Healthy sexual development : a multidisciplinary framework for research

A group of Australian researchers from a range of disciplines involved in studying children's sexual development developed a framework for researching healthy sexual development that was acceptable to all disciplines involved. The 15 domains identified were: freedom from unwanted activity; an understanding of consent; education about biological aspects; understanding of safety; relationship skills; agency; lifelong learning; resilience; open communication; sexual development should not be “aggressive, coercive or joyless;” self-acceptance; awareness and acceptance that sex is pleasurable; understanding of parental and societal values; awareness of public/private boundaries; and being competent in mediated sexuality.

Rumination, post-traumatic growth, and distress : structural equation modelling with cancer survivors

Objective Theoretical models of post-traumatic growth (PTG) have been derived in the general trauma literature to describe the post-trauma experience that facilitates the perception of positive life changes. To develop a statistical model identifying factors that are associated with PTG, structural equation modelling (SEM) was used in the current study to assess the relationships between perception of diagnosis severity, rumination, social support, distress, and PTG. Method A statistical model of PTG was tested in a sample of participants diagnosed with a variety of cancers (N=313). Results An initial principal components analysis of the measure used to assess rumination revealed three components: intrusive rumination, deliberate rumination of benefits, and life purpose rumination. SEM results indicated that the model fit the data well and that 30% of the variance in PTG was explained by the variables. Trauma severity was directly related to distress, but not to PTG. Deliberately ruminating on benefits and social support were directly related to PTG. Life purpose rumination and intrusive rumination were associated with distress. Conclusions The model showed that in addition to having unique correlating factors, distress was not related to PTG, thereby providing support for the notion that these are discrete constructs in the post-diagnosis experience. The statistical model provides support that post-diagnosis experience is simultaneously shaped by positive and negative life changes and that one or the other outcome may be prevalent or may occur concurrently. As such, an implication for practice is the need for supportive care that is holistic in nature.

Immigration distress and associated factors among Vietnamese momen in transnational marriages in Taiwan

The purpose of this study was to explore the types and predictors of immigration distress among Vietnamese women in transnational marriages in Taiwan. A cross-sectional survey with face-toface interviews was conducted for data collection. A convenient sample of 203 Vietnamese women in transnational marriages in southern Taiwan was recruited. The Demographic Inventory measured the participants’ age, education, employment status, religion, length of residency and number of children, as well as their spouse’s age, education, employment status and religion. The Demand of Immigration Specific Distress scale measured the level of distress and had six subscales: loss, novelty, occupational adjustment, language accommodation, discrimination and alienation. Among the 203 participants, 6.4% had a high level of immigration distress; 91.1% had moderate distress; and 2.5% had minor distress. Higher mean scores were found for the loss, novelty and language accommodation subscales of the Demand of Immigration specific Distress scale. Participant’s (r = 0.321, p < 0.01) and spouse’s (r = 0.375, p < 0.01) unemployment, and more children (r = 0.129, p < 0.05) led to greater immigration distress. Length of residency in Taiwan (r = 0.576, p < 0.001) was an effective predictor of immigration distress. It indicated that the participants who had stayed fewer years in Taiwan had a higher level of immigrant distress. Health care professionals need to be aware that the female newcomers in transnational marriages are highly susceptible to immigration distress. The study suggests that healthcare professionals need to provide a comprehensive assessment of immigration distress to detect health problems early and administer culturally appropriate healthcare for immigrant women in transnational marriages.

Workplace sexual harassment 30 years on : a review of the literature

Despite its proscription in legal jurisdictions around the world, workplace sexual harassment (SH) continues to be experienced by many women and some men in a variety of organizational settings. The aims of this review article are threefold: first, with a focus on workplace SH as it pertains to management and organizations, to synthesize the accumulated state of knowledge in the field; second, to evaluate this evidence, highlighting competing perspectives; and third, to canvass areas in need of further investigation. Variously ascribed through individual (psychological or legal consciousness) frameworks, sociocultural explanations and organizational perspectives, research consistently demonstrates that, like other forms of sexual violence, individuals who experience workplace SH suffer significant psychological, health- and job-related consequences. Yet they often do not make formal complaints through internal organizational procedures or to outside bodies. Laws, structural reforms and policy initiatives have had some success in raising awareness of the problem and have shaped rules and norms in the employment context. However, there is an imperative to target further workplace actions to effectively prevent and respond to SH.

The psychological distress of the young driver : a brief report

Objective: To explore the role of psychological distress in the self-reported risky driving of young novice drivers. Design: Cross-sectional online survey of 761 tertiary students aged 17-25 years with an intermediate (Provisional) driving licence who completed Kessler’s Psychological Distress Scale and the Behaviour of Young Novice Drivers Scale. Setting: Queensland, Australia, August-October 2009. Main outcome measures: Psychological distress, risky driving. Results: Regression analyses revealed that psychological distress uniquely explained 8.5% of the variance in young novice’s risky driving, with adolescents experiencing psychological distress also reporting higher levels of risky driving. Psychological distress uniquely explained a significant 6.7% and 9.5% of variance in risky driving for males and females respectively. Conclusions: Medical practitioners treating adolescents who have been injured through risky behaviour need to aware of the potential contribution of psychological distress, whilst mental health professionals working with adolescents experiencing psychological distress need to be aware of this additional source of potential harm. The nature of the causal relationships linking psychological distress and risky driving behaviour are not yet fully understood, indicating a need for further research so that strategies such as screening can be investigated.

