Health-related quality of life in transgender adolescents: Associations with body image and emotional and behavioral problems

Background: Transgender adolescents who apply for treatment often experience a marked increase in body-related distress when entering puberty, accompanied by internalizing problems and poor peer relations. Although adolescence is a time of considerable psychosocial and physical change, generally associated with a decline in health-related quality of life (HRQoL), research on HRQoL in transgender youth and possible predictors is sparse. This study thus aims to explore the predictive value of body image factors and emotional and behavioral problems for HRQoL.

Methods: This cross-sectional one-group observational study was carried out at the Child and Adolescent psychiatric department (Gender Identity Service) in Hamburg, Germany. A sample of n = 126 (103 trans male and 23 trans female) adolescents, who were referred for counseling and/or treatment completed different standardized instruments before undergoing any sort of treatment. Firstly, five dimensions of HRQoL were explored in transgender adolescents and secondly, a linear regression model was applied to assess the impact of body image and emotional and behavioral problems on overall HRQoL.

Results: HRQoL was generally impaired in transgender adolescents compared to norm scores, especially with regard to aspects of psychological and physical well-being. Linear regression analysis revealed that greater internalizing problems and less body satisfaction significantly predicted lower HRQoL outcomes.

Conclusions: Impaired HRQoL may be explained by high degrees of internalizing problems and low body satisfaction. Thus, one important aim of mental health professionals working with youth should be to provide appropriate treatment and counseling options that may contribute to overall well-being in the long-term.     

A neural theory of visual attention: bridging cognition and neurophysiology

A neural theory of visual attention (NTVA) is presented. NTVA is a neural interpretation of C. Bundesen's (1990) theory of visual attention (TVA). In NTVA, visual processing capacity is distributed across stimuli by dynamic remapping of receptive fields of cortical cells such that more processing resources (cells) are devoted to behaviorally important objects than to less important ones. By use of the same basic equations used in TVA, NTVA accounts for a wide range of known attentional effects in human performance (reaction times and error rates) and a wide range of effects observed in firing rates of single cells in the primate visual system. NTVA provides a mathematical framework to unify the 2 fields of research--formulas bridging cognition and neurophysiology.     

Seeing or hearing? Perceptual independence,modality confusions,and crossmodal congruity effects with focused and divided attention

Observers were given brief presentations of pairs of simultaneous stimuli consisting of a visual and a spoken letter. In the visual focused-attention conditon, only the visual letter should be reported; in the auditory focused-attention condition, only the spoken letter should be reported; in the divided-attention condition, both letters, as well as their respective modalities, should be reported (forced choice). The proportions of correct reports were nearly the same in the three conditions (no significant divided-attention decrement), and in the divided-attention condition, the probability that the visual letter was correctly reported was independent of whether the auditory letter was correctly reported. However, with a probability much higher than chance, the observers reported hearing the visual stimulus letter or seeing the spoken stimulus letter (modality confusions). The strength of the effect was nearly the same with focused as with divided attention. We also discovered a crossmodal congruity effect: Performance was better when the two letters in a stimulus pair were the same than when they differed in type.     

Somatovisceral interactions in visceral perception: Abdominal masking of colonic stimuli

Clinical and experimental evidence on referred pain and spinal-afferent convergence demonstrates a close relationship between visceral and somatosensory perception, which is important for current models of symptom perception and central body representation. The study uses a psychophysical approach to quantify these interactions at the perceptual level, taking into account problems of comparable intermodal scaling and the role of awareness. An experiment on somatosensory masking of distension stimuli in the colon is reported in which a multiple staircase method of forced choice discrimination with concurrent sensation ratings was employed. Results showed perceptual masking of visceral by abdominal stimuli but not vice versa. The masking effect was not enhanced by intratomal placement of the abdominal stimulus in the lower left quadrant. This contradicts the spinal sensory convergence model and points to perceptual interactions at higher brain levels. Loglinear analysis of relations between discrimination and subjective sensation revealed qualitative differences of somatovisceral perception at the preconscious as compared to the conscious level. This argues for a two-process model of integrative body perception.     

Sexual submissiveness in women: costs for sexual autonomy and arousal

Women are bombarded with images of women's sexual submission and subservience to male partners. The authors argue that women internalize this submissive role, namely, they associate sex implicitly with submission. The authors propose that this association leads to submissive sexual behavior, thereby reducing sexual autonomy and arousal. Study 1 found that women implicitly associated sex with submission. Study 2 showed that women's implicit association of sex with submission predicted greater personal adoption of a submissive sexual role. Study 3 found that men did not implicitly associate sex with submission. Study 4 demonstrated that women's adoption of a submissive sexual role predicted lower reported arousal and greater reported difficulty becoming sexually aroused; sexual autonomy mediated these effects.     

Men's sex-dominance inhibition: do men automatically refrain from sexually dominant behavior?

Men receive conflicting messages about their sexual roles in heterosexual relationships. Men are socialized to initiate and direct sexual activities with women; yet societal norms also proscribe the sexual domination and coercion of women. The authors test these competing hypotheses by assessing whether men inhibit the link between sex and dominance. In Studies 1a and b, using a subliminal priming procedure embedded in a lexical decision task, the authors demonstrate that men automatically suppress the concept of dominance following exposure to subliminal sex primes relative to neutral primes. In Studies 2 and 3, the authors show that men who are less likely to perceive sexual assertiveness as necessary, to refrain from dominant sexual behavior, and who do not invest in masculine gender ideals are more likely to inhibit dominant thoughts following sex primes. Implications for theories of automatic cognitive networks and gender-based sexual roles are discussed.