Problematic Sexual Behavior in Children.

It is important for health care professionals to have a strong knowledge base of childhood sexual development, to know how to differentiate between problematic and normative sexual behaviors, and counsel parents accordingly given their assessment of the behaviors. A review of the literature suggests that sexual behaviors are a common occurrence in childhood, though some behaviors are rare regardless of age. Frequency of the behavior, developmental considerations, and the level of harm may help health care professionals assess whether the sexual behavior is typical or problematic. Research suggests that the development of problematic sexual behavior is related to a variety of child, family, developmental, and social factors. Recommendations for clinical care for this population are offered, and a case study highlights a health care professional's appropriate assessment and decision making.

Caring for individuals with a difference of sex development (DSD): a Consensus Statement.

The term differences of sex development (DSDs; also known as disorders of sex development) refers to a heterogeneous group of congenital conditions affecting human sex determination and differentiation. Several reports highlighting suboptimal physical and psychosexual outcomes in individuals who have a DSD led to a radical revision of nomenclature and management a decade ago. Whereas the resulting recommendations for holistic, multidisciplinary care seem to have been implemented rapidly in specialized paediatric services around the world, adolescents often experience difficulties in finding access to expert adult care and gradually or abruptly cease medical follow-up. Many adults with a DSD have health-related questions that remain unanswered owing to a lack of evidence pertaining to the natural evolution of the various conditions in later life stages. This Consensus Statement, developed by a European multidisciplinary group of experts, including patient representatives, summarizes evidence-based and experience-based recommendations for lifelong care and data collection in individuals with a DSD across ages and highlights clinical research priorities. By doing so, we hope to contribute to improving understanding and management of these conditions by involved medical professionals. In addition, we hope to give impetus to multicentre studies that will shed light on outcomes and comorbidities of DSD conditions across the lifespan.

Psychosexual development and satisfaction with timing of developmental milestones among adult survivors of childhood cancer.

OBJECTIVE: To extend the limited research on psychosexual development among childhood cancer survivors, by not only focusing on the prevalence and age of milestone attainment, but also survivors' attitudes toward the timing of reaching such milestones. METHODS: Adult survivors of childhood cancer (N = 90; Mage  = 29.8, SD = 5.2), recruited from a US pediatric institution, completed online surveys indicating whether they had reached 5 milestones of psychosexual development (ie, first kiss, first boy-/girlfriend, first physical intimacy, sexual debut, first time in love), age at attainment, and perceptions about the timing (ie, right time, wished it had happened earlier, wished they had waited). RESULTS: Almost all survivors had reached each milestone (≥90%), except for sexual debut (83.3%). Survivors reported their first kiss as the earliest milestone at age 14.6 (N = 82, 92%) and falling in love as the latest milestone at age 18.8 (N = 80; 90%). This timing did not differ by sex/cancer-specific factors. Most survivors (~60%) felt they reached each milestone at the right time. Compared with US normative data, both male and female survivors were less likely to have experienced their sexual debut and were approximately 1.5 years older at sexual debut. Nevertheless, 59% of survivors felt that this timing was right and 31% wished they had waited longer. CONCLUSIONS: This is the first study to demonstrate that although childhood cancer survivors may delay some aspects of psychosexual development, most are satisfied with this timing. Research and clinical practice should emphasize survivors' perceptions/satisfaction toward psychosexual development rather than focusing only on normative milestone attainment.

Validación de la versión reducida para adolescentes de la Encuesta revisada de opinión sexual / Validation of the reduced version for adolescents of the Revised sexual opinion survey