Below the ‘tip of the iceberg’: extra-legal responses to workplace sexual harassment

Despite longstanding and explicit legal frameworks for preventing and responding to sexual harassment, only a small proportion of those sexually harassed use legal avenues of redress to seek justice. In contrast to legal cases which constitute the ‘tip of the iceberg’, this study examines extra-legal strategies — the less visible but more frequent, ‘everyday’, formal and informal organizational practices. We report on a national prevalence survey conducted by the Australian Human Rights Commission which examined how ‘targets’ use formal organizational grievance mechanisms, and/or other informal methods to redress, resist or avoid workplace sexual harassment. The findings revealed that the majority of targets do not formally report it because of fear of retribution or that nothing will be done, but they sometimes use apparently proactive or assertive alternative strategies, such as seeking informal assistance and ‘dealing with the problem themselves’. These responses occur in the context of extra-legal facets of organizational life which affect the extent to which sexual harassment and other unfavorable and discriminatory acts are tolerated.

Parents’ views about child sexual abuse prevention education : a systematic review

This paper presents the results of a systematic review of literature on the topic of parents’ views about child sexual abuse prevention education. It describes: i) what parents know about child sexual abuse prevention education; ii) what child sexual abuse prevention messages parents provide to their children and what topics they discuss; iii) what parents’ attitudes are towards child sexual abuse prevention education in schools; and iv) their preferences for content. Electronic database searches were conducted to identify relevant literature published in English relating to child sexual abuse prevention programs and parent’s views. A total of 429 papers were evaluated with 13 studies identified as meeting the study’s inclusion criteria. Worldwide, empirical research on parents’ views about child sexual abuse prevention programs is limited and more research is needed in Australia. Implications for future research and practice are outlined.

Feasibility of brief psychological distress screening by a community-based telephone helpline for cancer patients and carers

Background Up to one-third of people affected by cancer experience ongoing psychological distress and would benefit from screening followed by an appropriate level of psychological intervention. This rarely occurs in routine clinical practice due to barriers such as lack of time and experience. This study investigated the feasibility of community-based telephone helpline operators screening callers affected by cancer for their level of distress using a brief screening tool (Distress Thermometer), and triaging to the appropriate level of care using a tiered model. Methods Consecutive cancer patients and carers who contacted the helpline from September-December 2006 (n = 341) were invited to participate. Routine screening and triage was conducted by helpline operators at this time. Additional socio-demographic and psychosocial adjustment data were collected by telephone interview by research staff following the initial call. Results The Distress Thermometer had good overall accuracy in detecting general psychosocial morbidity (Hospital Anxiety and Depression Scale cut-off score ≥ 15) for cancer patients (AUC = 0.73) and carers (AUC = 0.70). We found 73% of participants met the Distress Thermometer cut-off for distress caseness according to the Hospital Anxiety and Depression Scale (a score ≥ 4), and optimal sensitivity (83%, 77%) and specificity (51%, 48%) were obtained with cut-offs of ≥ 4 and ≥ 6 in the patient and carer groups respectively. Distress was significantly associated with the Hospital Anxiety and Depression Scale scores (total, as well as anxiety and depression subscales) and level of care in cancer patients, as well as with the Hospital Anxiety and Depression Scale anxiety subscale for carers. There was a trend for more highly distressed callers to be triaged to more intensive care, with patients with distress scores ≥ 4 more likely to receive extended or specialist care. Conclusions Our data suggest that it was feasible for community-based cancer helpline operators to screen callers for distress using a brief screening tool, the Distress Thermometer, and to triage callers to an appropriate level of care using a tiered model. The Distress Thermometer is a rapid and non-invasive alternative to longer psychometric instruments, and may provide part of the solution in ensuring distressed patients and carers affected by cancer are identified and supported appropriately.

The prevalence and correlates of postcoital dysphoria in women

This study examined the lifetime and 4-week prevalence of postcoital dysphoria (PCD) and its relationship with psychological distress and reports of past sexual abuse. Amongst 222 female university students, 32.9% reported having ever experienced PCD while 10% reported experiencing PCD in the previous four weeks. Multiple regression analyses revealed support for the hypothesis that lifetime and 4-week prevalence of PCD would be positively correlated with psychological distress. Lifetime prevalence of PCD, but not 4-week prevalence, correlated with reports of childhood sexual abuse. These factors explained only minimal variance in PCD prevalence, prompting further research into this significantly under-investigated sexual difficulty.

