Relationships between affective components and sexual behaviors in sexual aggressors

The aim of the current study was to verify whether relationships exist in sexual aggressors between affective components (moods and emotions following conflicts) and sexual behaviors (fantasies and masturbatory activities during such fantasies). We therefore developed the Fantasy Report, a self-assessment method for recording affective components and sexual behaviors. Nineteen rapists, 12 heterosexual pedophiles, and 8 homosexual pedophiles filled out the Fantasy Report every 2 days for 2 months. In rapists and heterosexual pedophiles, negative moods and conflicts coincided with overwhelming deviant sexual fantasies and increased masturbatory activities during such fantasies. For the homosexual pedophiles, the data revealed a significant relationship only between affective components and deviant sexual fantasies. The emotions most frequently reported were anger, loneliness, and humiliation by the rapists, loneliness and humiliation by the heterosexual pedophiles, and loneliness by the homosexual pedophiles. These data are discussed on the basis of the Relapse Prevention Model.     

The role of parent-child bonding, attachment, and interpersonal problems in the development of deviant sexual fantasies in sexual offenders

To understand the origin, development, and functions of deviant sexual fantasy in sexual offenders, the present article investigates three areas of the literature on sexual offenders (i.e., parent-child relationships, attachment, and interpersonal problems), hypothesizing a possible path through which dysfunctional parent-child relationships might lead to deviant sexual fantasies. The review of the literature provides indirect evidence that an insecure attachment style developed in response to dysfunctional parenting practices may generate feelings of inadequacy and inferiority to others and a lack of the self-confidence and social skills to initiate or maintain consensual intimate relationships with appropriate others. It is hypothesized that such problems, in turn, might promote low levels of intimacy and satisfaction in romantic relationships and serious and chronic emotional loneliness, withdrawal, and negative attitudes (such as anger and hostility) toward potential partners, leading to a progressive retirement from the real world and refuge in an internal world of deviant sexual fantasies in order to satisfy attachment-related needs for intimacy, emotional closeness, or power. Such a combination of insecure attachment, interpersonal problems, and use of deviant sexual fantasies as a means to achieve the intimacy, power, or control absent from reality might predispose to sexual offending.     

An Exploration of Developmental Factors Related to Deviant Sexual Preferences Among Adult Rapists

The aim of this study was to investigate developmental factors related to deviant sexual preferences in a sample of 118 sexual aggressors against women. For each subject, developmental factors were collected through a semistructured interview, whereas sexual preferences were assessed phallometrically using French translations of audiotaped stimuli developed by G. G. Abel, E. B. Blanchard, J. V. Becker, and A. Djenderedjian (1978). Using multiple regression analyses, our results showed that a sexually inappropriate family environment, use of pornography during childhood and adolescence, and deviant sexual fantasies during childhood and adolescence are related to the development of deviant sexual preferences. These results are in agreement with Knight and Sims-Knight's model of sexual aggression (R. A. Knight & J. E. Sims-Knight, in press).     

The Sexual Histories and Fantasies of Youthful Males: A Comparison of Sexual Offending,Nonsexual Offending,and Nonoffending Groups

The present clinical and theoretical literature suggests that adolescents' sexual histories and fantasies are factors contributing to the onset and perpetuation of criminal sexual behaviors. However, few data exist either to support or to refute such assertions. The purpose of the present study was to describe the self-reported sexual histories and fantasies of four groups: 104 incarcerated adolescent sexual offenders between 10 and 15 years of age, 198 16- to 20-year-old incarcerated sexual offenders, 124 incarcerated youth without a history of sexual offending, and 135 male nonoffending undergraduates. Youthful sexual offenders reported fewer consenting sexual experiences and more involvement in nonconsenting and paraphilic behaviors than both incarcerated nonsexual offenders and college males. Moreover, both sexual offenders and incarcerated nonsexual offenders reported more atypical and voyeuristic experiences, and fewer nondeviant sexual fantasies than college males. These results are discussed in terms of both social deficit and deviant conditioning models of sexual offending, leading to speculation that, contrary to clinical lore, criminal activity may be associated with suppressed levels of nondeviant fantasy rather than elevated levels of deviant fantasy.     

