5 alpha-reductase-deficient kindreds have been shown to have mutations in 5 alpha-reductase 2, the predominant form in the prostate. The biological role of 5 alpha-reductase 1 has not yet been ascertained, but at present it cannot be ruled out that some of the actions ascribed to testosterone are indeed in cells producing DHT via this enzyme. The activity of 5 alpha-reductase is also implicated in benign prostatic hypertrophy, hirsutism and possibly male-pattern baldness; recent evidence discounts the role of 5 alpha reductase 2 in sebaceous glands and acne. Specific inhibitors of both enzymes are now available and finasteride, a 5 alpha-reductase 2 inhibitor, has been used successfully in clinical trials of benign prostatic hypertrophy. Knowledge of 5 alpha-reductase is expanding dramatically at the moment with the application of molecular biological methods. The advent of antibodies to the isoenzymes should herald further understanding of their biological and clinical roles.

Animals↗
PubMed2004

Father hunger and narcissistic deformation.

The author advances the hypothesis that paternal availability and the relationship between the mother and father are crucial components of evolving character structure in children. He proposes that a kind of narcissistic pathology featuring perverse sexuality may eventuate in the absence of paternal availability and in the presence of a disordered relationship between the parents. He also suggests that the ways in which aggression is or is not modulated and organized are crucial components of this evolving disorder, and that boys are more susceptible to its full manifestation and expression than are girls.

Adolescent↗
PubMed1998

[Psychodynamics and therapy of trichotillomania].

After a short review of the literature, some aspects of the psychodynamics and therapy of trichotillomania with an adolescent patient are presented that up to now have not been described in great detail. Against the backdrop of previous fears of being abandoned, the patient feels threatened that while coping with the developmental tasks of sexuality and aggressiveness she will be dropped once again. This psychodynamically oriented therapy makes it possible for the patient to accept and verbalize the corresponding feelings in a relationship that gives a feeling of security. Therefore, the symptoms that previously served the purpose of regulating diffuse inner tensions and fears may be abandoned.

Acculturation↗
PubMed2006

Gender development in women with congenital adrenal hyperplasia as a function of disorder severity.

Prenatal-onset classical congenital adrenal hyperplasia (CAH) in 46,XX individuals is associated with variable masculinization/defeminization of the genitalia and of behavior, presumably both due to excess prenatal androgen production. The purpose of the current study was threefold: (1) to extend the gender-behavioral investigation to the mildest subtype of 46,XX CAH, the non-classical (NC) variant, (2) to replicate previous findings on moderate and severe variants of 46,XX CAH using a battery of diversely constructed assessment instruments, and (3) to evaluate the utility of the chosen assessment instruments for this area of work. We studied 63 women with classical CAH (42 with the salt wasting [SW] and 21 with the simple virilizing [SV] variant), 82 women with the NC variant, and 24 related non-CAH sisters and female cousins as controls (COS). NC women showed a few signs of gender shifts in the expected direction, SV women were intermediate, and SW women most severely affected. In terms of gender identity, two SW women were gender-dysphoric, and a third had changed to male in adulthood. All others identified as women. We conclude that behavioral masculinization/defeminization is pronounced in SW-CAH women, slight but still clearly demonstrable in SV women, and probable, but still in need of replication in NC women. There continues a need for improved instruments for gender assessment.

Adrenal Hyperplasia, Congenital↗
PubMed1995

Gender, psychopathology, and development: from puberty to early adulthood.

We tested the hypothesis that the expression of schizophrenic psychopathology is dependent on the stage of adolescent development. The study had a retrospective design, using high-quality case-note material of cases of schizophrenia at first admission. Patients with onset of illness between the age of 11 and 21 years were included. Sexual delusions were more apparent in females (OR = 3.6;95% CI 1.6-8.0), but otherwise no gender differences in the frequency of a range of positive symptoms were apparent. There was evidence that the age at which positive symptoms first appeared differed between males and females. The frequency of typical, 'first rank' schizophrenic symptoms such as auditory hallucinations, passivity phenomena and though interference, increased linearly with age in male patients, but did not vary with age in their female counterparts. The likelihood of displaying delusional beliefs such as persecutory delusions, explanatory delusions, delusions of reference and grandiose delusions increased with age in both sexes, but the association was stronger in males. The observation that typical schizophrenic symptoms in male patients are relatively uncommon during early adolescence, but increase as they grow older, could be explained by the later manifestation of puberty and associated maturational processes in boys.

Adolescent↗
PubMed1989

From protomasochism to masochism. A developmental view.

A developmental view may help clarify confusions that exist regarding masochism. Following Loewenstein, I suggest that protomasochism be distinguished from masochism. Protomasochism comprises conditions prior to the oedipal period which may lead to masochism. Preoedipal precursors of masochism are organized and transformed during the oedipal stage and later. A conscious or unconscious genital sexual fantasy in which pain is an integral part may appear at that time. The demonstration of such a fantasy is essential for the definitive diagnosis of masochism. It is overdetermined and may result from a variety of dynamic configurations and genetic origins. In making those suggestions, I assume, following Freud, that erotogenic masochism is basic to all forms of masochism.

Adolescent↗
PubMed1984

Puberty.

Explore the source record for details and available documents.

Adolescent↗
PubMed1997

Toward a strategy for healthy adolescent development.

Mel Sabshin and I worked closely together during the 1950s, and his influence on me-as on so many others-has persisted ever since. I have never ceased to be deeply impressed by his intellectual curiosity, his strong sense of social responsibility, his integrative capacity across disciplines, and his constructive problem-solving orientation. One of his pioneering and enduring interests over several decades has been in the study of normality. Within that frame-work, he has devoted special attention to adolescent development. In this article I pick up on this strand of his interest. During much of my career, and especially during the past 14 years at the Carnegie Corporation, I have sought ways to build the knowledge base on adolescent development and put that knowledge to use in preventing lifelong casualties.

Adolescent↗
PubMed1983

The effect of juvenile-onset manic-depressive disorder on the developmental tasks of adolescence.

The impact on the individual of manic-depressive disorder can be devastating. This is most evident in adolescence, an epoch during which many cases first declare themselves. Adolescence is a crucial developmental phase during which confidence, initiative, and sociability are consolidated. Core symptoms of manic-depressive disorder involve all these functions, and appropriate adolescent development can be further undermined by the knowledge that these same functions can be driven out of control by the illness. An illustrative case of an articulate young lady suffering from manic-depression is described, and her feelings about the uncertainty introduced into her life by the illness are compellingly presented in a poem. The major implication of our observations is that adolescent-onset manic-depressives need not be burdened additionally by developmental arrest or delay. They frequently need psychotherapy to adjust to the handicap of their illness.

Adolescent↗