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PubMed1984

Reflections on Dora: the case of hysteria.

It is with Dora that psychoanalysis becomes what we know it to be: the problem of the transference is introduced for the first time in her case. Although the number of papers written on this case is astonishing we still want to know more and more about her. Maybe this is a characteristic of the hysteric: it tantalizes us, waving a cape--like a bullfighter--that hides nothing behind it. In the second part of this paper, I refer to certain changes in psychoanalytic theory which would account for the apparent 'disappearance' of hysteria. In the third part, I relate hysteria to femininity. I suggest there is an hysterical stage in the development of women, characterized by divalence. Whilst ambi-valence describes a situation in which the subject has to decide whether he loves or hates his object, divalence would describe the situation in which the subject is confronted with the choice between mother and father, within the context of the oedipal drama. This is specifically feminine because it is the woman who has to change from one to the other in her development. When the subject gets 'fixed' to this stage, we find an hysteric who cannot determine the object of her desire, and she will always remain in the middle, unable to choose between mother or father, incapable of defining herself as a woman or a man--in spite of her apparently sexualized 'feminine self'.

Female↗

PubMed1978

Sex role stereotypes and children's memory for story content.

This investigation examined children's memory for stereotypic and reverse-stereotypic sex role content in their reading material. In experiment 1, lists of traits and behaviors deemed typical of boys and girls were obtained from 2 classrooms of fifth-grade students. 4 experimental stories were developed from these lists of stereotypic items, each depicting a male and female character who exhibited an equal number of masculine and feminine characteristics. In experiment 2, 24 fifth-grade students of each sex read 2 experimental stories and were administered a choice-recognition test. Results revealed that both sexes remembered more of the masculine sex typed characteristics of male characters and more of the feminine sex-typed characteristics of female characters. Moreover, the subjects were less proficient in remembering trait than behavioral descriptions and were particularly unlikely to remember the feminine traits of male characters. On the basis of these findings, it was speculated that children use the sex role stereotype as an organizational framework in reading comprehension. Possible implications of this research for children's reading programs were discussed.

Child↗

PubMed1983

On the vicissitudes of female sexuality: the difficult path from 'anatomical destiny' to psychic representation.

The author studies female sexuality under six headings: 1) The essential nature of feminine orgastic pleasure in its spreading-out quality in waves of excitement within her body. This experience in itself gives rise to a genital psychic representation that lacks precise limits, and indeed for many women is regarded in addition as potentially overwhelming and uncontrollable. 2) Vaginal erotism is also prone to stir up anxious feelings that are not only difficult to define and delimit corporally but are also impregnated with oral and anal fantasy elements, all of which contribute to a fantasy of the vagina as an 'insatiable hole' that swallows and destroys, and this may mitigate against sexual maturity in the women. 3) The little girl has not met the same type of threats and interdictions that engender the castration complex in the boys. Thus there is a risk that she may continue to think of her sexual excitement and sensations as dangerous to her whole body, not only because she cannot link them to a clearly visible organ, but also because the limits that are set upon her search for pleasure are imprecise. 4) A further consequence is that the sensual attachment to the primitive mother-body is less readily given up than is that of the little boy. In addition the ambivalent attitude of the mother to her girl-child frequently places one more stumbling block in the path to the achievement of adult female sexuality. The effects of these factors upon super-ego structure are also considered. 5) 'Penis-envy' like all stable psychic formations comes to be seen as multidimensional, intimately linked to desires and fears concerning both parents. 6) Finally, since the complex questions concerning feminine sexuality are not limited to women, the unconscious feminine identifications of men are briefly examined.

Adult↗

PubMed1981

Adult reactions to children's cross-gender verbal behavior.

Reactions of teachers and college students were obtained to a child, labeled male or female, exhibiting stereotypically masculine or feminine verbal behavior. The findings were: (1) adults did not redirect or discourage cross-gender compared with gender-appropriate behavior; (2) adults rated same-sex children higher on a subset of masculine traits, regardless of the child's behavior; (3) adult females rated the child more positively and responded to the child in a more reinforcing manner than did males; (4) male teachers responded to the child more positively than nonteachers, but the reverse was true for females; (5) all adults reinforced feminine more than masculine behaviors; and (6) nonteachers were more attracted to the female child and the child exhibiting feminine behaviors, while teachers were more attracted to the male child and the child exhibiting masculine behaviors.

