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Results for “Psychosexual Development”

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Medical and psychosexual outcome in women affected by complete gonadal dysgenesis.

BACKGROUND: Prenatal exposure to testicular hormones influences the development of brain structures and behavior in many non-human mammalian species. Less understood is the role of possessing a Y chromosome, independent of testicular hormones, on psychosexual differentiation. HYPOTHESIS: Phenotypic women affected by complete gonadal dysgenesis possess a 46,XY chromosome complement and streak gonads. This population is suitable to test the influence of an absence of androgens and Müllerian inhibiting substance on psychosexual development in genetic males. PATIENTS: Three 46,XY women diagnosed with complete gonadal dysgenesis participated. METHODS: Psychosexual development, medical outcome and knowledge of medical condition were assessed with a written questionnaire and a physical examination. RESULTS: All participants were healthy, compliant with their hormone therapy, and exhibited female-typical psychosexual development. However, participants were poorly informed about their condition and the fertility treatment options available to them. CONCLUSIONS: These data indicate no obvious role for genes on the Y chromosome, outside of its pseudoautosomal region and SRY, on psychosexual differentiation in genetic males who do not produce testicular hormones. Greater efforts need to be made to educate affected women about their pregnancy options.

Adult↗

The development of normal and autistic children: a comparative study.

This study tests the hypothesis that the development of normal and autistic children differs only in rate and asymptote. A total of 195 normal children between 1 and 5 years of age, 160 normal children between 3 months and 24 months of age, and 41 autistic children between 5 and 11 years of age were evaluated on the eight psychological variables constituting the Behavioral Rating Instrument for Autistic and other Atypical Children (BRIAAC). While many similarities were found, there were a sufficient number of differences to justify DMS-III's statement that certain autistic behaviors are not normal at any stage of development. Differences were particularly prominent when the development of normal infants was compared with that of severely disturbed autistic children. In general, the issue of whether deviant development differs only quantitatively from normal development can best be decided on the basis of developmental data and by utilizing instruments that sample all the major characteristics of both populations.

Age Factors↗

Ambiguous genitalia--an Indian perspective.

Ambiguity of genitalia in the newborns and children still remains a poorly understood subject and even during the postgraduate teaching programmes, very little attention has been paid to make this subject popular. There is also no chapter "without tears" on the subject for the proper management and to prevent the agony of the parents resulting from the ignorance and the social stigma. The purpose of this brief communication is to project the practical management of Children with intersex disorders, based on our clinical experience from the pediatric intersex clinic at AIIMS.

Adolescent↗

Comorbidity of substance abuse and schizophrenia: the role of pre-morbid adjustment.

Co-morbid substance use and abuse is common in schizophrenic patients, and the role of substance abuse in initiating and maintaining psychosis has important definitional and aetiological implications. We investigated the issue in a cohort of 131 schizophrenic patients. We found non-users (N = 67) were similar to pathological users (N = 64) in current symptomatology and clinical history. The pathological users did, however, have better pre-morbid adjustment levels. Only alcohol use and to some extent cannabis use contributed to this effect; use of stimulants or hallucinogens did not. These results indicate the importance of evaluating the various types of substance used when attempting to explore the significance of co-morbidity. The results also suggest that co-morbidity of substance abuse and schizophrenia may be explained by a common factor antecedent to both: better pre-morbid adjustment. A two-stage model is proposed to explain these findings: increased sociability increases exposure to opportunities of substance use in a subset of patients; subsequent onset of psychotic illness accelerates the use to a pathological level as the individual attempts to cope with the stress of the developing mental illness.

Adaptation, Psychological↗

Some pitfalls in the assessment of analyzability in a psychoanalytic clinic.

We have described some of the problems encountered in an analyzability committee's evolving approach to the assessment of applicants to a psychoanalytic clinic. A primary error was to think in terms of the level of drive development--equating pathology at an oedipal level with analyzability. Recognition that the more important issue for assessment purposes was the presence or absence of those ego capacities and personality characteristics necessary for success in analysis has led to a reorientation of our approach.

Adjustment Disorders↗

Psychoanalyses of children of survivors from the holocaust: case presentations and assessment.

Case illustrations are used to support the hypothesis that there may be a survivor-child's complex, though a pathological syndrome cannot be detected. A metapsychological profile extrapolated from a long analysis is intended to serve as a vehicle for comparison with other similar cases. The salient features of this profile seem to be derived from the survivor's family's intense preoccupation with life and death and with the means of undoing the parent's past degradation and redeeming his guilt.

Child, Preschool↗

Ethics and the management of the patient with intersex: a middle way.

We review the controversies surrounding the management of patients born with ambiguous genitalia to determine the strengths and weaknesses of recommendations for clinical practice. Traditional practice involves paternalistic decision making by medical practitioners, including the use of deception and/or incomplete communication of facts about the infant's condition and early surgical intervention to make a "definitive" sex and gender assignment. However, modern scientific evidence about sex-role determination refutes earlier theories supporting the appropriateness and need for early decisions. Some intersex individuals have begun to speak out against their treatment, denouncing the secretive approaches and cosmetic surgery without the specific consent of the (mature) affected individuals. They argue for complete disclosure of information regarding the condition and deferral of all surgery until at least adolescence. The traditionalist practices no longer conform to modern legal or ethical standards of care. The position of some intersex activists ignores the potential for psychosocial harm to intersex children and our society's general and strong deference to parental discretion in decisions for and about their children. We argue for a middle way, involving shared decision making with parents of children with intersex and the honoring of parental preferences for or against surgery.

Disorders of Sex Development↗

Psychological aspects of precocious puberty. An overview.

During the last three decades the psychological consequences of precocious puberty have received considerable attention. The nature and shortcomings of relevant studies are described. It is emphasized that specialized counselling and guidance of families with children who have to cope with precocious puberty is important, since it often contributes to an appropriate behaviour adjustment without the development of psychiatric symptomatology. Guidelines for medical service and psychological management are provided.

Child↗