Development and Validation of the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults

PurposeWe developed and validated a measure that assesses the latent construct of sexual and reproductive empowerment among adolescents and young adults. A specific measure for this group is critical because of their unique life stage and circumstances, which often includes frequent changes in sexual partners and involvement from parents in decision-making.MethodsAfter formative qualitative research, a review of the literature, and cognitive interviews, we developed 95 items representing nine dimensions of sexual and reproductive empowerment. Items were then fielded among a national sample of young people aged 15–24 years, and those who identified as sexually active completed a 3-month follow-up survey. We conducted psychometric analysis and scale validation.ResultsExploratory factor analysis on responses from 1,117 participants resulted in the Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults, containing 23 items captured by seven subscales: comfort talking with partner; choice of partners, marriage, and children; parental support; sexual safety; self-love; sense of future; and sexual pleasure. Validation using logistic regression demonstrated that the subscales were consistently associated with sexual and reproductive health information and access to sexual and reproductive health services measured at baseline and moderately associated with the use of desired contraceptive methods at 3-month follow-up.ConclusionsThe Sexual and Reproductive Empowerment Scale for Adolescents and Young Adults is a new measure that assesses young people’s empowerment regarding sexual and reproductive health. It can be used by researchers, public health practitioners, and clinicians to measure sexual and reproductive empowerment among young people.     

Using Narrative practices in a group sex therapy context

ABSTRACT

Discussions of the machinations of sex and pleasure (as distinct from sexuality and LGBTIQ issues) have largely been absent from Narrative practices and as a result, little has been documented on how Narrative practices could work in a sex and pleasure therapy context. This essay describes a sex-focussed group therapy project using Narrative practices conducted in Melbourne, Australia spanning 15 weeks from April 2015 to September 2015. This paper covers the structure, practices, learnings, cohort and context, and offers a rationale and structure for other therapists to consider when doing the same. It examines the value of group process when discussing sex and pleasure as a powerful tool to reduce the stigma of sex and bring pleasure forward as a valid reason for seeking therapy.     

Anticipatory pleasure and approach motivation in schizophrenia-like negative symptoms

Previous research of negative symptoms in schizophrenia has emphasized an anticipatory pleasure deficit, yet the relationship of this deficit to patients' motivation in everyday life is poorly understood. This study tested the link between anticipatory pleasure and two broad motivational systems that are said to regulate the intensity of approach and avoidance behavior, the Behavioral Inhibition system (BIS) and the Behavioral Activation System (BAS). It was hypothesized that high vulnerability for negative symptoms would be associated with low reward responsiveness and that this association will be mediated by the amount of anticipated pleasure. Students (n=171) with varying vulnerability for negative symptoms (assessed by the Community Assessment of Psychic Experiences) completed questionnaires regarding (a) anticipatory and consummatory pleasure, and (b) responsiveness to threat and reward. As hypothesized, anticipatory pleasure correlated significantly negatively with subclinical negative symptoms (r=−0.21) and significantly positively with BAS (r=0.55). Furthermore, evidence for a partial mediation effect was found. The findings support the notion of a close association between negative symptoms, the ability to anticipate pleasure and approach motivation that is evident even in healthy persons. It is suggested that the behavioral deficits immanent to negative symptoms reflect difficulties in the ability to translate emotions into motivation.     

Ⅹ Ⅹ Ⅳ European Stroke Conference

<正>Time:May 12-15,2015Venue:Vienna,AustriaEmail:m.g.hennerici@eurostroke.euWebsite:http://www.eurostroke.eu/On behalf of the European Stroke Conference(ESC)Programme Committee it is my pleasure to invite you all to theⅩⅩⅣ     

生物技术实验教学的实践和思考

现代生物技术的发展如火如荼,精通生物技术的优秀医学人才供不应求。因此,加大生物技术教学的力度刻不容缓,在生物技术实验教学过程中采取如下举措:提高教师自身的综合素质;因时因地因材施教;愉快教学;注重能力培养;课程整合及课堂上合理规划时间,以更好地激发学生的求知欲,提高教学质量。     