Adult↗

PubMed1976

Freud's views on early female sexuality in the light of direct child observation.

Freud's writings on early female sexuality are reviewed in order to demonstrate which of his central assumptions are supported and which have been corrected by the direct observation of young children. The study of the emergence of core gender identity in little girls is a key to the modification of Freud's statements on the onset of and crucial factors in the development of femininity. Cognitive functions, learning experiences, and language are believed to be more important than Freud stressed, and penis envy and feelings of inferiority are relegated to a less universal and less necessary place in the onset of femininity. The role of the father is given different emphasis. Direct observation clarifies many aspects of masturbation or early genital self-stimulation in the young female: its onset; its feminine rather than masculine character; its early vicissitudes; its importance relative to other behavior; the impact of the discovery of anatomical difference; one special way it is affected by parental attitude; and how it contrasts with comparable behavior in the young male. Observation refutes Freud's often quoted statement that masturbation is further removed from the nature of women than of men.

Child↗

PubMed1994

Gender labels and play styles: their relative contribution to children's selection of playmates.

The relative contribution of gender labels and play styles (masculine or feminine) in playmate selection was evaluated in 60 children between the ages of 4 and 8 years using a novel interview measure. In the interview, when targets' gender labels and targets' play styles were presented as independent dimensions, children showed predicted sex differences in preferences for gender labels and for play styles (including toys, rough-and-tumble play, and activity level). However, when targets' gender labels and targets' play styles were presented as competing dimensions, boys of all ages chose female targets with masculine play styles over male targets with feminine play styles. In contrast, younger girls (4-5-year-olds) chose female targets with masculine play styles, whereas older girls (6-8-year-olds) chose male targets with feminine play styles. This suggests possible sex differences in the contribution of gender labels and of play styles in the development of children's preferences for same-sexed playmates.

Age Factors↗

PubMed1977

Male homosexual behavior and ego function strategies in the group encounter.

This paper analyzes characteristic patterns of interaction by male homosexuals in the group treatment context according to both psychodynamic and behavioral criteria. Extensive clinical observation has yielded an overview of high probability homosexual response in group settings to the masculine male, older male, feminine male, feminine female, older feminine female, and masculine female. The nature of self-exploration and expression of intimacy is affected deeply by certain key intrapsychic factors and subtle situational cues. The paper stresses the critical importance associated with group leaders acquiring an understanding of antecedents to personality deficits in male homosexuals.

Ego↗

PubMed1997

The stress connection. Women and coronary heart disease.

Assessment and treatment of the stressors associated with major medical illness such as CHD without regard to gender overlooks women's issues in some extremely fundamental ways. To ensure that rehabilitation formats are relevant for women, more qualitative studies are needed so that women can give voice to the story of an MI recovery from a feminine perspective. It is vital to understand the psychologic contribution to the development and treatment of CHD both as described by women in their own words and as evaluated by distinctly feminine constructs. Assessment of psychosocial factors should be an essential component of a CHD diagnostic evaluation. Although little can be done about a genetic predisposition to CHD, education and personal support can help women make needed lifestyle changes to forestall further cardiac damage and to improve a woman's level of functioning. The capacity to take charge of one's life and social support are strong counterpoints to negative psychosocial symptoms of CHD. There is a strong need to make rehabilitation programs for women with CHD contextually congruent. Strategies to involve women in cardiac rehabilitation must take into account a woman's needs, providing both age-appropriate physical exercise and psychologic social support for women at times convenient to their schedules. Women must be given permission to let go of normally performed duties after a major cardiac event and to seek out what is meaningful. Group formats that offer women essential social support, an opportunity to verbally process the meaning of a life-threatening diagnosis, an opportunity to share their experiences with other women, and the ability to reconstruct a new sense of self based on feminine constructs may be as important for women as other lifestyle structural components in effective rehabilitation programs. Society must reclassify the CHD disease process as one that equally affects women. Research studies with women as primary subjects and key informants can provide needed direction in the identification of psychosocial risk factors and appropriate treatments to reduce alarming morbidity and mortality of CHD in women. More data are needed about the psychosocial mechanisms that aggravate and mediate physiologic responses in CHD in women.

