Sexuell übergriffiges und aggressives Verhalten im Kindesalter Einflüsse entwicklungsrelevanter Faktoren

During the last years increasing attention has been paid to young children and adolescents with sexual coercive behaviour. During the year 2007 altogether 232 boys and 30 girls under the age of 14 years were reported to the police because of sexual assaults. In NRW an increasing number of in- and out-patient institutions offers specific and unspecific treatment programs for these children. The major aim of our study, which is supported by the Ministry of Employment, Health and Social Affairs of the state of NRW, is to evaluate the wide range of different treatment programs and to find predictors for successful or difficult treatment outcomes. Furthermore we are interested in differences between children with sexual problem behaviour and children with exclusively aggressive problems. So far 23 institutions take part in our research project and our total sample currently consists of 75 boys between 9 - 15 years. A psychometric test battery is applied at the beginning of individual treatment. Our first results highlight differences in socio-demographic data between children with sexual coercive behaviour and children with exclusively aggressive behaviour problems. Compared to children with exclusively aggressive problem behaviour, children with sexual problem behaviour come more often from incomplete families with no male parent, have experienced more psychological and physical violence and have been more often victims of sexual abuse. Compared to children with exclusively aggressive behaviour problems they score significantly higher on the “Depression / Anxiety” scale of the SPS-J, although average T-scores for both groups are within the normal range. Regarding cognitive functioning there are no significant differences between both groups.     

Hypoactive Sexual Desire in Heterosexual Women:

The problem of hypoactive sexual desire is the most common sexual problem that heterosexual couples and individuals present to sex therapists. Often it is a woman who reports that she has the problem, or her male partner brings her to therapy believing she has hypoactive desire. The treatment literature describes a variety of causes that contribute to the disorders of sexual desire. However, most of the literature looks primarily at the causes within an individual's history of within a couple's relationship. There does not seem to be adequate consideration given to the social and cultural limitations that have defined and prescribed a sexual role for women that is primarily oriented to the service of male needs rather than female sexual pleasure. This article will analyze some of the social and cultural forces that limit female sexual expression, and are a neglected factor when causes for low sexual desire in heterosexual women are given.     

Jugendliche Sexualstraftäter: Spezialfälle der Prognoseerstellung?

This study compared a sample of 273 juvenile (aged 14 to under 18), 178 adolescent (aged 18 to under 21) and 273 adult (older than 20 years) male sex offenders modus operandi (or MO, the way in which they committed their offenses), frequency of recidivism and predicted recidivism via the static-99. In terms of the frequencies of the MO aspects we found that juveniles and adolescents differed significantly from adult sexual offenders. However, concerning the frequency of sexual violent behaviors, adolescents committed more severe offenses in contrast to the two other groups. The comparison of recidivism rates indicated that adolescent sexual offenders were significantly less likely to commit a new sexual offense, but were considerably more likely to commit a non-sexual violent offense compared to adult sexual offenders. For juvenile offenders, only few static-99 variables were predictive of future recidivism in comparison to the other groups, suggesting that the static-99 may only have a restricted utility in juvenile offenders. Further, juvenile offenders risk levels were found to fall primarily within the medium risk group making individual differentiation of potential risk difficult. It is suggested that additional predictors, which help to differentiate young sexual offenders must be investigated.     

No Means Yes? Perpetuating Myths in the Sexological Construction of Women's Desire

The diagnosis and treatment of desire disorders are contentious issues within sexual medicine today. The issue of women's sexual desire (or rather lack of sexual desire) in particular, has highlighted a variety of problems within the current diagnostic framework for sexual dysfunctions. In an effort to rectify some of these problems, the concept of receptivity has been put forward by a number of clinicians with the suggestion that this better reflects women's experiences of desire. It is argued here, however, that he concept of receptivity presents serious problems for women in heterosexual relationships. Rather than helping women, furthering this concept may simply reinforce male sexual demands, curtail women's sexual autonomy, and promote coercive sex as an acceptable norm. It should therefore not be adopted by therapists.     

