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[Deviation in psychosexual development in the pre-puberty children].

Psychosexual health of 308 children, aged 2-11 years, as well as that of their families, was studied. Deviations in psychosexual development were found in 34.6% of the children examined. The following types were detected: difficulties in formation of gender-determined behavior features--64.4%, precocious psychosexual development--13.7%, delayed psychosexual development--12.3%, obsessive masturbation--9.6%. Risk factors for deviant psychosexual development were found.

Child↗

Croup, a disorder of the anal phase of development. A contribution to our understanding of the psychosexual development of the larynx.

A brief history of croup is presented. The forms of croup under examination are defined with emotional factors at one end of a continuum and viral and traumatic factors at the other. The complexity of the disorder and its peculiar clinical characteristics are explained. Some of these characteristics are: (1) the predominant 1-3-year age range, which corresponds to the anal stage of development; (2) the relief afforded by vomiting; (3) the occurrence of attacks at night and during sleep, (4) the relative dryness of the cough and its harsh metallic quality; (5) the frequent presence of a ticklish, irritating sensation in the throat; and (6) the presence of edema and/or laryngospasm. Three case vignettes are presented. These cases support a previously developed theory concerning the impulses and defenses underlying the croup attack. Croup is seen as a fixation at the oral level with a regression to that level in the face of conflicts of the anal or sometimes the oedipal stage. The psychosexual development of the larynx is discussed.

Adolescent↗

"Johnny, I Hardly Knew Ye:" toward revision of the theory of male psychosexual development.

"The psychology of women," as it now exists, is a shadowy negative of the psychology of men, and can be successfully formulated only if male psychology is reassessed and considerably revised. Male theorists and practitioners have made virtues of the harsh facts of male socialization. These conditions, which have unhappy repercussions in the male ego and in the culture as a whole, are modifiable only if they are identified and understood.

Anxiety, Castration↗

Psychosexual development: a model for teaching nursing intervention.

This model is an attempt to meaningfully reduce psychosexual development to its essential elements in order to facilitate learning, and, ultimately, the development of nursing interventions that are evolved from a theoretical base, produced out of a wholistic view of psychosexual development and arise from a conception of sexuality as a healthy, normal phenomenon. It certainly possesses limitations. No model can replace the nurse-client relationship upon which knowledge and insight into the client's unique character and needs are based. However, utilizing a model as a foundation for learning and nursing practice can become the first step in determining successful client service. Using a psychosexual development model in concert with our overall view of human beings serves to strengthen our commitment to treating individuals as integrated wholes. "Human sexuality, that dimension of maleness and femaleness in one's personality, is expressed in every human act; it is inseparable from the maintenance of one's health" (Jacobson, 1974).

Adolescent↗

Psychosexual development of adolescent males after malignancies in childhood.

We studied psychosexual development in 28 adolescent males who had survived leukemia and compared it with that in 25 adolescent males who had survived other malignancies in childhood. A clinical semistructured psychiatric interview was used to form 8 criteria of psychosexual development. Sexual identity was also assessed using a psychological test. By every criterion, development was more disturbed in patients who had survived leukemia. Attitudes toward adult-type genital sexuality, contact ability with the opposite sex, and the developmental level of sexuality were most significantly affected.

Adolescent↗

Psychosexual development in adolescents with chronic medical illnesses.

The author provides a literature review and developmental formulation, with the goal to assist clinicians working with medically ill adolescents with psychosexual issues. MEDLINE and PsychINFO database searches of English-language medical journal articles published between 1986 and 1997 for articles related to medical illness and psychosexual development in adolescence were done. The author found that little systematic research on the psychosexual implications of medical illnesses for adolescents has been undertaken, but existing studies suggest that psychosexual development is negatively affected by medical illness. A three-phase model of adolescent psychosexual development is presented, with specific psychosexual tasks associated with each phase. Impediments to progressing through adolescent psychosexual phases due to medical conditions are identified, and case examples are provided. The author concludes that clinicians working with adolescents with medical conditions should attend to the possibility of psychosexual impediments in these adolescents and use developmentally appropriate methods for assessing and treating these difficulties when they arise.

Adaptation, Psychological↗

Reflections of testicular damage on psychosexual development in adolescent males who survived childhood malignancies.