Introducción. La Encuesta revisada de opinión sexual (EROS) mide las actitudes sexuales, pero puede resultar extensa para población adolescente. Las actitudes sexuales son importantes de conocer debido a que son uno de los factores que determinan las conductas sexuales. Objetivo. Crear una versión reducida, válida y fiable de dicha escala. También se estudia la influencia del sexo, el tener pareja y el curso escolar. Material y método. El muestreo se realizó por conglomerado no probabilístico, de lo que resultó una muestra de 879 adolescentes, con edades comprendidas entre 12 y 18 años. Se utilizó el cuestionario EROS. Se realizó el cálculo de la ecuación Spearman-Brown para calcular el número definitivo de ítems. Resultados. La ecuación de Spearman-Brown aconseja reducir a 8 ítems la versión definitiva, eligiéndose aquellos que presentaban una mejor correlación ítem-total corregida. Igualmente, el coeficiente alfa de Cronbach indicó una alta consistencia interna de la prueba (0,839). Tras realizar el análisis factorial exploratorio utilizando el análisis de componentes principales y la rotación varimax, se obtuvieron 2 factores, que explican el 60,49% de la varianza. Además, se comprueba que existen diferencias significativas en función de las variables sexo, pareja y curso escolar. Conclusiones. La versión reducida de EROS presenta parámetros adecuados para ser utilizada en investigación. Tiene como ventaja ser más accesible para la población adolescente. Por otro lado, se confirma que el sexo, el curso escolar y el tener pareja influyen en la respuesta ante los estímulos sexuales en dicha población (AU)

Introduction. The Revised sexual opinion survey (R-SOS) measures sexual attitudes, but it can be extensive for adolescent population. It is important to know sexual attitudes, because they are one of the factors that determine sexual conducts. Objective. To create a limited, valid and reliable version of the abovementioned scale. The influence of sex, having a relationship and the academic year is also studied. Material and method. Sampling was carried out by non-probabilistic cluster. This resulted in a sample of 879 adolescents, between 12 and 18 years of age. The questionnaire R-SOS was used. The calculation of the equation Spearman-Brown was performed to obtain the definitive number of items. Results. The Spearman-Brown equation advises to reduce the definitive version to 8 items. Those items that presented a better total-item correlation were elected. Likewise, Cronbach's alpha rate indicated high internal consistency of the test (0.839). Besides, it is proved that significant differences exist according to the variables of sex, being in a relationship and the academic year. Two factors were obtained which explain 60.49% of the variance after conducting the exploratory factor analysis using the analysis of main components and the rotation varimax. Conclusions. The reduced version of R-SOS has adequate parameters to be used in the research. One of its advantages is that it is more accessible for the adolescent population. One the other hand, it has been confirmed how sex, the academic year and being in a relationship influence the answer to sexual stimulants of the abovementioned population (AU)

Determinantes psicossociais do funcionamento sexual e bem-estar sexual subjetivo em homens adultos portugueses / Psychosocial determinants of sexual functioning and subjective sexual well-being in portuguese adult men

Introdução. O funcionamento sexual e o bem-estar sexual subjetivo são dimensões humanas muito importantes que contribuem para a qualidade de vida dos homens; no entanto, não existe nenhum estudo que informe acerca de medidas normativas junto de homens portugueses. Objetivos. Avaliar os níveis de funcionamento sexual e bem-estar sexual subjetivo numa amostra de homens adultos portugueses, comparar diferenças entre grupos e determinar o grau de associação entre as 2 variáveis. Material e método. Participaram no estudo 603 homens adultos (média de idades=42,05 anos; desvio padrão=13,93) que preencheram um questionário sociodemográfico, o questionário de mudanças no funcionamento sexual e o questionário de avaliação do bem-estar sexual subjetivo, medidas estas que foram disseminadas através da internet. Resultados. Os resultados obtidos permitiram produzir uma tabela de dados normativos para o funcionamento sexual e bem-estar sexual subjetivo, tendo sido encontradas diferenças estatisticamente significativas na comparação entre grupos em função da idade, escolaridade, local de residência, existência de filhos, estado civil e ocupação profissional. Verificou-se também uma forte correlação entre as 2 dimensões. Discussão e conclusões. Esta investigação permite evidenciar a importância dos determinantes psicossociais na expressão da funcionalidade sexual e bem-estar sexual subjetivo, na medida em que os técnicos que trabalhem com homens nesta área deverão estar atentos ao modo como os contextos psicossociais interferem na expressão sexual (AU)

