109 resultados para sexual health


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Examination of previous empirical literature illustrates how researchers have concentrated on documenting the impact of childhood sexual abuse (CSA) on the later psychological functioning of survivors, through comparisons with those who have not had such a history. Only more recently has there been a focus on assessing the relationship between aspects of the abuse and specific psychological difficulties. This thesis investigated the relationships between CSA characteristics and women’s later psychological adjustment. The role of attributions, coping methods, parenting competency and marital satisfaction were also investigated. Qualitative data on perception of benefit and general reflections of participants were used to explore participants’ self-esteem, locus of control, decisions relating to parenting, disclosure experiences, and attributions in relation to their abuse, including the search for meaning. Recruitment through newspapers and counselling services led to 118 women volunteering to complete a questionnaire evaluating the characteristics of their CSA and their current psychological adjustment. Of this group, 33 subsequently volunteered to participate in a telephone interview that explored in greater depth issues related to the long-term impact of their CSA. Both quantitative and qualitative analyses were conducted on the data. The women reported a high prevalence of dysfunction in their families of origin. Abuse had generally commenced by middle childhood, and lasted for a number of years and often involved a number of perpetrators. Perpetrators were most likely to be intrafamilial, with stepfathers being over-represented. Sexual activities generally involved physical contact, with participation often induced by the use of coercion. Participants demonstrated significant difficulties in psychological adjustment, but attributions regarding the abuse improved over time. Some concerns were expressed regarding parenting competency, and avoidant coping methods were favoured. In general, participants were satisfied with their current marital relationship. Significant associations were found between coping methods, attributional style, beliefs and various psychological adjustment measures. Participants, in general, demonstrated low self-esteem and displayed an external locus of control. As a consequence of their experience of CSA, many participants reported they had decided not to have children. For those who did have children, CSA was almost universally seen as having had an impact on their parenting. Disclosure of CSA was usually delayed for a number of years, with poor outcomes generally resulting from disclosure when it occurred. Women with current partners rated them as very caring and not controlling. Participants were generally still searching for meaning in their abuse, despite many having accepted it. Survivors outlined an extensive range of long-term effects of CSA, and nominated a number of strategies that would assist in reducing these effects. The results of the study indicated that there are a number of characteristics associated with CSA which signal a higher risk of difficulties in psychological adjustment. Concerns of survivors regarding parenting were confirmed according to those who undertook this role. Unfortunately, concerns expressed by survivors that disclosure of their CSA would have had negative consequences was usually the case when they did finally disclose. However, the accessing of social and family support appeared to have an important role in changing the attributions of survivors regarding their CSA. Furthermore, change of attributions in relation to abuse may provide the key to resilience in survivors against the negative impact of CSA on later psychological adjustment.