Refusing to be Marginalized: Groupwork in Mental Health Services for Women Survivors of Childhood Sexual Abuse

Childhood sexual abuse is a major aetiological factor in the development of mental health difficulties experienced by women. Although this conclusion is supported by two decades of extensive research, it has had little impact on the provision of mainstream mental health services. It remains exceptional for there to be specialist therapy or counselling provision for women survivors of childhood sexual abuse within statutory mental health services. This represents a serious gap in service provision and, it is argued, results in extended and inappropriate treatment for women survivors using mental health services. In this article, the development of a multi-agency approach to the provision of groupwork for women survivors of childhood sexual abuse within mental health service is described. A women-centred model of groupwork is outlined. Evaluation and funding are discussed. It is argued that, as a time-limited and effective treatment option, groupwork for women survivors of childhood sexual abuse should form a central part of service provision within statutory adult mental health services.     

Compulsive and addictive sexual disorders and the family

In the treatment of sexual addiction and compulsivity, the family unit is often neglected. Yet this disorder has a major impact not only on the identified patient, but also on the spouse or partner (the coaddict) and on the family as a whole. Moreover, the family unit is the context in which the sexual addict continues to live, and the mental health of the partner has a significant impact on the sexual addict's recovery. Increasing evidence points to a family history of addiction or dysfunction as a primary contributor to both sexual addiction and coaddiction in adulthood. When compulsive sexual behaviors are present within a family, treatment of both members of the couple improves the couple's relationship as well as the mental health of each partner. In addition, treatment of children in such a family can help break the cycle of sexual addiction and prevent its perpetuation into the next generation.     

Sexual risk as an outcome of social oppression: data from a probability sample of Latino gay men in three U.S. cities

Based on data from a probability sample of 912 Latino gay men in 3 U.S. cities, a multivariate model of sexual risk was tested, including experiences of homophobia, racism, and poverty as predictors. Participants reported multiple instances of verbal and physical abuse, rude mistreatment, and discrimination on account of their sexual orientation and their race or ethnicity. Many reported experiences of poverty, such as inability to pay for basic necessities of food or shelter. Men who reported more instances of social discrimination and financial hardship were more psychologically distressed and more likely to participate in "difficult" sexual situations, as predicted. Participation in difficult sexual situations mediates the effects of social oppression and psychological distress on sexual risk behavior.     

The experimental analysis of human sexual arousal: Some recent developments

Experimental analyses of human sexual arousal have been decidedly sparse. Recent developments in the analysis of derived relational responding, however, have opened the way for a modern behavior-analytic treatment of complex or "novel" human behavior, including specific instances of human sexual arousal. The current article examines some of these developments and their relevance to the analysis of emotional behavior, with a focus on sexual arousal. Recent research that has examined the acquisition of sexual stimulus functions within a relational frame paradigm is then outlined. Finally, a series of relational frame interpretations of a variety of human sexual arousal phenomena is offered.     

Trieb und Instinkt

To say that human beings also have a self-preservation instinct just as animals is only meaningful in the sense of attachment and affection mediated by mutual communication. It is from the beginning covered up by the truly human sexual phenomena of seduction and narcissistic reciprocity. Beside that we have a sexual drive which has a more important, not to say, decisive role from birth until puberty. This latter is the subject of psychoanalysis because it is anchored in the unconscious. Finally, we also have an (innate, endogenic) sexual instinct which appears in puberty persisting the whole adult life and meets at its appearance the infantile sexual drive which was existing all the time. It is very difficult to give an epistemological definition of the (innate) sexual instinct because it does not manifest itself in a pure form, but only in unclear transactions with infantile sexuality dominating the unconscious. The subject of psychoanalysis is the unconscious and the unconscious is itself the sexuality sensu Freud, the pre-, para- or genital infantile sexuality. The sexual has its origins in the phantasy which is naturally anchored in our body.     