Introduction. Sexual functioning and subjective sexual well-being are very important human dimensions that contribute to the quality of life of men; however, there are no studies to report about normative measures for the Portuguese male population. Purpose. To assess the levels of sexual functioning and subjective well-being in a sample of Portuguese adult men comparing differences between groups and determine the degree of association between the two variables. Materials and Methods. Participants in the study were 603 adult men (mean age=42.05 years, standard deviation=13.93) who completed a sociodemographic questionnaire, the changes in sexual functioning questionnaire and the subjective sexual well-being questionnaire. These measures disseminated over the internet. Results. The results obtained allowed us to produce a table of normative data for sexual functioning and subjective sexual well-being, and statistically significant differences were found when comparing groups according to age, education, place of residence, number of children, marital status and their occupation. There was also a strong correlation between the two dimensions. Discussion and Conclusions. This research allows us to highlight the importance of psychosocial determinants in the expression of sexual function and subjective sexual well-being, to the extent that the health professionals who work with men in this area should be aware of how psychosocial contexts interfere with their sexual expression (AU)

Family, Peer, and Pubertal Determinants of Dating Involvement Among Adolescents.

This study examines the influence of family, peer, and biological contributors to dating involvement among early adolescents (11-14 years of age; n = 244). Further, we assess how parental monitoring may be modified by pubertal maturation and older sibling risky behavior. Data on delinquent peer affiliation, pubertal maturation, parental monitoring, older sibling risky behavior, and dating involvement were gathered through observations and surveys from adolescents, mothers, older siblings, and teachers. Results indicate that lower levels of parental monitoring and higher levels of older sibling risky behavior were related to adolescents' dating involvement through delinquent peer affiliation. Pubertal maturation was directly related to dating involvement for early daters. Findings emphasize the value of examining social and biological factors, in concert, over time.

Psychosexual development management of bladder exstrophy epispadias in complex patients.

INTRODUCTION: Bladder-exstrophy-epispadias complex (BEEC) represents a spectrum of urogenital step-wise malformations: epispadias, complete exstrophy, and cloacal exstrophy. Psychosexual development in adolescent patients with BEEC may become especially problematic. At present, there are few contributions in the literature investigating the validity of psychosexual treatment in order to tackle this particularly emotional and personal development phase. OBJECTIVE: The study aimed at verifying the efficacy of an intervention methodology for psychosexual support of a group of adolescents with BEEC. The main goal of the intervention program was to educate the adolescents and re-frame how they see themselves or feel about themselves, especially in relation to BEEC. In particular it was predicted that the program could: (1) improve the perception of pleasure concerning the body, particularly regarding the genital area, giving proper and specific information on pleasure, masturbation and medical history of BEEC; and (2) elicit a more relational-affective perspective on sexuality. STUDY DESIGN: 13 adolescent patients took part in the 1-year program. The effects of the intervention program were verified through a test-retest methodology using Sexuality Evaluation Schedule Assessment Monitoring (SESAMO). RESULTS: The results showed that participants changed their attitude in several psychosexual areas, more specifically: psycho-environmental situations, body experience, areas of pleasure, medical and sexual history, and motivation and conflict areas (Summary Table). DISCUSSION: This study demonstrated, for the first time, that a targeted program may significantly improve the psycho-sexual condition of adolescents with BEEC. In particular, this research showed that adolescents need to be able to discuss and tackle topics of a psychological and sexual nature, as well as receive understandable answers that can be put into practice in their everyday lives. The study had several methodological limitations, especially owing to the limited number of participants, the absence of a follow-up period of a few months after the intervention, and the overall exploratory nature of the program. CONCLUSION: This intervention methodology may be considered a first attempt at improving the self-esteem of adolescents with BEEC, by contrasting forms of psychological difficulties in order to improve the quality of life of these young people.

