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PubMed1975

[New views on the significance and treatment of undescended testis (author's transl)].

Undescended testis is of clinical importance because there are increased risks of milignancy and torsion and disturbances of fertility and psychosexual development. New quantitative morphologic investigations show that human prepubertal testicular maturation does not occur in phases but is continuous. This made it necessary to investigate afresh the causes of disturbance of fertility and the treatment of indescended testis. Our own investigations show that damage to the germ epithelium need not be congenital but may develop because of its ectopy. If, in dogs, a testis is placed into the abdomen, not only this but also the normally placed testis in the scrotum is damaged. The diameter of the tubules and their surfaces as well as the numbers of pachtenous primary spermatocytes are significantly reduced both in the displaced and the normally placed testis. Nuclear surfaces and density of the cells involved in spermatogenesis differ from those in the controls. The findings support the plea for early hormonal or surgical treatment in order to prevent later disturbances of fertility.

Age Factors↗
PubMed1979

Negative attitudes toward masturbation in sex therapy.

The incidence of masturbation in males and females as reported by Kinsey was cited as basic data to support Gagnon and Simon's theoretical conceptions of differences in the psychosexual development of males and females. The use of masturbation as treatment in sex therapy was reviewed. An inventory to measure negative attitudes toward masturbation was described, and four research studies supporting its construct validity was summarized. The affective-cognitive structure of masturbation-guilt was posited to inhibit masturbatory behavior and to elicit negative affects such as guilt and disgust as a consequence of masturbation. The use of the inventory measuring negative attitudes toward masturbation was illustrated using the P-LI-SS-IT model. Intensive therapy from a gestalt sex therapy perspective was illustrated as integrating the negative masturbatory schema into self-regulating awareness-expression cycles. A caution to sex therapists alerted them to the importance of awareness of emotions, fantasy, and sociosexual meanings in sex therapy rather than using masturbation as a packaged technique.

Affect↗
PubMed1987

The psychological facet of psychosomatic disturbances.

The first part of this paper deals with the psychological background to the most common difficulties in the relation between doctors and patients, particularly when the two parties disagree about the diagnostic and therapeutic approach to a psychosomatic affection. The following causes for discord are discussed: Alexithymia--a mental deficiency that obstructs the insight into the connection between emotional and physical reactions to all types of life experiences; Anal object relationships--a disturbance of the psychosexual development in early childhood, involving in particular the risk of a destructive struggle for power between the patient and the doctor; Regression--the return to a more infantile stage of behaviour in a person who had once passed that stage, involving the risk of mistrust and hatred from the patient towards a doctor whom he conceives as coldhearted and repudiating; Gain of illness--unconscious psychic defence mechanisms that are often misunderstood and may lead the unwise and unsuspecting doctor to fateful errors of treatment and management. The second part describes the tactics for a fruitful cooperation between doctor and patient in regard to the investigation and management of gastrointestinal complaints, possibly originating from psychosomatic reactions to stress and other psychological and social strains. Before the diagnosis is made, it is essential to pursue in parallel two lines of investigation--the somatic and the psychosocial--to avoid one line impeding advances along the other. When a thorough somatic examination has made it clear that the patient's complaints are not caused by an organic disease and the patient's search for a psychosomatic connection has not yet been successful, the so-called redirectional work remains.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1986

A developmental approach to pregnancy prevention with early adolescent females.

Traditional pregnancy prevention strategies employed with adults and older teens do not recognize significant developmental differences between early adolescents and other age groups. Methods that compliment, reflect, and are consistent with developmental needs of the young teen provide cogent approaches to teen pregnancy prevention. Particular emphasis should be placed on interpersonal relationships and their importance in the young woman's life, especially the relationship between the young teen and her parents. Developing and improving all relationships instrumental in positively affecting teen decision-making represent potent approaches to pregnancy prevention. The axioms of Piaget, Erikson, and Mercer are examined in regard to cognitive, social, emotional, and psychosexual development in the 12-14 year old. Young teens' responses to sex education as well as their use of contraception are reviewed in relation to developmental theory.

Adolescent↗
PubMed1990

[Sex determination in ambiguous genitalia].

Choice of sex in children with ambiguous genitalia requires morphological evaluation of external and internal genitalia together with prevision of the kind of pubertal and psychosexual development. Female features in female pseudohermaphroditism, ambiguous in true hermaphroditism and mixed gonadal dysgenesis, male, ambiguous or female in male pseudohermaphroditism, are usually awaited. Increased risk of malignancy in poorly differentiated male gonads should be considered. In neonates diagnostic procedures should be urgently undertaken in order to choose correct sex as soon as possible. Parents must be convinced from the beginning in order to remove any possible doubt. There should be no change in sex, as a rule, after the second year of life, unless a strong psychosexuality arises in definite opposition to the sex so far assumed. In our experience, in 4 out of 23 cases with ambiguous genitalia, neonatal choice of female sex was refused by parents.