Psychoanalytic perspectives on paraphilias and perversions

Since Freud’s exposition of the nature of perversion in his seminal work, Three Essays on the Theory of Sexuality there has been a multitude of rich and varied explorations of human sexual fantasies and behaviours that are considered as perversions within the psychoanalytic literature. However, with more recent societal shifts towards the acceptance of sexual orientations and practices which would previously been categorized as deviant, perversion has become a pejorative term seen as stigmatizing and debasing those whose sexual preferences do not conform to the traditional norm. In this paper I argue that certain psychoanalytic concepts of perversion retain utility in how we might think about and help individuals whose sexual desires and practices cause distress to themselves and/or others, particularly in the realm of intimate relationships. Historical and contemporary theories about the nature and origins of perverse fantasies and behaviour are presented and explored, focusing on how perversion may be conceptualized as a defence against early anxieties and disturbances in the mother–infant relationship. Such ideas inform a psychoanalytic approach to the treatment of perversions, particularly in consideration of transference and countertransference dynamics. The ideas in this paper are based on my work at the Portman Clinic in London, UK.     

Erotic Transference and Its Relationship to Childhood Seduction

The phenomenon of an erotic transference has long been a difficult, if not mysterious, process within clinical psychoanalysis. Traditionally, the development of an erotic transference has been viewed as a negative clinical event fueled by the analyst's countertransference reaction. A much neglected dimension, the relationship between childhood seduction and the development of an erotic transference, will be introduced and examined. In three clinical cases our data suggest that actual sexual abuse in childhood is a causal factor in the manifestation of an erotic transference in the clinical interaction of an analysis.     

A COMPARISON OF MALE AND FEMALE COLLEGE STUDENTS' EXPERIENCES OF SEXUAL COERCION

Research comparing men's and women's experiences of sexual coercion has typically assessed differences in prevalence rates and risk. We extended this line of research by comparing the contexts of sexual coercion and reactions to sexually coercive experiences in an attempt to understand the meanings that men and women attribute to these events. Participants were 433 randomly selected college students who responded to an anonymous survey. In line with past research, more men than women reported being sexually coercive, and more women than men reported being sexually coerced in the preceding year. There was a great degree of correspondence between men's and women's reports of the contexts within which sexual coercion occurred. According to their reports, sexual coercion occurred primarily within the heterosexual dating context. Compared to men, however, women reported more negative reactions and stronger resistance to the use of sexual coercion. These findings emphasize how comparisons of prevalence rates alone may obscure important differences in the phenomenology of sexually coercive incidents for men and women. Findings are discussed in terms of implications for the development of education and prevention programs and the need to reevaluate current approaches to interpreting prevalence reports.     

The impact of institutional factors on officially reported sexual assaults in prisons

Not only has research on prison sexual assault been rather scarce the past four decades, but few of these studies have ascertained the number of officially reported inmate-on-inmate sexual assaults. In addiition, no study exists which has rigorously examined which, if any, institutional factors impact the number of officially reported inmate-on-inmate sexual assaults in prisons. Using data from a national sample of 226 prison wardens, this study examines the impact of institutional factors on officially reported sexual assaults. The most salient variables in the study were current number of inmates and wardens’ perceptions of inmate fear of sexual assault. Wardens overseeing institutions with higher numbers of inmates were more likely to report that inmates had been sexually assaulted and those who ran minimum-security prisons were less likely to report sexual assaults within their facilities.     

