"Finding My Worth as a Sexual Being": A Qualitative Gender Analysis of Sexual Self-Concept and Coping in Survivors of Childhood Sexual Abuse.

Childhood sexual abuse (CSA) is likely to have impacts on adult survivors' sexuality, particularly on their sexual self-concept. However, little is known about how survivors cope with CSA-related sexual impacts, including sexual self-concept impairments. Thus, this study aimed to examine the interplay between sexual self-concept and coping strategies in CSA survivors by (1) documenting the manifestations of their impaired sexual self-concepts; (2) identifying their strategies to cope with the sexual impacts of CSA; and (3) examining gender differences on sexual self-concept impairments and coping strategies. Content analysis was conducted on semi-structured interviews with 25 women and 26 men adult survivors of CSA recruited via social networks and victim support organizations. Analyses yielded three conceptual categories: (1) Developing an unconsolidated and unfavorable sexual self-concept following CSA; (2) Avoiding CSA-related sexual impacts and impaired sexual self-concept; (3) Approaching CSA-related sexual impacts with more authenticity. Men often managed their suffering and compensated for their impaired sexual self-concept by engaging in sexual dominance and over-investment, by accepting their sexual difficulties and relying on medication to overcome them. Women tended to restrict themselves and disconnect sexually to avoid suffering, complied with their partners' sexual demands out of a sense of duty, prioritized sexual intimacy over orgasm, and seek professional help. Interventions with survivors should promote the development of approach strategies to cope with sexual difficulties, including self-concept impairments, and foster sexual authenticity.

Auditory and somatosensory feedback mechanisms of laryngeal and articulatory speech motor control.

PURPOSE: Speech production is a complex motor task involving multiple subsystems. The relationships between these subsystems need to be comprehensively investigated to understand the underlying mechanisms of speech production. The goal of this paper is to examine the differential contributions of 1) auditory and somatosensory feedback control mechanisms, and 2) laryngeal and articulatory speech production subsystems on speech motor control at an individual speaker level using altered auditory and somatosensory feedback paradigms. METHODS: Twenty young adults completed speaking tasks in which sudden and unpredictable auditory and physical perturbations were applied to the laryngeal and articulatory speech production subsystems. Auditory perturbations were applied to laryngeal or articulatory acoustic features of speech. Physical perturbations were applied to the larynx and the jaw. Pearson-product moment correlation coefficients were calculated between 1) auditory and somatosensory reflexive responses to investigate relationships between auditory and somatosensory feedback control mechanisms, and 2) laryngeal and articulatory reflexive responses as well as acuity measures to investigate the relationship between auditory-motor features of laryngeal and articulatory subsystems. RESULTS: No statistically significant correlations were found concerning the relationships between auditory and somatosensory feedback. No statistically significant correlations were found between auditory-motor features in the laryngeal and articulatory control subsystems. CONCLUSION: Results suggest that the laryngeal and articulatory speech production subsystems operate with differential auditory and somatosensory feedback control mechanisms. The outcomes suggest that current models of speech motor control should consider decoupling laryngeal and articulatory domains to better model speech motor control processes.

Experiences of Disclosure and Reactions of Close Ones from the Perspective of Child Sexual Abuse Survivors: A Qualitative Analysis of Gender Specificities.

The disclosure of child sexual abuse (CSA) is a complex process that remains partially understood, despite its crucial role in survivors' recovery. Gender specific experiences of disclosure have been little investigated while this information is crucial to better tailor interventions for survivors. This qualitative study aims to 1) explore survivors' experiences in disclosing to close ones, and 2) contrast experiences of male and female survivors. Fifty-one CSA survivors (25 women and 26 men) aged 18 years or older were recruited via community services for survivors. Two main categories emerged from thematic content analysis: 1) experiences of disclosure hindering CSA recovery or 2) ones fostering CSA recovery. Men felt ignored when their close ones were focused on their own emotions of indifference, helplessness and guilt toward CSA. Men felt guilty when confronted with reactions of blame for their own inaction or disempowered when pressured to remain silent or to forgive. Women felt ignored when their close ones showed anger toward their perpetrator. Women felt guilty when they were held accountable for CSA events or disempowered when pressured to take legal actions. Women, but not men, reported feeling considered through caring and heart-to-heart discussions. Recommendations for awareness messages and practitioners are discussed.

Executive Functions and Social Cognition in Juveniles Who Have Sexually Offended.