Coronary Disease↗

PubMed1998

[Congenital absence of the vagina. Mayer-Rokitansky-Kuster-Hauser syndrome. Presentation of a case and review of the literature].

The normal development of the feminine reproductive tract depends on complete interaction between genetic, hormonal and environmental factors to produce the differentiation of the Müellerian, Wolff and urogenital sinus. The alteration in this balance result in a wide spectrum of the reproductive tract anomalies including imperforated hymen, vaginal septum, vaginal atresia, incomplete fusion of the Müellerian conducts and Müellerian aplasia. In order to evaluate the feminine genital tract disorders, we studied a feminine with amenorrhea and primary sterility. Ultrasonography and diagnosis laparoscopy where performed. Incomplete fusion of Müellerian conducts was observed. Blood genetics tests plus biopsy of ovarian tissue were taken which reported 46 XX karyotype with no structural anomalies. Conservative evaluation and management.

Adult↗

PubMed1976

Length of hospitalization on a short-term therapeutic community. A multivariate study by sex across time.

Patient length of hospitalization was examined in a private short-term therapeutic community unit using a longitudinal, multimethod, -ultivariate approach, with data analyzed separately by patient sex. Patient data were entered into stepwise linear regression analyses for weeks 1, 2, and 4 of an average seven-week hospitalization for male and female patients separately. Results for men were not specifically replicated among the women. Longer-staying men were diagnosed more frequently as "personality disorders," tended to be somewhat aloof, perceived the ward as encouraging denial, facade, order, and organization. Among women, verbal behavior, interpersonal relations, discontentedness with family, and other variables were related to length of hospitalization. Shorter-staying male and female patients tended to exhibit characteristics at the "feminine" end of a hypothetical masculinity-femininity continuum. Conforming, accepting behavior seemed reinforced for all patients.

Adult↗

PubMed1981

Childhood sexual identity, childhood religiosity, and "homophobia" as influences in the development of transsexualism, homosexuality, and heterosexuality.

We have studied the interaction between boyhood cross-gender behavior, "homophobia," and religiosity in men raised as Catholics who, during adulthood, considered themselves transsexual, homosexual, or heterosexual. The sample consisted of 43 transsexual, 78 homosexual, and 43 heterosexual subjects matched for age, race, educational level, and economic status. The transsexual men recalled the most "feminine" behavior during boyhood, followed by the homosexual men. The heterosexual group was most "homophobic," followed by the transsexuals. "Homophobia" positively correlated with religiosity among adult transsexuals and heterosexuals. Transsexuals, recalling childhood, perceived their parents as being more religious than did the homosexuals. At intermediate levels of "femininity," greater "homophobia" scores were associated with more transsexual characteristics. These data support the thesis that early developmental aspects of sexual identity, and later concerns over homosexuality that are partly of a religious derivative, may contribute to a transsexual outcome.

Attitude↗

PubMed1999

Lesbians, bisexual women, and body image: an investigation of gender roles and social group affiliation.

OBJECTIVE: This study examined the effects of considering oneself to be masculine, feminine, or androgynous in appearance, of having friends who share one's gender and sexual orientation, and of affiliating with three subcommunities within the lesbian society on various aspects of body image. METHOD: Self-report measures were obtained from 188 lesbian and bisexual females. RESULTS: Feminine women reported lower body satisfaction than did androgynous or masculine identified subjects. Those whose friends shared their sexual orientation and gender had more positive body images than those whose friends shared only gender. In contrast, community affiliation was unrelated to body satisfaction. DISCUSSION: Within-group differences among lesbians may be central to understanding body image in this group.

Adolescent↗

PubMed1980

The relationship of sex role to self-concept.

