Psychosocial Adjustment in Male-to-Female Transsexuals: An Overview of the Research Evidence

Transsexualism has been defined as an extreme gender dysphoria; it refers to unhappiness with one's biological sex and the desire to have the body of the opposite sex and to be regarded by others as a member of that other sex. Transsexualism is not a common condition, but its prevalence is not yet known. A large number of transsexuals receive hormonal treatment and sex reassignment surgery (SRS). In spite of years of poor quality research, due in part to methodological problems, recent research on surgical outcomes has provided important information. However, psychological research into transsexualism has ignored the cognitive style and psychological functioning of transsexuals, and very little effort has been made to incorporate research findings into the development of psychological treatments to improve the quality of life for transsexuals.     

Transsexualism: Some Theological and Ethical Perspectives

Abstract : The debates in church and theological circles regarding sexuality have been dominated by the subject of homosexuality. There has been far less theological discussion and ethical reflection regarding transgendered people and transsexualism in particular. This article introduces readers to some basic facts about transsexualism and to a selection of theological and ethical responses to this phenomenon with particular attention to how the notion of “disordered sexuality” is a factor in both the debate over the ethical status of transsexualism and homosexual unions.     

THE REMAINS OF THE DAY: TRANSSEXUALITY,PSYCHODYNAMICS AND THE MODERN NHS

This paper describes a psychodynamic understanding of transsexualism and some related implications for NHS services. Following a brief literature review the author describes a series of clinical vignettes that tease out psychically important transsexual dilemmas. Specifically, themes of conflict with authority, idealization of destructive solutions and learning to live with regret are explored. Finally a psychological differentiation of transsexual issues is suggested as potentially helpful for future service development.     

β2-糖蛋白Ⅰ依赖性自身抗体与自然流产的关系

为探讨β2-糖蛋白Ⅰ依赖性自身免疫抗体对自然流产病因诊断价值.将59名自然流产患者作为研究组,同时选择29名正常妊娠的产妇作为对照组.结论显示检测抗磷脂抗体能提高对自然流产患者病因诊断,β2-糖蛋白Ⅰ依赖性抗心磷脂抗体的特异性较单纯抗心磷脂抗体的特异性高,诊断妊娠丢失的病因更准确.     

Transsexualism and the Church

Abstract

Transsexualism raises many perplexing issues for Christians. This paper first reviews the scientific evidence, especially that relating to the biological aspects, and then issues relating to transsexualism as a social construct. It is suggested that it is wise to reject both the idea that transsexualism is completely determined by biological factors, and that it is nothing but a social construct. There are also intriguing issues about specifically religious attitudes to transsexualism, that are in some ways similar to those raised by eunuchs. Two recent Christian contributions to the Christian discussion of transsexualism are then reviewed—the scholarly work of Oliver O'Donovan, and the more popular report of the Evangelical Alliance. The latter raises interesting issues for discussion, but its negative attitude to transsexualism is not always justified by the arguments presented. Finally, practical issues facing the Church are considered, including those relating to transsexual clergy.     

Psychological Distress,Anxiety, and Depression of Cancer-Affected BRCA1/2 Mutation Carriers: a Systematic Review

Understanding the intermediate- and long-term psychological consequences of genetic testing for cancer patients has led to encouraging research, but a clear consensus of the psychosocial impact and clinical routine for cancer-affected BRCA1 and BRCA2 mutation carriers is still missing. We performed a systematic review of intermediate- and long-term studies investigating the psychological impact like psychological distress, anxiety, and depression in cancer-affected BRCA mutation carriers compared to unaffected mutation carriers. This review included the screening of 1243 studies. Eight intermediate- and long-term studies focusing on distress, anxiety, and depression symptoms among cancer-affected mutation carriers at least six months after the disclosure of genetic testing results were included. Studies reported a great variety of designs, methods, and patient outcomes. We found evidence indicating that cancer-affected mutation carriers experienced a negative effect in relation to psychological well-being in terms of an increase in symptoms of distress, anxiety, and depression in the first months after test disclosure. In the intermediate- and long-term, no significant clinical relevant symptoms occurred. However, none of the included studies used specific measurements, which can clearly identify psychological burdens of cancer-affected mutation carriers. We concluded that current well-implemented distress screening instruments are not sufficient for precisely identifying the psychological burden of genetic testing. Therefore, future studies should implement coping strategies, specific personality structures, the impact of genetic testing, supportive care needs and disease management behaviour to clearly screen for the possible intermediate- and long-term psychological impact of a positive test disclosure.     

