The impact of sexual esteem, body esteem, and sexual satisfaction on psychological well-being in people with physical disability

The current study investigated the association between sexuality and psychological well-being in people with physical disabilities. A total of 1,196 participants completed the study. There were 748 participants who had a physical disability and 448 participants who were able-bodied. The results demonstrated that sexual esteem, body esteem, and sexual satisfaction were strong predictors of self-esteem and depression among people with physical disability, and that this relationship was stronger among people with physical disability than able-bodied participants. It was also found that body esteem was more closely associated with self-esteem in disabled women, while sexual esteem was more closely associated with self-esteem in disabled men. The results of the study suggest that researchers and clinicians who are concerned with the psychological health of people with physical disability should consider strategies to improve the body esteem and sexual well-being of people with physical disabilities.

Changes over time in sexual and relationship functioning of people with multiple sclerosis

Relationship and sexual satisfaction among people with multiple sclerosis (MS) has received little research attention. This article reports on a longitudinal investigation of the impact of coping style and illness-related variables among people with MS and the general population on sexual and relationship functioning. Both men (n = 120) and women (n= 201) with MS and men (n = 79) and women (n = 160) from the general population participated in the study at two points in time, 6 months apart. People with MS experienced lower levels of sexual activity, sexual satisfaction, and relationship satisfaction and higher levels of sexual dysfunction. Generally speaking, the time 1 levels of the health and coping variables explained little of the variance in the time 2 sexual and relationship variables. However, sexual activity at time 1 contributed significant unique variance to relationship satisfaction at time 2 for MS men, and coping strategies at time I contributed to relationship satisfaction among general population women at time 2. Furthermore, for those respondents who had been diagnosed with MS for less than 7 years, levels of sexual activity at time 2 were predicted by levels of sexual and relationship satisfaction, as well as levels of sexual activity at time 1. These results suggest that strategies used to cope with illness may not play a major role in sexual and relationship satisfaction. However, an examination of these strategies over a longer time frame is needed.

Outside belonging : multi-sexual relationships as border existence

This article draws from an ongoing Australian research project with over 60 culturally and sexually diverse women in monogamous, open, and polyamorous relationships with bisexual-identifying and/or bisexualbehaving men. Positioned within a queer feminist deconstructive theoretical framework, this research provides insights into the border existences of these women and their partners, and their negotiations of “new rules” and boundaries in order to construct healthy relationships. What are the various ways that HIV/AIDS impacts women in relationships with bisexual men? How do they deal with issues such as social, community, workplace and familial ostracism? Probyn's term, “outside belonging” (1996: 9) is applicable to the border existences of thesewomen and their bisexual male partners. Their multi-sexual relationships are both “outside” gendernormative and heteronormative constructs of marital and defacto relationships and yet “belonging,” for the partnersmay “pass” as a “normal” couple. They are also “outside” the dominant constructs of Australian gay identity and community while simultaneously “belonging” due to their partners', and sometimes their own, same-sex attractions and relationships.

Correlates of sexual assault in a sample of male African American crack cocaine users

Although numerous studies have reported an association between substance use and sexual assault, little is known about the impact of sexual assault on male African American crack cocaine users. This study found that from a sample of 137 respondents from Houston, Texas, one-third reported having been sexually assaulted at least once during their lifetime. Respondents who reported sexual assault were using cocaine more often and were more likely to be physically dependent on drugs and to report greater numbers of physical health problems due to their drug use. However, no differences were identified in respect of reported mental health problems, or problems with family, friends or the workplace associated with drug use. The findings suggest further research as to the impact of sexual assault on male crack cocaine users is warranted and that clinical staff working with male substance users require some awareness of the impacts of sexual assault.