Consideraciones sobre la oralidad y la relación de objeto oral / Some considerations on orality and oral object relations

Este artículo permite comprender cómo la oralidad que, en la concepción del autor, mantiene una relación estrecha con el narcisismo, se opone en su esencia a la analidad. La dialéctica narcisismo-pulsiones, y en particular narcisismo-analidad, es así esclarecida (AU)

This article offers an understanding of how orality - in the author's conceptualization, closely related to narcissism - is diametrically opposed to anality. This therefore elucidates the dialectic between narcissism and the drives, and in particular narcissism and anality (AU)

Propriedades psicométricas da versão portuguesa da Nova Escala de Satisfação Sexual - versão curta / Psychometric properties of the Portuguese version of the New Sexual Satisfaction Scale - Short

Introdução. A satisfação sexual constitui atualmente um constructo essencial no campo do estudo da sexualidade humana. Objetivo. A presente investigação teve como objetivo proceder à validação da versão portuguesa da Nova Escala de Satisfação Sexual - versão curta (NSSS‐S), instrumento em formato curto que avalia a satisfação sexual em homens e mulheres. Material e métodos. Recorreu‐se a um total de 298 participantes de ambos os sexos, os quais preencheram o questionário com a tradução para português da NSSS‐S. Resultados. Foram demonstradas as principais propriedades psicométricas da validação da NSSS‐S, das quais se destacaram a estrutura fatorial bidimensional e o alfa de Cronbach (≥0,89). Discussão. A NSSS‐S revelou ter a estrutura bidimensional da NSSS original e obtiveram‐se valores bons a nível de consistência interna, de validade convergente, de validade divergente e de validade concorrente. Conclusões. As boas propriedades psicométricas encontradas justificam e reforçam a recomendação de utilização da NSSS‐S na população portuguesa (AU)

Introduction. Sexual satisfaction is an essential construct in the study of human sexuality. Objective. The aim of the present study was to validate the Portuguese version of the New Sexual Satisfaction Scale-Short (NSSS‐S), a short form scale that assesses sexual satisfaction among men and women. Material and methods. A total of 298 participants completed the Portuguese version of the NSSS‐S. Results. The main psychometric properties of the Portuguese version of the NSSS‐S were assessed, most importantly the two‐factor structure and Cronbach's alpha (≥0.89). Discussion. The NSSS‐S revealed the bidimensional structure of the original NSSS and good values were obtained in terms of internal consistency, convergent validity, divergent validity and concurrent validity. Conclusions. The use of the Portuguese version of the NSSS‐S is justified and reinforced since it has sound psychometric properties (AU)

[COMPREHENSIVE DIAGNOSTICS IN PATIENTS WITH GENOTYPE 47,XXY KLINEFELTER SYNDROME].

We undertook biochemical, hormonal, cytological analysis and sequencing CAG repetitions of androgen receptor gene in order to elucidate the cause of clinical polymorphism of Klinefelter syndrome. Elevated levels of LH (19.8 ± 4.2 E/l), FSH (22.7 ± 6.1 U/l), total cholesterol (6.8 ± 2.6 mmol/l), triglycerides (3.3 ± 1.0 mmol/l), and glucose (9.9 ± 3.8 mmol/l) suggested disturbances of lipid and carbohydrate metabolism. Two thirds of the patients had Klinfelter syndrome associated with mental retardation and psychic disorders. Patients with cleft palate and mental retardation and with psycho-social disorders had 45 and 43 CA G repetitions respectively, those without associations 38-40 repetitions. Increased frequency of CAG repetitions was directly proportional to the level ofpsychic development, social adaptation and professional activity but inversely proportional to the development of masculine sexual traits.

Early Sexual Intercourse: Prospective Associations with Adolescents Physical Activity and Screen Time.

OBJECTIVES: To assess the prospective associations of physical activity behaviors and screen time with early sexual intercourse initiation (i.e., before 15 years) in a large sample of adolescents. METHODS: We used two waves of data from the Rotterdam Youth Monitor, a longitudinal study conducted in the Netherlands. The analysis sample consisted of 2,141 adolescents aged 12 to 14 years (mean age at baseline = 12.2 years, SD = 0.43). Physical activity (e.g., sports outside school), screen time (e.g., computer use), and early sexual intercourse initiation were assessed by means of self-report questionnaires. Logistic regression models were tested to assess the associations of physical activity behaviors and screen time (separately and simultaneously) with early sexual intercourse initiation, controlling for confounders (i.e., socio-demographics and substance use). Interaction effects with gender were tested to assess whether these associations differed significantly between boys and girls. RESULTS: The only physical activity behavior that was a significant predictor of early sexual intercourse initiation was sports club membership. Adolescent boys and girls who were members of a sports club) were more likely to have had early sex (OR = 2.17; 95% CI = 1.33, 3.56. Significant gender interaction effects indicated that boys who watched TV ≥2 hours/day (OR = 2.00; 95% CI = 1.08, 3.68) and girls who used the computer ≥2 hours/day (OR = 3.92; 95% CI = 1.76, 8.69) were also significantly more likely to have engaged in early sex. CONCLUSION: These findings have implications for professionals in general pediatric healthcare, sexual health educators, policy makers, and parents, who should be aware of these possible prospective links between sports club membership, TV watching (for boys), and computer use (for girls), and early sexual intercourse initiation. However, continued research on determinants of adolescents' early sexual initiation is needed to further contribute to the strategies for improving adolescents' healthy sexual development and behaviors.