Although neuropsychological assessments provide valuable information for those working in forensic mental health, few neuropsychological studies concern persons who sexually offend, particularly juveniles who have sexually offended (JSO). It has been suggested that, contrary to current theories, executive function in JSO, as a group, is no more impaired than it is in juvenile delinquents in general. However, JSO with child victims seem to be more impulsive than JSO whose victims are peers or adults. To verify this potentially important (and unexpected) finding, a sample of adolescent males (N = 134; 15.6 ± 1.5 years old) that included JSO, general delinquents, and underprivileged nondelinquents was assessed using a battery of behavioral and psychological tests that focus on impulsivity. No difference was found between groups regarding higher order executive functions as measured with the Wisconsin Card Sorting Task but JSO with child victims were found to be the most impulsive subgroup as evidenced with the Iowa Gambling Task, the Stop-Signal Reaction Task, and the Impulsive scale of the Social Problem Solving Inventory. They also had the highest number of prescriptions for attention deficit hyperactivity disorder (ADHD) medication. These results, which contradict hypotheses derived from assessment of adult sex offenders, illustrate an important difference between the cognitive profiles of adult and juvenile males who sexually offended. They also confirm that JSO whose victims are children appear to be more impulsive.

Refining algorithmic estimation of relative fundamental frequency: Accounting for sample characteristics and fundamental frequency estimation method.

Relative fundamental frequency (RFF) is a promising acoustic measure for evaluating voice disorders. Yet, the accuracy of the current RFF algorithm varies across a broad range of vocal signals. The authors investigated how fundamental frequency (fo) estimation and sample characteristics impact the relationship between manual and semi-automated RFF estimates. Acoustic recordings were collected from 227 individuals with and 256 individuals without voice disorders. Common fo estimation techniques were compared to the autocorrelation method currently implemented in the RFF algorithm. Pitch strength-based categories were constructed using a training set (1158 samples), and algorithm thresholds were tuned to each category. RFF was then computed on an independent test set (291 samples) using category-specific thresholds and compared against manual RFF via mean bias error (MBE) and root-mean-square error (RMSE). Auditory-SWIPE' for fo estimation led to the greatest correspondence with manual RFF and was implemented in concert with category-specific thresholds. Refining fo estimation and accounting for sample characteristics led to increased correspondence with manual RFF [MBE = 0.01 semitones (ST), RMSE = 0.28 ST] compared to the unmodified algorithm (MBE = 0.90 ST, RMSE = 0.34 ST), reducing the MBE and RMSE of semi-automated RFF estimates by 88.4% and 17.3%, respectively.

Hypernasal Speech Is Perceived as More Monotonous than Typical Speech.

BACKGROUND/PURPOSE: Anecdotal clinical reports have stated that hypernasal speech sounds monotonous. However, the relationship between the perception of intonation (i.e., the fundamental frequency variation across an utterance) and hypernasality (excessive nasal resonance during the production of non-nasal sounds) has not been investigated in research. We hypothesized that auditory-perceptual ratings of intonation would be significantly lower for more hypernasal stimuli. METHODS: One male and one female voice actor simulated 3 levels of intonation (monotone, normal, and exaggerated) at 4 different levels of hypernasality (normal, mild, moderate, and severe). Thirty participants listened to the simulations and rated the intonation on a visual analogue scale from 0 (monotone) to 100 (exaggerated). RESULTS: A mixed-effects ANOVA revealed main effects of intonation (F2 = 236.46, p < 0.001), and hypernasality (F3 = 159.89, p < 0.001), as well as an interaction between the two (F6 = 28.35, p < 0.001). Post hoc analyses found that speech was rated as more monotonous as hypernasality increased. Summary/Implications: The presence of hypernasality in speech can lead listeners to perceive speech as more monotonous. Instrumental measures should be used to corroborate auditory-perceptual evaluations of speech features like intonation.

Who am I as a Sexual Being? The Role of Sexual Self-Concept Between Dispositional Mindfulness and Sexual Satisfaction among Child Sexual Abuse Survivors.