ASSESSING THE CANDIDATE AS A WHOLE: A HISTORICAL AND CRITICAL ANALYSIS OF INDIVIDUAL PSYCHOLOGICAL ASSESSMENT FOR PERSONNEL DECISION MAKING

Although individual assessment is a thriving area of professional practice in industry, it receives little, if any, attention from textbooks on industrial psychology or personnel management. This article is an attempt to establish individual assessment's place in the history of personnel selection, and to examine why the practice has survived despite receiving little attention in research and graduate training. It is argued that the clinical, holistic approach that has characterized individual-assessment practice has survived primarily because the "elementalistic" testing approach, focusing on traits and abilities, has often been dismissed as inadequate for addressing the complexities of the executive profile. Moreover, public displeasure with standard paper-and-pencil testing in the 1960s and 1970s made the holistic approach to assessment an attractive, alternative. The article contrasts individual assessment practice with the current state of knowledge on psychological assessment and personnel decision making. Like psychotherapy in the 1950s, individual psychological assessment appears to have achieved the status of functional autonomy within psychology.     

Prognostic Factors for Distress After Genetic Testing for Hereditary Cancer

The psychological impact of an unfavorable genetic test result for counselees at risk for hereditary cancer seems to be limited: only 10–20 % of counselees have psychological problems after testing positive for a known familial mutation. The objective of this study was to find prognostic factors that can predict which counselees are most likely to develop psychological problems after presymptomatic genetic testing. Counselees with a 50 % risk of BRCA1/2 or Lynch syndrome completed questionnaires at three time-points: after receiving a written invitation for a genetic counseling intake (T1), 2–3 days after receiving their DNA test result (T2), and 4–6 weeks later (T3). The psychological impact of the genetic test result was examined shortly and 4–6 weeks after learning their test result. Subsequently, the influence of various potentially prognostic factors on psychological impact were examined in the whole group. Data from 165 counselees were analyzed. Counselees with an unfavorable outcome did not have more emotional distress, but showed significantly more cancer worries 4–6 weeks after learning their test result. Prognostic factors for cancer worries after genetic testing were pre-existing cancer worries, being single, a high risk perception of getting cancer, and an unfavorable test result. Emotional distress was best predicted by pre-existing cancer worries and pre-existing emotional distress. The psychological impact of an unfavorable genetic test result appears considerable if it is measured as “worries about cancer.” Genetic counselors should provide additional guidance to counselees with many cancer worries, emotional distress, a high risk perception or a weak social network.     

