Prevalence and correlates of sexual morbidity in long-term breast cancer survivors

Objective: Breast cancer survivors report adverse sexual effects (sexual morbidity) such as disrupted sexual function, sexual distress and body dissatisfaction. However, most studies have failed to evaluate the persistence of these effects in long-term survivors. The present study comprehensively assessed the prevalence and predictors of sexual/body image problems among survivors three or more years post diagnosis.

Design/outcome measures: Eighty-three breast cancer survivors completed surveys a median of seven years post diagnosis. Survey items probed demographic, diagnostic and clinical information, in addition to sexual activity, sexual function (Female Sexual Function Index [FSFI]), body image, and distress regarding body changes and sexual problems (Female Sexual Distress Scale-revised; FSDS-R).

Results: Seventy-seven percent of all participants and 60% of sexually active participants qualified for sexual dysfunction based on the FSFI. Between 37 and 51% met criteria for female sexual dysfunction, based on two FSDS-R clinical cut-offs. Body satisfaction was worse than normative values, while body change stress was mid-range. Notable sexual morbidity predictors included mastectomy, which was associated with worse sexual/body change distress, and post-treatment weight gain, which predicted greater body dissatisfaction/body change stress.

Conclusions: Breast cancer survivors report substantial sexual morbidity years after treatment, especially after mastectomy or post-treatment weight gain. Breast cancer patients and their providers should be aware of these potential sexual effects.     

An interactional approach to sexual dysfunctions

Abstract

This paper offers an interactional perspective as a broad and practical conceptual framework with which to understand patterns of sexual dysfunction. The theoretical model centers on the power of the sexual interaction as a critical focus for therapeutic change. The model is developed by presenting: the basic sexual interaction cycle, the individual and interactional variables that modify the sexual interaction cycle, and the creation of a continuously changing figure/ground configuration of sexual and nonsexual patterns. At various points in the discussion of the model, initial clinical strategies are derived to illustrate the applicability and advantages of an interactional perspective on sexual relationships.     

A Research Inquiry into Some American Women's Sexual Concerns and Problems

Abstract

The New View of Women's Sexual Problems is supported by findings of the 1993-94 Ellison/Zilbergeld sexuality survey of 2,632 mostly white, college-educated women born 1905-1977 (Ellison, 2000; see questionnaire at www.womenssexualities.com). Sexual experiences of women with previous year sexual partners are reported. The most important sexual concerns or problems in the previous year of 1,637 women are categorized: 34% desire/frequency (low sexual desire, desire discrepancy); 28.5% physical responsiveness (female arousal, orgasm; male partners' erectile difficulties, ejaculatory control); 16% lovemaking (sexual technique); 7.5% finding a partner; < 5% sexual relationship, fertility, pregnancy, STDs/safe sex, the woman's body/health, non-monogamy, orientation; 547 others reported none. Exemplary quotes from respondents are included. Sex therapy for low sexual desire is addressed. Recommended solutions emphasize individual differences and the multidimensionality of sexuality.     

Book Review

Abstract

ARCHIVES OF SEXUAL BEHAVIOR Myocardial infarction and its influence on male sexual function, by C. B. Dhabuwala, A. Kumar,&;J. M. Pierce, 1986, 15(6), 499-504

BEHAVIOR THERAPY Parental perception and treatment outcome in families of aggressive children: A causal model, by Jean E. Duman, 1986, 17, 420-432

PSYCHOTHERAPY Counseling violent couples using Walker's model, by J. Harris, 1986, 23(4), 613-621     

Experiences of transgender prisoners and their knowledge,attitudes, and practices regarding sexual behaviors and HIV/STIs: A systematic review

Background: Despite transgender people being more visible in prison systems, research suggests they are at higher risk of experiencing sexual violence compared to other prisoners. Research also suggests that transgender prisoners experience harassment, and physical and sexual assault by fellow prisoners, and prison officers who lack transgender-specific health knowledge. There exist no systematic reviews on the experiences of transgender people in prisons. This review aims to fill this research gap. The following question developed in consultation with transgender, sexual health/HIV and corrective services stakeholders has guided the systematic review: What are transgender and gender-diverse prisoners’ experiences in various prison settings and what are their knowledge, attitudes and practices regarding sexual behaviors and HIV/STIs?