Emerging health issues: the widening challenge for population health promotion

The spectrum of tasks for health promotion has widened since the Ottawa Charter was signed. In 1986, infectious diseases still seemed in retreat, the potential extent of HIV/AIDS was unrecognized, the Green Revolution was at its height and global poverty appeared less intractable. Global climate change had not yet emerged as a major threat to development and health. Most economists forecast continuous improvement, and chronic diseases were broadly anticipated as the next major health issue. Today, although many broadly averaged measures of population health have improved, many of the determinants of global health have faltered. Many infectious diseases have emerged; others have unexpectedly reappeared. Reasons include urban crowding, environmental changes, altered sexual relations, intensified food production and increased mobility and trade. Foremost, however, is the persistence of poverty and the exacerbation of regional and global inequality. Life expectancy has unexpectedly declined in several countries. Rather than being a faint echo from an earlier time of hardship, these declines could signify the future. Relatedly, the demographic and epidemiological   transitions have faltered. In some regions, declining fertility has overshot that needed for optimal age structure, whereas elsewhere mortality increases have reduced population growth rates, despite continuing high fertility. Few, if any, Millennium Development Goals (MDG), including those for health and sustainability, seem achievable. Policy-makers generally misunderstand the link between environmental sustainability (MDG #7) and health. Many health workers also fail to realize that social cohesion and sustainability—maintenance of the Earth’s ecological and geophysical systems—is a necessary basis for health. In sum, these issues present an enormous challenge to health. Health promotion must address population health influences that transcend national boundaries and generations and engage with the development, human rights and environmental movements. The big task is to promote sustainable environmental and social conditions that bring enduring and equitable health gains.

Delphi expert consultation. Final report. Report to Department of Health, Victims of Violence and Abuse Prevention Programme

This report presents the results of one piece of research conducted as a part of the VVAPP programme, namely a three round Delphi consultation. This Delphi consultation was undertaken to identify where there is and is not consensus among experts about what is known and what works in the treatment and care of people affected by child sexual abuse, domestic violence and abuse, and rape and sexual assault. While helping to identify areas of agreement and disagreement about effective mental health service responses, the consultation will also support the evidence base derived from the literature review that is being undertaken as part of the wider VVAPP programme of work

Effects of sexually transmitted infection status, relationship status, and disclosure status on sexual self-concept

Research has indicated that having a sexually transmitted infection (STI) such as genital herpes and genital human papilloma virus (HPV) can have a negative impact on an individual's sexuality. The current study was designed to evaluate the effect of STI status, relationship status, and disclosure status on various dimensions of sexual self-concept. A questionnaire that evaluated the above variables was completed by 117 individuals with genital herpes, 82 individuals with HPV, and 75 individuals with no STI. The results demonstrated that having herpes or HPV had a significant negative impact on aspects of sexual self-concept. It does not appear that an individual's relationship status is a factor associated with the impact of having an STI on the sexual self-concept. Respondents who had disclosed their STI to their partners, however, had significantly more positive feelings about aspects of their sexual self-concept than those who had not disclosed their STI to their partners. The implications of these research findings for health practitioners are discussed.

The "HEALTH" model- part 1 : treatment program guidelines for complex PTSD

This paper outlines the development and piloting of the “HEALTH” model for treatment of Complex PTSD in clients who have experienced multiple traumas across childhood and adulthood - particularly child sexual abuse and sexual assault in adulthood. As a guideline-based treatment model, HEALTH outlines six stages of intervention: (1) having a supportive therapist; (2) ensuring personal safety; (3) assisting with daily functioning; (4) self-regulation - learning to manage core PTSD symptoms; (5) treating Complex PTSD symptoms; and, finally, (6) having patience and persistence to enable “ego strengthening”. Using a case study approach, we provide both qualitative and quantitative assessment data for the individuals in the study, all of whom displayed numerous pre-treatment symptoms of Complex PTSD. Such programs are different to standard PTSD treatment programs that focus predominantly on core PTSD symptoms of re-experiencing, avoidance and arousal. The results of this study provided support for the use of guideline-based treatment programs that cater specifically for the needs of those who have suffered long-term/multiple trauma experiences by targeting Complex PTSD symptoms.

