Disabilities and sexual expression: A review of the literature

Since the late 1980s and early 1990s, scholars have sought to advance a more nuanced and robust understanding of the sexual lives of disabled people. In doing so, these scholars have identified some of the barriers to sexual expression that disabled people face as well as some of the positive and pleasurable aspects of disabled people's sexual lives. This article reviews research regarding the sexual expression and activity of disabled people as well as some of the challenges to sexual expression that people with disabilities experience. Persons with disabilities—whether they are acquired, congenital, intellectual, physical, and/or sensorial impairments—continue to encounter alienation, stigmatization, and discrimination, particularly in terms of their sexuality. However, I argue that if proper laws, policies, and adequate supports are in place, people with disabilities can further challenge and push past these barriers to engage in a wide array of sexual and erotic acts. Furthermore, although the amount of disability‐sexuality‐related research has increased over past decades, I argue that many intersections of disability and sexuality remain under‐studied and that further research in this field is necessary.     

An exploratory qualitative study of the self-reported impact of female-perpetrated childhood sexual abuse

The limited findings on the impact of female-perpetrated sexual abuse of children are often contradictory, particularly in relation to males. In this exploratory qualitative study, a sample of nine men and five women who reported that they had been sexually abused by women in their childhood were recruited from the general community. They completed a questionnaire that asked them to describe various aspects of their abuse experiences and the perceived consequences. For both men and women, the abuse was associated with negative outcomes across a range of functional areas in both childhood and adulthood. Many impacts were similar to those reported by victims of male-perpetrated sexual abuse. It is argued that the consequences of female-perpetrated child sexual abuse are serious, and further research is required to bring these issues to the awareness of both the public and professionals working in the field of child protection and counseling.     

Body image and female sexual functioning and behavior: a review

Knowledge in the research fields of body image and sexuality has significantly increased in the last decade. In this review, data from 57 studies were compiled for a review of empirical evidence regarding the association between sexuality and body image among healthy women. The overall conclusion is that body image issues can affect all domains of sexual functioning. Cognitions and self-consciousness seem to be key factors in understanding the complex relationships between women's body image and sexuality. Body evaluations and cognitions not only interfere with sexual responses and experiences during sexual activity, but also with sexual behavior, sexual avoidance, and risky sexual behavior.     

Older lesbian sexuality: identity, sexual behavior, and the impact of aging

In response to the very limited and mostly outdated literature on older lesbian sexuality, this exploratory study examined older lesbian sexual identity, romantic relationships, the impact of aging, and experiences of discrimination within these contexts. Utilizing an online survey that recruited via numerous online lesbian communities and snowball sampling, 456 lesbians over the age of 50 responded to closed, Likert scale, and open-ended questions that provided a preliminary understanding of older lesbian sexuality. The results indicated that older lesbians have experienced fluidity in past romantic and sexual relationships, as well as in erotic fantasies, despite strong identification with being lesbian. The findings also indicate a decreased focus on sexuality in the context of relationships, with more focus on stability and continuity. Future research is needed that provides greater specificity and detail about older lesbian conceptions of sexual behavior and sexual identity labels, as well as specific sexual behaviors.     

The impact of family structure and social change on adolescent sexual behavior

This article presents a biophysical perspective on adolescent sexual feelings and behavior. The study particularly analyzes sexual attraction, desire, and mate selection as evolutionary adaptations just as important to species survival. Sex differences in mating strategies are described as part of this evolutionary adaptation. Recent research findings demonstrate how these strategies explain contemporary sexual and reproductive behavior in Western societies today, as they do sexual behavior in the past or across diverse cultures. The implications of this analysis are significant to intervention efforts to postpone sexual initiation and avert nonmarital births. Discussion on demographic and normative changes that affect adolescent sexual behavior included trends in sexual maturation and changing marriage norms. The author urges greater emphasis on the early pubertal years; increased attention to teaching adolescents more about their own sexual development; a less absolutist focus on sexual abstinence, which may be appropriate and more feasible for 12 year olds but not for 16 year olds; better and more widespread sex education at earlier ages and throughout the school curriculum; frank discussion of all the options available for those who experience an unwanted pregnancy; and same level of attention towards adolescent boys and girls.     

