Childhood Sexual Trauma in Gay Men

Summary

Social context is a crucial lens through which to see and understand the experience of gay men who have been sexually abused as children. Clinicians who recognize the complex interplay of forces within this context will be better able to serve their gay male sexual abuse survivor clients. Given the trauma inherent in a cultural context which stigmatizes, devalues, pathologizes and punishes homosexuality, the added trauma of childhood sexual abuse in effect exponentially intensifies the trauma and the task of healing. It is particularly important that clinicians assist clients to separate sexual abuse and its effects from sexual orientation. Ideally, the former comes to be seen as imposed from without due to another's pathology, and the latter as an intrinsically good and positive part of self that exists entirely apart from the former. The phenomenon of an “Imprinted Arousal Pattern” (IAP), common among sexual abuse survivors, induces the individual to continue to be eroticized by stimulation and circumstances that overtly or covertly resemble the abuse circumstances. Case illustrations are provided to aid the reader in understanding and assisting others to work through this dynamic.     

Insights and recommendations for recruitment and retention of low socio-economic parents with overweight children

Low socio-economic groups are typically difficult to recruit and retain in health research, which makes it difficult to investigate their health-related beliefs and behaviours. Low socio-economic parents with overweight or obese children took part in a longitudinal qualitative child obesity study over 12?months. These parents’ views of and recommendations for appropriate recruitment and retention strategies are reported. Their interpretations and suggestions are considered in the light of the difficulties that were experienced in designing the study to meet their needs and the approaches that were found to be more effective in achieving and maintaining a viable study cohort. Relevant aspects of recruitment included remuneration, recruitment locations and the use of appropriate weight-related terminology. Retention factors included protocol flexibility, ongoing remuneration and learning opportunities. Barriers to ongoing participation are also discussed. Suggestions are provided for future qualitative research with low socio-economic families.     

Testosterone deficiency and the metabolic syndrome

Evidence is presented to link components of the metabolic syndrome to testosterone deficiency and obesity. Testosterone deficiency in hypogonadism or testosterone deprivation in normo-gonadotropic men increases fat mass as well as fasting insulin levels. Testosterone supplementation (TS) in a dose dependent manner, increase lean body mass (LBM), reduces fat mass, body mass index (BMI) and waist hip ratio in both young and elderly hypogonadal men. A negative association between T and insulin resistance as well as impaired glucose intolerance has been demonstrated and in type 2 diabetic men TS improves metabolic parameters. TS improves most components of the metabolic syndrome and also reduces inflammatory cytokines.     

Bone mineral density in men with and without the metabolic syndrome

The objective of this study was to measure bone mineral density (BMD) in middle-aged men with and without the metabolic syndrome according to the International diabetes federation (IDF) definition from 2005. We studied 80 men (mean age: 51.9 ± 9.0 y, mean body mass index (BMI): 32.0 ± 1.7 kg/m²) with and 92 men without the metabolic syndrome (mean age: 52.6 ± 15.1 y, mean BMI: 24.9 ± 2.8 kg/m²). Height (cm), weight (kg), waist circumference (cm) and blood pressure were measured. Fasting plasma glucose (FPG) and blood lipids were determined. BMD at the lumbar spine and total hip was measured by dual X-ray absorptiometry on a Hologic QDR 4500 bone densitometer. In men around 59.3% had a waist circumference > 94 cm (abdominal obesity). Among them 58.7% showed abnormal BP values. Around 30.7% had FPG ≥ 5.6 mmol/L and 22.7% had low high density lipoprotein (HDL)-cholesterol and 36.6% had hypertriglyceridemia. In men with the metabolic syndrome, mean lumbar spine BMD was 0.986 ± 0.210 g/cm² and total hip BMD – 1.012 ± 0.209 g/cm². The corresponding values in men without this syndrome were 0.934 ± 0.179 g/cm² and 0.894 ± 0.189 g/cm², respectively. The inter-group BMD difference reached statistical significance only at the hip (p = 0.039). Respectively, the prevalence of osteoporosis at the central sites was significantly higher in men without the metabolic syndrome (MS) (13.2 versus 20.8%, p = 0.03). Our data confirmed the trend for higher BMD in the studied men with the metabolic syndrome.     

Gender,Racial, and Ethnic Disclosure in NIH K-Award Funded Diabetes and Obesity Clinical Trials∗

In 1993, the National Institutes of Health (NIH) passed The Revitalization Act (Subtitle B) which mandated that all NIH funded clinical trials have “appropriate representation” of minority and women subjects. Our aim was to evaluate the impact of the mandate by examining the reporting and inclusion of minority and female subjects into NIH K-Award funded clinical trials, addressing the minority predominant diagnoses of diabetes and clinical obesity. Using the CRISP search engine and PUBMED, we selected publications published by the National Institute on Aging (NIA) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) K-grant recipients during 1989–2004, associated with all the diabetes and obesity clinical trials. Studies were stratified into three timeline categories (1989–1993, pre-mandate; 1993–1996, post-mandate, and 1997–present, well past mandate) to evaluate trends in the recruiting of minorities and women before, during, and after the passing of the Revitalization Act. Of the 165 papers, only 37% disclosed race, a number that did not improve over time (p = .15), whereas 92% disclosed gender. Clinical trials that focused on females increased across the 3 timeframes (p < .001) for diabetes studies but not obesity studies. Overall, disclosure of race declined over the 3 timeframes whereas individually, the disclosure of African Americans improved.     

Childhood Sexual Abuse and Drug Use Among Low-Income Urban Puerto Rican Women

SUMMARY

This study examines the relationship between childhood sexual abuse and adult drug use among low-income urban Puerto Rican women. Interviews were conducted with 718 women, 408 involved in drug use and a comparison group of 310 non drug-users. Results demonstrate a strong association between childhood sexual abuse and adult drug use. The impact of childhood sexual abuse was greater for women reporting greater abuse severity, abuse by a family member, and increased abuse duration. Findings support a direct effects model of childhood sexual abuse on adult drug use. The increased rates of drug use among victims of childhood sexual abuse did not appear to be mediated by other childhood maltreatment or family background factors. Implications for practice and research are discussed.     

Effect on Preschoolers' Literacy when Never‐Married Mothers Get Married

Healthy Marriage programs in the United States aim to promote marriage primarily among low‐income individuals. There is little research assessing whether children fare better when their never‐married mothers get married. The present study uses the Early Childhood Longitudinal Survey–Birth Cohort to test the hypothesis that children have higher literacy scores when their mothers who had never married when the children were 9 months old had married when the children were 48 months old (N = 2,800). A small positive effect was found, but only when marriage was compared with cohabitation. The association between marriage and literacy is partially explained by mothers' increased household income. The children of mothers who were single noncohabitants or married and then divorced or separated were also doing better with respect to literacy than children of cohabiting mothers. Future research is needed to better understand how cohabitation is associated with negative effects on children's literacy.