Risk assessment of sexual offenders for extended supervision orders in New Zealand : basic principles and current practice

A growing number of jurisdictions in North America, the United Kingdom, and Australasia have enacted legislation allowing for special sentencing, civil commitment, and community supervision options for high risk sexual offenders. In New Zealand, one example of this concern for public protection is the Parole (Extended Supervision) Amendment Act 2004, which provides for additional supervision of sexual offenders with child victims for up to 10 years after their release from prison. Recent experience with expert evidence and judicial decision making in such cases suggests that those involved in the process might benefit from a more thorough understanding of the current state of sexual offender risk assessment that can be provided by mental health professionals.

Effect of deer velvet on sexual function in men and their partners: a double-blind, placebo-controlled study

The use of alternative medicines and herbal remedies is an increasing trend in Western societies. For years, people have taken products made of deer velvet for their alleged beneficial effects on sexual function. There has been no scientific investigation of the effects of deer velvet powder on the sexual functioning of human males. This study investigated sexual function in men during a 12-week double-blind, placebo-controlled trial of deer velvet. Thirty-two volunteer male participants, aged 45–65 years, and their partners, were randomly assigned to either the deer velvet or placebo study group. The males took capsules containing ground deer velvet or placebo everyday for 12 weeks. Two sexual function questionnaires (the International Index of Erectile Function and the Brief Index of Sexual Function for Women) used at pre- and posttreatment assessed changes in sexual functioning in males and their partners. Blood tests at baseline, and end of study, determined levels of sex-related hormones in male participants. There were no significant differences in the sexual behavior of the men taking deer velvet compared with the men taking placebo capsules. There were no significant hormone changes from baseline to the end of the study in either group of men. We conclude that in normal males there was no advantage in taking deer velvet to enhance sexual function. All alternative health products or nutritional supplements should be subjected to randomized placebo-controlled trials to determine efficacy.

Relationship between hypoactive sexual desire disorder and aging

Objective: Explore the association between Hypoactive Sexual Desire Disorder (HSDD) and aging. The American Foundation of Urologic Disease and the American Psychiatric Association stipulate that HSDD is only diagnosed when both low sexual desire and sexually related personal distress are present.
Design : Community-based, cross-sectional study.
Setting : Europe (UK, Germany, France, Italy) and the USA.
Patient(s) Women aged 20-70 in sexual relationships participating in the Women’s International Study of Health and Sexuality (n=1998 Europe, n=1591 USA).
Intervention(s) : No interventions were administered.
Main Outcome Measures : Self-administered questionnaire that included two validated instruments: Profile of Female Sexual Function© measured sexual desire; Personal Distress Scale© measured sexual distress. Women with low desire and distress were considered to have HSDD.
Results : The proportion of European women with low desire increased from 11% amongst women aged 20-29 years to 53% amongst women aged 60-70 years. The proportion of American women with low desire displayed a trend towards an increase with age. In the 20-29 year age group 65% of European women and 67% of American women with low sexual desire were distressed by it. This decreased to 22% and 37%, respectively, in the 60-70 year age group. In Europe and the USA the prevalence of HSDD in the population did not change significantly with age (6-13% in Europe, 12-19% in the USA).
Conclusions: The proportion of women with low desire increased with age while the proportion of women distressed about their low desire decreased with age. Consequently, the prevalence of HSDD remained essentially constant with age. This may explain why no association between HSDD and age is often reported in the literature.

Lesbian parents negotiating the health care system in Australia

Twenty Australian lesbian-parented families were interviewed in multigenerational family groups about the interface between their public and private worlds. Experiences of the health care bureaucracy were difficult, whereas many participants found individual providers to be approachable and caring. Three strategies were used for disclosure of their sexual orientation to health care providers: private, proud, and passive. Influences on the strategy used included family formation, role of the non-birth parent, geographic location, and expected continuity of care. Parents displayed a high degree of thoughtful planning in utilizing their preferred disclosure strategy in order to optimize safety, particularly for their children.