‘Just stupid drama queens’ : how police constrain, regulate, and punish the public visibilities of sexual/gender diversity as out of place

Using interview data on LGBT young peoples’ policing experiences, I argue policing practices work to constrain public visibilities of sexual and gender diversity in public spaces. Police actions recounted by LGBT young people suggest the workings of a certain kind of visuality (Mason, 2002) and evidenced more subtle actions that sought to constrain, regulate, and punish public visibilities of sexual and gender diversity. Aligning with the work of sexualities academics and theorists, this paper suggests that, like violence is itself a bodily spectacle from which onlookers come to know things, policing works to subtly constrain public visibilities of “queerness”. Policing interactions with LGBT young people serves the purpose of visibly yet unverifiably (Mason, 2002) regulating displays of sexual and gender diversity in public spaces. The paper concludes noting how police actions are nonetheless visible and therefore make knowable to the public the importance of keeping same sex intimacy invisible in public spaces.

A Sexual Health Programme Implemented in a Psychiatric Inpatient Unit

Research has shown that people with a mental illness are an at-risk group for sexually transmitted infections. A programme for preventing risk behaviours for sexually transmitted infections among people with psychiatric disorder was designed and implemented by mental health occupational therapists. This programme used an interactive didactic approach to provide education and awareness of sexual health issues to acute psychiatric inpatients. Twenty-four participants completed a sexual health questionnaire, which was designed for this study, both before and after attending the programme. They had a higher than expected knowledge of sexually transmitted infections and safe sex practices at pre-test. The education programme resulted in a statistically significant but modest increase in sexual health knowledge. These findings indicate that there are benefits in providing sexual health education to clients with a mental illness. Further programme development should be directed towards sexual health decision-making and behaviour change.

Sh-h-h-h : representations of perpetrators of sexual child abuse in picturebooks

Children’s picturebooks dealing with the topic of child sexual abuse first appeared in the early 1980s with the aim of addressing the need for age-appropriate texts to teach sexual abuse prevention concepts and to provide support for young children who may be at risk of or have already experienced sexual abuse. Despite the apparent potential of children’s picturebooks to convey child sexual abuse prevention concepts, very few studies have addressed the topic of child sexual abuse in children’s literature. Based on a larger study of 60 picturebooks about sexual child abuse published over the past 25 years, this paper critically examines eight picturebook representations of the perpetrators of sexual child abuse as a way to understand how potentially dangerous adults are explained to the young readers of these texts.

Effects of disclosure of sexual identity at work for gay, lesbian, bisexual, transgender and intersex (GLBTI) employees in Queensland

All Australian businesses are governed by legislation aiming to prevent workplace discrimination based on sexual orientation and sexual identity and serious penalties apply to companies found contravening legislation. While other Australian studies have examined these issues, Queensland has either not been included or relevant data is not easily identified. This paper presents the results of an exploratory study using a quantitative survey to determine the consequences of disclosure of a person’s sexual orientation or gender identity to colleagues in workplaces in Queensland. Results suggest GLBTI workers are disclosing their sexuality more and are experiencing more discrimination in the workplace, despite anti-discrimination policies. This suggests the need to further investigate companies’ compliance with workplace legislation.

When does pain and distress relief hastening death become killing?

This paper discusses the question of when pain and distress relief known to hasten death would cross the line between permissible conduct and killing. The issue is discussed in the context of organ donation after cardiac death, and considers the administration of analgesics, sedatives, and the controversial use of paralysing agents in the provision and withdrawal of ventilation.

Methods used in cross-cultural comparisons of sexual symptoms and their determinants

This is the fourth in a series of reviews of cross-cultural studies of menopausal symptoms. The purpose of this review is to examine methods used in cross-cultural comparisons of sexual symptoms among women at midlife, and to examine the determinants of sexual symptoms and how those determinants were measured. The goal of this review is to make recommendations that will improve cross-cultural comparisons in the future. The review included nine studies that explicitly examined symptoms in different countries or different ethnic groups in the same country and included: Australian/Japanese Midlife Women's Health Study (AJMWHS), Decisions At Menopause Study (DAMeS), Four Major Ethnic Groups (FMEG), Hilo Women's Health Survey (HWHS), Mid-Aged Health in Women from the Indian Subcontinent (MAHWIS), Penn Ovarian Aging Study (POAS), Study of Women's Health Across the Nation (SWAN), Women's Health in Midlife National Study (WHiMNS), and Women's International Study of Health and Sexuality (WISHeS). Although methods used for assessing sexual symptoms across cultures differed between studies, statistically significant differences were reported. Cross-cultural differences in sexual symptoms exist, and should be measured by including the following symptoms: loss of interest in sex, vaginal dryness, and the Females Sexual Function Index which covers desire, arousal, lubrication, orgasm, satisfaction, and pain on intercourse. The measurement of these symptoms will provide an evidence-based approach when forming any future menopause symptom list and allow for comparisons across studies.