中国的心理测量发展史

有关心理测量的思想起源于中国古代。但西方科学的心理测验理论与方法是20世纪初自西方传人中国的。30年的发展取得很大成绩,但道路艰辛曲折,文章分三个阶段对之作了回顾。一、最早是1915年外国学者为比较中美儿童的智力差异对广州500名小学生进行测试。同一时期,我国学者也开始自己编制测验,"小学生毛笔书法量表"是最早的标准化教育测验。廖世承和陈鹤琴1920年在南京高等师范开设测验课程,出版《心理测验法》一书,正式介绍科学的心理测验。与美国专家合作编制多种测验,1923年与美国专家合作对全国小学生进行测试,得出了三至八年级学童的年龄与班级常模,引起了教育界的注意。艾伟从1925年起致力编制中小学不同年级和学科的测验以及能力测验,还与张耀翔编制了识字测验与阅读测验等,对我国教育测验的发展做出了很大贡献。"中国测验学会"1931成立。并创办会刊《测验》有效地推动了当时测验研究的开展.1937年"七七"事变后,工作继续进行和扩展,但受战争的影响,发展上减慢了速度。二、1949年新中国成立后,由于政治上的变迁,心理测验被视为禁区,认为它违心,反动,没有人敢于问津。文化大革命中,心理学被打成伪科学,心理测验更是全盘否定了。三.文革以后,心理学恢复。而心理测验面对着既缺人力又少资料的困难。林传鼎等三位教授于1980年春举办了第一个全国性心理测验培训班,是心理测验再生的标志。此后各高等院校逐步开设心理测量学课程。通过引进各种心理测量理论,修订外国测验和逐步向自编我国测验发展,几年中取得了良好效果。1984年中国心理学会下属的‘心理测量分会’成立,1990年加入国际测验委员会(ITC)成为它的一个国家会员。1991年在南京举办了国内第一个心理测验国际性学术会议,又与台湾学者交流,建立起隔年一次海峡两岸心理与教育测量学术研讨会的协议。这些都对中国心理测验的发展都起了积极作用。80年代后期国家实行改革开放,经济转型,心理测验逐渐渗入医学、教育、企业、和组织人事部门等多种应用领域,扩大了对社会的影响。教育是其最早也是最重要的应用领域。从高考开始向各种考试、应用领域广泛扩展,取得良好效果。尤其是在人力资源、心理咨询领域,心理测验发展迅速日益兴旺。社会各界从多方面加深了对心理测量的认同,使它变成为一个相当热门的应用科学了。最后,文章从测验的数量、质量,数据处理的方法技术,测验者素质提高和法律完备等几个方面分析了存在问题并提出对今后的展望。     

Arbitrary metrics in psychology

Many psychological tests have arbitrary metrics but are appropriate for testing psychological theories. Metric arbitrariness is a concern, however, when researchers wish to draw inferences about the true, absolute standing of a group or individual on the latent psychological dimension being measured. The authors illustrate this in the context of 2 case studies in which psychologists need to develop inventories with nonarbitrary metrics. One example comes from social psychology, where researchers have begun using the Implicit Association Test to provide the lay public with feedback about their "hidden biases" via popular Internet Web pages. The other example comes from clinical psychology, where researchers often wish to evaluate the real-world importance of interventions. As the authors show, both pursuits require researchers to conduct formal research that makes their metrics nonarbitrary by linking test scores to meaningful real-world events.     

Testing hypotheses on specific environmental causal effects on behavior

There have been strong critiques of the notion that environmental influences can have an important effect on psychological functioning. The substance of these criticisms is considered in order to infer the methodological challenges that have to be met. Concepts of cause and of the testing of causal effects are discussed with a particular focus on the need to consider sample selection and the value (and limitations) of longitudinal data. The designs that may be used to test hypotheses on specific environmental risk mechanisms for psychopathology are discussed in relation to a range of adoption strategies, twin designs, various types of "natural experiments," migration designs, the study of secular change, and intervention designs. In each case, consideration is given to the need for samples that "pull-apart" variables that ordinarily go together, specific hypotheses on possible causal processes, and the specification and testing of key assumptions. It is concluded that environmental risk hypotheses can be (and have been) put to the test but that it is usually necessary to use a combination of research strategies.     

The NASA/LRC computerized test system

A new testing package, including apparatus and tasks, is described for the study of behavior of a variety of species in a variety of experiments. The package is described with respect to the kinds of comparative psychological investigations for which it is well suited. The preliminary data generated within this new testing paradigm demonstrate that the NASA/LRC Computerized Test System provides a flexible yet powerful environment for the investigation of behavioral and psychological processes.     

Atypical Gender Development–A Review

ABSTRACT

In 2003, the Gender Identity Research and Education Society (GIRES) ran a small symposium in London, assisted by a Trans Group, founded in 1993, with the aim of moving transsexualism from its current categorisation, in the International Classification of Diseases (ICD 10), as a psychiatric disorder. GIRES was awarded additional funding for this project from the King's Fund-an eminent charity providing funds for medical and scientific work.