Considerations on Fantasy Use by Child Molesters and Exhibitionists

In many sex offender treatment programs, the examination and replacement of deviant fantasy use with appropriate fantasy use is a well-established practice. This practice is based on the assumption that sexual offenders use deviant masturbatory fantasies prior and after committing sexual offenses, but the data available to support this assumption is fairly limited. This study attempted to test the validity of this assumption by finding out whether a majority of exhibitionistic offenders and child molesters used deviant masturbatory fantasies prior and/or after their first offense. Data analysis from 57 child molesters and 25 exhibitionistic offenders indicate that a majority of these offenders used masturbatory deviant fantasies before and after their first offenses, but they tended to use significantly more deviant fantasies after they engage in their first actual offense. Content of deviant fantasies was examined in relation to victim specificity. There were no significant differences between the number of deviant fantasies reported about a specific victim versus the number of fantasies reported about a nonspecific victim. We found a significant positive correlation between the number of deviant fantasies reported and the number of months spent in treatment by child molesters, but not by exhibitionistic offenders. Some tentative explanations for these findings are offered, but further elucidation is necessary.     

Predictors of Recidivism in Australian Juvenile Sex Offenders: Implications for Treatment

Juvenile sex offenders charged with their first sexual offence were compared with recidivist juvenile sex offenders who had been charged with more than one sexual offence on a number of factors related to sexual offending. Participants were 70 male juvenile sex offenders, aged 13–21 years who were awaiting court disposition. Negative family history, negative family characteristics, school and learning problems, social skill deficits, deviant sexual experiences, deviant sexual fantasies, and cognitive distortions were assessed for their direct and mediating roles in recidivism. Path analysis indicated that poor social skills, learning problems, and deviant sexual experiences were causally related to recidivism of sexual offending. Poor social skills were directly related to recidivism, whereas cognitive distortions and deviant sexual fantasies mediated the role of learning problems and deviant sexual experiences. There was a significant association between deviant sexual experience and learning problems. The findings support the role of cognitive distortions and deviant sexual fantasies in recidivist sexual offending for this sample. The causal role identified for poor social skills and learning problems in recidivism for sexual offending has implications for treatment and therefore deserves further attention.     

What treatment do sex offenders want?

Eighty-seven sex offenders being assessed pretrial and presentence or posttrial for probation/parole were administered a questionnaire inquiring about desire for treatment, acceptable types of treatment and the nature of any problems, as perceived by the offenders. Three groups were examined: sexual aggressors against adult females, incest perpetrators, and pedophilic offenders. In spite of their legal circumstances, only 49.4% of the sex offenders wanted treatment. The preferred therapies were individual psychotherapy, social skills training and group therapy. The most frequently used therapy for sex offenders, namely, aversion conditioning, was among the least acceptable, along with castration, sex drive reducing drug therapy, and, paradoxically, group therapy. Male therapists were preferred more than twice as often as female therapists. Sex offenders saw interpersonal relations and lack of social skills as their major problems. Many were concerned about coping with the sequelae of their crimes. Less than two in five considered their anomalous sexual behavior to be a problem for them. Results suggest that there is considerable disparity between therapists' application of treatment and the offenders' perceptions of their own needs. Improving congruence between therapist and offender-patient goals may enhance treatment compliance and therapy success for sex offenders generally.     

Headache as a Stressor: Dysfunctional versus Adaptive Coping Styles

The common stressor faced by all headache sufferers is the headache itself. Dysfunctional headache coping styles can be classified as sensitizing (hypervigilance and anticipation, catastrophizing, hyperempathy) or minimizing (alexithymia, stoic denial, anger suppression). Dysfunctional coping often takes place in an interpersonal context (theater of pain), marked by excessive pain behavior and embellishment, catastrophizing and hypervigilance in the family, stoicism and misinterpretation of pain, pain language as a substitute for emotional expression, or enabling of disability and pseudo-coping. More adaptive coping styles include balanced use of distraction and body awareness, strategic proactive coping, balanced interpersonal discussion of pain, and pain acceptance. In addition to headache-related research on coping styles, this article reviews relevant studies from neuroimaging, non-headache chronic pain disorders, and clinical experience in a comprehensive, multidisciplinary headache center.     

