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PubMed1991

Pubertal disorders. Psychology and clinical management.

The behavioral data reviewed herein must be viewed with caution. Although there are reports that adhere to rigorous methodology, these are the exception. Most reports do not adequately describe either the methodology used or their sample. Subjects are often of mixed endocrine diagnoses, and sometimes the results are of both boys and girls. All of these pitfalls make interpretation of results difficult and limiting. With this in mind, the following conclusions are offered. The majority of behavioral data on precocious puberty comes from studies of IPP in girls. Cognitively, IPP has been associated with average to high-average intelligence. Purportedly, the finding of lower visual-spatial skills than verbal skills in early maturing boys and girls has received equivocal support by cognitive studies of IPP individuals. Similarly, clear differences in hemispheric lateralization have not been demonstrated. Aside from increased somatic complaints during the nonmenstrual phases of their menstrual cycle, girls with IPP show a spectrum of behavior adjustments. Major psychopathology is rare. Clearly, their early development makes them look older than their actual age, which probably alters the expectations others have for them. Psychosexually, however, IPP girls develop in concert with their chronologic age and social experience, rather than their early biologic maturation. However, recent reports suggest a modest influence of hormones. In summary, these studies support an interactionist theory of human psychosexual development. Research data on IPP girls suggest that they do not significantly differ from girls who are early maturers but within the normal range. Research on these girls indicates that most negotiate their puberty without severe problems. There has been less research on IPP boys because it occurs so rarely. Most of what is understood about precocious puberty in boys comes from boys with precocious puberty secondary to poorly controlled CAH. Behavioral data on individuals with delayed puberty come almost exclusively from boys. Although CD appears to be the most frequently diagnosed form of delayed puberty and does not reflect a known pathologic process, men with CD as well as those with organic disorders appear to be at risk for psychosocial and psychosexual difficulties. These difficulties are not severe forms of psychopathology. Rather, they probably represent problems negotiating the expected adolescent lessons of psychosocial development with a physique that places them at a disadvantage. They clearly look younger than their actual chronologic age. Cognitively, as with the children with precocious puberty, there is no evidence of intellectual impairment associated with delayed puberty.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1983

Sexual orientation and consistency of sexual identity.

The semantic confusion in the use of the terms sexual and gender identity and role is discussed. Theories concerning the development of the sense of sexual identity in normals have been based largely on the sense of sexual identity in sexually deviant subjects. It is suggested that such subjects may have a stronger and more consistent sense of sexual identity than subjects unaware of sexually deviant impulses. Male medical students in two consecutive years anonymously completed a questionnaire concerning their sexual orientation, preference, role, and identity. In both years, students aware of a homosexual component answered the items investigating their sexual identity with greater consistency than did the students unaware of a homosexual component.

Adult↗
PubMed1996

Developmental effects on the adolescent of a temporary ileostomy.

Adolescence is an exciting time of transition, as the child breaks away from a dependent role and establishes an independent adult identity. Adolescents vacillate between dependence and independence as they meet the daily challenges of growing up. The adolescent with a chronic illness, however, may find dependence thrust upon him or her by physical condition and health care needs. This article describes how a temporary ileostomy can interfere with the adolescent's ability to master developmental tasks. Initial findings from semistructured interviews of four teenage boys provide evidence of the effects of a temporary ileostomy on an adolescent's psychosocial development.

Activities of Daily Living↗
PubMed1991

Changes in human figure drawings during intensive treatment.

This article examines change in the human figure drawings (HFDs) of 32 seriously disturbed young adults during the course of intensive inpatient treatment. HFDs drawn at the time of admission were compared with HFDs obtained more than 1 year after intensive treatment began; both sets were scored on the Goodenough-Harris Scale (GH) and the Robins Balance-Tilt Scale (RBT). The findings indicate that the HFDs significantly improved over the course of treatment, but only for those patients judged introjective, not anaclitic. These findings are consistent with prior research on the same population that were based on analyses of clinical case records and Rorschach protocols (Blatt, Ford, Berman, Cook, & Meyer, 1988). Significant change in the HFDs over the course of treatment suggests that the HFDs provide a unique and independent dimension for assessing therapeutic change.

Adolescent↗
PubMed2004

Mysteries of the void: an analyst's view of female urination.

Anxiety, shame, guilt, and depression accompany the absence or loss of urinary sphincter control at both ends of the life cycle. The economic costs are high when one reflects that incontinence limits access to child-care facilities and thus the mothers return to gainful employment. It is often the prime reason for admission to nursing home care for the grandmother. Poise and increased self-esteem go along with "being dry." Dysuria accompanying acute or interstitial cystitis also interferes with personal peace and the ability to work productively. A psychoanalytic review of developmental stages and their constellation of affects and defenses in regard to "wetness" will be discussed as well as when to refer, clarify, or make or receive a urological referral for your patient, their child, or parent.

Child Development↗