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PubMed2000

Barriers to adolescent adherence to contraception. Knowledge Of depo provera timing

Background: Depo Provera is a long-acting progestin contraceptive method that is both highly effective and safe. However, continuation rates at one-year range from 30-42%. It has been suggested that one common reason for discontinuation is poor adherence with appointments. Poor adherence could be related to lack of knowledge regarding the timing of the next injection. Therefore, the purpose of the current investigation was to examine whether adolescent girls were knowledgeable about when their next injection was due.Methods: Adolescent girls were recruited from an urban-based adolescent clinic to participate in a longitudinal study of psychosexual development. The girls were seen every 6 months over three years. At the last three visits, those adolescents on Depo Provera were asked when their next injection was due. Responses were coded as accurate if the date given was within 10-14 weeks of the last injection. Results: There were 45 girls who were using Depo Provera and seen for at least one study visit. The girls ranged in age from 15-19 years, and 87% were African-American; the remainder were Caucasian. 22 girls were seen/and on Depo Provera for 1 visit, 12 for 2 visits, and 11 for 3 visits. Collapsing their answers across visits, 27 of girls were always correct, 11 were sometimes correct, and 7 were never correct. Race and age were not related to whether they were always correct, sometimes correct, or never correct. At the last visit, we examined whether or not length of time on Depo Provera was related to correctness. The relationship appeared to be curvilinear. That is, those girls who had been on Depo Provera the longest time (>/= 18 months) and the least (< 6 months) time were most likely to be correct.Conclusions: This study demonstrates that many (40%) adolescents do not know when their injection is due, and in fact, the correctness of adolescents' knowledge is not consistent over time. Age and race were not significantly related to knowledge of timing. Therefore, ALL adolescents should be provided with reminders about the timing of their next injection. Finally, the curvilinear relationship needs to be examined further. This finding that adolescents on Depo Provera for 6-12 months were the least knowledgeable is consistent with research on oral contraceptive adherence indicating this is a vulnerable time period for contraceptive discontinuation.

Journal Article↗
PubMed1990

Abnormal eating attitudes in London schoolgirls--a prospective epidemiological study: outcome at twelve month follow-up.

The occurrence and course of eating disorder in a large representative population of 15-year-old London schoolgirls has been assessed using a two-stage survey methodology. Attempts to control weight were common and often transient. Dieting was in the great majority of girls found to be a benign practice without progression to more extreme concerns about food and weight. However, a small proportion of dieters did become cases and formed the majority of new cases found at follow-up. The relative risk of dieters becoming cases was eight times that of non-dieters. Many factors conventionally associated with eating disorder were associated more with attempting weight control than caseness. These included pre-morbid personality, pre-morbid obesity and family weight pathology. Other factors, including social class, career choice and psychosexual development, had no association either with attempting weight control or caseness.

Adolescent↗
PubMed2000

Birth order and ratio of brothers to sisters in transsexuals.

BACKGROUND: As previous studies with homosexual males have revealed a later birth order, more older brothers and more brothers than sisters, this research was extended to a large series of transsexual males and females, some of whom are homosexual. METHODS: The male sample comprised 442 male-to-female transsexuals, subdivided by sexual partner preference: 106 homosexual, 135 heterosexual, 155 bisexual and 46 asexual. One hundred female-to-male transsexuals were also studied: 75 homosexual, 16 bisexual, seven heterosexual and five asexual. Birth order was computed by both Slater's Index and Berglin's Index. RESULTS: Homosexual male-to-female transsexuals have a later than expected birth order and more older brothers than other subgroups of male-to-female transsexuals. Each older brother increases the odds that a male transsexual is homosexual by 40 %. CONCLUSIONS: Hypotheses explaining the extension of prior findings to this large sample of transsexual males include a progressive maternal immunization to the male foetus either through the H-Y antigen or protein-bound testosterone or alterations in foetal androgen levels in successive pregnancies, all modifying male psychosexual development. Data on the sexual orientation of younger brothers of homosexual male transsexuals in this study are not consistent with the progressive immunization hypothesis.

Adult↗
PubMed2001

Hand preference, sexual preference, and transsexualism.

Atypical handedness patterns, i.e., persons being less exclusively right-handed, have been found previously in large samples of male and female homosexuals and in small samples of male and female transsexuals compared to controls. The posited role of prenatal androgen influencing both cerebral hemispheric dominance and psychosexual development warrants further study with large samples of transsexuals. 443 male-to-female transsexuals and 93 female-to-male transsexuals were studied for their use of the right or left hand in six common one-handed tasks. Both male and female transsexuals were more often nonright-handed than male and female controls were. Results suggest an altered pattern of cerebral hemispheric organisation in male and female transsexuals.