Investigated the relationship of sex role in 136 Ss as measured by the Bem Sex Role Inventory to measures of self-concept and overt anxiety. Persons who rated themselves low in both masculine and feminine attributes were found to have significantly poorer self-concept than both androgynous and masculine Ss, which suggests that this group should be distinguished from high-high scorers labeled as androgynous. There was no significant difference in self-concept between masculine and androgynous Ss, and the masculine group reported significantly lower levels of anxiety. These findings support a previous contention that it is the presence of masculine attributes rather than a balance of masculinity and femininity that is crucial to personal adjustment.

Adult↗

PubMed1982

MMPI correlates of the BEM Sex Role Inventory and Extended Personal Attributes Questionnaire in a male psychiatric sample.

Obtained normative data and MMPI correlates of two measures of sex role orientation (Bem Sex Role Inventory and Extended Personal Attributes Questionnaire) in a sample of male psychiatric inpatients (N = 55). Means and subscale intercorrelations similar to those found in college samples were found for each sex role scale. With regard to self-reports of psychopathology, desirable masculine traits generally were related positively to adjustment, undesirable masculine and feminine traits were related negatively, and desirable feminine traits were unrelated to pathology. No consistent sex role correlates with MMPI MF were found, contrary to previous research with normal groups.

Acting Out↗

PubMed1984

Sex-role affiliation among male alcoholics.

Male alcoholic veterans were sex-typed more frequently as feminine than masculine on the PRF ANDRO when compared to college males or older, nonalcoholic veterans (N = 123). Endorsement of passive-feminine characteristics among alcoholics (1) is interpreted to be a consequence, not a cause of the disorder; (2) is considered reversible with the achievement of sustained sobriety; and (3) is a feature that possibly needs to be addressed directly in order to facilitate successful therapeutic interventions.

Adult↗

PubMed1984

The relationship between sex-role orientation and the type A behavior pattern: a test of the main effect hypothesis.

Examined the relationship between sex-role orientation and the Type A behavior pattern. Eighty undergraduates were classified as high or low on masculinity and femininity on the basis of Bem Sex Role Inventory (BSRI) formed on student Jenkins Activity Survey (JAS) scores for pooled Ss, for males, and for females; each yielded a main effect for masculinity. JAS scores were correlated positively with BSRI Masculinity scores and not correlated with BSRI Femininity scores across pooled Ss, across males, and across females. These results are discussed in terms of their research and treatment implications.

Adult↗

PubMed1990

The relationship of measures of sex-typed play with clinician ratings on degree of gender disturbance.

Forty-nine boys, aged 3 to 11 years, who were referred for an evaluation of a potential gender identity disorder of childhood, were assessed with a standardized in vivo behavioral observation of sex-typed play in an alone condition and with the parent-report Bates-Bentler Games Inventory. Without access to these measures of sex-typed play, an independent clinical psychologist rated each of the subjects on a 9-point scale that indicated the degree of severity of a gender disturbance, based upon child and parent interviews and a complete psychological test battery. The percentage of feminine play in the behavioral observation procedure was found to be correlated significantly with the clinician rating of degree of gender disturbance (r = .55). The Games Inventory was found to differentiate significantly the gender-disturbed boys from the nonclinical reference group on its feminine/preschool games, masculine nonathletic games, and athletic games subscales and on its composite index of feminine play preference; however, only the composite index (and none of the 3 subscales) was correlated significantly (r = .34) with degree of severity of gender disturbance.

Child↗

PubMed2004

Prophylactic mastectomy for the prevention of breast cancer.

