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PubMed2000

Differential environmental factors in anorexia nervosa: a sibling pair study.

OBJECTIVES: Previous studies have explored differences in psychosocial and familial factors between women who develop anorexia nervosa and those who do not. However, these studies have generally used between-group comparisons. This study looks at the environmental factors which may be antecedents of anorexia nervosa looking at sister pairs where one had anorexia nervosa and the other did not. DESIGN: A paired design was used to compare anorexic women with an unaffected sister on a number of background variables, including sibling interaction, parental care, peer group characteristics and other events unique to the individual. METHODS: The Sibling Inventory of Differential Experience (SIDE) was used to determine non-shared environment. Out of an initial sample of 148 women with past or current anorexia nervosa, 28 were identified who had sisters with no reported history of eating disorders and who also consented to complete the questionnaire. RESULTS: Anorexic sisters perceived more maternal control and reported more antagonism towards and jealousy of their sisters than did unaffected sisters. In addition, anorexic women reported having had fewer friends and boyfriends than their sisters. CONCLUSIONS: These results confirm the perceived differences in background environment between women with and women without anorexia nervosa. These issues are discussed in relation to behavioural genetics, family dynamics and psychosexual development.

Adolescent↗
PubMed1999

Estrogen: consequences and implications of human mutations in synthesis and action.

Recent developments have advanced our knowledge of the role of estrogen in the male. Studies of the mutations in CYP19, the gene encoding aromatase, in six females and two males and a mutant estrogen receptor alpha in a man are described. These observations provide illuminating new insights into the critical role of estrogen in the male (as well as female) in the pubertal growth spurt and skeletal maturation, and in the importance of estrogen sufficiency in the accrual and maintenance of bone mass. The weight of evidence supports an effect of androgens on the latter processes, but this effect has not been quantitated. There is a discordance in the estrogen-deficient male between skeletal growth and skeletal maturation and the accrual of bone mass and density. Estrogen synthesis by the testis is limited before puberty, and estrogen deficiency does not affect the age of pubertal onset. Estrogen deficiency in men leads to hypergonadotropism, macroorchidism, and increased testosterone levels. Estrogen lack has a significant effect on carbohydrate and lipid metabolism, and estrogen resistance was associated with evidence of premature coronary atherosclerosis in a man. These observations have highlighted the role of extraglandular estrogen synthesis and intracrine and paracrine actions. In the human, in contrast to nonprimate vertebrates, aromatase deficiency and estrogen resistance (alpha) does not seem to affect gender identity or psychosexual development. The clinical repercussions of mutations in CYP19 on the fetal-placental unit have highlighted the major role of placental aromatase in the protection of the female fetus from androgen excess, thus preventing androgen-induced pseudohermaphrodism and virilization of the mother. These features are compared with the virilization that occurs in utero in the female spotted hyena. The novel features of the aromatase deficiency syndrome in the affected female--in the fetus, during childhood, and at puberty--are discussed, including virilization at puberty and development of polycystic ovaries. The severity of the syndrome correlates with the severity of impairment of aromatase formation in expression systems. Finally, the structural consequences of missense mutations in CYP19 are described in accordance with a model of the structure of human aromatase.

Aromatase↗
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↗
PubMed1995

Women, alcohol, and sexuality.

Alcohol consumption increases subjective sexual desire, arousal, and pleasure for many women, although it lowers physiological arousal. Despite the general belief that alcohol disinhibits female sexual behaviors, alcohol leads to changes in sexual behavior only for a minority of women. Expectancies about the effects of alcohol on sexual behavior may be important mediators of the alcohol-sexual behavior linkage. There also is a relationship between overall alcohol consumption and risky sexual behavior for women, but when alcohol use at or preceding individual instances of sexual activity is examined, there is no association in the majority of studies. Alcohol use by both perpetrators and victims has been implicated in instances of sexual victimization. Heavy alcohol consumption and alcohol problems in women are associated with heightened risk of childhood incest, sexual assault, and sexual dysfunction.

Adolescent↗
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↗
PubMed1993

The children of homosexual and heterosexual single mothers.

Children reared in homes headed by homosexual and heterosexual mothers were compared with respect to the mothers' and children's attitudes towards marriage, procreation and homosexuality. The mothers did not prefer their children to be homosexual; they desired them to marry and procreate. This was expressed more unambiguously for their sons. The children mirrored these expectations, boys with greater frequency than the girls. Most of the children expressed reservations about having a homosexual mother.

Adolescent↗
PubMed1986

Female ego ideal conflicts in adulthood.