Childhood sexual abuse (CSA) is associated with long-lasting and pervasive impacts on survivors' sexual health, particularly on their sexual satisfaction. Dispositional mindfulness has been found to be associated with greater sexual satisfaction among adult CSA survivors. However, the mechanisms involved in this association remain understudied. The present study examined the role of sexual self-concept (i.e., sexual esteem, sexual preoccupation, and sexual depression) in the relationship between dispositional mindfulness and sexual satisfaction among CSA survivors. A total of 176 adult CSA survivors (60.6% women, 39.4% men) completed an online survey assessing dispositional mindfulness, sexual self-concept, and sexual satisfaction. Path analyses revealed that dispositional mindfulness was positively related to sexual satisfaction through a significant indirect effect of higher sexual esteem and lower sexual depression. The integrative model explained 66.5% of the variance in sexual satisfaction. These findings highlight the key roles that dispositional mindfulness and sexual self-concept play in CSA survivors' sexual satisfaction. Implications for interventions based on trauma-sensitive mindfulness targeting the sexual self-concept are discussed, as they may promote sexual satisfaction in adult CSA survivors.

Delayed Auditory Feedback Elicits Specific Patterns of Serial Order Errors in a Paced Syllable Sequence Production Task.

PURPOSE: Delayed auditory feedback (DAF) interferes with speech output. DAF causes distorted and disfluent productions and errors in the serial order of produced sounds. Although DAF has been studied extensively, the specific patterns of elicited speech errors are somewhat obscured by relatively small speech samples, differences across studies, and uncontrolled variables. The goal of this study was to characterize the types of serial order errors that increase under DAF in a systematic syllable sequence production task, which used a closed set of sounds and controlled for speech rate. METHOD: Sixteen adult speakers repeatedly produced CVCVCV (C = consonant, V = vowel) sequences, paced to a "visual metronome," while hearing self-generated feedback with delays of 0-250 ms. Listeners transcribed recordings, and speech errors were classified based on the literature surrounding naturally occurring slips of the tongue. A series of mixed-effects models were used to assess the effects of delay for different error types, for error arrival time, and for speaking rate. RESULTS: DAF had a significant effect on the overall error rate for delays of 100 ms or greater. Statistical models revealed significant effects (relative to zero delay) for vowel and syllable repetitions, vowel exchanges, vowel omissions, onset disfluencies, and distortions. Serial order errors were especially dominated by vowel and syllable repetitions. Errors occurred earlier on average within a trial for longer feedback delays. Although longer delays caused slower speech, this effect was mediated by the run number (time in the experiment) and small compared with those in previous studies. CONCLUSIONS: DAF drives a specific pattern of serial order errors. The dominant pattern of vowel and syllable repetition errors suggests possible mechanisms whereby DAF drives changes to the activity in speech planning representations, yielding errors. These mechanisms are outlined with reference to the GODIVA (Gradient Order Directions Into Velocities of Articulators) model of speech planning and production. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.19601785.

On the Role of Neural Oscillations Across Timescales in Speech and Music Processing.

This mini review is aimed at a clinician-scientist seeking to understand the role of oscillations in neural processing and their functional relevance in speech and music perception. We present an overview of neural oscillations, methods used to study them, and their functional relevance with respect to music processing, aging, hearing loss, and disorders affecting speech and language. We first review the oscillatory frequency bands and their associations with speech and music processing. Next we describe commonly used metrics for quantifying neural oscillations, briefly touching upon the still-debated mechanisms underpinning oscillatory alignment. Following this, we highlight key findings from research on neural oscillations in speech and music perception, as well as contributions of this work to our understanding of disordered perception in clinical populations. Finally, we conclude with a look toward the future of oscillatory research in speech and music perception, including promising methods and potential avenues for future work. We note that the intention of this mini review is not to systematically review all literature on cortical tracking of speech and music. Rather, we seek to provide the clinician-scientist with foundational information that can be used to evaluate and design research studies targeting the functional role of oscillations in speech and music processing in typical and clinical populations.

Feedback and Feedforward Auditory-Motor Processes for Voice and Articulation in Parkinson's Disease.

PURPOSE: Unexpected and sustained manipulations of auditory feedback during speech production result in "reflexive" and "adaptive" responses, which can shed light on feedback and feedforward auditory-motor control processes, respectively. Persons with Parkinson's disease (PwPD) have shown aberrant reflexive and adaptive responses, but responses appear to differ for control of vocal and articulatory features. However, these responses have not been examined for both voice and articulation in the same speakers and with respect to auditory acuity and functional speech outcomes (speech intelligibility and naturalness). METHOD: Here, 28 PwPD on their typical dopaminergic medication schedule and 28 age-, sex-, and hearing-matched controls completed tasks yielding reflexive and adaptive responses as well as auditory acuity for both vocal and articulatory features. RESULTS: No group differences were found for any measures of auditory-motor control, conflicting with prior findings in PwPD while off medication. Auditory-motor measures were also compared with listener ratings of speech function: first formant frequency acuity was related to speech intelligibility, whereas adaptive responses to vocal fundamental frequency manipulations were related to speech naturalness. CONCLUSIONS: These results support that auditory-motor processes for both voice and articulatory features are intact for PwPD receiving medication. This work is also the first to suggest associations between measures of auditory-motor control and speech intelligibility and naturalness.