Brain↗
PubMed1992

Differential effects of women's child sexual abuse and subsequent sexual revictimization.

This study examines the differential effects of sexual revictimization in a community sample of 248 African-American and White American women, ages 18 to 36. Two classifications of sexual revictimization over the life course were used to assess the effects on later sexual and psychological functioning. The findings suggest that unintended pregnancies and abortions were significantly associated with sexual revictimization. Women who reported more than one incident in both childhood and adulthood were also likely to have multiple partnerships and brief sexual relationships. The findings are discussed within the context of the dynamics of sexual revictimization and its effects. Suggestions are offered for therapeutic strategies with survivors in order to minimize the effects of sexual revictimization.

Adolescent↗
PubMed1992

Effect of incest on self and social functioning: a developmental psychopathology perspective.

The effects of child sexual abuse have become a leading concern of mental health service providers. Despite an explosion of studies, one major difficulty in this research is the lack of a developmentally sensitive model for conceptualizing short- and long-term effects and continuity and discontinuity of effects over time. This article proposes a model based in the perspective of developmental psychopathology. It is argued that incest has its unique negative effects in the domains of self and social functioning, specifically in jeopardizing self-definition and integration, self-regulatory processes, and a sense of security and trust in relationships. Studies with clinical samples indicate that diagnostic conditions associated uniquely with a history of incest reflect serious self- and social impairments. A review of the developmental literature on self and social development summarizes each major developmental transition from infancy to middle adulthood, and the implications for the negative effects of incest on development are discussed. Finally, implications for developmentally sensitive research are discussed.

Adolescent↗
PubMed1991

Do parent-child relationships change during puberty?

This article reviews changes in parent-child relationships during puberty, emphasizing the developmental processes that might be implicated in these changes. Evidence suggests increases in conflict and less warm interactions in relationships between parents and children during puberty. Changes are assumed to be short term, although little longitudinal research has directly addressed the issue of long-lasting effects. Other developmental changes occurring for the adolescent, the parent, or both (such as social cognitive or self-definitional change), as well as other relationship changes, personality characteristics, and the sheer number of life events or transitions have all been posited as potential contributors to changes in the parent-child relationship for young adolescents. These possible contributors, however, have seldom been studied in conjunction with pubertal changes. Such integrative research is necessary to test various models through which puberty, social relationships, social cognitive, self-definitional, and other processes influence one another and are influenced by one another during the transition to adolescence.

Adolescent↗
PubMed2002

Sexuality and haemophilia: connections across the life-span.

A broad overview of sexuality issues and needs as they relate to haemophilia are presented. Venturing well beyond 'safer sex', sexuality is defined here to encompass physical, emotional, social, interpersonal, moral, and cultural aspects. From this perspective, sexuality extends beyond behaviour and includes a person's thoughts, feelings, nature, and identity. As a means of experiencing intimacy, sexuality is a significant factor in achieving quality of life with chronic illness. Its impact in haemophilia is influenced by different stages of physical and psychosexual development, misconceptions about sexuality, and unique concerns for this group, including joint disability, human immunodeficiency virus, medication side-effects, and other complications. This paper explores the interconnections of sexuality with haemophilia, with a focus on the roles that haemophilia care providers can play in addressing these issues. A biopsychosocial model of aspects and interrelationships regarding sexuality and haemophilia is proposed for use in understanding individuals and planning care approaches. The PLISSIT model is offered to guide counselling about sexuality on different levels of complexity. Sample strategies for initiating discussion, communicating about sex, and developing goals and interventions are presented.

Comprehensive Health Care↗
PubMed1993

[Hermaphroditism verus: clinical aspects, diagnosis and therapy in adulthood].

A 20-year old woman, who underwent an intersex operation during infancy, was presented for evaluation of the gonads because of suspected true hermaphroditism. The phenotype was female with regular menstruations. Examination revealed an ovarian tumour of 8 cm on the left side and a normal right ovary. During the operation, the tumour was revealed as an endometriosis cyst, which could be excised whilst preserving the ovarian tissue. The right gonad was an ovotestis. The testicular part was removed because of a 4% risk of malignancy. The different combinations of ovary/testis and ovotestis are described. Diagnosis and therapy of true hermaphroditism should be performed as early as possible to obtain an adequate gonadal function and an undisturbed psychosexual development.

Adult↗
PubMedDate not supplied

[Sex behavior in puberty].