The impact of schools and school programs upon adolescent sexual behavior

Because most youth are enrolled in school for many years before they initiate sex and when they initiate sex, schools have the potential for reducing adolescent sexual risk-taking. This paper reviews studies which examine the impact upon sexual risk-taking of school involvement, school characteristics, specific programs in school that do not address sexual behavior, and specific programs that do address sexual risk-taking. Multiple studies support several conclusions. First, involvement in and attachment to school and plans to attend higher education are all related to less sexual risk-taking and lower pregnancy rates. Second, students in schools with manifestations of poverty and disorganization are more likely to become pregnant. Third, some school programs specifically designed to increase attachment to school or reduce school dropout effectively delayed sex or reduced pregnancy rate, even when they did not address sexuality. Fourth, sex and HIV education programs do not increase sexual behavior, and some programs decrease sexual activity and increase condom or contraceptive use. Fifth, school-based clinics and school condom-availability programs do not increase sexual activity, and either may or may not increase condom or contraceptive use. Other studies reveal that there is very broad support for comprehensive sex- and HIV-education programs, and accordingly, most youth receive some amount of sex or HIV education. However, important topics are not covered in many schools.     

What we know about social structure and homicide: a review of the theoretical and empirical literature

This article reviews what we have learned about social structure and homicide during the last 30 years, paying close attention to empirical tests of subculture, strain (both absolute and relative deprivation), and social disorganization theories. First, this review reveals that researchers have difficulty operationalizing culture in terms of values and instead often rely on regional location or group membership as a proxy for subculture. Though the findings relating subculture to homicide are inconsistent, however, culture should not be ignored. Second, the positive relationship between poverty and the spatial distribution of homicide rates is the most consistent finding in this literature, while empirical evidence of the effects of inequality on homicide is neither as strong nor as consistent. Finally, social disorganization is more consistent in explaining the variation of homicide rates than the subcultural and relative deprivation models, with elements of disorganization such as city size, family disruption, and heterogeneity all showing relatively consistent effects.     

Mental illness and problematic sexual behaviors. A review of the recent literature

Advanced practice nurses and other health care professionals have increasingly been working with individuals with mental illnesses who also have a history of sexual misconduct. Unfortunately, due partly to minimal research on the subject--especially in the nursing field--these professionals are addressing the needs of this population without adequate preparation. This article provides an overview of mental illness and problematic sexual behaviors (MI/PSB) and highlights the importance of additional research for the MI/PSB population as a subgroup of sex offenders.     

Seeking medical help for sexual concerns in mid- and later life: a review of the literature

Research consistently reports that older people tend not to seek medical help for sexual concerns or difficulties. This article reviews the literature to examine help-seeking for, and doctor-patient interactions about, sexual problems in the middle and later life age groups. Twenty-five articles from 1999 to 2010 were identified and analyzed. Significant barriers to seeking medical help included psychosocial factors relating to the patient, such as thinking that sexual changes were "normal with ageing," and also to the doctor-for example, assuming that sex was less important to older patients than it was to their younger patients. Inadequate training at medical school for health care professionals (HCPs) was also identified as a barrier. People were more likely to seek help if their doctor had asked about sexual function during a routine visit sometime during the previous three years. However, doctors tended not to take a proactive approach to sexual health management, and indeed often had limited knowledge of later-life sexuality issues. There are clear implications for sexual well-being if the doctor does not ask and the patient does not tell. Providing education about later-life sexuality for HCPs is crucial if we are to meet the needs of older patients in useful and effective ways.     