Sexualized behaviors in cohorts of children in the child welfare system.

The current retrospective archival study investigated the patterns of normative sexualized behavior (NSB), problematic sexualized behavior (PSB), and sexual perpetration for three age cohorts of boys and girls in a high-risk child welfare sample. All children in the present sample had exhibited some form of PSB in the past. We hypothesized that the incidence rates (IR) of NSBs would increase linearly from the early childhood cohort (Ages 2/3-7) to the middle childhood cohort (Ages 8-11) to the preadolescence/adolescence cohort (Ages 12-17), for girls and boys. Although the base rate of sexual behaviors generally increases as children age, children tend to hide sexual behaviors starting at an early age. We therefore hypothesized that a concave quadratic trend would be evident for most PSBs. We further predicted that older children would have a greater incidence of PSB, as well as more victims, compared with younger children. We found the predicted upward linear trend for NSB for both girls and boys, with minimal IR differences between the early childhood and middle childhood cohorts. IRs were remarkably high and comparable across age groups for both boys and girls, with respect to the same three PSBs. For the two perpetration history variables, there was a concave effect, with girls and boys in the middle childhood cohort exhibiting the lowest IR. Results are explained in the context of previously established patterns of sexualized behavior, as well as the reporting of such behaviors.

Lo arcaico y lo sensorial / The archaic and the sensorial

En este trabajo se reflexiona sobre distintas concepciones del concepto de lo arcaico. Este término ha sido usado por diferentes autores y en distintos contextos. Todos ellos se refieren a las primeras etapas del desarrollo psicológico del individuo y a la organización mental. Se destaca el aporte de Bion, al incluir a los pensamientos no solo como producto sino como impulsor de la formación del aparato psíquico. Este enfoque ubica la experiencia emocional primitiva con sus vivencias sensoriales en los niveles arcaicos del pensamiento. Por este motivo el autor sostiene la importancia del factor sensorial, como defensa frente a ansiedades primitivas, lo que es ilustrado a través de un material clínico (AU)

In this paper, the author takes into account different meanings on the concept of archaic. This term was used by different authors and in diverse contexts. All of them relate to early stages of the individual psychological development and the mental organization. Bion’s contribution is under-scored, because he considers thoughts not only as a result of the mind’s functioning but as a dynamic factor which urges mind’s formation. This view situates primitive emotional experience along with sensory events in the archaic stages of thinking. That is why the author underlines the importance of the sensory aspect, as a defense in front of primitive anxieties, which is illustrated through clinical material (AU)

Confusión de lenguas entre los adultos y el niño. El lenguaje de la ternura y de la pasión / Confusion of tongues between the adults and the child. The language of tenderness and of passion

El título original de este trabajo, Las pasiones de los adultos y su influencia sobre el desarrollo del carácter y de la sexualidad del niño, da cuenta de la hipótesis fundamental del autor sobre la importancia del traumatismo y, en particular, del traumatismo sexual como factor patógeno. Denuncia que los niños son víctima de violencia y de violaciones o seducciones incestuosas mucho más a menudo de lo que se cree, y considera que esto va a traer una serie de consecuencias psíquicas, tales como el mecanismo de identificación con el agresor, la introyección del sentimiento de culpa, la fragmentación o atomización y la confusión. Asimismo, pueden padecer una inhibición sexual o desarrollar una perversión. El autor plantea revisar la teoría sexual y genital aludiendo a la importancia del factor exógeno, de la pasión del adulto, como condicionante del sadomasoquismo en el niño. Partiendo de su experiencia clínica, y a raíz de ciertas dificultades de la técnica, como la excesiva docilidad de algunos de sus pacientes, el autor se replantea los efectos de sus propias resistencias como analista, y modifica su técnica haciendo hincapié en la comprensión, la simpatía Y la confianza que le permitirán acceder al material oculto (AU)

