Perfectionism and Sexual Satisfaction in Intimate Relationships

This study sought to provide information on the relations between trait perfectionism and perfectionistic self-presentation and sexual satisfaction in married couples. A sample of 74 married or cohabiting couples were recruited from the community to participate in the study. They completed measures of perfectionism, perfectionistic self-presentation, sexual satisfaction, dyadic adjustment, and depression. The results showed that the interpersonal dimensions of trait perfectionism were negatively related to general sexual satisfaction and sexual satisfaction with the partner for both husbands and wives. After partialing out marital satisfaction and depression, the husband's sexual satisfaction was significantly negatively correlated with his own socially prescribed perfectionism and with his wife's ratings of other-oriented perfectionism. The wife's satisfaction was significantly negatively correlated both with her husband's socially prescribed perfectionism and with her own socially prescribed perfectionism, other-oriented perfectionism, and perfectionistic self-presentation. Regression analyses suggest that the wife's other-oriented perfectionism is a unique predictor of her general lower sexual satisfaction and her husband's lower satisfaction with her contribution to the sexual relationship. Overall, the findings suggest that perfectionistic expectations have an important role to play in sexual satisfaction in married couples.     

Sexual and Physical Abuse Among Adolescent Girls with Disruptive Behavior Problems

We examined the prevalence and age of onset of physical and sexual abuse in a clinic-referred sample of adolescent girls, as well as differences in diagnoses and symptoms among abused and non-abused girls. Forty-nine girls (aged 13–17 years) with disruptive behavior were interviewed along with their primary caretaker. Data were gathered through both a structured interview with the girl and her parent, as well as self and parent-report questionnaires. Findings indicated that the prevalence of Conduct Disorder (CD) and Major Depression were higher for abused girls. Somatoform Pain Disorder was significantly less likely for physically abused girls, compared to girls who were both physically and sexually abused. Of CD symptoms, truancy was twice as high for the physically and sexually abused group, compared to the prevalence for non-abused girls. Internalizing symptoms were also highest for the dual abuse group. Onset graphs show that the onset of sexual abuse usually occurred at an earlier age than the onset of physical abuse. Abused girls showed an earlier age of onset of CD symptoms. Results indicated that the experience of combined types of abuse is associated with a poorer psychiatric prognosis.     

Reducing HIV risk-associated sexual behavior among african american adolescents: Testing the generality of intervention effects

This randomized controlled trial tested the effects of a theory-based culture-sensitive HIV risk-reduction intervention among 496 inner-city African American adolescents (mean age = 13 years) and examined the generality of its effects as a function of the facilitator's race and gender and the gender composition of the intervention group. Adolescents who received the HIV risk-reduction intervention expressed more favorable behavioral beliefs about condoms, greater self-efficacy, and stronger condom-use intentions postintervention than did those who received a control intervention on other health issues. Six-month follow-up data collected on 93% of the adolescents revealed that those who received the HIV risk-reduction intervention reported less HIV risk-associated sexual behavior, including unprotected coitus, than did their counterparts in the control condition. Self-reported sexual behavior and changes in self-reported behavior were unrelated to scores on a standard measure of social desirability response bias. There was strong evidence for the generality of intervention effects. Moderator analyses testing eight specific interaction hypotheses and correlational analyses indicated that the effects of the HIV risk-reduction intervention did not vary as a function of the facilitator's race or gender, participant's gender, or the gender composition of the intervention group. This research was supported in part by grants from the National Institute of Child Health and Human Development (R01-HD24921), the National Institute of Mental Health (R01-MH45668), and the Social Science and Humanities Research Council of Canada. The authors gratefully acknowledge the contributions to this research of Margaret Bleier, Daria Boccher-Lattimore, Nancy L. Moore, Tatiana Perrino, Paul Pintella, and Fran Rosenfeld and the helpful suggestions of Isabel Fernandez, Caryn Lerman, and Ann O'Leary regarding an earlier version of this article.     

The Professional Autonomy of the Medical Doctor in Italy

This contribution deals with the issue of the professional autonomy ofthe medical doctor. Worldwide, the physician's autonomy is guaranteedand limited, first of all, by Codes of Medical Ethics. InItaly, the latest version of the national Code of MedicalEthics (Code 1998) was published in 1998 by the Federation ofprovincial Medical Associations (FnomCeO). The Code 1998acknowledges the physician's autonomy regarding the scheduling, thechoice and application of diagnostic and therapeutic means, within theprinciples of professional responsibility. This responsibility has tomake reference to the following fundamental ethical principles:(1) the protection of human life; (2) the protection of thephysical and psychological health of the human being; (3) therelief from pain; (4) the respect for the freedom and the dignityof the human person, without discrimination; (5) an up-to-datescientific qualification (Art. 5). The authors underline that autonomyis an anthropological – and consequently ethical –characteristic of the human person. Different positions on autonomy inbioethics (individualistic, evolutionistic, utilitarian andpersonalistic models) are explained. The relation between theprofessional autonomy of the physician and the autonomy of the patientand of colleagues is discussed. In fact, the medical doctor isobliged: (1) to respect the fundamental rights of the person,first of all his/her life; (2) to ensure the continuity of thecare, even if he can only relieve the patient's suffering; (3) tomaintain, except under certain circumstances, professional secrecy andconfidentiality regarding patients and their medical records. Moreover,the physician cannot deny the patient correct and appropriateinformation. He/she should not perform any diagnostic or therapeuticactivity without the informed consent of the patient and the medicaldoctor must give up medical treatment in case of documented refusal ofthe individual. Furthermore, the medical doctor has the right to raiseconscientious objections if he/she is requested to perform medicalactions that are contrary to his/her conscience or medical opinion,unless this attitude would seriously and immediately harm the patient.Regarding the relationships with colleagues, the physician is obliged tosolidarity, mutual respect, and care of sick colleagues. Finally, theauthors discuss the Italian legislation affecting the physician'sprofessional autonomy: (1) the SSN health care Acts; (2) theso-called Charter for Public Health Care Services; (3) the Acts onprivacy; (4) Good Clinical Practice.     

