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PubMed2006

[A child presenting with fever and arthritis due to disseminated gonorrhoea].

A 12-year-old boy with Down's syndrome presented with fever, arthritis and petechiae. Investigations revealed the presence of disseminated gonorrhoea. The patient made a good recovery after antibiotic therapy. A contact investigation was carried out, as well as talks with the family and school, and the case was reported to the Child Abuse Advice and Report Centre. The gonorrhoea was found to be caused by incest. Sexual abuse should be suspected in every child (certainly over the age of 1 year) with a sexually transmitted disease.

Anti-Bacterial Agents↗
PubMed1984

[The St-Denis youth clinic.].

The Clinique des Jeunes St-Denis was founded in 1977 to provide complete medical and psychosocial services to young clients in matters of sexuality. The work assumed by a multi-disciplinary team has provided its members with an opportunity for growth and allowed them to investigate the different aspects of their work load. The actual clinical needs and the effective treatment are discussed : abortion, incest, sexually transmitted diseases, etc. Groups are formed in order to perceive the adolescent as a whole and not only its sexual dimension ; and a concern for preventive action is always present. A research on these matters has been initiated.

English Abstract↗
PubMed1991

Abortion attitudes and practices of family and general practice physicians.

BACKGROUND: Approximately 1.5 million abortions are performed each year in the United States. Little information has been published on the abortion attitudes and practices of family physicians. The object of this investigation was to assess the abortion attitudes and practices of family and general practice physicians in Kansas. METHODS: A 19-item self-administered survey questionnaire was designed and mailed to 856 family and general practice physicians in Kansas. RESULTS: A 63% survey response rate was obtained. Seventy-eight percent of the physicians reported that abortion should be legal, but only 56% of the respondents classified themselves as pro-choice. Conversely, only 8% reported that legal abortion should not be available, even though 33% classified themselves as pro-life. The majority of physicians reported that abortion is an appropriate option to save the life of the mother, in cases of rape or incest, and when a fetal anomaly is diagnosed. Only three respondents (0.5%) had performed abortions during the previous year. In general, female physicians and physicians over the age of 40 years (regardless of sex) were more likely to be pro-choice and to view a woman's personal decision as a circumstance in which abortion may be appropriate. CONCLUSIONS: Physician's views about abortion and their practice patterns are important components of health care for thousands of women each day.

Abortion, Induced↗
PubMed1991

Clinical characteristics of hospitalized military patients with narcissistic personality disorder.

Clinical characteristics of 21 psychiatric military inpatients meeting DSM-III and DSM-III-R criteria for narcissistic personality disorder (NPD) were compared to the characteristics of 42 inpatients having other personality disorders (OPD). Chart review indicated that the major differences between NPD and OPD patient groups included a greater likelihood for NPD patients to have been admitted for physically violent conduct and that they were more likely to be undergoing a personally significant rejection, such as divorce or separation, at the time of hospitalization. Additionally, there was a tendency for NPD patients to be sexually abusive towards children, indicating a violation of the incest taboo.

Adult↗
PubMed1991

Rorschach indicators of chronic childhood sexual abuse in female borderline inpatients.

Recent research indicates a high incidence of childhood sexual abuse and incest among female patients with a diagnosis of borderline personality disorder (BPD). The author investigated the detection and long-term aftereffects of this abuse using a constellation of Rorschach scores that were predicted to occur more frequently in borderline patients with extended sexual victimization before age 14. Sixty-two subjects were divided into two groups (33 with and 29 without such a history) and compared on the following features: color-dominated percepts, primary-process content, confabulation, activity versus passivity, and two new scores related to dissociative symptoms. Some subjects were also administered the Dissociative Experiences Scale and the DSM-III Structured Clinical Interview for posttraumatic stress disorder. The sexually abused group had significantly higher scores both on the Rorschach features and on the clinical measures. The author contends that the identified Rorschach constellation reflects symptoms associated with these trauma-related syndromes, which are more central to the profile of BPD, both on psychological tests and clinically, than is generally recognized.

Adult↗
PubMed1990

[Gynecology and obstetrics in the Bible. I. From procreation to pregnancy].