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Sexual arousal is a complex and dynamic element of women’s sexuality. Accounts vary, however most multidimensional models highlight the cognitive, affective and physiological components of the female sexual arousal response. While literature examining the peripheral physiological changes that occur during female sexual arousal abounds, there has been a dearth of literature pertaining to the cognitive and affective components. Thus, while many authors have included cognitive and emotions as independent components of the female sexual arousal response, there has been little empirical research to validate this approach. The aim of the current thesis was to examine the cognitive and affective components of female sexual arousal in more depth, investigating the nature of the relationship between these components under various experimental conditions. In order to do so, two integrated studies were conducted, each highlighting the effects of either external or internal variables on women’s subjective sexual arousal, absorption, positive affect and negative affect. Study One was designed to evaluate women’s emotional and cognitive processing of two elements of erotic film – foreplay and erotic context. 60 women were asked to report their subjective sexual arousal, absorption, positive affect and negative affect in response to one of four erotic film excerpts. The erotic excerpts varied in accordance with the degree of foreplay (low vs. high) depicted and the context in which the sexual activities took place (novel vs. habitual context). Women in the study responded more favourably to the high foreplay erotic film excerpt, subsequently reporting higher degrees of subjective sexual arousal, absorption and positive affect. Women also responded favourably to the erotic excerpt filmed in a novel context, reporting greater subjective sexual arousal as a result. The environment in which the sexual encounters were filmed failed to have an effect however, on women’s absorption or their positive or negative affect. The results of Study One suggest that stimulus specific variables, such as the degree of foreplay depicted, have a significant influence on female cognitive and emotional processing of erotic film. The results also suggest that a relationship exists between absorption, subjective sexual arousal and positive affect, albeit a correlational one. Specifically, there was evidence of parallel processing during sexual arousal, as participant reported sexual arousal, absorption and positive affect all increased and decreased in unison. Based on the results it was suggested that future research attempt to experimentally manipulate one of these variables, to examine its direct effect on the remaining variable. Thus, Study Two aimed to examine the effects of absorption on women’s cognitive and emotional processing of erotica. Study Two manipulated absorption at two levels (high vs. low), examining the impact of these states on participants’ subsequent absorption, subjective sexual arousal and positive and negative affect. 62 women were asked to read one of two sets of test session instructions. The first, participant-oriented instruction set, instructed participants to immerse themselves in the erotic film excerpt, as if they were active participants in the sexual exchange. The second, spectator-oriented instruction set, directed participants to observe and evaluate the erotic film. These instructions were designed to elicit high and low degrees of absorption, respectively. The utility of this approach when manipulating female absorption, was demonstrated by self reported ratings of absorption, given at the conclusion of the film presentation. Participants were also asked to report their subjective sexual arousal and positive and negative affect at the conclusion of the erotic film presentation. The findings of this study suggest that the adoption of a participant-oriented (high absorption) perspective elicits more favourable responses from participants than a spectator-oriented (low absorption) perspective, with participants in the former experimental group reporting greater degrees of subjective sexual arousal and positive affect. Negative affect was equivalent across experimental conditions, with the participants reporting that they experienced little to no aversive feelings during either of the experimental conditions. The results suggest that the degree to which a women immerses and absorbs herself in a sexual stimulus has a significant impact in her subsequent cognitive and affective processing of that stimulus. More specifically, it appears that women respond more favourably when they are highly absorbed and immersed in a stimulus, reporting greater subjective sexual arousal and positive affect. Overall, the results of Studies One and Two highlight the dynamic and complex nature of female sexual arousal. It appears that women have definite cognitive and affective responses to sexual stimuli. The magnitude of these responses may be mediated by a number of factors however, including the intrinsic qualities of the stimulus and the degree to which the woman attends to the stimulus. Both these variables act to either enhance or inhibit the sexual arousal response. There results have important implications for current sexuality literature. While women’s cognitions and emotions in response to erotic film were generally highly correlated, in some instances they differed, warranting their inclusion as separate elements in models of female sexual arousal. Furthermore, it might be suggested that the inclusion of an additional variable – absorption – into current models of female sexual arousal would prove beneficial, aiding researchers to better understand and predict the arousal process. As such, recommendations are made for a revised model of female sexual arousal. In terms of future directions, the results of the present thesis have implications for the treatment of sexual dysfunctions, suggesting that clinicians need to understand the internal and external variables that might contribute to the aetiology and maintenance of their presenting problems.

