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Developmental considerations in the psychotherapy of latency-age children.

A discussion of "Dream Analysis in the Treatment of an Eleven-Year-Old Boy" by Harold M. Voth, M.D. An investigation of the role of memory in free association is presented. It is described that the mode of registration and recall (sensory images and/or words and/or abstractions) differs in the child of latency age from that in the adult. The child in the latency-age period undergoes a marked series of developmental changes in the elements used in memory organization. To the extent that these differences in the mode of manifestation of memory exist, there are differences between the free associations of the child and the free associations of the adult. Children do free associate. It is necessary to understand the principles which govern age-appropriate memory elements in the child before these free associations can be used therapeutically. The memory organizations, memory modes, and the theory of their ontogenesis is presented, followed by clinical examples of the application of this theoretical material in the psychotherapy of children.

Affect↗

Primary femininity, bisexuality, and the female ego ideal: a re-examination of female developmental theory.

While the concept of primary femininity advances our understanding of the girl's developmental experience, a number of contradictions and problematic assumptions are at the present time contained within this concept. I propose that we use the phrase "primary sense of femaleness" to refer to the girl's earliest sense of self deriving from the mental representation of her body. In addition, I argue that the concepts of a primary sense of femaleness and of a bisexual matrix are not mutually exclusive; an early sense of self located in a female body can co-exist with the fantasy of potential unlimited by gender. Finally, I examine the role of the mother as ego ideal for the girl.

Aggression↗

The magical age of 10.

Developmental processes of "puberty" and their cultural contexts in understanding the emergence of sexual subjectivity, especially sexual attraction, prior to gonadarche are critically examined. In particular, we consider the hypothesis that "sexual attraction" follows the onset of adrenal puberty, termed adrenarche, precipitating the development of stable and memorable attraction toward others approximately by the age of 10. In a prior study, the authors suggested that adrenarche is a significant source of this developmental change in sexuality (McClintock, M., and Herdt, G., 1996). The inferential evidence from New Guinea is compared with recent studies from the United States, including clinical findings on "precocious puberty." We conclude with the question of whether the age of 10 is a human universal in the development of attraction and sexuality.

Child↗

Ego functioning during latency.

The latency period is an extremely important transition between the preschool years and adolescence. Normal ego functioning is described, especially cognition, socialization, motor development, and defensive functions.

Child↗

The impact of adolescent development on recovery from traumatic brain injury.

This article analyzes the role an adolescent's development plays in the recovery from traumatic brain injury. Erikson's model of psychosocial development is used to describe the characteristics of the adolescent head-injured patient. The role of family, peers, body image, and sexuality are discussed. Suggestions are offered regarding ways in which the rehabilitation practitioner can conduct comprehensive patient and family counseling and promote optimal developmental recovery after discharge from the rehabilitation facility.

Adolescent↗

Gender dysphoria and gender change in chromosomal females with congenital adrenal hyperplasia.

This article reviews the literature on studies and case reports on gender identity and gender identity problems, gender dysphoria, and gender change in chromosomal females with congenital adrenal hyperplasia, raised male or female. The large majority (94.8%) of the patients raised female (N= 250) later developed a gender identity as girls and women and did not feel gender dysphoric. But 13 (5.2%) patients had serious problems with their gender identity. This percentage is higher than the prevalence of female-to-male transsexuals in the general population of chromosomal females. Among patients raised male, serious gender identity problems were reported in 4 (12.1%) out of 33 patients. From these observations, we conclude that the assignment to the female gender as a general policy for 46,XX patients with CAH appears justified, even in severely masculinized 46,XX newborns with CAH (Prader stage IV or V).

Adrenal Hyperplasia, Congenital↗

Adult erotosexual status and fetal hormonal masculinization and demasculinization: 46,XX congenital virilizing adrenal hyperplasia and 46,XY androgen-insensitivity syndrome compared.

Among 30 young women with a history of the treated adrenogenital syndrome (CVAH), 11 (37%) rated themselves as bisexual or homosexual. Among a control group consisting of 15 women with the 46,XY androgen-insensitivity syndrome (AIS) plus 12 with the Rokitansky syndrome (MRKS), the corresponding figure was 2 (7%), both bisexual. Chi-square was significant beyond the 0.01 level. In Kinsey's 1953 sample 15% of women experienced homoerotic arousal imagery by age 20, and 10% had had homoerotic partner contact. The most likely hypothesis to explain the CVAH findings is that of a prenatal and/or neonatal masculinizing effect on sexual dimorphism of the brain in interaction with other developmental variables.

Adrenal Hyperplasia, Congenital↗

The course of individual adaptation to life changes.

The study of internal processes of adaptation to external life changes is presented as a concrete approach to studying one kind of person--situation interaction. Theoretical and empirical descriptions of the course of emotional adaptation to changes and reviewed. The empirical derivation and cross-validation of a measure of four stances in a sequence of emotional adaptation to the external environment are described. Then, the validity of the notion that life changes stimulate emotional adaptation is tested in a separate study comparing college freshmen and seniors. Results indicate that freshman are concerned with issues characteristic of earlier developmental stances and seniors with later ones. The relevance and benefits of this general approach and specific methodology for the study of personality and adult development are discussed.

Adaptation, Psychological↗

Masculine girls and feminine boys: genetic and environmental contributions to atypical gender development in early childhood.

In this genetic study of atypical gender role development, parents of 5,799 twin pairs, ages 3 and 4, rated their twin children's masculinity and femininity. Boys were selected as gender atypical if they were highly feminine (top 5%, 10%, or 15%) relative to other boys, and girls were selected if they were highly masculine relative to other girls. Gender-atypical boys and girls were each divided into 2 groups: fully gender atypical (e.g., feminine boys also low on masculinity) and partially gender atypical (e.g., feminine boys who are not low on masculinity). DeFries-Fulker (DF; J. C. DeFries & D. W. Fulker, 1985, 1988) extremes analysis yielded moderate group heritability and substantial shared environment effects for atypical gender role behavior. However, for fully gender-atypical girls, group heritability accounted for most of the variance, and shared environment had no effect. The results are discussed in light of past studies and potential implications for atypical gender development.

Child, Preschool↗