Disorders of Sex Development↗
PubMed1977

Clinical assessment of a profession: Roman Catholic clergymen.

The present study investigated the personality of the American Catholic priest by means of clinical procedures. It is based on a national, randomly selected, representative sample. Recorded 2-hour clinical interview plus a battery of standardized as well as specially designed psychological tests were administered to 271 Ss. A clinical report was written for each priest based on all the interview data. Four categories or types of classification were devised to describe and to distinguish the priests along a continuum of soci-psychological development: maldeveloped (8%), underdeveloped (57%), developing (29%), and developed (6%).

Adult↗
PubMed1990

Anorexia nervosa in adolescent males: a review and case study.

The clinical presentation of anorexia nervosa among males is quite rare. This paper examines the personality and developmental issues of anorexia nervosa in adolescent males through a comprehensive review of the literature and a case presentation. In addition, this paper will demonstrate the application of the empirical literature in the development of a conceptual model to identify critical diagnostic and psychotherapeutic issues within the assessment of a clinically rare case, a male adolescent with anorexia nervosa.

Adolescent↗
PubMed1975

[Gynecological remarks on the problem of the artificial vagina (author's transl)].

Accurate differentiation of the pathologic state must precede surgical construction of an artificial vagina. Moreover, it is necessary to know whether a uterus is present and whether the psychosexual development of the patient is female. Differential diagnosis is concerned with various forms of intersexuality, especially aplasia and atresia of the vagina. Relevant cases are reported. The author prefers the McIndoe operation, because of its low risk. If the patient has a uterus (i.e. women with AGS with complete masculinization or women with atresia of the vagina) more effective operations should be done, as intercourse and conception are possible after surgery in these women.

Adrenal Hyperplasia, Congenital↗
PubMed1987

Psychological findings in early treated cases of female pseudohermaphroditism caused by virilizing congenital adrenal hyperplasia.

Nine female adolescents with female pseudohermaphroditism resulting from virilizing congenital adrenocortical hyperplasia (CAH) were studied in terms of gender identity, sex-role behavior, psychological adjustment, and psychosexual development. A group of adolescents with chronic illness was used as a control. The Draw-A-Person, the Bem Sex-Role Inventory, Rorschach, TAT, and a questionnaire reviewing peer and romantic activities were administered to both groups. The two groups were comparable on measures of general personality adjustment, with the CAH girls showing a trend toward greater bodily concerns. Sex-role identity for both groups was near the adolescent girl norms for both Femininity and Masculinity, with virilized CAH girls showing slightly higher Androgyny scores. Significant differences were found on gender identity as measured by greater differentiation of the drawn male figure as well as a trend toward drawing the male figure first. The CAH females also showed consistent patterns of psychosocial delay in dating and sexual relations as compared to the control group. Gender identity in this group appears to be mediated by body image. The resulting ambivalence may be evidence of feelings of incompetence, leading to resistance to social interactions and goals involving intimacy and nurturance.

Adolescent↗
PubMed1992

A review of the long-term effects of child sexual abuse.

The existing literature on the long-term sequelae of child sexual abuse is reviewed. The evidence suggests that sexual abuse is an important problem with serious long-term sequelae; but the specific effects of sexual abuse, independent of force, threat of force, or such family variables as parental psychopathology, are still to be clarified. Adult women with a history of childhood sexual abuse show greater evidence of sexual disturbance or dysfunction, homosexual experiences in adolescence or adulthood, depression, and are more likely than nonabused women to be revictimized. Anxiety, fear, and suicidal ideas and behavior have also been associated with a history of childhood sexual abuse but force and threat of force may be a necessary concomitant. As yet, there is insufficient evidence to confirm a relation between a history of childhood sexual abuse and a postsexual abuse syndrome and multiple or borderline personality disorder. Male victims of child sexual abuse show disturbed adult sexual functioning. The relation between age of onset of abuse and outcome is still equivocal. Greater long-term harm is associated with abuse involving a father or stepfather and abuse involving penetration. Longer duration is associated with greater impact, and the use of force or threat of force is associated with greater harm.

Adaptation, Psychological↗
PubMed1989

Infant testicular prostheses.