The original title of this text, The passions of adults and thezr influente on the sexual and character development of the child illustrates the author's fundamental hypothesis on the importance of trauma, particularly of sexual trauma as a pathogenic factor. He claims that children are the victims of violence and incestuous rape or seduction much more freequently than was thought, and considers that these abuses will give rise to important psychic consequences, such as the mechanism of identification with the aggressor, the introjection of guilt, fragmentation or atomization and confusion. In addition, they could also suffer from sexual inhibition or develop a perversion. The author suggests to review sexual and genital theory in order to include the passion of the adult, meaning the importance of the exogenous factor as a determinant for the development of sadomasochism in the child. Drawing upon his clinical experience, and as a result of certain technical problems, such as the excessive docility of some of his patients, the author reconsiders the effects of his own resistances as an analyst, and modifies his technique with an emphasis on understanding, a sympathetic stance and trust, enabling him to gain access to the hidden material (AU)

Hormonal and developmental influences on adolescent suicide: a systematic review.

BACKGROUND: Teen suicide is a major public health problem. In the United States, it is the third cause of death among the 10-24 year olds. Adolescence involves numerous changes, whether physical, social, emotional or hormonal. At a neurobiological level, a teenager's nervous system is also affected and undergoes significant modifications. SUBJECTS AND METHODS: We conducted a systematic review of electronic literature published between January 1990 and August 2014 via MEDLINE, PubMED and PsychINFO to list articles concerning the risk of teen depression and suicide risks in adolescents as well as those relating to the adolescent's neuro-anatomical brain and the effect that puberty has on it. RESULTS AND DISCUSSION: When analyzing the various studies, it is clear that all support the idea that adolescence is a special period, both at neuroanatomical and biological levels. The risk of impulsiveness and depression is explained, anatomically, by a faster maturation of the limbic system, and biologically, by a higher sensitivity of the serotoninergic system and to glucocorticoids, which themselves are influenced by the specific hormonal environment during this period. Moreover and above all, adolescence is a vulnerable time for many reasons: physical, hormonal, social, cognitive, and emotional changes, self-development, etc. We should not restrict it to structural neurological changes without taking into account the other factors or compartmentalize young people into a reductive model based on determinism. CONCLUSIONS: Adolescence is a time of change, transformation, and adaptation. The hormonal events that occur during this period have significant effects on brain development, neuro-cerebral chemistry, adolescent behavior and risks of depression. It is important to try to prevent suicide and depression in adolescents considering its entirety and complexity but also by paying attention to neuro-biological factors even if, at present, many research projects are currently underway to develop an appropriate drug therapy strategy.

Hábitos sexuales en los adolescentes de 13 a 18 años / Sexual behavior in adolescents 13 to 18 years old