The Bible illustrates some interesting views on the matter of Gynecology and Obstetrics. Beside the Old and New Testaments, some Apocrypha have to be discussed for their content about this subject. This article concerns the following points: impregnation, formation of the human embryo, Eve's creation, indirect fecundation and spermatic pollution, bi-sexuality of the first man, libido, signs of virginity, female infertility, incest, multiparity, post-menopausal conception, the fructifying powers of amulets, plants and seeds, the course of pregnancy and antenatal care, normal and difficult labour, premature birth (was Moses premature?), perineal tears, the first birth without pain, twin pregnancy, procidentias, breech delivery, maternal deaths, midwives and Pharaoh, nursing, swaddling, breast-feeding and weaning of the baby. Uncleanliness and purification of the woman following childbirth or during menstruation according to levitical advice are discussed.

Bible↗
PubMed1990

[Gynecology and obstetrics in the Bible. II. Labor and the puerperium].

The bible illustrates some interesting views on the matter of Gynecology and Obstetrics. Beside Old and New Testaments, some Apocryphas have to be discussed for their contents about this subject. This article concerns the following points: impregnation, formation of the human embryo, Eve's creation, indirect fecundation and spermatic pollution, bi-sexuality of the first man, libido, signs of virginity, female infertility, incest, multiparity, post-menopausal conception, the fructifying powers of amulets, plants and seeds, the course of pregnancy and antenatal care, normal and difficult labour, premature birth (was Moses premature?), perineal tears, the first birth without pains, twin pregnancy, procidentias, breech delivery, maternal deaths, midwives and Pharaoh, nursing, swaddling, breast-feeding and weaning of the baby. Uncleanliness and purification of the woman following childbirth or during menstruation according to levitic advices are discussed.

Abortion, Spontaneous↗
PubMed1990

[Results of ambulatory care of 103 patients who committed sex offenses].

103 sexual delinquents were treated in our sexological outpatient clinic. These men were referred for compulsory treatment by courts on account of: indecent exposure (N = 51, i.e. 49.5%), heterosexual aggression (N = 22, i.e. 21.3%), homosexual offence with minors (N = 18, i.e. 17.5%), hetero-sexual paedophilia (N = 8, i.e. 7.8%), fetishist offence (N = 2, i.e. 1.9%), incest with adolescent daughter (N = 1) and zoophilia (N = 1). Sexological treatment consisted of psychotherapeutic, sociotherapeutic and drug treatment. After a three-year follow-up the results were evaluated as favourable in 44 men (i.e. 42.7%). 33 men (i.e. 32.1%) relapsed and committed a further sexual crime. 26 men (i.e. 25.2%) remain in a long-term medical care, as favourable sexual adaptation was not achieved in these cases within three years of treatment. Psychological, psychosexual and social characteristics of patients are analysed in connection with results of sexological treatment.

Adult↗
PubMed1989

[Must the European fetus be a legal chameleon?].

Currently a legal "haze" surrounds the problem of the fetus in Europe, and there is a need to set this problem in order as a safety for intervening physicians. Actually, some legislation tends to protect the fetus while others authorize its destruction. Under the French law, the fetus appears quite personalized. For instance, in the jurisprudence of non-assistance to a person in danger, it was suggested that an obstetrician perform an immediate caesarean section after death. Other authors have advocated emergency transfusion of blood or blood products to a pregnant woman who refuses any treatment because of religious beliefs, when a fetal risk was demonstrated. Most jurisdictions indict for voluntary homicide when an obstetrician's or a midwife's fault has resulted in fetal death in utero or during delivery. On the contrary, suppression on intra-uterine life may be considered as legal within the framework of the law on VIG (voluntary interruption of pregnancy), as no date-limit is provided for therapeutic interruption of pregnancy. Therefore, severe maternal distress and the strong probability of a fetal malformation incompatible with life, leave the specialists quite undecided in the face of requests for therapeutic interruptions that some jurists have justifiably advised to name, most of the time, "eugenic". The author mentions the fetus conceived after rape or incest, the fetus presenting a malformation, the fetus with trisomy..., who are not particularly protected from a legal standpoint, as well as the fetus threatened of destruction after a sex selection or if the fetus is among an excessive number resulting from ovarian hyperstimulation.

Female↗
PubMed1989

Preventing staff-patient sexual relationships.