Traditionally, the parents of young boys with an absent testis are advised to let the child decide whether he wants a testicular prosthesis after he enters puberty. Unfortunately, the decision by an adolescent to undergo prosthesis insertion often is made only after experiencing ridicule and embarrassment about the genital appearance. Accordingly, we have offered to implant an infant size prosthesis in patients with cryptorchidism when inguinal and abdominal exploration demonstrates that the testis is absent. A total of 41 boys less than 5 years old with an absent testis underwent simultaneous insertion of a testicular prosthesis. The only complication was a superficial wound infection that did not necessitate removal of the prosthesis. Two boys report mild scrotal discomfort. In long-term followup 91 per cent of the families rated the cosmetic appearance as "good" and 94 per cent were content with the decision regarding placement of a prosthesis. Although many assume that these boys will desire a larger prosthesis after puberty, this consideration seems to be irrelevant. Longer followup will be necessary to ascertain whether this approach alters the psychosexual development of these patients. We believe that young boys with an absent testis should be considered for simultaneous testicular prosthesis insertion at inguinal exploration or orchiectomy.

Body Image↗
PubMed1990

Abnormal eating attitudes in London schoolgirls--a prospective epidemiological study: outcome at twelve month follow-up.

The occurrence and course of eating disorder in a large representative population of 15-year-old London schoolgirls has been assessed using a two-stage survey methodology. Attempts to control weight were common and often transient. Dieting was in the great majority of girls found to be a benign practice without progression to more extreme concerns about food and weight. However, a small proportion of dieters did become cases and formed the majority of new cases found at follow-up. The relative risk of dieters becoming cases was eight times that of non-dieters. Many factors conventionally associated with eating disorder were associated more with attempting weight control than caseness. These included pre-morbid personality, pre-morbid obesity and family weight pathology. Other factors, including social class, career choice and psychosexual development, had no association either with attempting weight control or caseness.

Adolescent↗
PubMed1992

Differential effects of women's child sexual abuse and subsequent sexual revictimization.

This study examines the differential effects of sexual revictimization in a community sample of 248 African-American and White American women, ages 18 to 36. Two classifications of sexual revictimization over the life course were used to assess the effects on later sexual and psychological functioning. The findings suggest that unintended pregnancies and abortions were significantly associated with sexual revictimization. Women who reported more than one incident in both childhood and adulthood were also likely to have multiple partnerships and brief sexual relationships. The findings are discussed within the context of the dynamics of sexual revictimization and its effects. Suggestions are offered for therapeutic strategies with survivors in order to minimize the effects of sexual revictimization.

Adolescent↗
PubMed1992

Effect of incest on self and social functioning: a developmental psychopathology perspective.

The effects of child sexual abuse have become a leading concern of mental health service providers. Despite an explosion of studies, one major difficulty in this research is the lack of a developmentally sensitive model for conceptualizing short- and long-term effects and continuity and discontinuity of effects over time. This article proposes a model based in the perspective of developmental psychopathology. It is argued that incest has its unique negative effects in the domains of self and social functioning, specifically in jeopardizing self-definition and integration, self-regulatory processes, and a sense of security and trust in relationships. Studies with clinical samples indicate that diagnostic conditions associated uniquely with a history of incest reflect serious self- and social impairments. A review of the developmental literature on self and social development summarizes each major developmental transition from infancy to middle adulthood, and the implications for the negative effects of incest on development are discussed. Finally, implications for developmentally sensitive research are discussed.

Adolescent↗
PubMed1991

Do parent-child relationships change during puberty?

This article reviews changes in parent-child relationships during puberty, emphasizing the developmental processes that might be implicated in these changes. Evidence suggests increases in conflict and less warm interactions in relationships between parents and children during puberty. Changes are assumed to be short term, although little longitudinal research has directly addressed the issue of long-lasting effects. Other developmental changes occurring for the adolescent, the parent, or both (such as social cognitive or self-definitional change), as well as other relationship changes, personality characteristics, and the sheer number of life events or transitions have all been posited as potential contributors to changes in the parent-child relationship for young adolescents. These possible contributors, however, have seldom been studied in conjunction with pubertal changes. Such integrative research is necessary to test various models through which puberty, social relationships, social cognitive, self-definitional, and other processes influence one another and are influenced by one another during the transition to adolescence.

Adolescent↗
PubMedDate not supplied

[Sex behavior in puberty].

The increasing number of Aids cases raises questions as to the risks to which young people are exposed. The present study attempts to illustrate the psychological development of sexuality during puberty. Taking development-psychological and depth-psychological aspects into account, the author attempts to throw light on the development of the ego and the instinctual and defensive behavior of young people. These intrapsychic constellations and social norms have a major influence on young people's sexual behavior.

Adolescent↗