Reward and the serotonergic system

Anhedonia, as a failure to experience rewarding stimuli, is a key characteristic of many psychiatric disorders including depression and schizophrenia. Investigations on the neurobiological correlates of reward and hedonia/anhedonia have been a growing subject of research demonstrating several neuromodulators to mediate different aspects of reward processing. Whereas the majority of research on reward mainly focused on the dopamine and opioid systems, a serotonergic mechanism has been neglected. However, recent promising results strengthen the pivotal role of serotonin in reward processing. Evidence includes electrophysical and pharmacological as well as genetic and imaging studies. Primate research using single-unit recording of neurons within the dorsal raphe nucleus argues for a serotonergic mediation of reward value, whereas studies using intracranial self-stimulation point to an important contribution of serotonin in modulating motivational aspects of rewarding brain stimulation. Pharmacological studies using agonists and antagonists of serotonergic receptor subtypes and approaches investigating an increase or decrease of the extracellular level of serotonin offer strong evidence for a serotonergic mediation, ranging from aversion to pleasure. This review provides an argument for serotonin as a fundamental mediator of emotional, motivational and cognitive aspects of reward representation, which makes it possibly as important as dopamine for reward processing.     

Anticipatory Pleasure Skills Training: A New Intervention to Reduce Anhedonia in Schizophrenia

PURPOSE. Anhedonia is a challenging symptom of schizophrenia and remains largely recalcitrant to current pharmacological treatments. The goal of this exploratory pilot study was to assess if a cognitive–sensory intervention could improve anticipatory pleasure. DESIGN AND METHODS. Five participants meeting the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) criteria for schizophrenia, presenting severe anhedonia and stabilized on atypical antipsychotic medication, received between 10 hours and 25 hours of training. FINDINGS. Results show that the patients improved on the anticipatory scale of the Temporal Experience of Pleasure Scale. Daily activities of the patients were also increased. PRACTICE IMPLICATIONS. These preliminary data need to be interpreted with caution given the small sample of the study, but they offer promising paths to develop new interventions to alleviate anhedonia in schizophrenia.     

Love the gap: Embodied longing for the other in the therapeutic space

ABSTRACT

This article explores the phenomenon of ‘embodied longing’ through a sequence of creative and relational events in the author’s personal therapy with a male psychotherapist. Following the evolution of her somatic body map, crafted inside and outside of sessions, the author illustrates her dynamic engagement with ‘the other’ within and without as a woman in flesh and blood. Pivoting around cellular memory of her conception and loss of a twin brother shortly after conception, this article brings together sensuous exploration of sexuality and critical reflection on gender identity from the vantage point of pre-natal development.     

Pain relief as an opponent process: a psychophysical investigation

Relief from pain in humans is frequently measured by computing the reduction on an 11-point pain intensity scale. However, this definition of relief may be insufficient to capture the utility of pain relief for the individual. Based on pain literature and evidence from studies examining relief and reward, it is clear that pain relief is a broad concept comprising several factors, only one of which is pain intensity reduction. According to opponent process theory, all sensations consist of a primary process and a slow 'opponent process' of opposite valence, the purpose of which is to reduce the deviation from homeostatic balance. Here, opponent process theory provided a framework to explore the interaction between pain, relief and reward. We devised three psychophysical studies examining the temporal (Experiment I) and magnitude (Experiments I and II) relationships between pain severity and its subsequent relief. In Experiment III, we further manipulated the magnitude and pleasantness of relief experienced by applying innocuous cooling following noxious heat stimulation of capsaicin-sensitized skin. Results confirmed predictions from opponent process theory and showed that pain intensity reduction was significantly stronger than relief intensity ratings. Furthermore, continuous relief ratings appeared to reflect the speed of pain intensity reduction. Varying pain intensity parametrically confirmed that relief increases with pain intensity. That innocuous cooling following primary hyperalgesia intervention significantly increased the intensity, pleasantness and duration of relief provides further evidence that pain relief encapsulates more than a reduction in pain intensity. Importantly, the high relief pleasantness ratings confirmed the hypothesized link between relief and reward.