Chest reconstructive surgeries in transmasculine youth: Experience from one pediatric center

Background: For many trans males, having chest reconstruction is a very important part of the transitioning process. Guidelines from WPATH and the Endocrine Society suggest 16 to 18 years old as an acceptable age for this surgical intervention. In clinical practice, the decision depends on factors such as a person's desires, insurance coverage, and availability of local surgical experts. We present data about chest reconstructive surgeries in transgender youth from a Pediatric Gender Management (GeM) clinic.

Methods: For this retrospective, observational study, data were collected from GeM clinic patients seen from 10/1/2011 to 1/31/2017. All subjects consented or assented to being included in an IRB-approved clinical database.

Results: Of 210 patients from our clinic, 167 consented to being added to an institutional review board–approved database and followed prospectively. The average age at the initial visit was 15.2 years (range, 4.7–20.9). Among consenting subjects, 55 were trans females, 108 were trans males, and four identified as nonbinary. Fourteen subjects had chest reconstruction with the mean age being 17.2 years (range, 13.4–19.7); three subjects were under age 16. For five subjects, including the youngest one, insurance paid for the procedure. All participants but one were receiving testosterone treatment. Per the surgeons' preferences, testosterone was usually not temporarily stopped prior to the procedure. Six subjects had the procedure done locally; others sought surgical care out of the town, state, or country. All subjects were very satisfied with the aesthetics of the surgical outcome. The self-reported complication rate was low. Many more GeM clinic patients wish to have breast/chest surgery but lack of insurance coverage makes the surgery cost prohibitive.

Conclusion: For many trans males, chest reconstructive surgery is an integral part of the transition process. Patients' age at the time of surgical procedure varies greatly; some have chest surgery before age 16. In the United States, chest reconstruction surgery is usually not covered by insurance. Therefore, many patients seeking surgical care are forced to pay out of pocket.     

Four meanings of “categorization”: A conceptual analysis of research on person perception

It is widely assumed that people tend to “categorize” other people. However, the term “categorization” has been used with qualitatively different underlying definitions in the person perception literature. We present a conceptual analysis in which we disentangle four existing definitions: (a) categorization as representing, (b) categorization as dichotomizing, (c) categorization as organizing, and (d) categorization as grouping. Subsequently, we show that seemingly antagonistic viewpoints in the literature may be reconciled by disentangling these definitions. Furthermore, we argue that disentangling these definitions is vital for theoretical interpretations of (past and future) empirical findings. Overall, our work aims to contribute to the clarity of person perception theories, provide novel perspectives on existing debates, and serve as a stepping stone for more differentiated models of person perception.     

Comorbidity of Personality Disorders and Somatization Disorder: A Meta-analytic Review

Meta-analysis of studies assessing the comorbidity of somatization disorder (SD) with one or more personality disorders (PDs) revealed that-contrary to the assertions of the Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision)-SD co-occurs with the majority of Axis II PDs. Although comorbidity effect sizes (rs) linking SD with paranoid PD and obsessive-compulsive PD were small, effect sizes for antisocial, borderline, narcissistic, histrionic, avoidant, and dependent PD yielded rs about or above 0.20. Comorbidity information in future versions of the DSM should be revised to reflect the greater number of PDs empirically linked with SD.

Virtual prejudice

According to recent theorizing in social psychology, social behavior is controlled not only by reflective, but also by impulsive systems. The latter are based on associative links that may influence behavior without intent. The current study examined how prejudiced implicit associations affect physiological and automatic behavioral responses. Our native Dutch participants were immersed in a virtual environment in which they encountered virtual persons (avatars) with either White or Moroccan facial features. In line with our predictions, participants maintained more distance and showed an increase in skin conductance level when approaching Moroccan avatars as opposed to White avatars. Participants’ implicit negative associations with Moroccans moderated both effects. Moreover, evidence was found that the relation between implicit prejudice and distance effects was fully mediated by skin conductance level effects. These data demonstrate how prejudiced implicit associations may unintentionally lead to impulsive discriminatory responses.     