A woman's early development, including the unique mother-daughter bonding, the development of her body image, her castration and annihilation fears, and the interaction with her father, causes specific conflicts when she comes to make choices about motherhood and career. She struggles with disrupting and changing the early mother-daughter bond, with her belief that she should be able to accomplish what she expects of herself without help, with her priorities of relatedness to others as she deals with a larger number of people. She struggles with assertion and anger in her self-interest and with ego ideal expectations that demand she have infinite patience and caring for others.

Adult↗
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↗
PubMed1984

Effects of prenatally administered 17 alpha-hydroxyprogesterone caproate on adolescent males.

The study was designed to determine whether exogenous prenatal exposure to 17 alpha-hydroxyprogesterone caproate (Delalutin) affects male recreational interests in boyhood and adolescence and male psychosexual development and whether total dosage, duration, and time of exposure has an effect on the previously mentioned variables. Subjects included 25 prenatally Delalutin-exposed males and 25 closely matched unexposed males. Subjects were administered the Bender Visual-Motor Gestalt Test, the Draw-a-Person Test, the Rosenzweig Picture-Frustration Study for Adolescents, the Embedded Figures Test, and the Forer Structured-Sentence Completion Test. Also, both subjects and their mothers were interviewed. Analysis of the data utilized raters to score subjective test instruments. Statistical analysis was conducted by t test, sign test, and multiple correlation. Only one significant difference was evident. Delalutin-exposed subjects spend significantly more time in the sedentary pursuit of watching television. However, there was no significant difference in their expressed interest in watching television or the type of television programs selected. The total dosage, duration, and period of gestation of drug administration had no significant effect in altering the findings. But a subtle difference was observed when the Delalutin regimen was not constant and when there was an interaction between psychological variables and the drug regimen.

17 alpha-Hydroxyprogesterone Caproate↗
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↗
PubMed1995

The social effects in adult life of chronic physical illness since childhood.

UNLABELLED: An unselected group of 487 (222 females, 265 males) patients with juvenile onset chronic physical disorders was studied at the age of 19-25 years for their social outcome and compared with an age-matched group of 202 physically healthy controls. The interview covered both comprehensive and vocational schooling, data on their employment status, relationship to parents and sexual development in detail. The overall social maturation index showed poor social maturation in patients more often than in the controls. At the time of the study 23% of the patients and 11% of the controls had no vocational education or were not on their way to gaining it. Excluding those with a disability pension (10%), working experience, employment status and unemployment were fairly similar in both groups. Sexual development was delayed more often in the patients than in the controls and the patients were significantly more often unmarried and living in the same household as their parents. However, social and psychological factors accumulating in excess in the patient group were observed more significant than the physical disease to the delayed social maturation. CONCLUSION: Among patients with chronic physical disorders there is a minor group with delayed social maturation. Those at risk can easily be recognized even before adolescence in order to offer them and their parents support to achieve reasonable social development in early adulthood.

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↗
PubMedDate not supplied

Sexual abuse of children in day care centers.

Sexual abuse of children in day care center settings has received considerable attention in the past decade. The nature and extent of allegations of sexual abuse in day care poses unique challenges to clinicians. Cases of sexual abuse in day care typically involve multiple victims and multiple perpetrators, and use of extreme threats to prevent disclosure. This article reviews the available research findings on the types of abuse known to occur in day care, the dynamics involved including the types of threats used to silence young victims, and patterns of disclosure. The impact of sexual victimization in day care on children and parents is discussed. Implications for the clinical evaluation of preschool-aged children in cases of suspected abuse in day care settings are presented. Developmental considerations related to psychosexual development and the development of memory and language are reviewed. Psychological defenses in repetitive trauma are discussed.

Child↗
PubMed1994

Sexuality in the later years--the impact of health and body-image in a sample of older women.

Research on sexuality in the elderly is still rather scarce. Quite often, there is an underlying assumption that health problems function as main constraints against sexuality in the later years. This article tries to challenge this view and proposes that health aspects tend to be--at least among women--quite overestimated. The data presented here are from a study on sexuality and ageing. Sixty West German women, born between 1907 and 1936 had been interviewed on their psychosexual development in the context of their life-histories. The results show that health variables are of rather little significance in explaining the development and/or maintenance of sexual interest and activity in old age. More general aspects of the so-called body-image seem to be more valid in shedding some more light on the determinants of psychological well-being and of keeping sexuality alive in old age.

Age Factors↗
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↗
PubMed1986

Long-term results of transpubic prostatomembranous urethroplasty in children.

From 1970 to 1985, 30 children between 9 and 13 years old underwent transpubic urethroplasty for traumatic prostatomembranous urethral strictures. Of these patients 5 were followed into adulthood 7 to 10 years postoperatively and were reassessed as to potency, ejaculation, semen quality, psychosexual development, and ability to work and to participate in sports. All of the patients were potent, sexually active and free of any significant impediment to ordinary activity.

Adolescent↗