Coping during inpatient stroke rehabilitation: an exploratory study.

The emotional impact of surviving a stroke has not received the same attention as physical aspects. This is particularly true regarding how stroke survivors cope during inpatient rehabilitation. This study examined the coping strategies used by stroke survivors undergoing inpatient rehabilitation and the relationships between demographic or clinical variables and coping behaviors. This case series examined 16 acute stroke survivors via standardized assessments and a medical records review completed during the first week of inpatient rehabilitation. Stroke survivors used combinations of multiple coping strategies. All stroke survivors used a higher number and frequency of adaptive rather than maladaptive strategies. Women used a higher number of adaptive strategies. Stroke survivors with depression used maladaptive coping strategies more frequently, whereas those presenting with a greater number and severity of comorbidities used adaptive coping strategies more frequently. Stroke survivors with higher levels of coping self-efficacy used the strategies of active coping and positive reframing more frequently. Based on these results, it is recommended direct-care providers place greater emphasis on objectifying the emotional consequences of stroke. Further research is recommended regarding understanding the relationship between coping and outcomes.     

Methods of coping with neoplastic disease in men with non-muscle-invasive bladder cancer

Only limited data evaluating coping methods in patients with bladder cancer are available in the literature. Also, it is unclear how the mental status of these patients affects their stress coping strategies. The aim of the study was to evaluate the stress coping strategies in patients with non-muscle-invasive bladder cancer (NMIBC) and to assess the impact of sociodemographic factors, presence of anxiety and depressive symptoms and degree of sexual satisfaction on stress coping strategies. This prospective cohort study included 100 male patients qualified for control cystoscopy who underwent at least one transurethral resection of bladder tumour (TURB) procedure in the past for NMIBC and at least one control cystoscopy. The minimal follow-up period after primary TURB was 1 year. The MiniCOPE, the Hospital Anxiety and Depression Scale and the Sexual Satisfaction Questionnaire were used. The questionnaires were completed anonymously before cystoscopy in a room that provided privacy. Majority patients with NMIBC chosen adaptive strategies, with ‘accepting’ and ‘seeking emotional support’ being the most common. The choice of strategy was influenced by the severity of anxiety and depressive symptoms as well as the level of sexual satisfaction and pain sensations. Also, sociodemographic variables, such as marriage status, progeniture or the level of education played a role in strategy selection. The results of this study indicate that patients with NMIBC choose adaptive stress coping strategies. It also provides a better understanding of the impact of various aspects of mental health in patients with NMIBC on coping with stress. Each patient treated for NMIBC should undergo appropriate psychological and sociodemographic evaluation, which will allow easier identification of patients at high risk of treatment and postoperative surveillance discontinuation.     

Development and preliminary validation of a paraphilic sexual fantasy questionnaire

A sexual fantasy questionnaire (SFQ) measuring paraphilic and nonparaphilic fantasies was developed. Aspects of reliability were assessed in a sample of convicted male child molesters (27 inmates and 15 outpatients) and a convenience comparison group of 87 male undergraduates. Results indicated adequate test-retest reliability (mean r=.84), acceptable percentage agreement on repeated items (90%), and adequate internal consistency (mean Cronbach alpha=.82). The convergent validity of the SFQ was supported by the finding that child molesters reported significantly more deviant fantasies involving children than comparison subjects. Consistent with previous research, child molesters reported a similar number of normal sexual fantasies.     