Methods: The review followed the PRISMA guidelines and searches were conducted in four databases for the period of January 2007 to August 2017. Studies were assessed against predetermined inclusion and exclusion criteria. Included studies were peer-reviewed, written in English with online full-text availability and reported data on transgender and gender-diverse prisoner experiences relevant to the research question.

Results: Eleven studies (nine qualitative, one quantitative, one mixed-methods; nine in USA, two in Australia) met the criteria for review. Four studies were of high quality, six were of good/acceptable quality, and one study was of modest quality. Transgender and gender-diverse prisoners reported a range of challenges which included sexual assault, discrimination, stigma, harassment, and mistreatment. Information on their sexual health and HIV/STIs knowledge, attitudes, practices is in short supply. Also, their lack of access to gender-affirming, sexual health/STIs and mental health services is commonplace.

Conclusions: The experiences of transgender prisoners as reported in this review are almost uniformly more difficult than other prisoners. Their “otherness” is used as a weapon against them by fellow prisoners through intimidation and violence (including sexual) and by prison officers through neglect and ignorance.     

Who is a homosexual? A critique of the heterosexual‐homosexual dimension

Abstract

The heterosexual‐homosexual distinction as a construction inhibits appreciation of the diversity of sexual experience by encouraging use of static labels to classify people's continually evolving sexual histories. Distinguishing sexual preference may expedite comprehension of sexual acts, but is counterproductive when considering whole persons. We question the need for biological explanations of homosexuality and propose that “coming out” as homosexual is a personal choice to be celebrated, not a biological abnormality. We perceive sexuality as merely one aspect of per‐sonhood. When people instead see self‐proclaimed homosexuals as “homosexuals and only homosexuals” sexual behavior overshadows other salient individual characteristics, and sexual desire becomes inseparable from personality style.     

Does the horny man think women want him too? Effects of male sexual arousal on perceptions of female sexual willingness

ABSTRACT

Disputes over acquaintance rape typically center on the issue of whether the alleged victim consented to sex. Disputed sexual encounters often take place when one or both involved parties is sexually aroused, and this arousal might influence the extent to which the parties perceive sexual consent. Two studies tested the effects of men’s sexual arousal on their interpretations of the extent to which 25 hypothetical female behaviors reflected sexual willingness. Arousal was manipulated via written fantasies (Study 1) or exposure to erotic material (Study 2). Manipulated arousal and individual differences in rated arousal were each associated with greater perceptions of female sexual willingness. Manipulated arousal was significant only for single men in Study 2. Findings suggested present-state sexual arousal affects single men’s interpretations of women’s sexual willingness. Men’s sexual arousal might prominently contribute to misunderstandings in sexual communication.     

Family Therapy for Substance Use among Sexual Minority Youth: A Review of Treatment Options

Abstract

Substance use disorders are nearly twice as common among sexual minority youth (SMY) as among their heterosexual peers. Most applied literature about this population suggests interventions on either the individual or community level, and the benefits of family therapy for this population are often overlooked. The present literature review (a) outlines clinical knowledge related to sexual minority youth and substance use (e.g., prevalence rates, contributing factors), (b) discusses the importance of clinical self-awareness around these topics, and (c) outlines clinical behaviors and interventions from literature that may be employed when working with substance-using SMY and their families.     

Sibling Child Sexual Abuse Research Review and Clinical Implications

SUMMARY

Although sex play is a part of normal childhood development, some sexual activity may be coerced or forced and may have negative long-term consequences and, thus, be considered abusive. However, childhood sexual abuse perpetrated by siblings, cousins, or peers receives relatively little attention from either researchers or practitioners. In the present article, the literature on sibling child sexual abuse is critically reviewed, and particular attention is focused on defining sibling sexual abuse, and determining its scope and effects. Clinical Implications are derived as well. Although the article focuses on sibling sexual abuse, the concepts considered here also apply to other forms of same-age (or near same-age) child sexual relationships.     