Academic Performance of Students with Emotional and Behavioral Disorders Served in a Self-Contained Setting

This study describes the academic, social, and behavioral performance of elementary and secondary students with emotional and behavioral disorders (EBD) receiving services in a self-contained school for students with serious behavior problems, with an emphasis on how school adjustment and problem behavior patterns predict academic performance. Results revealed that elementary and secondary group scores were well below the 25th percentile on reading, math, and written expression measures. Further, a seven variable model representing academic, social, and behavioral domains was able to differentiate between age groups explaining 54% of the variance and correctly classifying 78.26% (n = 18) of the elementary students and 84.21% (n = 16) of the secondary students. Findings also suggested that behavioral variables (e.g., school adjustment, externalizing, and internalizing) were predictive of broad reading and broad written expression scores, with school adjustment (a protective factor) accounting for the most variance in the three-variable model. Limitations and recommendations for future research are addressed.     

Developing rich and quickly accessed knowledge of an artificial grammar

In contrast to prior research, our results demonstrate that it is possible to acquire rich, highly accurate, and quickly accessed knowledge of an artificial grammar. Across two experiments, we trained participants by using a string-edit task and highlighting relatively low-level (letters), medium-level (chunks), or high-level (structural; i.e., grammar diagram) information to increase the efficiency of grammar acquisition. In both experiments, participants who had structural information available during training generated more highly accurate strings during a cued generation test than did those in other conditions, with equivalent speed. Experiment 2 revealed that structural information enhanced acquisition only when relevant features were highlighted during the task using animation. We suggest that two critical components for producing enhanced performance from provided model-based knowledge involve (1) using the model to acquire experience-based knowledge, rather than using a representation of the model to generate responses, and (2) receiving that knowledge precisely when it is needed during training.     

Person–Group Dissimilarity in Involvement in Bullying and Its Relation with Social Status

This study tested a person-group dissimilarity model for the relation between peer preference on the one hand, and bullying and victimization on the other. This model accounts for both individual and group (i.e., classroom) factors and postulates that children will be rejected by their peers when they display behaviors that deviate from the group norm. We tested the model in a sample of 2,578 early adolescents in 109 middle school classrooms. Multilevel analysis was used to account for our nested data when examining individual and group effects simultaneously in cross-level interaction terms. The results supported our hypotheses based on the dissimilarity model. Classroom norms of behavior appeared to affect the relation between involvement in bullying and peer preference, in that early adolescents who bullied were more likely to be rejected by their peers in a classroom where bullying was non-normative. In classrooms where bullying was normative, adolescents who bullied were less likely to be rejected or were even liked by their peers (i.e., positive scores on peer preference). The same was true for victimization, although victims still had low scores on peer preference even when victimization was normative. Theoretical and practical implications of these results are discussed in terms of directions for future research and intervention in bullying.     

Randomized controlled evaluation of an early intervention to prevent post-rape psychopathology

A randomized between-group design was used to evaluate the efficacy of a video intervention to reduce post-traumatic stress disorder (PTSD) and other mental health problems, implemented prior to the forensic medical examination conducted within 72 h post-sexual assault. Participants were 140 female victims of sexual assault (68 video/72 nonvideo) aged 15 years or older. Assessments were targeted for 6 weeks (Time 1) and 6 months (Time 2) post-assault. At Time 1, the intervention was associated with lower scores on measures of PTSD and depression among women with a prior rape history relative to scores among women with a prior rape history in the standard care condition. At Time 2, depression scores were also lower among those with a prior rape history who were in the video relative to the standard care condition. Small effects indicating higher PTSD and Beck Anxiety Inventory (BAI) scores among women without a prior rape history in the video condition were observed at Time 1. Accelerated longitudinal growth curve analysis indicated a videoxprior rape history interaction for PTSD, yielding four patterns of symptom trajectory over time. Women with a prior rape history in the video condition generally maintained the lowest level of symptoms.