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In the last thirty years there have been many research studies which have examined the reasons why adolescents and young adults engage in sexual behaviours. Most of these studies have lacked a theoretical basis, Consequently there are many links made between variables, but no consistency across studies, or attempts to develop an underlying theory to explain the results. However, there have been theoretical models developed to explain adolescents’ and young adults’ sexual decision making. Unfortunately, many of these models have not been empirically validated. This thesis attempts to address these deficiencies in the literature by utilising a theory of behaviour and applying it to adolescent and young adult sexual decision making. This theory is the Theory of Planned Behaviour (TPB). Two longitudinal studies were conducted to examine the utility of an adaptation of the TPB to sexual decision making among adolescents and young adults. In the first study 58 adolescent males, aged between 14 years and 18 years participated in a longitudinal study using a questionnaire adapted from the Depth of Sexual Involvement Scale. In the second study, 194 young adults (156 female, 38 male) aged between 18 years and 21 years participated in a similar study. The first study found that intention to engage in behaviour was well predicted, although some of the variables in the model, did not in fact, contribute significantly to the prediction. The prediction of behaviour was less strong than that of intention. Study two found that intention to engage in behaviours was well predicted by the model. However, the degree to which intention led to behaviour was not well predicted. Overall, the results of these studies suggest that the TPB is a good theoretical basis from which to launch a systematic and theoretically informed explanation of adolescent and young adult sexual decision making. However, other factors may need to be added to the model to fully describe the decision making process and accurately predict behaviour. Suggestions are made for future research, as well as interventions that may arise as more knowledge is gathered using this paradigm.

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This thesis highlights the importance of workers’ perceptions of and attitudes to sexual harassment. Past researchers have found that a variety of individual factors (age, gender, gender role, and past experiences of sexual harassment), and organisational factors (gender ratio, sexual harassment policies and the role of employers), correlate with the incidence of sexually harassing behaviours. Two studies presented in this thesis extend this research and were designed to investigate how these factors relate to workers’ attitudes towards and perceptions of sexual harassment. Study one investigated 176 workers from a large, white-collar organisation. Study two sampled 75 workers from a smaller, blue-collar organisation. By comparing two different workplaces the effect of the organisational climate was investigated. Individuals from Study two experienced more sexual harassment, were more tolerant of sexual harassment and perceived less behaviour as sexual harassment compared with individuals from Study one. The organisational context was found to affect the way in which organisational and individual factors related to workers' attitudes to and their experiences of sexual harassment. However, the factors that influenced workers’ perceptions of sexual harassment were stable across both studies. Although workers’ attitudes to and their perceptions of sexual harassment were significantly correlated, they were influenced by different factors. Overall, workers’ perceptions of sexual harassment were influenced by their attitudes, the behavioural context, and the gender of the victim and perpetrator. In contrast, attitudes to sexual harassment appeared to be more strongly influenced by individual factors, such as age, gender, gender role, past experiences of sexual harassment, and perceptions of management’s tolerance of sexual harassment. The broader implications of these findings are discussed and recommendations for future research are suggested.

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This thesis examined the aetiology of female sexual dysfunction (FSD) and a model to represent sexual function. Relationship factors were the main predictor of sexual function for women with FSD. A circular model of sexual response represented women's sexual experience for those with FSD and those who did not have FSD. In order to illustrate the role of family emotional involvement in children's development of psychological disorders the portfolio presents and explores four case studies.

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The focus of this research was to obtain an understanding of the social and sexual behaviour of adolescents with High Functioning Autism (HFA) or Down Syndrome (DS) in comparison to Typically Developing (TD) adolescents across cultures. The findings highlight the importance of cross-cultural research and indicate the need for sex education. The portfolio presents four case studies which support the proposition that insecure attachment is only likely to lead to depression in the presence of socially-related and other psychological difficulties, since not all insecurely attached children develop depressive symptoms.

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This thesis examined the nature of the body image construct, as well as the relationships between body image and self-esteem, depression, anxiety, and social functioning. Body image was demonstrated to play an important role in the everyday lives of adolescent boys and girls, and men and women throughout adulthood.

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This study examined factors expected to influence the relationship between sexual abuse and academic achievement in an adolescent inpatient psychiatric population. It was found that sexual abuse combined with either low intelligence, substance abuse, internalising behaviour problems or externalising behaviour problems predicted poor academic achievement. The supporting portfolio aims to discuss the proposed relationship between attachment and adolescent depression, highlighting the clinical relevance of this body of research with four cases of adolescent depression.

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Emotional intelligence includes one's ability to identify, use, understand and manage emotions. This thesis indicates that, when compared to peers with no convictions and those with violent convictions, adolescent sexual offenders have lower levels of emotional intelligence in general and, that, in particular, they had problems identifying, using and managing their emotions.