Just as the awareness of incest and childhood sexual abuse has grown in recent years, so too has knowledge of sexual exploitation of patients by psychotherapists and other mental health professionals. Almost no one, however, has discussed the prevalence of this problem in the hospital setting. The authors were members of a study group that thoroughly reviewed reported incidents in their own institution, leading to the recommendation that education is the best preventive measure currently available. The authors discuss fundamental issues involved in such a study, summarize profiles of patients and staff members who may be vulnerable to sexual involvement, and describe the main components of a preventive educational approach.

Antisocial Personality Disorder↗
PubMed1988

Child maltreatment and its victims. A comparison of physical and sexual abuse.

Although physical and sexual abuse are separate and distinct types of victimization, their impact on children is quite similar. Both of these forms of maltreatment involve the exploitation or misuse of a child by a parent or caretaker in the context of a pathologic family system. Physical and sexual abuse constitute an acute traumatic event for the child, generating phobic responses and anxiety-related symptoms including post-traumatic stress disorder. The long-term traumatic elements stemming from the chronic stigmatization and scapegoating contribute to problems of depression and low self-esteem and distortions in character formation. Betrayal by a primary caretaker leads to mistrust of others and difficulties with object relationships. Perhaps the most striking similarity between physical and sexual abuse of children is the tendency of the children to re-enact and recreate their victimization with others, leading to a transmission of violence in the next generation. Like their parents who were frequently victimized during childhood, they repeat and perpetuate an "aggressor-victim" interaction in their subsequent relationships. Both physical and sexual abuse are embedded in a deviant family structure, which adds to the psychopathology of the children. The contrast between physical and sexual abuse can be demonstrated by their specific impact on aggression and sexuality, respectively. The physically abused child has difficulty in experiencing and modulating aggressive impulses, whereas the victim of incest is often impaired in his ability to experience and integrate sexual feelings. The physically abused child is also at greater risk for cognitive and CNS impairment. Intervention with the abusing parents is the first step in protecting the children from further damage, but treatment of the child victims is necessary not only to diminish their psychopathology and emotional distress, but to prevent the cycle of violence in the next generation.

Adolescent↗
PubMed1988

Serial rapists and their victims: reenactment and repetition.

The major finding in this study of 41 serial rapists is the large numbers of reported and unreported victims. For over 1200 attempted and completed rapes, there were 200 convictions. The hidden rapes or earliest nonreported victims of these men as boys and adolescents were identified from their families, their neighborhood, and their schools. Examining the possible link between childhood sexual abuse and criminal behavior in this sample of 41 serial rapists, 56.1% were judged to have at least one forced or exploitive abuse experience in boyhood, as compared to a study of 2,972 college males reporting 7.3% experiencing boyhood sexual abuse. Looking within the abused samples, 56.1% of the rapists reported forced sex, compared to the college sample's 30.4%. Also, the rapist sample revealed higher rates of family member as abuser (48.4%), compared to 22.2% for the college sample. Retrospective reconstruction of the sexual activities and assertive behaviors of these men as boys reveals that 51% of the boys reenact the abuse as a preadolescent with their earliest victims being known to them (48% as neighborhood girls), family (25% as sisters), or girlfriend (25%). The onset of rape fantasies in midadolescence (mean age 16.9) crystalizes the earlier sexually initiated behaviors into juvenile behaviors of spying, fetish burglaries, molestations, and rapes. Repetition of these juvenile behaviors set their criminal patters on strangers--their next group of victims. To reduce victimization, serial rapists need to be identified early and stopped. This means acknowledging and reporting boy sexual abuse. This includes being sensitive to the reenactment behaviors noted in the initiated activities of abused children, which in turn need to be differentiated from peer play. Closer attention needs to be paid to families with incest behavior to insure that younger children are protected. Adolescents showing early repetitive juvenile delinquent behaviors must be assessed for physical and sexual abuse, and intervention must be planned to deal with the victimization. In the investigation and apprehension of serial rapists, law enforcement might pay closer attention to fetish burglaries and the spying, secretive behaviors that serve as the prototype for rape behavior.

Child↗
PubMed1987

Adolescent sexual abuse: clinical discussion of a community treatment response.

