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Measuring public attitudes on abortion: methodological and substantive considerations.
Data from a 1989 CBS News/New York Times survey are used to examine the effect that the framing of questions on abortion has on estimates of what proportions of the population support various legal positions. The nationwide data and results from six state polls show that general questions with only two or three options overestimate the proportions of respondents who either favor a ban on all abortion or who would allow abortion under all circumstances. Questions that pose specific circumstances result in movement of respondents out of extreme categories and into more moderate ones. Even respondents who indicate they would favor abortion in all specific circumstances and those who favor abortion in none are likely to moderate their views when asked if they support restrictions that have been proposed in a number of states.
The parental paradox.
Parenthood is in turmoil: On the one hand many of the parental tasks have been taken over by social institutions and on the other psychological aspects of the parent-child relation are emphasized. We see three important developments: The relationship between parents and children has been democratized, the psychological and juridical position has been acknowledged and the social check on parental behaviour has changed dramatically. In this dynamic field, children's rights have risen as a new way of solving family problems. Rights for children create new possibilities for recognizing the growing independence of children. But these may reinforce individualistic developments and a laissez-faire attitude towards children. If personal interests are the primary goals of relations, children as vulnerable subjects will be more at risk.
The devastation of childhood sexual abuse.
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[Sexual abuse of children. A regional study of the prevalence and characteristics].
BACKGROUND: In contrast to angloamerican countries there are no national figures for the incidence and prevalence of sexual abuse in Germany. Reports based on criminal statistics are inappropriate and are often misinterpreted. METHODS: In this report we present the main results of a regional study of the prevalence of sexual abuse in childhood and compare them with angloamerican studies. RESULTS: Based on replies from 1009 students and apprentices (age > 18y) the prevalence for criminal sexual abuse was found to be 25.2% for females and 6.2% for males. A breakdown of these figures showed that females reported having to experience anal, oral or sexual intercourse (2.3%), physical contact (11.7%), exhibitionism (4.6%) and other sexual behaviour without physical contact (6.6%). For males the prevalence rates for these categories of sexual abuse were 1.5%, 2.4%, 0.9% and 1.5% respectively. All these figures, especially those for males, should be evaluated critically as actual prevalence rates are probably higher. Girls, particularly those aged 6-10 years, are more often involved than boys. Ninety percent of physical abuse happens with persons known to the victim (60% within the family, only 8% with strangers. In general 95% of abusers are male, however in 25% of cases of hands-on-contact with boys the abusers are female. From the relative frequency of reported abuse we estimate the potential incidence to be 1:30 within the family, 1:23 with other acquaintances and 1:6 with strangers. CONCLUSIONS: The importance of regional differences should not be underestimated. These results cannot be generalized for the whole of Germany. Only prevalence studies appropriately reflect the scale of the problem; they are necessary for a broad, a rational and a sufficient planning of strategies designed for prevention, intervention and rehabilitation. More scientifically based epidemiological studies on the extend of sexual abuse are required in Germany.
The family romance fantasies of adopted children.
Despite the absence of psychoanalytic studies to support the position, family romance fantasies have been assumed to be similar in form and function in both the adopted child and the blood kin child. My studies, documented herein from the analyses of three adoptees, reveal that knowing one is adopted results in modifications of the fantasy and that certain types of adoptees seem incapable of effectively creating the paradigmatic family romance fantasy.
Homosexual parents.
Does the homosexuality of parents affect the sexual orientation or experiences of their children? Seventeen of 5,182 randomly obtained adults from six U.S. cities answered questionnaires indicating that they had a homosexual parent. Parental homosexuality may be related to findings that: (1) 5 of the 17 reported sexual relations with their parents; (2) a disproportionate fraction reported sexual relations with other caretakers and relatives; and (3) a disproportionate fraction: (a) claimed a less than exclusively heterosexual orientation (47%); (b) indicated gender dissatisfaction; and (c) reported that their first sexual experience was homosexual. Of 1,388 consecutive obituaries in a major homosexual newspaper, 87 of the gays who died had children and registered a median age of death of 47 (the 1,267 without children had a median age of death of 38); 10 lesbians did and 24 did not have children. We estimate that less than 1% of parents are bisexual or homosexual and that < 7% of gays and about a third of lesbians are parents.
[A team for the sexually abused?].
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[Questionnaire on psychosexual development of children--development of a guideline for diagnosis of sexual abuse].