Common themes and structures in male victims' stories of religion and sexual abuse

This paper presents some outcomes of research on the narrative construction of religion and sexual abuse in male victims. Twelve open biographic interviews with adult male survivors of childhood sexual abuse have been analysed for content and structure. Three narrative themes were identified to appear in all interviews: distance/proximity, power/powerlessness and guilt/innocence. Using statistical methods (correlations and cluster analysis), the relation was investigated between these narrative themes and categories of evaluation, life period addressed, religion, sexuality and significant others. At group level, very few correlations or patterns were found. Two possible explanations are discussed: (1) the lack of canonical stories and (2) the limitations to narrative competence as a result of traumatization. Structure analysis at the individual level yields relatively coherent patterns, so that the second explanation hypothesized seems less likely. Based on content and structure analysis, three narrative methods of construction are discussed: contrasting stories of sexual abuse and religion, sequencing stories and reinterpreting themes from both religion and sexual abuse. Finally, implications are discussed concerning researching canonical stories and their impact on coping, understanding and facilitating the creative potential of narrators, and the complicated relationship of individual constructions, confessional convictions and academic theological theories.     

The interplay of received social support and self-regulatory factors in smoking cessation

Objective: In smoking cessation, individual self-regulation and social support have both proven to be useful. However, the roles of self-regulatory processes and social support are mostly examined separately. The present study aims at examining the unique and joint interactive effects of self-regulation as specified in the health action process approach (HAPA) and social support on smoking cessation. The study tested whether social support can compensate for low levels of self-regulation or whether synergistic effects emerge.

Design & Measures: Around a self-set quit date, 99 smokers completed baseline questionnaires on HAPA-variables, smoking-specific received social support and smoking cessation (continuous abstinence and point prevalence), with a follow-up Cpproximately 29?days after the quitdate.

Results: Social support moderated the association between volitional self-efficacy and smoking, as well as coping planning and smoking but not between action planning and smoking. No compensatory effect of social support for lower levels of individual regulation emerged but the combination of high levels of the individual variables and social support was related to successful smoking cessation, indicating a synergistic effect.

Conclusions: The results confirm the importance of examining both self-regulation and social factors in smoking cessation. This should be considered when developing future interventions for smoking cessation.     

Sex,Disorder and Perversion

Abstract

This paper aims to describe an objective account of sexual perversion. That is, it seeks to characterize sexual perversion as something which is not simply a deviation from a statistical norm but rather as something which violates an objective naturalistic norm. The central point is that perversion consists in the introduction of a strange and extraneous loop in the aetiology of sexual sensations, and this extraneous loop makes it possible to characterize sexual perversion as an objective disorder which is in need of therapy.     

Child Sexual Abuse

Summary

Children who are recent victims of sexual abuse may initially present to their primary care health provider. Often, the outward manifestations of sexual abuse are somatic complaints or nonspecific behavioral changes. Retrospective reports of adults suggest that about 20-30% of women were sexually abused as children, with figures for men ranging from 10-15%. Interview guidelines for children and adolescents emphasize the need for sensitivity to cognitive development and emotional issues while simultaneously being focused on eliciting specific behavioral data. The use of anatomically detailed dolls, in the context of a comprehensive assessment, is discussed. Health care providers are mandated reporters and must disclose suspected child sexual abuse to the state's child protective service department. Guidelines for reporting as well as addressing this issue with parents are discussed.     

Porneia,Homosexuality, and the Need for Homiletic Evolution

Abstract

Does preaching about human sexuality fixate upon the themes of porneia and homosexuality? And if so, do those homiletic preferences narrowly characterize the sexual body politic of the United States? Engaging the writings of Patrick Cheng, Kyle Harper, Mark Jordan, and Jeff Chu, Gerald C. Liu examines genealogical and empirical accounts of porneia and homosexuality to request broader conceptions of sexual difference from preachers who dare to speak about sex, especially with respect to race and in particular, Asian American male sexual identity.     

Treating the Sexual Concerns of Adult Incest Survivors and Their Partners

SUMMARY

Negative attitudes about sex and sexuality and many types of sexual dysfunction are common aftereffects of sexual child abuse and incest. The traumatic sexualization and the aversive sexual conditioning resulting from childhood abuse have long gone unrecognized, however. This article presents research findings regarding the impact of incest on sexual attitudes and functioning along with treatment recommendations.