Sexual self-concept among men and women child sexual abuse survivors: Emergence of differentiated profiles.

BACKGROUND: Child sexual abuse (CSA) can impact survivor's sexuality, notably regarding sexual self-concept, a key component of sexual well-being. Yet, sexual self-concept has been understudied among CSA survivors and gender differences have been sparsely investigated. OBJECTIVE: The current study aimed to identify CSA survivors' distinct profiles according to their sexual self-concept, and compare these profiles based on factors such as CSA characteristics, gender, current age, sexual functioning and adult sexual assault (ASA). PARTICIPANTS AND SETTING: A total of 176 CSA survivors (60 % women, 40 % men), recruited through community organizations for CSA victims and social media publications, completed an online survey. METHODS: Hierarchical cluster analysis was performed using the Sexuality Scale (Snell & Papini, 1989). Chi-square and ANOVA tests were used to compare the groups on external variables. RESULTS: Cluster analysis revealed the best overall fit for a three-group model. The Confident and non-preoccupied profile (48 %) is characterized by a moderate score on sexual esteem and the lowest scores of sexual preoccupation and depression. The Demeaning and depressive (37 %) profile is characterized by the lowest scores on sexual esteem and the highest scores on sexual depression. The Hyperconfident and preoccupied profile (15 %) shows the highest scores on sexual esteem and sexual preoccupation. CONCLUSION: Sexual self-concept is an important component of sexuality that needs to be addressed by practitioners working with CSA survivors. Given heterogeneity and gender differences among survivors, identification of profiles is relevant for adapting interventions and clinical care.

Voice Onset Time in Individuals With Hyperfunctional Voice Disorders: Evidence for Disordered Vocal Motor Control.

Purpose This study examined vocal hyperfunction (VH) using voice onset time (VOT). We hypothesized that speakers with VH would produce shorter VOTs, indicating increased laryngeal tension, and more variable VOTs, indicating disordered vocal motor control. Method We enrolled 32 adult women with VH (aged 20-74 years) and 32 age- and sex-matched controls. All were speakers of American English. Participants produced vowel-consonant-vowel combinations that varied by vowel (ɑ/u) and plosive (p/b, t/d, k/g). VOT-measured at the release of the plosive to the initiation of voicing-was averaged over three repetitions of each vowel-consonant-vowel combination. The coefficient of variation (CoV), a measure of VOT variability, was also computed for each combination. Results The mean VOTs were not significantly different between the two groups; however, the CoVs were significantly greater in speakers with VH compared to controls. Voiceless CoV values were moderately correlated with clinical ratings of dysphonia (r = .58) in speakers with VH. Conclusion Speakers with VH exhibited greater variability in phonemic voicing targets compared to vocally healthy speakers, supporting the hypothesis for disordered vocal motor control in VH. We suggest future work incorporate VOT measures when assessing auditory discrimination and auditory-motor integration deficits in VH.

Exploring parent sexuality profiles and links with the sexuality profiles of adolescents who have engaged in sexual abuse.

BACKGROUND: Parents play an important role in children's development of sexual norms and behaviors. Regarding the family environment of adolescents who have engaged in sexual abuse (AESA), some studies have suggested potential factors of interest, although the sexuality of AESA parents has yet to be considered. OBJECTIVES: (1) Explore sexual profiles among parents, (2) Examine if the sexual profiles of parents are related to the sexual profiles of AESA. PARTICIPANTS AND SETTING: Participants include 201 parents (116 mothers, 85 fathers) of AESA recruited from specialized treatment and youth centers in Quebec. METHODS: Hierarchical and nonhierarchical methods were used to generate cluster solutions. Chi-square or Fisher's exact tests were then conducted to explore links between parents' and AESA sexuality profiles. RESULTS: Three sexuality profiles emerged separately for mothers and fathers, showing similar patterns. Parents in the first two clusters (Overinvested and Atypical Sexuality - OAS and Overinvested and Non-Atypical Sexuality - ONAS) showed greater interest/investment in sexuality and an earlier sexual onset. However, they differed on their sexual interests: Most parents in the OAS cluster reported a greater variety of atypical fantasies and atypical sexual behaviors, while the sexual interests of parents in the ONAS cluster were mainly limited to non-atypical sexuality. Parents in the third cluster (Constrictive Sexuality - CS) were less interested and invested in sexuality. A link between the exacerbated sexuality of mothers (OAS cluster) and of adolescents was also found. CONCLUSIONS: This study represents a first step in showing a potential correspondence between parents' and AESA sexuality profiles.