The purpose of this paper is to present a questionnaire which can collate data on the psychosexual development of children. There are as yet few contributions from the field of empirical research dealing with the question of "normal" psychosexual development patterns. There is also a lack of standardised procedures by which this aspect of child development can be assessed. For this reason we have developed a questionnaire relating to the theme of child sexuality which can be used in the framework of history and which was examined as part of a clinical study supported by a grant from the Deutsche Forschungsgemeinschaft. The questionnaire contents questions put to parents relating to the sexual development of children, on how sexuality is talked about and dealt with in the family, and on precisely-defined and described experiences of the child and other members of the family. At the time we present a method of judging normative sexual development of the child and of disturbances such a sexual abuse. In order to deal with this question the collation of information from four different areas is required: physical development and symptoms, behaviour of the child, family context including psychosocial adversities and parent-child interaction. Case studies will illustrate how data from the four areas are related and can accordingly be assessed in order to be able to make judgments on the psychosexual development of children. We see this method as helpful in order to determine whether or not a child was sexual abused. Thus, consideration of each individual case in context is necessary if a balanced judgment is to be arrived at.
Anatomy of soul murder, Part II: Family romance and structure of delusion in the memoirs of D. P. Schreber.
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Survivors of sexual abuse allege therapist negligence.
In two recent litigation cases, adult survivors of sexual abuse claimed that their current symptomology was linked to the failure of mental health professionals to provide appropriate treatment. If mental health practitioners are to be held accountable for providing acceptable standards of treatment, these standards must be based on empirical evidence of the efficacy of treatment methodologies. This article provides a review of the professional literature and determines that with the exception of time-limited group treatment, which appears to reduce symptoms in some survivors of sexual abuse, there is an absence of clear evidence of treatment efficacy. Other data point to low consumer satisfaction with treatment, the absence of evidence for a consistent symptom presentation in survivors of sexual abuse that confounds standardizing treatment approaches, and iatrogenic effects of some forms of treatment. The authors conclude that, at this time, there is little empirical data to support the development of standards of practice for treating women who have been sexually abused as children.
Absence of serum alanine aminotransferase activity in a neonate.
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Projections of domestic violence and erotic terror on the film screen.
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[Psychoanalytic therapy of sexually abused adolescents].
Sexual abuse as an extreme childhood trauma produces distorted object-images, introjects of violence which reproduce the trauma permanently through symptoms and acting-out. Although the traumatic power should be relived in transference, psychoanalytic therapy does not always mean permanent interpretation of transference, rather supporting, confirming, valuing activity is indicated. The following scopes can be differentiated: idealization, changing the therapeutic object into a triangulating one; negative transference of an archaic destructive mother imago, nevertheless also of the traumatic object, setting free hidden aggressive affects; emerging of the specific sexual trauma in transference and counter-transference. In the whole course of therapy, especially at the end, working through of guilt-feelings, shame and mourning permits the separation from the traumatic objects, although the danger of returning to them, often represented by the real actual objects, does not guarantee a full success in all cases.
Forensic gynaecology.
To put a patient at ease is always important, but this is especially so when making an examination following a sexual offence. The place of examination is important. The choice can be a police station, a hospital or your own consulting-room. If at all possible, your own consulting-room is best. Always explain exactly what you are doing and for what reason. This is reassuring to the patient. Take the specimens systematically. Number and label them carefully before handing them over to the police officer. Notes taken at the time of your examination can be used when giving evidence in court. Therefore legible notes are invaluable. I have also found it useful to have a photostat of my statement as a witness. The police will provide this on request. Note-taking is particularly important in cases in which there are special difficulties. Examinations following sexual assault involve attending court to give evidence. By no means all the examinations made will lead to court cases. Often the accused cannot be found, sometimes the woman drops the allegation, or the Director of Public Prosecutions does not recommend the case to come for trial. Since the Criminal Justice Act 1967 it has been possible in all criminal proceedings to admit a written statement as evidence just as if it had been given orally. This statement must be signed by the witness, who will be liable to prosecution if he has stated in it anything that he knew to be false or did not believe to be true. A copy is served on the opposing side and if they make no objection it can be used by the defence in evidence. In other words, your presence in court is necessary only if some point needs to be made clear by cross-examination. I should like to see long-term follow up of rape victims. At present there is none that I know of, but at least some immediate reassurance and explanation can be given to the patient, together with treatment and recommendations for further care if necessary.
"Reporting costs" to nonoffending parents in cases of intrafamilial child sexual abuse.
Findings from a study of 104 nonoffending parents and their sexually abused children suggest four areas in which nonoffending parents experience significant change or loss as a result of the disclosure of the sexual abuse of their children. The term reporting cost was coined to describe these changes and losses. The four types of reporting costs found are relational, financial, vocational, and residential. Nonoffending parents experienced an average of three major costs from the disclosure of intrafamilial sexual abuse.
[Language and sex. Empirical studies of a subculture].
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