Testing a theoretical model of adolescent sexual behavior among rural families in poverty

This was a study of 357 adolescents, aged 13 to 17 years, who resided in a family receiving AFDC in 10 rural counties in Arkansas. The study had a twofold purpose: 1) to examine what elements of social control, social learning, and strain theories predicted 3 measures of sexual behavior; and 2) to test an integrated theoretical model with 2-stage least squares regression to see if it fit the data on the 3 measures of sex. The measures of sexual behavior were frequency of sexual intercourse in the past year, number of sexual partners in the past year, and number of sexual partners in lifetime. Bivariate analyses revealed that the consistent predictors of the 3 measures of sex were age, gender, attachment to mother, beliefs, parental supervision and punishment, family and friend support, frustration, and use of rationalizations. The theoretical model that fit all measures of sex showed that bonding influences sexual behavior through frustration, and that age, gender and rationalizations directly impact behavior.     

Parent loss and childhood bereavement: some theoretical considerations

This paper attempts to review critically the major psychoanalytic positions on the impact of parent loss during childhood. An effort is made to review systematically the issues of the loss of a parent as a love object, the loss of a parent as a narcissistic injury, children's cognitive understanding of death, and the relationship between loss and trauma. Two questions are raised by our efforts to understand the impact of the loss of a parent through death on children under ten years of age. First, what psychological tasks do children confront and what modes of coping do they use to deal with such an event? And, second, does such an event invariably lead to some pathological result for the child, or may its effects be normalized in the course of time? Although these questions may be seen as empirical questions needing to be answered through the collection of data that would confirm or negate the hypotheses generated, the questions are always posed within the context of a theoretical framework that colors how data is collected and which data is collected. By reviewing the theoretical positions, we come to the conclusion that no single approach is sufficient to explain the complexity of the impact of the death of a parent on a child. We propose that since no integrated conceptual framework presently encompasses all that needs to be explained, it is necessary to use a multivariant approach. Such an approach may be helpful in generating hypotheses and in beginning the task of systematic data collection.     

Some theoretical considerations on confidential adoption part IV: Countertransference

Psychological self-awareness is as essential to the maturation of one's professional self as is the development of theoretical and clinical expertise in child placement. This paper represents a first published attempt at examining countertransference in adoption. The focus is within the context of confidential adoptions, which the authors believe is more child-focused and intrapsychically based than the current experimentation with open adoptions. A distinction is made between countertransference and non-countertransference issues. Countertransference responses are divided into Racker's three categories: the concordant; the complementary; and the disjunctive. Clinical data illustrates these responses in actual practice from the perspective of confidential adoptions.This paper was presented in 1985 before the Illinois Infant Mental Health Association, National Society of Clinical Social Workers, and the National Association of Social Workers National Professional Symposium.This is the last of a series. Parts I, II, and III were published in Vol. 2, Nos. 1, 2, and 3.     

Parents' knowledge,attitudes and practices about preventing child sexual abuse: a literature review

Increased concern about high rates of child sexual abuse has led to the demand for more prevention programmes, particularly those aimed at parents. Research on how parents manage and reduce the risk of child sexual abuse can help plan programmes. This literature review explores published research on the knowledge, attitudes and practices of parents on the risk and prevention of child sexual abuse and identifies gaps and needs for further research. The majority of studies reviewed originated in North America and Asia, were quantitative, surveyed mainly mothers and were more than ten years old. Recommendations are made for more current and country specific research, further research to gain a deeper understanding of how parents manage the risk of child sexual abuse, more comprehensive research covering a range of knowledge, attitude and practice variables, and greater inclusion of fathers in research. Copyright © 2009 John Wiley & Sons, Ltd.     

Promoting sexual health and responsible sexual behavior: an introduction

Facing a myriad of sexual health problems today, health ministries are being compelled to develop comprehensive approaches to sexual health promotion. Recently, there have been several attempts to develop these strategies at national, regional, and global levels. One of the challenges of articulating strategies has been arriving at basic definitions of sex, sexuality, sexual health, and responsible sexual behavior. However, there is remarkable consistency throughout these recent documents. These documents call for leadership of the health sector to create better climates for discussion of sexuality, access to information and education about sexuality, prevention strategies, access to care, and more research in human sexuality and evaluation of programs designed to promote sexual health and responsible sexual behavior.     