We studied testicular growth and psychosexual development in 41 young males who had survived malignancies in childhood. The focus of the study was evaluation of the connection between the possible pathologies of these two phenomena. The size of the testicles was measured in millilitres and compared with reference values. The psychosexual development was evaluated using three approaches: the interviewer's evaluation, the patient's subjective assessment and information gained by specific questions. On the basis of the developmental theory of adolescence described by Blos, the appropriate development in each criterion was defined. Our results indicated that both psychosexual and somatic development were impaired. A significant relationship existed between testicular size and three criteria assessed by the patients: the patients who felt that their pubertal development was different from that of their peers, those who felt that their developmental failures were related to their personal medical histories, and those who did not feel that they had the ability to have sexual intercourse and/or children. The last group had significantly smaller testicles than the others. We speculate that the perception of the small size of testicles may trigger the psychological experiences of failed development, leading to narcissistic problems in adolescent development. In order to prevent these harmful consequences it will be necessary for different specialists to work together with the families and patients.

Adolescent↗

[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.

Adolescent↗

Psychosexual development in genetic males assigned female: the cloacal exstrophy experience.

Genetic males who have cloacal exstrophy, a rare, severe pelvic field defect that leads to aphallia, traditionally have been socially, legally, and surgically sex-assigned female at birth and reared female, despite a male karyotype and a typical male prenatal hormonal milieu. Psychosexual development in such children previously has been unknown. Studies of 29 children revealed that despite the absence of the typical postnatal and pubertal androgen surges and the presence of female genitalia, all female-assigned subjects displayed a marked male-typical shift in psychosocial and psychosexual development. Nearly half of them have declared themselves male. Psychosexual development, including gender identity, in genetic and hormonal male neonates seems to be influenced heavily by prenatal androgen exposure. The clinical practice of surgical sex assignment at birth requires re-evaluation.

Bladder Exstrophy↗

The role of the object in drive cathexis and psychosexual development.

Alternate axes are explored in the orthodox formulation of drive cathexis and psychosexual development, with implications for corresponding object relation modes engendered by these processes. Somatic and defensive aspects are shown to impact on the function of the "other" as the individual matures. The separation/individuation process is subsumed into this overall developmental continuum, and the centrality of the object as a focus in cathexis and drive delineation is critically evaluated. The homeostatic notion of equilibration is appealed to in synthesizing the factors emerging from the analysis.

Cathexis↗

[The perception of family function and psychosexual development in obese adolescents].

The interaction of psychological and social factors with family functioning and psychosexual development was studied in obese adolescents. Family functioning was evaluated using the triaxial classification of Tseng and McDermott. A total of 246 adolescents 8 to 18 years old (124 males and 122 females) were grouped in two: obese (n = 109) and non obese (n = 137). With the use of multivariate analysis it was found that the group of obese youngsters had higher rates of triangular parents-child dysfunction (p < 0.001) and more disapproval for their feeding behavior (p = 0.002); on the other hand, they considered they were more accepted in the family (p = 0.029) and felt greater concern from their parents (p = 0.004). It was concluded that the feeding behavior is interrelated with several aspects of the family psychodynamics which has an effect on the adolescents homeostasis and on his own body image perception. Those factors should be taken into consideration when the obese youngster is studied in clinical practice.

Adolescent↗

Psychosocial and psychosexual development in childhood and adolescence within the exstrophy-epispadias complex.

PURPOSE: We report the psychosocial and psychosexual development of children and adolescents with the exstrophy-epispadias complex (EEC) after complete functional repair using the Erlangen single stage technique. MATERIALS AND METHODS: In a long-term retrospective followup of an average of 11.1 years 100 patients with EEC (76 boys and 24 girls, mean age 14.5 years) were evaluated with respect to medical history, and received a general questionnaire concerning their social and psychosocial situation. A total of 54 patients who were 15 years or older (mean age 18.5) received an additional questionnaire to assess detailed sexual history. RESULTS: Of the patients 81% returned the general questionnaire within 3 weeks. School education level and social integration were high. In about 25% of the patients impairment of daily life was significant, and in 58.7% peer relations were altered. Of the adolescent group 76% answered the special questionnaire. Genital satisfaction and genital touching were rated low, and avoidance of nudity in public areas was common. All patients expressed heterosexuality and 43.9% had engaged in sexual intercourse but 58.5% displayed anxiety about sexual activity. It is noteworthy that 93.9% expressed an interest in psychological assistance. CONCLUSIONS: Despite a high degree of social integration and adult adaptation, children and adolescents with EEC suffer from psychosocial and psychosexual dysfunction requiring special questionnaires for adequate assessment. Anxiety about genital appearance and sexual activity is a common phenomenon among adolescents with EEC, even when they present with nearly "normal" genitalia and participate with satisfaction in sexual activity. Further studies are needed to understand the exstrophy problem and supply all patients with EEC with the individual care they need.

