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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↗
PubMed2003

Fertility in women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

UNLABELLED: Fertility in women with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency appears to be reduced. The purpose of this review is to summarize the reported evidence about subfertility in women with CAH and to review the causes of reduced fertility. Compared with a non-CAH female population, pregnancy and live-birth rates are severely reduced in salt-wasting patients, mildly reduced in simple virilizing patients, and normal in nonclassical patients. Several factors have been suggested to contribute to the impaired fertility in CAH females: adrenal overproduction of androgens and progestins (17-hydroxyprogesterone and progesterone), ovarian hyperandrogenism, polycystic ovary syndrome, ovarian adrenal rest tumors, neuroendocrine factors, genital surgery, and psychological factors such as delayed psychosexual development, reduced sexual activity and low maternal feelings. It is obvious that these factors are interrelated. Improving endocrine, surgical, and psychological management could contribute to improving fertility chances in these patients. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader will be able to define the various types of CAH, to describe the fertility issues in the CAH patients, to outline the various other causes of hyperandrogenism, and to list the treatment options for the patient with CAH.

Adrenal Glands↗
PubMed1984

Microvascular surgical orchiopexy in the treatment of high-lying undescended testes.

Extensive laboratory experiments in animals have led us to believe that autotransplantation of the testis in the human is feasible. To date, nine of our patients (aged 4-13 years) with undescended intra-abdominal testes have undergone autotransplantation. Using a microvascular surgical technique to anastomose the testicular vessels to the inferior epigastric vessels, it has been possible to place the testis in a scrotal position in every case. No postoperative complications have been noted. Follow-up varied from 9 to 18 months and no atrophy of the testis was observed in this period. Doppler investigations on all of the transplanted testes continue to demonstrate good arterial flow. The aim of surgery on the undescended testis is not only to increase the chances of fertility and to diminish the possibility of malignant transformation but also, more importantly perhaps, to prevent possible abnormal psychosexual development in the child.

Adolescent↗
PubMed1995

A multifactorial approach to the study of gender characteristics.

The present article reviews some of the central conceptual issues confronted by gender researchers as they have tried to forge a theory of gender identity that can account for the complexity and diversity of gender-related characteristics displayed by women and men. An emerging consensus suggests that gender is incorporated into an individual's self-concept in multiple and loosely connected ways. We review one example of this emerging multiplicity perspective, Spence's (1993) multifactorial gender identity theory, and describe three recent studies testing its usefulness. We also discuss ways in which multiplicity models of gender could benefit from considering parallel developments in the general personality literature regarding the problem of levels or domains. In particular, it is argued that McAdams's (this issue) integrative three-level model of the structure of personality offers a helpful framework for guiding future test construction and theory development in gender research.

Adolescent↗
PubMed1995

Child and adolescent sex abuse perpetrators: a review of the research literature.

This paper reviews the existing literature on selected issues in relation to child and adolescent sex abuse perpetrators. The relatively recent recognition of this phenomenon and the multiple problems of definition in this field may have affected the figures for incidence and prevalence. Among known cases a high proportion of young sex abuse perpetrators have suffered earlier adversities such as sexual and physical victimisation, dysfunctional family relationships and peer isolation. Despite a slender research data base on which to draw, treatment programmes for this client group have proliferated and many of these have not been adequately evaluated. There is a pressing need for the adoption of agreed definitions of outcome targets and measures and establishing longterm outcome studies with this group of children and adolescents.

Adolescent↗
PubMed1985

Rites of passage in families with adolescents.

In previous generations society defined expectations and constructed events to promote individual development, a functional family organization, and cultural continuity. Culturally defined and accepted rites of passage that were previously observed in families with adolescents have given way to a more vague and meaningless set of adolescent expectations and affirmations. It is proposed that this change has interfered with the mission of the family to promote functional adolescent development and with the ability of the family during this life cycle stage to operate with a sense of community attachment. This paper addresses the importance of rites of passage as they pertain to family development and change and presents ideas about making them explicit in family therapy to change family interaction and structure. Prescribed family rituals that are straightforward, developmentally relevant, and interactional can be effective without consideration to whether they are paradoxical. Three clinical illustrations are presented to highlight this therapeutic approach.

Adolescent↗
PubMed1998

Friends, lovers and spouses: intimacy in young adults.

Intimacy in young heterosexual adults was studied as a function of their familial roles. The 168 males and females employed represented four familial role groups: late adolescents, single adults, married people and parents. Participants were administered two forms of an Intimacy Scale (Sharabany, 1994) in which they described their desired and their obtained intimacy with a same-sex and an opposite-sex best friend. Results indicated that (a) intimacy of adults with opposite-sex partner was higher than intimacy with same-sex friend. (b) Although no direct effect of familial role on intimacy was found, the married and parent groups displayed greater intimacy towards their spouses than late adolescents and single adults towards their opposite-sex partners. (c) Women who were late adolescents and women who were married scored significantly higher than men in intimacy. However, single women expressed significantly lower intimacy than single men. (d) Higher intimacy with opposite-sex partner was associated with a concurrent lower same-sex intimacy. (e) Satisfaction with other-sex partner was higher in the married group than in the other groups.

Adolescent↗
PubMed1995

Psychological characteristics of maltreated children: putative risk factors and consequences.

Although there is considerable evidence that the maltreatment of children is widespread and that it can have significant adverse effects on the victims, specific abuse-outcome patterns are not obvious beyond the link between physical abuse and aggression, and the link between sexual abuse and poor sexual adjustment. Although concepts of invulnerability or child resilience are somewhat controversial (see Rutter 1983), some children from severely maltreating backgrounds do not evidence apparent adverse outcomes (e.g. Farber & Egeland 1987, Herrenkohl et al 1991). It is unknown whether the more favorable outcomes are the result of child resilience or the influence of environmental buffers. More research clearly is needed to fully understand the behavioral risks and consequences of maltreatment.

Aggression↗
PubMed1975

Psychodynamics of the young handicapped person.

Psychodynamics of personality and ego development are related to motor development. The body image concept, important for normal psychologic performance is often impaired by somatic or cerebral defects. Adolescents are particularly depressed by loss of self-esteem and thwarting of future career goals. Sexuality is an important consideration for the handicapped.

Body Image↗
PubMed1992

A case of premenstrual distress: bisexual determinants of a woman's fantasy of damage to her genital.

Case material is used to illustrate specific clinical application of the concept of primary femininity. Some contemporary contributions to the psychoanalytic theory of female psychosexual development are presented as complementary with, rather than contradictory to, more familiar, longstanding formulations that emphasize phallic strivings in women. In the clinical example reported, a fantasy of genital damage underlay a woman's premenstrual distress. Aspirations and concerns related to both aspects of her fundamental bisexuality participated in symptom formation and had to be investigated in order to achieve symptom relief. As the analytic work unfolded, it could be seen that the patient's awareness of her feminine aims served to keep her masculine aims out of awareness, and vice versa.

Adult↗