Introducción: la población adolescente es especialmente vulnerable a los riesgos relacionados con su conducta sexual, dado que se trata de un periodo de maduración en el que experimentar forma parte de esta etapa evolutiva. El embarazo en adolescentes y la maternidad temprana están asociados con el fracaso escolar, el deterioro de la salud física y mental, aislamiento social, pobreza y otros factores relacionados. Por otra parte, no usar métodos anticonceptivos de barrera aumenta el riesgo de infecciones de transmisión sexual (ITS), con serias consecuencias a corto y largo plazo en la salud biopsicosocial de los adolescentes. Objetivos: conocer las características sobre sexualidad de los adolescentes de la provincia de Valladolid. Métodos: estudio transversal descriptivo mediante encuesta anónima a una muestra de 2412 escolares de 13 a 18 años, en el curso académico 2011-2012. Resultados: el 81% de los alumnos consideran que tienen una información muy buena o buena sobre sexualidad. El 75% de los alumnos consideran que la información que tienen sobre infecciones de transmisión sexual es muy buena o buena. Han tenido relaciones con penetración el 30,4% de los alumnos. La edad de inicio de las relaciones sexuales completas se sitúa entre los 15 y 16 años (50,9%). La mayoría declaran que utilizan algún método anticonceptivo en sus relaciones (91,3%), pero todavía hay un 8,7% que refiere no utilizar ninguno. La mayoría utilizan como método anticonceptivo el preservativo (89,6%). Un 20,9% de los adolescentes que mantienen relaciones sexuales con penetración han utilizado en alguna ocasión la píldora del día después o anticoncepción de urgencia. El 3,6% declara haberse quedado embarazada o haber dejado embarazada a su pareja. Conclusiones: a pesar de considerarse suficientemente informados sobre sexualidad e ITS, los adolescentes presentan comportamientos de riesgo en sus actividades sexuales (AU)

Introduction: the adolescent population is particularly vulnerable to the risks related with their sexual behavior, because it is a period of maturation and experience which is part of this evolutionary stage. Teenage pregnancy and early motherhood are associated with school failure, impaired physical and mental health, social isolation, poverty and other related factors. Moreover the non-use of appropriate protective barriers increases the risk of sexually transmitted infections (STI), with serious consequences in the short and long term biopsychosocial adolescent health. Objectives: to determine the characteristics of adolescent sexuality in the province of Valladolid. Methods: cross-sectional study, using an anonymous survey to 2412 schoolchildren 13-18 years old in the academic year 2011-2012. Results: 81% of students feel they have very good or good information on sexuality. 75% of students believe that the information they have about STI is very good or good. 30.4% have had sexual intercourse. The age of first complete sexual intercourse is between 15 and 16 years (50.9%). Most of the adolescents use a contraceptive method in their relationships (91.3%), but there are still 8.7% referring not using any. Most of the students use the condom for contraceptive method (89.6%). 20.9% of teens who have had sex with penetration have used 'the morning-after pill' or emergency contraception at some time. 3.6% reported having being pregnant or having left his partner pregnant (AU)

Una manera diferente de abordar la sexualidad, la contracepción y la prevención de infecciones de transmisión sexual desde la escuela en la Costa da Morte / A different approach to sexuality, contraception and prevention of sexually transmitted infections from school on Costa da Morte

Introducción: La actividad sexual en edad precoz se relaciona con conductas de riesgo que pueden dar lugar a embarazos no deseados (END) o infecciones de trasmisión sexual (ITS). Los centros de enseñanza son los espacios idóneos para realizar actividades educativas en materia de sexualidad. Nuestro estudio tiene como objetivos: averiguar los conocimientos sobre sexualidad, anticoncepción e ITS de los alumnos de 2º,3º y 4º de la ESO, generar conocimientos y actitudes adecuadas en torno a la sexualidad y valorar los resultados de nuestra intervención educativa. Material y Métodos: Estudio descriptivo de corte transversal que cuenta con la participación de 686 alumnos con edades comprendidas entre los 13 y 16 años pertenecientes a centros educativos de A Costa da Morte. Realizamos sesiones educativas sobre sexualidad, anticoncepción e ITS con exposiciones teórico-prácticas. Elaboramos dos tipos de cuestionarios: uno de conocimientos, pre y post-intervención, y otro de satisfacción. Resultados: Los adolescentes conocen la mayoría de los métodos anticonceptivos, aunque la información que manejan es dispar. Existe un déficit de conocimientos respecto a las ITS importante; los jóvenes no conocen sus signos/síntomas, las medidas de prevención, los mecanismos de transmisión, ni las actitudes a seguir con la población portadora. Conclusión: La enfermería tiene un papel clave como impulsora de actitudes positivas en la salud sexual de los jóvenes. Es fundamental, para favorecer la adquisición de conocimientos en torno a la sexualidad, transformar a los adolescentes en los protagonistas de su historia a través de intervenciones innovadoras y participativas (AU)