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Research has shown that female-perpetrated child sexual abuse is under-recognised. Three studies were undertaken concerning victims' experiences, professional perspectives and court sentencing transcripts. These studies found that victim impact was significant; professionals considered the phenomenon less serious than male sexual offending; and that female sexual offenders were dealt with less harshly than male offenders within the criminal justice system. The portfolio examines four case studies concerning adult females who have reported a history of child sexual abuse within the context of a dual-diagnosis counselling agency and investigates both psychological and behavioural difficulties revealed by each of the young women.

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This thesis examined the relationships between men's body image, different media influences, sexual orientation, and sexual risk taking. In comparison to heterosexuals, gay men were significantly less satisfied with their bodies. Media influences predicted men's body image, and gay men demonstrated greater internalisation of media messages compared to heterosexual men. Based on four case studies the portfolio demonstrates that motivational interviewing might be a useful approach to manage ambivalence and resistance to clients presenting with an anxiety disorder or a parent-child relational issue.

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Background

Ensuring the sexual and reproductive health of the population is essential for the wellbeing of a nation. At least three aspects of sexual and reproductive health are among the key policy issues for present Australian governments: maintaining and increasing the birth rate; reducing the abortion rate; and preventing and controlling Chlamydia infections.

The overall aim of the Australian Longitudinal Study of Health and Relationships is to document the natural history of the sexual and reproductive health of the Australian adult population.
Methods/design

A nationally representative sample of Australian adults 16–64 years of age was selected in a two-phase process in 2004–2005. Eligible households were identified through random digit dialling. We used separate sampling frames for men and women; where there was more than one eligible person in a household the participant was selected randomly. Participants completed a computer-assisted telephone interview that typically took approximately 25 minutes to complete. The response rate was 56%. A total of 8,656 people were interviewed, of whom 95% (8243) agreed to be contacted again 12 months later. Of those, approximately 82% have been re-contacted and re-interviewed in 2006–07 (Wave Two), with 99% of those agreeing to be contacted again for Wave Three.
Discussion

ALSHR represents a significant advance for research on the linked topics of sexual and reproductive health. Its strengths include the large sample size, the inclusion of men as well as women, and the wide age range of the participants.

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There has been limited evaluation of the effectiveness of psychological interventions for female sexual dysfunction (FSD). Further, none of these studies have evaluated the effectiveness of these interventions delivered over the internet. The current study evaluated an internet-based psychological treatment program for FSD. In total, 39 women (17 in treatment group, 19 in control group) completed the program. The results demonstrated that women who completed treatment reported improved sexual and relationship functioning in comparison to those who received no treatment. The portfolio draws on four case studies from the author's placement experience to demonstrate the role of negative life events, social support and psychological adjustment.

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Interviews with women regarding their experiences of sexual desire informed the development of the Female Sexual Desire Questionnaire. A validation sample of 741 women completed this questionnaire, with six interrelated factors found. These components of sexual desire were labelled: Dyadic Desire, Solitary Desire, Resistance, Positive Relationship, Sexual Self-image, and Concern. The portfolio concludes that a standard evaluation process is needed to assess the effectiveness of men's behaviour change groups (MBCGs), and that such programs should comprise only one component of a comprehensive multifaceted intervention strategy against intimate partner violence (IPV). Four case studies are presented.

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The thesis aimed to identify and compare individual differences in anger related affective responses upon exposure to neutral, violent and sexually violent film. The findings revealed that both graphic and non-graphic sexually violent film content may have a stronger impact on viewers' anger levels than exposure to standard violent film. The portfolio examined in four case studies the utility of the Violence Risk Scale when seeking to identify factors associated with risk of violent recidivism and subsequent treatment targets for intellectually disabled offenders . Treatment indications must consider the impaired cognitive and adaptive abilities and the difficulties inherent in modifying the behavioural characteristics of intellectually disabled offenders.