The increasing number of Aids cases raises questions as to the risks to which young people are exposed. The present study attempts to illustrate the psychological development of sexuality during puberty. Taking development-psychological and depth-psychological aspects into account, the author attempts to throw light on the development of the ego and the instinctual and defensive behavior of young people. These intrapsychic constellations and social norms have a major influence on young people's sexual behavior.

Adolescent↗
PubMed1993

Oral pessimism and depressive symptoms.

I examined the relation of oral optimistic and oral pessimistic personality traits to depressive symptoms to assess the psychoanalytic claim that fixation at the early phase of the oral stage of psychosexual development is related to depression. College students (N = 140) were administered the Oral Optimism Questionnaire (OOQ; Kline, 1978) and Oral Pessimism Questionnaire (OPQ; Kline, 1978) and the Beck Depression Inventory (BDI; Beck, Ward, Mendelsohn, Mock, & Erbaugh, 1961). Oral pessimism and levels of depressive symptoms were positively correlated, and a subsample of subjects with clinical levels of depressive symptoms also scored significantly higher on the Oral Pessimism Questionnaire than the rest of the sample. For the whole sample, 10 BDI items correlated significantly with the OPQ scores, and 5 OPQ items correlated significantly with the total BDI scores. The psychoanalytic claim relating fixation at the oral pessimism stage to depressive symptoms was supported.

Depressive Disorder↗
PubMed1999

Gender in homosexual boys: some developmental and clinical considerations.

Each of the homosexual men I have worked with has described gender-discordant traits during childhood that made him feel "different." In this article I illustrate that early parental admonitions and interventions to curb or replace these traits with more typically male behaviors may be harmful to the child's development, particularly to his emotional resilience. As a result, some gay adults have lost their capacity to recognize and express a variety of affects, and some attempt to avoid intimate relationships that evoke these and other repudiated "feminine" traits.

Adolescent↗
PubMed1990

Developmental aspects of self-esteem in the analysis of an 11-year-old boy.

This paper explores the vicissitudes of self-esteem in the analysis of an 11-year-old boy. The paper highlights the complex interplay from different developmental periods that underlies the growth and sustaining of self-esteem. This interplay, catalyzed in the crucible of the transference, includes issues of evolution of affect states, self-structure, object relations, psychosexual development, conflict, and defenses.

Child↗
PubMed1976

Anger, sexuality, and the growth of the ego.

This paper examines the long-term issues of sexual dysfunction in terms of normal psychosexual development. Human sexual development and ego growth take simultaneous origin within the symbiotic relationship of the child and its first nurturant caretaker, usually the mother. Infantile sexuality, the pleasure of the total body, is equivalent to love and dependent upon sameness and continuity, tending toward fusion. Adult sexuality depends for its emotional impetus upon separateness and difference between lovers. Once established, adult sexual relationships drift inexorably toward the symbiotic unity implicit in loving. Genital sexuality may be sacrificed in the preference for more global satisfactions reminiscent of the infantile sexual experience. Essential to the adult sexual relationship then is the capacity to bear and express conflict and anger as a means of breaking the symbiotic tie; a continuous restructuring of ego boundaries is necessary for the maintenance of a functioning sexual relationship of long duration.

Adult↗
PubMed1989

Counselling and selection of homosexual couples in fertility treatment.

Artificial insemination with anonymous donor sperm (AID) is a widespread practice for heterosexual couples in which the male partner appears to be infertile. The Centre for Reproductive Medicine of the Brussels University teaching hospital has been one of the first to extend this form of therapy to lesbian couples. In the course of the past 7 years, 27 lesbian couples have come to the centre with a request for AID. The question of whether children can be brought up within such a frame of reference cannot be dissociated from the question of attitudes towards homosexuality as such. Such attitudes still solicit a whole range of controversial reactions. This paper will deal with the most important findings from investigations thus far carried out on the issue of homosexual parenthood. It also sets out the selection criteria used in the evaluation of applicants. A profile of the homosexual couples selected will be presented, with particular attention to their social status, their psychosexual development and their motivation towards parenthood.

Counseling↗
PubMed1990

Pineal melatonin in schizophrenia: a review and hypothesis.

It has long been suggested that abnormal functions of the pineal gland may be implicated in the pathophysiology of schizophrenia. We present evidence proposing that diminished melatonin secretion may be associated with the pathophysiology of a subgroup of schizophrenic patients characterized by cerebral atrophy and ventricular enlargement, negative symptoms, impaired cognitive and psychosexual development, onset at pubescence, poor response to neuroleptic medication, and possible increased risk of extrapyramidal symptoms. This view holds that a subnormal plasma melatonin level may be a marker of a subgroup of schizophrenia and may also denote a specific genetic susceptibility.

Dyskinesia, Drug-Induced↗