Investigating the impact of violations of the “left and top means first” heuristic on response behavior and data quality

ABSTRACT

Web surveys are an established data collection mode that use written language to provide information. The written language is accompanied by visual elements, such as presentation formats and shapes. However, research has shown that visual elements influence response behavior because respondents sometimes use interpretive heuristics to make sense of the visual elements. One such heuristic is the ‘left and top means first’ (LTMF) heuristic, which suggests that respondents tend to believe that a response scale consistently runs from left to right or from top to bottom. We conducted a web survey experiment to investigate how violations of the LTMF heuristic affect response behavior and data quality. For this purpose, a random half of respondents received response options that followed a consistent order and the other half received response options that followed an inconsistent order. The results reveal significantly different response distributions between the two groups. We also found that inconsistently ordered response options significantly increase response times and decrease data quality in terms of criterion validity. We, therefore, recommend using options that follow the design strategies of the LTMF heuristic.     

The impact of climate change and natural disasters on vulnerable populations: A systematic review of literature

ABSTRACT

Climate change is acknowledged as being a crucial determinant of public health. The United States is experiencing an increase in the frequency and intensity of natural disasters as a result of climate change activity, influencing the ways federal, state, and local governments are addressing the growing issue. Individuals who are vulnerable to the effects of extreme weather, namely the poor, the elderly/disabled, children, prisoners, and substance abusers have experienced heightened levels of mental, emotional, and bodily stress due to natural disaster exposure. Researchers from a variety of disciplines, public health, social science, and environmental studies, in particular, are examining how natural disasters are impacting mental and physical health functioning while noting the demographic factors leaving certain groups more susceptible to harm. A systematic literature review was conducted on the past 12 years of research that examined natural disaster-related experiences and psychological and physiological health outcomes on populations who are more vulnerable to adverse weather impacts. It was found that the mental and physical health of marginalized populations during and after a natural disaster were elevated and/or exacerbated by circumstances pertaining to the weather event and the lack of disaster-response actions. It was also found that fostering social capital is a way to combat stressors in disadvantaged communities. It is imperative that clinicians and policy makers confront the issue of climate change and natural disasters, developing relief efforts and preventative measures to secure the well-being of underserved groups who may not have many resources at their disposal.     

Disclosing sexual abuse: the impact of developmental variables

Despite increasing evidence that even a young child can be a competent witness in a court of law, there is one factor that is often used to impeach the credibility of a child in a sexual abuse case, and that is the nature and timing of the child's disclosure of the sexual victimization. This paper examines the impact of developmental variables on that disclosure and suggests that when those variables are recognized, the credibility of the young child as a witness increases.     

Using theory-based constructs to explore the impact of Greek membership on alcohol-related beliefs and behaviors: a systematic literature review

By charter, national Greek organizations (ie, fraternities and sororities) place an emphasis on upholding personal integrity, academic scholarship, and development of campus leaders. Recent concerns, however, assert that the drinking behaviors of members of Greek organizations are antithetical to the mission of their universities. OBJECTIVE: The author's purpose in this review was to systematically examine scientific literature addressing the effect of Greek affiliation on alcohol-related beliefs and behaviors. The internal and external influences affecting Greek members' alcohol-related beliefs and behaviors are organized into a frame-work of various health behavior theories, based on the ecological perspective's levels of influence. RESULTS: Results provide a broad perspective into the individual characteristics, social peer network, and environmental aspects influencing alcohol-related behavior among Greek members. Findings suggest that Greek members comprise a subgroup that consumes alcohol in greater quantities, underscores and misperceives the risks of alcohol abuse, and emulates a social environment and culture in which drinking alcohol is a key part of life.