LGB-Affirmative Cognitive Behavioral Treatment for Social Anxiety: A Case Study Applying Evidence-Based Practice Principles

Guided by the American Psychological Association's principles of evidence-based practice, this article reviews a single-case treatment outcome study whereby a client characteristic, sexual identity, was integrated into the assessment and treatment of social anxiety symptoms. The case involved a young adult European-American male who presented to a training clinic with a primary diagnosis of social anxiety disorder as well as secondary symptoms of excessive worry and concerns of sexual identity confusion. Recent evidence suggests that gay men report more symptoms of social anxiety when compared to heterosexual men, and those who make more efforts to conceal their sexual identity experience increased anxiety and have greater difficulty committing to a personal identity. Further, it has been hypothesized that fear of rejection from heterosexual individuals underlies this anxiety. The client attended 50 sessions over the course of 18 months. Treatment progress was assessed via self-report questionnaires assessing social anxiety and worry. Consistent with principles of evidence-based practice, a cognitive behavioral treatment protocol was employed at the outset of therapy and resulted in a decline in the client's social anxiety scores. However, once the case conceptualization and treatment focus shifted to focus on sexual identity, his scores continued to decline at an even steeper rate. He ultimately came to identify himself as having a same-sex sexual orientation, began living his life in a manner consistent with that identification, and reported a number of positive outcomes at termination of therapy. Implications for treatment of social anxiety in sexual minorities are discussed.     

Photography as a therapeutic tool for substance abuse clients who have a history of sexual abuse

Symptoms of sexual abuse among persons in substance abuse treatment facilities may be difficult to recognise since presenting symptoms frequently mirror those associated with substance abuse. Additionally, treatment may be difficult due to a lack of previous verbal processing and shared negative defence mechanisms that are resistant to traditional talking therapy. The use of photography is presented here as a method of treatment initiation and exploration for substance abuse clients who have a history of sexual abuse. The paper reviews rationale, advantages, current applications and practitioner concerns associated with the use of photography as a therapeutic tool.     

The personality of opera singers

Ninety-one opera singers in the London area completed a questionnaire concerning their voice type, experience, physical characteristics, performance habits and personality. They also rated the personality of one singer of each voice type with whom they were familiar, and one man and one woman who were not singers. Higher-voiced singers emerged as more emotional, difficult, unreliable, conceited and feminine than lower-voiced singers of the same sex, according to their own report and that of others. Lower-voiced singers were taller and thinner, and within the men particularly, more inclined to sexual affairs with fellow singers. These findings are seen as consistent with German research showing a higher testosterone/oestradiol ratio in lower-voiced singers.     

保护动机对农村流动人口性病艾滋病高危性行为的预测

农村流动人口已经成为我国性病艾滋病预防干预的重点人群。为了探讨流动人口所存在的性病艾滋病高危性行为,以及保护动机（Protection Motivation）对性病艾滋病高危性行为的预测作用,研究选取2201名从农村到北京打工已有3个月的流动人口为被试,采用问卷调查的形式,要求其报自己报告初始性行为发生的时间、性伙伴的数量、商业性行为、性伙伴的性行为、安全套的使用,对我国性病艾滋病严重程度的评估,以及所拥有的性病艾滋病症状知识和传播知识。对904名已发生性行为的流动人口的统计分析发现：（1）农村流动人口存在较多的高危性行为,男性流动人口的高危性行为明显多于女性流动人口;（2）保护动机理论对农村流动人口的性病艾滋病高危性行为具有明显的预测作用,其中的外在奖励、内在奖励、反应效能和反应代价与农村流动人口的性病艾滋病高危性行为的关系更为密切。研究揭示,保护动机理论可以作为我国今后开展农村流动人口性病艾滋病高危性行为预防干预工作的一个基础     

Correctional institution based sex offender treatment: a lapse behavior study

The correctional community has engaged in a surge of sex offender treatment programs, both within the confines of the correctional institutions as well as at the community level. While there has been an increase in efforts to assess the effectiveness of these programs the research has been hampered by inconsistency in appropriate outcome measures. The present study addresses these shortfalls, while focusing on the early behavioral lapse indicators. The study focuses on the premise that not all sex offenders lapse in similar manners, and that those with adult and statutory victims would show more impulsive-criminal trends in lapse behavior when compared to those with child victims. The results support the premise on several variables, but not on sexual deviancy.