Differences in Automatic Thoughts Presented During Sexual Activity Between Sexually Functional and Dysfunctional Men and Women

The study is aimed at investigating the differences between individuals with and without sexual dysfunction on the automatic thoughts content (reported as usually presented) during sexual activity. A total of 491 individuals (163 women and 232 men without sexual problems and 47 women and 49 men with a DSM-IV diagnosis of sexual dysfunction) answered the Sexual Modes Questionnaire (SMQ; Nobre and Pinto-Gouveia (J Sex Res 40:368–382, 2003). Results indicated that men and women with sexual dysfunction reported having had significantly more negative thoughts during sexual activity compared to sexually healthy individuals. Failure and disengagement thoughts (I’m not satisfying my partner, I’m not getting turned on, when will this be over?), sexual abuse thoughts (this is disgusting, he only wants to satisfy himself), and lack of erotic thoughts were significantly more common in women with sexual dysfunction compared to sexually healthy women. Additionally, men with sexual dysfunction presented significantly higher scores on erection concern thoughts (I must be able to have intercourse, I must achieve an erection), failure anticipation thoughts (this is not going anywhere, I’m condemned to failure), and lack of erotic thoughts compared to men without sexual dysfunction. Overall, findings support clinical observations and experimental findings, indicating that cognitive distraction from erotic cues is strongly associated with sexual dysfunction. The increased use of cognitive techniques on the treatment of sexual dysfunction is a major implication of the study.     

Association of daily hassles,daily uplifts,coping styles and stress-related symptoms among women exposed to sexual abuse—A cross-sectional study

Background

Women who experience physical or sexual violence report poor self-perceived health. Knowledge of daily hassles, daily uplifts and coping styles, as well as how these factors can affect health and well-being among survivors of sexual abuse, is important for healthcare professionals to understand and target their needs.

Aim

The aim of the current study was to explore the association of daily hassles, daily uplifts, coping strategies and stress-related symptoms among female survivors of sexual abuse.

Methods

A group of women (n = 57), exposed to sexual abuse, were recruited from nine support centres in Norway. Participants completed a questionnaire that addressed demographics, socioeconomic conditions, trauma history, daily hassles, daily uplifts, coping styles and stress-related symptoms. Two groups of participants were compared: one group that had above-median scores on uplifts and adaptive coping styles and one group that had above-median scores on daily hassles and maladaptive coping styles.

Results

Results indicate that women who experienced more daily hassles and used maladaptive coping styles reported significantly more stress-related symptoms, and particularly emotional symptoms, than women who experienced more daily uplifts and used adaptive coping styles. There were few differences between the two groups related to socioeconomic conditions and trauma history.

Conclusion

The results indicate that women in both groups struggle with stress-related physical, emotional, cognitive and target group-specific symptoms. However, high incidence of daily hassles and the use of maladaptive coping styles were associated with an increase in stress-related symptoms. Novell’s findings indicate that despite severe traumatic experiences, adaptive coping styles and favourable perceptions of stress in everyday life were associated with a lower frequency of stress-related symptoms. It may therefore be helpful to focus on altering maladaptive coping styles to reduce stress-related symptoms among sexual abuse survivors.     

Mechanisms of psychological adaptation of anesthesiologists-resuscitators to the stress-induced conditions of professional occupation and possibilities of their correction within a teaching process

High psychological tension results in the development of specific coping behavior. Ninety-six anesthesiologists, including 62 (64.6%) males and 34 (35.4%) females, were examined to reveal the mechanisms of psychological adaptation to stress-induced conditions of professional occupation. The respondents were ascertained to most frequently use cognitive, emotional, and behavioral constructive copings in settling stress situations. Nonadaptive copings most commonly contemplate a refusal to get over difficulties due to the lack of faith in power, to the underestimation of the importance of negative events, to passivity, isolation, etc., which is traditionally considered to be a manifestation of the emotional burnout syndrome in attendants. Psychological training within a teaching process may be regarded as a help to physicians in developing constructive coping strategies, training in self-diagnosis and self-help in the early manifestations of emotional burnout.     

Childhood Attachments,Sexual Abuse,and Their Relationship to Adult Coping in Child Molesters

The present study examined the parent–child attachments, typical coping styles, and childhood sexual abuse among 30 child molesters, 24 nonsexual offenders, and 29 nonoffenders. The results indicated that all subjects reported greater security in their attachments to their mothers than to their fathers and the insecure patterns of childhood attachments were related to ineffective adult coping. The only difference observed in characteristic coping showed that child molesters were more likely to engage in emotion focused strategies. Child molesters reported having experienced high levels of childhood sexual abuse and these experiences appear to have been more distressing to them than to other subjects. The results are discussed in terms of their implications for theory and treatment.