Child Assent and Parental Permission in Pediatric Research

Since children are considered incapable ofgiving informed consent to participate inresearch, regulations require that bothparental permission and the assent of thepotential child subject be obtained. Assent andpermission are uniquely bound together, eachserving a different purpose. Parentalpermission protects the child from assumingunreasonable risks. Assent demonstrates respectfor the child and his developing autonomy. Inorder to give meaningful assent, the child mustunderstand that procedures will be performed,voluntarily choose to undergo the procedures,and communicate this choice. Understanding theelements of informed consent has been theparadigm for assessing capacity to give assent.This method leaves the youngest, leastcognitively mature children vulnerable towaiver of assent and forced researchparticipation. Voluntariness can also becompromised by the influence of authorityfigures who can exert undue influence andcoerce children to participate in research. This paper discusses factors that may influencethe decision to give assent/permission,potential parent-child conflict in theassent/permission process and how it isresolved, and potential parental undueinfluence on research participation. Theseissues are illustrated with quotations drawnfrom a larger qualitative study of parentalpermission and child assent (data notpresented). We suggest a developmentalapproach, viewing assent as a continuum rangingfrom mere affirmation in the youngest childrento the equivalent of the informed consentprocess in the mature adolescent.     

Parental divorce: long-term effects on mental health, family relations and adult sexual behavior

Specific long term effects of parental divorce were examined in a sample of 179 Icelanders, 20 to 30 years of age. The participants answered the Borromean Family Index, the Affect Balance Scale and a number of questions on sexual behavior and attitudes towards marriage and divorce. Results showed that compared to adults whose parents remained married, those of divorced parents reported more negative emotional experiences at the time of the study and had looser family ties. They also had greater number of short love affairs, had their first love affair at a younger age, had a greater number of sexual partners, and were younger at the time of their first sexual intercourse than adults whose parents remained married.     

Purposive aspects of the erotic transference

This paper illustrates the erotic transference of a male patient towards his female analyst and the pressures and resistances within the transference and counter-transference to act out sexually. The patient's desire to act out sexually is seen both as a form of repetition compulsion within the transference and, in its purposive aspect, as an expression of the patient's need to find a loving breast and an empathic father. The patient's confused sexual identity is seen as a narcissistic defence against the experience of unbearable frustration in the pre-Oedipal stage. Through internalizing a new primal scene, the patient is able to separate from his past and to work through the Oedipus complex within the transference.     

Opportunities of online analysis1

The question of whether tele-analysis is an acceptable way of conducting analysis has been discussed since it has become available. Merchant (2016) and others concluded that ‘the essentials of a genuine analytic process are not necessarily precluded’ (p. 1). In this paper, the author goes a step further and examines potential advantages of tele-analysis. There may be benefits for patients with a history of physical or sexual abuse who value the distance. The potential for a ‘safe place’ for work with erotic transference is also examined. In a further section the author is interested in allowing the analyst the freedom to practise in an authentic way, congruent with their personality. Also explored is the concept of the interactive field including the technological medium, which is subject to synchronistic events. Finally, the author gives examples of a deep connection between patient and analyst which came about despite the physical distance.     

Latent class analysis of college women's motivations for engaging in same-sex performativity

Same-sex performativity (SSP), or public performances of sexuality (e.g., kissing) between women who identify as heterosexual, is a relatively common relational experience among college-aged women. Identifying patterns of women's motivations for engaging in SSP can elucidate the heterogeneity among women's social and sexual behaviors during a critical developmental period (i.e., college). We used latent class analysis to identify classes of heterosexual undergraduate women who engaged in SSP (N = 282). We identified three classes of motivational patterns: Other-Motivated (i.e., notably motivated by male attention, wanting to shock others, wanting to bond, and social pressure), Ambiguously Motivated (i.e., most motivated by alcohol and fun, but minimally motivated overall), and Sexually Motivated (i.e., notably motivated by sexual desire and sexual experimentation). We then examined how class membership was associated with variables related to participants' evaluation of their SSP experience, self and identity, sexuality, and heterosexism. Classes significantly differed in SSP evaluations, as well as in certain facets of self and identity and sexuality (i.e., sorority membership and same-sex desire). These data provide evidence of substantial complexity in the characterizations of women who engage in SSP. We discuss the implications of the relationship between motivational patterns and women's evaluations of the SSP experience.     

Strengths and Limitations of Forensic Child Sexual Abuse Interviews with Anatomical Dolls: An Empirical Review

A comprehensive review of the use of anatomical dolls reveals three areas of research: (1) normative studies (with no known history of sexual abuse) of children's interactions with anatomical dolls; (2) comparative studies of children suspected of being victims of sexual abuse, and those believed not to be; and (3) the role anatomical dolls play in the identification of a child who has been sexually abused. The results of empirical studies in each area are mixed and inconsistent. However, there is general clinical support for the use of the anatomical doll as a demonstration aid during forensic interviewing with children over 3 years of age.     

The reliability of nocturnal vaginal blood flow

Fourteen subjects participated in a sleep study designed to document the reliability of measurements of REM-related vaginal blood-flow changes. Several standard sleep parameters were also examined for comparison with vaginal measures. The most reliable vaginal measure was the maximal change in disengorgement for a given REM period averaged across a night of REM periods. The reliability of this measure compared favorably with that of a highly reliable computerized measure of REM density. It is suggested that nocturnal vaginal blood-flow measures have sufficient reliability to be useful in the differential diagnosis of organic and psychogenic sexual dysfunction.This study was supported in part by a training grant to the Department of Clinical Psychology, University of Florida, Gainesville (USPHS532DE07133-02), and a grant from the NIH (USPHSCA26364R073241-29) to the second author.     

Transference-Love and Institutional Involvement in a Case of Psychotherapy Supervision

Transference-love in supervision remains a relatively unexplored subject in psychotherapy. This article describes and analyzes an incident of the supervision of a student whose dress code raised a question regarding the existence of transference-love. The role of the institution in maintaining a protective envelope is shown to be significant in the satisfactory resolution of what appeared to have been an impasse. In addition, multicultural and gender issues are examined to illustrate the complexity of the subject.