BACKGROUND: Breast cancer is the most common cancer and the second most common cause of cancer-related death among North American and Western European women. Recent progress in understanding the genetic basis of breast cancer, along with rising incidence rates, have resulted in increased interest in prophylactic mastectomy as a method of preventing breast cancer, particularly in those with familial susceptibility. OBJECTIVES: The primary objective was to determine whether prophylactic mastectomy reduces death from any cause in women who have never had breast cancer and in women who have a history of breast cancer in one breast. The secondary objective was to examine the effect of prophylactic mastectomy on other endpoints including breast cancer incidence, breast cancer mortality, disease-free survival, physical morbidity, and psychosocial outcomes. SEARCH STRATEGY: Electronic searches were performed in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, Cancerlit, and the Science Citation Index. SELECTION CRITERIA: Inclusion criteria were studies in English of any design type including randomized or nonrandomized controlled trials, cohort studies, case-control studies, and case series with at least ten participants. Participants included women at risk for breast cancer in at least one breast. Interventions included all types of mastectomy performed for the purpose of preventing breast cancer, including subcutaneous mastectomy, total or simple mastectomy, modified radical mastectomy, and radical mastectomy. DATA COLLECTION AND ANALYSIS: Information on patients, interventions, methods, and results were extracted by at least two independent reviewers. Methodological quality was assessed based on how well each study minimized potential selection bias, performance bias, detection bias, and attrition bias. Data for each study were summarized descriptively; quantitative meta-analysis was not feasible due to heterogeneity of study designs and insufficient reporting. Data were analyzed separately for bilateral prophylactic mastectomy (BPM) and contralateral prophylactic mastectomy (CPM). MAIN RESULTS: Twenty-three studies, including more than 4,000 patients, met inclusion criteria. No randomized or nonrandomized controlled trials were found. Most studies were either case series or cohort studies. All studies had methodological limitations, with the most common source of potential bias being systematic differences between the intervention and comparison groups that could potentially be associated with a particular outcome. Thirteen studies assessed the effectiveness of BPM. No study assessed all-cause mortality after BPM. All studies reporting on incidence of breast cancer and disease-specific mortality reported reductions after BPM. Nine studies assessed psychosocial measures; most reported high levels of satisfaction with the decision to have prophylactic mastectomy (PM) but more variable satisfaction with cosmetic results. Only one study assessed satisfaction with the psychological support provided by healthcare personnel during risk counseling and showed that more women were dissatisfied than satisfied with the support they received in the healthcare setting. Worry over breast cancer was significantly reduced after BPM when compared both to baseline worry levels and to the groups who opted for surveillance rather than BPM. Three studies reported body image/feelings of femininity outcomes, and all reported that a substantial minority (about 20%) reported BPM had adverse effects on those domains. Six studies assessed contralateral prophylactic mastectomy. Studies consistently reported reductions in contralateral incidence of breast cancer but were inconsistent about improvements in disease-specific survival. Only one study attempted to control for multiple differences between intervention groups, and this study showed no overall survival advantage for CPM at 15 years. Two case series were exclusively focused on adverse events from prophylactic mastectomy with reconstruction, and both reported rates of unanticipated re-operations from 30% to 49%. REVIEWERS' CONCLUSIONS: While published observational studies demonstrated that BPM was effective in reducing both the incidence of, and death from, breast cancer, more rigorous prospective studies (ideally randomized trials) are needed. The studies need to be of sufficient duration and make better attempts to control for selection biases to arrive at better estimates of risk reduction. The state of the science is far from exact in predicting who will get or who will die from breast cancer. By one estimate, most of the women deemed high risk by family history (but not necessarily BRCA 1 or 2 mutation carriers) who underwent these procedures would not have died from breast cancer, even without prophylactic surgery. Therefore, women need to understand that this procedure should be considered only among those at very high risk of the disease. For women who had already been diagnosed with a primary tumor, the data were particularly lacking for indications for contralateral prophylactic mastectomy. While it appeared that contralateral mastectomy may reduce the incidence of cancer in the contralateral breast, there was insufficient evidence about whether, and for whom, CPM actually improved survival. Physical morbidity is not uncommon following PM, and many women underwent unanticipated re-operations (usually due to problems with reconstruction); however, these data need to be updated to reflect changes in surgical procedures and reconstruction. Regarding psychosocial outcomes, women generally reported satisfaction with their decisions to have PM but reported satisfaction less consistently for cosmetic outcomes, with diminished satisfaction often due to surgical complications. Therefore, physical morbidity and post-operative surgical complications were areas that should be considered when deciding about PM. With regard to emotional well-being, most women recovered well postoperatively, reporting reduced cancer worry and showing reduced psychological morbidity from their baseline measures; exceptions also have been noted. Of the psychosocial outcomes measured, body image and feelings of femininity were the most adversely affected.

Breast Neoplasms↗