The nature of sexual reinforcement.

Sexual reinforcers are not part of a regulatory system involved in the maintenance of critical metabolic processes, they differ for males and females, they differ as a function of species and mating system, and they show ontogenetic and seasonal changes related to endocrine conditions. Exposure to a member of the opposite sex without copulation can be sufficient for sexual reinforcement. However, copulatory access is a stronger reinforcer, and copulatory opportunity can serve to enhance the reinforcing efficacy of stimulus features of a sexual partner. Conversely, under certain conditions, noncopulatory exposure serves to decrease reinforcer efficacy. Many common learning phenomena such as acquisition, extinction, discrimination learning, second-order conditioning, and latent inhibition have been demonstrated in sexual conditioning. These observations extend the generality of findings obtained with more conventional reinforcers, but the mechanisms of these effects and their gender and species specificity remain to be explored.     

The psychopathology of anorexia nervosa: A factor analytic investigation

To examine the psychopathology of anorexia nervosa, behavioral assessment measures sampling a wide range of relevant constructs were collected on 150 women diagnosed as having anorexia nervosa. The data were subjected to an exploratory factor analysis using maximum-likelihood estimation and oblique rotation. Five factors were extracted, which were titled Fasting and Restrictive Eating, Depression, Anxiety, and Negative Self-image, Bulimic Behaviors, Fear of Fatness/Body Image Disturbance, and Impulsive Behavior/Post-Traumatic Response. Discriminate function analysis suggested that, other than the bulimic behaviors factor, the Impulsive Behavior/Post-Traumatic Response factor best discriminated between bulimic and restrictor subtypes of anorexics. These data suggest that the underlying dimensions of anorexia nervosa are very similar to those of bulimia nervosa. The findings also have implications for the multidimensional assessment and treatment of anorexia nervosa as well as conceptual models of the disorder.     

AN ANALYSIS OF AND INTERVENTION IN THE SEXUAL TRANSMISSION OF DISEASE

Sexually transmitted diseases are a serious threat to the public health. Indeed, when an individual seeks medical treatment for a sexually transmitted disease, health authorities frequently attempt to identify, procure, and treat that individual's sexual contact(s). We conducted a comparative analysis of three alternative approaches to tracing the sexual partners of individuals diagnosed as having a sexually transmitted disease. The first approach involved counseling individuals (n = 27) infected with either gonorrhea or nongonococcal urethritis and exhorting them to procure their sexual partners for treatment. In addition to counseling, the second and third approaches involved distributing “occasion cards” for patients to use when informing sexual contacts of the need for treatment. Moreover, in the second approach, the counselor (a nurse or physician) informed infected patients (n = 19) that they and their partners could waive the $3 clinic fee contingent upon the partners seeking treatment within 1 week. In the third approach, the counselor asked infected persons (n = 19) to accept a follow-up telephone contact if their sexual partners failed to seek treatment within 1 week. The third approach was most effective. Ninety percent of the partners identified through this approach sought treatment, versus only about 60% of the partners in the other two conditions. The third approach was also the least expensive, costing about $2.95 to procure each partner for treatment.     

Worth the risk? Fear of being single and willingness to make risky health decisions in sex and dating contexts

Does fear of being single (FOBS) predict risky health behaviors when such behavior could promote pursuit of a romantic connection? Study 1 tested general tendencies toward taking health risks associated with FOBS. Study 2 tested how those with stronger FOBS navigated romantic versus non-romantic risk behavior during the COVID-19 pandemic. Study 3 extended the test of risky behavior beyond the pandemic to test whether FOBS was associated with willingness to engage in risky sexual behavior. Despite nonsignificant associations with taking health risks more generally, FOBS was associated with greater willingness to engage in risky behaviors in dating contexts, particularly when considering their willingness to settle for less in relationships. This research provides novel insight into dating choices associated with stronger FOBS and how willingness to settle predicts risky health behavior when it could appeal to romantic prospects.     

Subjective Sleep Disturbances in Sexual Assault Survivors: Associations With Trauma and Posttraumatic Stress Disorder Symptom Severity

Prior work implicates sleep disturbance in the development and maintenance of posttraumatic stress disorder (PTSD). However, the majority of this literature has focused on combat veteran men, and limited work has examined links between sleep disturbance and PTSD symptoms in sexual assault survivors. This is a notable gap in the literature, as sexual trauma is disproportionately likely to result in PTSD and is more common in women. We sought to examine the relations between subjective sleep disturbance, sexual assault severity, and PTSD symptoms in a sample of sexual assault survivors with PTSD (PTSD+), without PTSD (PTSD-), and healthy controls. The sample (N = 60) completed the Insomnia Severity Index and prospectively monitored their sleep for 1 week using the Consensus Sleep Diary. The sexual assault survivors also completed the Sexual Experiences Survey and PTSD Checklist-5. Results of group comparisons found that the PTSD+ group reported significantly higher insomnia symptoms, longer sleep onset latency, more nocturnal awakenings, and lower sleep quality compared to the healthy control group and higher insomnia symptoms compared to the PTSD- group. Results of regression analyses in the sexual assault survivors found that insomnia symptoms and number of nocturnal awakenings were significantly associated with higher PTSD symptoms, and sexual assault severity was significantly associated with higher insomnia symptoms, longer sleep onset latency, and lower sleep quality. These findings highlight specific features of sleep disturbance that are linked to trauma and PTSD symptom severity among sexual assault survivors.