Aim: Sexual activity at an early age is associated with risk behaviors that can lead to unwanted pregnancies or sexually transmitted infections (STIs). Schools are the ideal for educational activities in relation to sexuality. Our study aims to find out knowledge about sexuality, contraception and STIs to the students of 2nd, 3rd and 4th of Secondary School, generate appropriate knowledge about sexuality and evaluate the results of our intervention attitudes. Methods: A descriptive cross-sectional study with the participation of 686 students aged between 13 and 16 years old, belonging to schools in Costa da Morte. We offered educational sessions on sexuality, contraception and STIs with theoretical and practical presentations. We developed two types of questionnaires: one of knowledge, pre-post intervention and other about satisfaction. Results: Teenagers know most contraceptive methods, although the information they handle is questionable. There is a deficiency of knowledge related to the important STI; young people do not know their signs/symptoms, prevention, transmission mechanisms, and attitudes to go with the carrier population. Conclusion: Nurses play an important role in promoting a change of attitude in youth´s sexual behavior. Encouraging teens and transforming them in the protagonists of his story through innovative and participatory activities, is essential to achieve the acquisition of knowledge about sexuality (AU)

Vínculos, identidad y desarrollo psíquico / Bonds, identity and psychic development

Es a través de la necesaria relación con un otro como se estructura el psiquismo y se construye la identidad: desde la relación dual pasando por la aparición del tercero que da lugar al grupo primario o familia siendo después incluido el sujeto en sucesivos grupos en los que tiende a reproducir su posición en el grupo primero. Reflexionaré asimismo sobre las funciones de la terapia como relación con un otro haciendo un paralelismo con las 'tareas maternas' propuestas por Winnicott y en particular sobre el trabajo en aquellos trastornos en los que la acción aparece como principal forma de vínculo (AU)

It is through the necessary relation to others that the psyche is structured and identity is constructed: from the dual relationship through the emergence of the third that gives rise to the primary group or family then being included the subject in successive groups in which he/ she tends to play the same position. I also reflect on the roles of therapy as a relationship with another drawing a parallel with the 'maternal tasks' proposed by Winnicott and particularly on the work with those disorders in which the action appears as the main way to bond (AU)

A Cross-Section Study of the Ontogeny of Gender Roles in Women with DSD.

A review of gender role (GR) differentiation from early childhood through adulthood was conducted on males and females in general, as well as on females affected by congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency or complete androgen insensitivity syndrome (CAIS). Additionally, retrospective and current, self-rated GR assessments were evaluated from women with CAH (n = 9) or CAIS (n = 12), and unaffected women and men ranging in age from 16 to 59 years. Overall, GR differentiation occurs in early childhood and persists through adulthood. With advanced age, this differentiation may evolve into androgyny or even become undifferentiated for the general population. While more studies of GR exist for girls and women with CAH compared to those affected by CAIS, some developmental patterns can be observed from the limited data that exist. First, girls and women with CAIS report a female GR that persists through adulthood. Second, girls and women with CAH are more likely to report less feminine/ more masculine play in childhood followed by interests in male-typical leisure activities and career choices in adulthood. However, our data indicate that women with CAH report more feminine/ less masculine patterns of GR with age. Self-reported GR for women with CAH was indistinguishable from that of women with CAIS at the time of study participation in adulthood. With the availability of effective medications for treating hormone deficiencies associated with CAH, affected women are expected to live a full lifespan. Thus, our understanding of psychosexual development into older age is warranted.

Functional neuroanatomy of human cortex cerebri in relation to wanting sex and having it.

Neuroanatomical textbooks typically restrict the central nervous system control of sexual responsiveness to the hypothalamus, brainstem and spinal cord. However, for all its primitive functions human sex is surprisingly complex and versatile. This review aims to extend the neuroanatomy of sexual responsiveness by providing a comprehensive overview of the empirical evidence for cerebral cortical involvement. To this end I will structure relevant human brain research data to fit the sexual pleasure cycle template-wanting sex, having sex, inhibiting sex-arguing that going through these sexual response phases requires adequate shifting between functional cortical networks. The relevance of this notion for understanding certain sexual dysfunctions is discussed.