Adolescent sexual abuse is an overwhelming issue for society and the medical community. Adolescent medicine has only begun to emerge in the mainstream of medical practice. Sexual medicine, adolescent chemical dependency, and abusive medicine are emerging subspecialties of mainstream medicine, with victimization syndromes just beginning to be explored. Adolescent sexual abuse, sexual addiction disorders, family incest, eating disorders, depression, and suicide in adolescents all need to be viewed from epidemiologically regarding family and community orientation. I refer to physician and troubled adolescent relations as the quadruple passivity syndrome. The ego-centered, troubled adolescent denies he or she has problems but no desire for treatment; the physician denies that the adolescent has health problems and has no desire to evaluate them. Physicians need to take an aggressive role in identifying, treating, and preventing the victimization process in children, adolescents, adults, spouses, families, and geriatric patients. Physicians need to be trained to identify these patients and to develop treatment protocols. The victimization syndrome needs more research, publication, and surveillance by all medical associations, but primarily by family physicians and pediatricians. In conclusion this clinical discussion describes four main points: Sexually abused adolescents can be successfully treated by a multidisciplinary advocacy team. A community multidisciplinary team can work in a unified approach for the good of the community by putting an end to future generations of victimized adolescents and families. The medical community has the greatest challenge in training, educating, and becoming more aware about adolescent sexual abuse. The community must provide support for victims of sexual abuse.

Adolescent↗
PubMed1987

Sexual abuse of children: an update.

An increasing number of studies in the past decade have shown that sexual abuse of children is disturbingly common. The author reviews some of the more recent knowledge about the problem, with particular reference to medical implications. The incidence and distribution of the problem and the relative importance of the medical examination are reviewed, and the diagnostic significance of clinical presentations such as vulvovaginitis, recurrent urinary tract infection and masturbation is evaluated. The agents responsible for sexually transmitted diseases in abused children are reviewed. Many crucial psychosocial issues are raised in the evaluation and management of sexual abuse. The author discusses some aspects of abuse that are hard to confront, such as the possible pleasure of the child and the nonoffending role of the mother in cases of incest. Information from sources other than the medical literature on the characteristics of abusers, therapy and prevention is reviewed. The medical implications of the Badgley Report are also discussed.

Adolescent↗
PubMed1987

Familial bathing patterns: implications for cases of alleged molestation and for pediatric practice.

In a cross-sectional study of how 576, upper-middle class children were socialized around bathing behaviors, families were found to be variable in their handling of bathing practices. But as a group, children were found to bathe alone more frequently as they grew older, and parents were found to bathe less frequently with the child of the opposite sex, particularly as children grew older. It was uncommon for mothers to bathe or shower with sons older than 8 years of age or for fathers to bathe or shower with daughters older than 9 years of age, although most had stopped before that age. This cross-sex aversion may be a reflection of the incest taboo. Several suggestions are made about the development-related changes in bathing practices identified in the study.

Baths↗
PubMed1986

[The psychotic, laws and the Law].

We relate some clinical examples of patients who went to hospital as offenders (murders). They were not condemned because they were mentally ill; we tried to demonstrate that article 64 of the French law is inadequate in reference to modern psychological, phenomenological and psycho-analytical discoveries. We relate cases of patients who harshly punished themselves because they were not convicted by the Law. The last observation induces the transition between the Law, as Lacan says, (the fundamental taboo of incest) and the laws put up by our societies.

Civil Rights↗
PubMedDate not supplied

The admissibility of evidence in child sexual abuse cases.

Testimony in court by child victims of sexual abuse results in further trauma, frequently inconsistent or retracted accusations, and, in incest cases, exacerbation of family difficulties. A number of states have liberalized rules of evidence in such instances to spare the child; some states have enacted legislation simplifying introduction of the child's out-of-court statements, although the constitutionality of these statutes has yet to be tested.

Child↗
PubMed1983

[A "condemned" child. Case of borderline personality disorder].

The import of this observation resides in the significance of the patient's destiny and in the poor organization of his personality, indicating that defense mechanisms may have been prevented from building up as a result of the bearing of real and phantasmic events on his mental working. We speculate that a mechanism as essential as interiorization could not develop, as a direct result of the continuous confrontation of conflicts with a disrupted reality and the recollection of this last. The limits constituted by death and incest could not be normally interiorized and integrated within the psychic organization of this young boy, "doomed" at the age of four, and perhaps even earlier.

Borderline Personality Disorder↗