Activities of Daily Living↗

Psychosexual development and eating disorders.

The relationship among eating disorders (EDs), psychosexual and identity development, and physical maturation (puberty) is reviewed. The developmental tasks of adolescence are summarized, and research from both community studies and clinical samples on the association between the development of an ED and putative risk factors that include pubertal development and psychosexual behaviors and attitudes for children and adolescents is reviewed. Specific issues explored include the role of child and adolescent abuse and EDs in males. Overall evidence suggests the following: there are inconsistent findings regarding early pubertal development as a risk factor; there is some support for differences between the ED subtypes in sexual attitudes, behaviors, and experiences; sexual abuse is not a specific risk factor; and gender identity issues may play more of a role for adolescent males than females. However, psychosexual issues are neither sufficient nor necessary for the development of an ED in a young person. It should be considered as only one factor in the multidimensional, multifactorial framework needed to clarify this complex and still poorly understood set of disorders.

Adolescent↗

[Psychosexual development and sex life of women with congenital adrenogenital syndrome].

OBJECTIVE: The aim of the study was to examine the psychosexual development and sexual life of 13 adult women with congenital adrenogenital syndrome. DESIGN: A clinical study. SETTING: Psychiatric clinic, Gynecological clinic and Sexological institute, Medical Faculty of the Charles University in Prague. METHODS: The examination was carried out using a structured interview and three tests: MF (Masculinity and feminity), SFW (Sexual function of women) and SAI (Inventory of sexual arousibility). RESULTS AND CONCLUSION: It was ascertained that only about one third of the patients were coitally active and that the first intercourse was delayed. The results of the questionnaire SFW were in 66% subnormal and an adequate sexual arousability was found only in 40% of examined persons (the test SAI).

Adolescent↗

Psychosexual development of women with congenital adrenal hyperplasia.

Women with congenital adrenal hyperplasia (CAH) (N = 31) and their unaffected sisters or female cousins (N = 15) participated in a study of psychosexual development. All participants were > or = 18 years of age (mean age, 25 years; range, 18-40). Comparisons were also made between the CAH women with the salt-wasting (SW) form of the disorder and those with simple virilization (SV). A psychosexual assessment protocol examined six variables: (1) sex assignment at birth (probands only); (2) recalled sex-typed behavior during childhood; (3) gender identity and gender role identification in adulthood; (4) relationship status; (5) sexual orientation in fantasy; and (6) sexual orientation in behavior. Salt-wasting status and sex assignment at birth were also ascertained for the CAH women who either refused to participate in the study (N = 10) or could not be traced (N = 13). Compared to the controls, the women with CAH recalled more cross-gender role behavior and less comfort with their sense of "femininity" during childhood. The two groups did not differ in degree of gender dysphoria in adulthood, although the probands showed more cross-gender role identification. Three of the nonparticipant probands were living, as adults, in the male social role (2 reared from birth as boys and 1 who changed from the female to the male social role during adolescence). The CAH women and the controls did not differ in relationship status (married/cohabiting vs. single). The CAH women had lower rates of exclusive heterosexual fantasy and fewer sexual experiences with men than the controls; however, the CAH women did not have more sexual experiences with women than the controls. Comparisons between the SW and SV revealed several differences: the SW were less likely to be assigned to the female sex at birth, recalled more cross-gender role behavior during childhood, were less likely to be married or cohabiting, and had lower rates of sexual experiences with men. The results were discussed in relation to the effects of prenatal androgens on psychosexual differentiation.

Adrenal Hyperplasia, Congenital↗

Psychosexual development: an examination of the role of prenatal hormones.

Naturally occurring endocrine syndromes and the offspring from steroid-treated pregnancies are the major sources of evidence for a role of prenatal hormones in psychosexual development in man. Effects of prenatal androgens have been established for the sex-dimorphic behaviour clusters of energy expenditure (increased), parenting rehearsal (decreased), peer associations (shifted to male), and grooming-related behaviour (decreased); most of the information was obtained on the syndrome of congenital adrenal hyperplasia and in progestin-induced female hermaphroditism. Studies of children and adults exposed prenatally to exogenous oestrogens and/or progestagens suggest slight demasculinizing effects but cannot yet be considered conclusive. Gender identity is largely dependent on the sex of rearing; a direct role of prenatal hormones in its formation has not been shown. The evidence for the role of prenatal hormones in the development of sexual orientation is inconclusive.

Female↗