The members of the symposium included physicians and specialists in the different areas pertinent to the understanding and the treatment of transsexualism, and also the Member of Parliament who chairs the Parliamentary Forum for Transsexualism. Transsexual people were represented within this group. Members came from the United Kingdom, The Netherlands, Belgium, Japan and the United States of America. Professor Milton Diamond (USA) chaired the group who collaborated in producing the following paper. The team endeavoured to provide a balanced and comprehensive review of what is currently understood, in the scientific field, regarding atypical gender development and transsexualism.     

An Evaluation of the Validity of Rorschach Popular Responses as Differentiae of Ambulatory Schizophrenia

We compared MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, &; Kaemmer, 1989) profiles of 2 groups of adult biological men requesting sex reassignment surgery; 1 group was diagnosed with Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) transsexualism and the other with gender identity disorder of adolescence and adulthood, nontranssexual type (GIDAANT). Although the mean profiles for the transsexual group did not demonstrate any psychopathology, the GIDAANT group showed moderate psychopathology. A cluster analysis indicated that 85% of the transsexual group showed low psychopathology and 47% of the GIDAANT group showed severe psychopathology. Neither the MMPI-2 results nor the DSM-III-R clinical evaluation support the conclusion of many authors that transsexualism is associated with severe personality disorder; rather, the data indicate that transsexualism and other gender identity disorders without persistent wish for sex reassignment differ significantly in degree of psychopathology.     

Comparisons of two groups of sex-change applicants based on the MMPI

Out of 29 men asking for a sex-change, 16 reported clinical anamnesis criteria for transsexualism according to the DSM-III-R, a more restrictive diagnosis than the DSM-IV gender dysphoria diagnosis. In addition, all the subjects had taken an MMPI which, of course, did not contribute to the transsexualism diagnosis but which served to describe their personalities. The 16 subjects diagnosed as transsexual and the 13 who did not qualify for this diagnosis were compared on the basis of personality variables measured by the MMPI. Certain differences became evident. The transsexuals systematically complied to cultural stereotypes of femininity without any uneasiness, whereas the nontranssexuals could be subdivided into two groups, those with a vague sense of ill-being linked to a pronounced feminine identity or those with only a slight feminine identity and who showed no particular difficulties.     

Cost Effective Assessment Models in Providing Patient-Matched Psychotherapy

Examined are various models of assessing cost-effectiveness in the use of psychological measures employed for screening patient pathology through psychological testing as a precursor to providing psychotherapy. Actual and simulated quality assurance studies are provided. The authors caution that cost-containment limited to financial incentives may have negative consequences for patient care. Systems analysis and program restructuring designed to better balance the service system through levels of care may be more clinically sound, and less costly. Clinical algorithms and critical pathways are discussed, as are recommendations that incorporate psychological testing services as an ingredient in providing contemporary psychotherapy.     

The persistence of underpowered studies in psychological research: causes, consequences, and remedies

Underpowered studies persist in the psychological literature. This article examines reasons for their persistence and the effects on efforts to create a cumulative science. The "curse of multiplicities" plays a central role in the presentation. Most psychologists realize that testing multiple hypotheses in a single study affects the Type I error rate, but corresponding implications for power have largely been ignored. The presence of multiple hypothesis tests leads to 3 different conceptualizations of power. Implications of these 3 conceptualizations are discussed from the perspective of the individual researcher and from the perspective of developing a coherent literature. Supplementing significance tests with effect size measures and confidence intervals is shown to address some but not necessarily all problems associated with multiple testing.     

Psycho-Social Functioning in an Individual with Gender Identity Disorder

An adult transsexual male with presenting complaints of substance dependence was taken up for the study at the All India Institute of Medical Sciences. Past history covering substance use and transsexualism was followed by psychological assessment comprising of Verbal Adult Intelligence Scale, Draw-A-Person Test, Sentence Completion Test, The Adjustment Inventory and Rorschach Psychodiagnostics. The patient presented with interpersonal difficulties and distress owing to substance use. He reported being personally comfortable with his transsexual status and sought help for sex reassignment surgery. The study directs attention towards the fact that individuals with GID are at a risk for healthy adjustment with respect to their socio- cultural set up and in coping with situations. Hence, detailed assessment of distress related to GID, the social milieu leading to acceptance/isolation of the person and co-morbid conditions (if any) is productive.