Exploring sexuality profiles of adolescents who have engaged in sexual abuse and their link to delinquency and offense characteristics.

Very few studies have taken a specific interest in the various sexual dimensions, beyond delinquent sexual behavior, of adolescents who have engaged in sexual abuse (AESA). Those that went beyond delinquent sexual behavior have report mixed results, suggesting they are a heterogeneous group. The current study used cluster analysis to examine the sexuality profiles of AESA, which included information on several sexual dimensions (atypical and normative fantasies and experiences, drive, body image, pornography, first masturbation, onset of sexual interest and first exposure to sex). Participants (N = 136) are adolescents who have engaged in sexual abuse involving physical contact, for which at least one parent also participated in the study. They were recruited from six specialized treatment centers and three youth centers in Quebec (Canada). Cluster analyses were performed to identify specific sexual profiles. Results suggest three clusters of AESA: 1- Discordant sexuality pertaining to adolescents who show mostly normative sexual interests, 2- Constrictive sexuality, characterizing adolescents who seem to be less invested/interested in their sexuality and 3- Overinvested sexuality for adolescents showing an exacerbated sexuality, including atypical sexual interest. Additional analyses (ANOVAs and Chi-square tests) reveal that five delinquency and offense characteristics were significantly more likely to be present in the Overinvested than the Constrictive cluster: non-sexual offenses, three or more victims, peer victims and alcohol and drug consumption. Advancing our knowledge on this topic can provide relevant data for clinicians to better target interventions.

Sexual abuse perpetrated by adult and juvenile females: an ultimate attempt to resolve a conflict associated with maternal identity.

OBJECTIVE: The purpose of this article is to report the descriptive and phenomenological aspects of adult females (AF) and juvenile females (JF) who sexually abuse children and adolescents. A major focus is to study the relational problems during childhood and adulthood of this specific population and how they echo the relational aspects of their own victimization. METHODOLOGY: Since 1992, clinical and evaluative data were collected from a sample of 13 AF and 15 JF who had committed sexual abuse. The subjects were evaluated in the program for adult and adolescent sex offenders at the outpatient clinic of the Centre de Psychiatrie Légale de Montréal (affiliated with the Institut Philippe Pinel de Montréal). The data were collected by a multidisciplinary team of clinicians: psychiatrists, psychologists, criminologists and sexologists. A team of two or three clinicians who utilized a standardized interview grid evaluated each subject. RESULTS: Mean age at the time of the evaluation was 36.2 years (SD=9.28) for the AF and 14.7 years (SD=1.39) for the JF. A considerable percentage of the sexual abuses occurred in an intra-familial context for both groups (92.3% of the AF; 53.3% of the JF). Half of the AF not only committed sexual but also physical abuse of their victims. In addition, the precocious and repetitive dimension of the sexual abuses perpetrated by 33.3% of the JF was noted. CONCLUSION: This descriptive study reports a set of problematic relationships and a history of victimization among AF and JF. The history of the relationship with their parents frequently revealed that for JF, the father was absent or not very involved and for AF the father was sexually and physically abusive. On the other hand, a disturbed mother-child relationship among both AF and JF sexual abusers highlights an important conflict.

The gender identity of pedophiles: what does the outcome data tell us?.

The aim of this study was to determine whether pedophiles have a different gender identity profile compared with non-sexual offenders. Participants were 87 male adult subjects, divided into three groups: (a) 27 pedophiles who abused male victims, (b) 30 pedophiles who abused female victims, and (c) 30 non-sexual offenders. The gender identity factor was measured with the Mf scale of the MMPI and the Bem Sex Role Inventory (BSRI). Results indicated no significant inter-group differences in terms of gender identity. However, the order of the three groups regarding scores on the Bem-Masculinity and the Mf scale was as predicted. Conceptual and empirical elements related to gender identity are addressed in order to shed light on potential disturbances in the gender identity of pedophiles.