Adolescent males with urogenital anomalies: Their body image and psychosexual development

Three midadolescent males with major congenital urogenital anomalies and multiple surgical repairs are described. Each patient had suffered repeated profound insults to body image concepts and gender identity from infancy onward, now clearly reflected in his psychosocial behavior and in figure drawings. Of major importance is the total lack at any time of counseling and emotional support as a part of comprehensive management. A plea is made for awareness of the psychological effects of such disorders and the need for long-range therapeutic planning from early childhood through adolescence to develop sound compensatory modes of coping with this stress.Formerly fellow in adolescent medicine, New York University Medical Center, at the time the material for this report was collected. Received his M.D. and pediatric training at Boston University School of Medicine and Boston City Hospital. Research interests include comprehensive health care for adolescents and the effects of illness on adolescent psychological development.Received his Ph.D. in psychology from Heed University, Miami, Florida, and training in psychology and child development at New York University. Research interests include the psychological effects of hospitalization on children and youth, minimal brain dysfunction, and developmental assessment in infancy.Received her M.D. from the University of Rochester, pediatric training at University of Minnesota Hospitals and Babies Hospital, New York City, and training in adolescent medicine at Beth Israel Hospital, New York. Research interests include psychological effects of illness and hospitalization in adolescents, legal rights of minors, and adolescent sexuality.     

Invocation of coercion context in compliance communication -- power dynamics in psychiatric care

This article draws on observations from ethnographic fieldwork to develop a theoretical understanding of the power dynamics in psychiatric care. The aim is to analyze how psychiatric clinicians solve compliance problems by invoking "coercion context". It is suggested that clinicians take a rather instrumental approach to laws regulating coercive intervention. Clinicians may invoke a coercion context even with voluntary patients. For example, they may use wordings that connote coercion, or they may make use of how treatment wards are set up to accommodate involuntary patients, thus stalling voluntary patients who cannot exit through locked doors. A coercion context can also be invoked to solve mundane practical problems, e.g. when clinicians talk about "coerced showers". The management of information and maintaining a suitable "awareness context" with regards to coercion is an essential feature in clinical attempts to achieve compliance from patients. In conclusion, the notion of coercion context helps explain the confusing findings from previous research about patients' apparent misconceptions of their formal legal status. Furthermore, it is argued that research that rely on decontextualised, objectifications of "coercion" risk to miss the meaning coercion is assigned in everyday clinical practice.     

Interpersonal factors and personality disorders as discriminators between intra-familial and extra-familial child molesters

This article presents the results of research investigating the relation between interpersonal factors and personality disorders and intra-familial versus extra-familial child molesters. The sample contained 41 intra-familial and 43 extra-familial child molesters as well as a matched comparison group of 80 subjects. The analysis of the research results show that interpersonal factors, such as parental sensitivity, trust, and adult romantic attachment, discriminate between intra-familial and extra-familial child molesters. These findings structure the heterogeneous field of child molesters, as intra-familial child molesting seems to be related to relational attitude as well as personality disorders, whereas extra-familial child molesting is mainly related to personality disorders without showing significant deficits in the interpersonal factors that were measured. These results contribute to the explanation of this deviant sexual conduct and to the development and differentiation of the treatment of child molesters.     

Complex suicides--a review of the literature

The term "complex suicide" stands for suicides committed by using more than one method. A distinction can be made between planned and unplanned complex suicides (primary/secondary combinations). In planned complex suicides 2 or more methods are applied simultaneously in order to make sure that death will occur even if one method fails. In unplanned complex suicides the mode of performance is changed after the first method chosen failed or was working too slow or proved to be too painful. In planned complex suicides typically two of the generally common methods of suicide (e.g. ingestion of medicines, hanging, use of firearms, drowning, fall from a height) are combined. But also unusual combinations have been described such as the simultaneous firing of two guns, self-immolation in combination with other suicide methods or shooting oneself while driving a car. In unplanned complex suicides self-inflicted injuries by sharp force, especially cuts of the wrists, are often found as the primary act of suicide. In some cases the suicide switches from cuts to stabs (mostly to the heart region). Other methods often used after the first phase of suicide are hanging and jump from a height. In the literature the use of up to 5 suicidal methods applied one after the other have been described.     

Bildungsexpansion und Wandel des politischen Interesses in Westdeutschland zwischen 1980 und 2002

Interest in politics is a prerequisite for political participation and political engagement. The promotion of political engagement and education to politically mature citizens were basic concerns of educational reforms in the 1960s. This article focuses on the question if educational expansion has lead to a rise in political interest. To reproduce the change in political interest adequately, effects of education, age, period and cohort will be analyzed simultaneously. The data base of the empirical analyses is a cumulated data set consisting of the German General Social Survey (ALLBUS) from 1980 to 2002. Results show that there is a robust effect of education: More highly educated people are more politically interested. Regarding educational expansion evidence suggests that it actually leads to a rise in political interest.     

Characteristics of individuals petitioned for civil commitment

This article explores the demographic and criminal characteristics of a group of sex offenders currently residing in a facility for civilly committed sex offenders. Legal and clinical records were used and data coded. This sample is compared to published data on a group of civilly committed sex offenders in another state. Results indicated that there were numerous similarities and some differences between the two groups. Further research needs to be conducted on civilly committed sex offenders in other states to better understand this population.