Gender development in boys born with hypospadias.

Fetal testicular androgens in several mammalian species are responsible for the sexual differentiation of both the genitalia and the brain, the latter effect being related to behavioral sex-dimorphisms. Because prenatal endocrine abnormalities can be inferred from genital defects, studies of individuals born with anomalies potentially elucidate the contribution of androgens to the development of gender-related variation in human behavior. This study concerns the gender-role behavior of middle childhood boys (ages 6-10 years; n = 175) born with hypospadias, an androgen-related genital anomaly. Parents completed standardized gender behavior questionnaires in a postal survey. Hypospadias subjects did not show consistent differences from a community control group (n = 333) in feminine behavior, but significant, small, increases in masculine behavior were found. Severity of the hypospadias was unrelated to gender-role behavior. A number of surgery-related hospitalizations, however, were correlated with increased gender-atypical behavior. It is concluded that the hypoandrogenization associated with hypospadias does not interfere with the development of gender-typical masculine behavior.

Gender-related assessment of childhood play.

Parent-report based scales for the assessment of sex-dimorphic behavior are an important tool in research on psychosexual differentiation and its disorders. This paper presents the factor analysis and corresponding scale development for the slightly expanded Child Game Participation Questionnaire (Bates & Bentler, 1973), based on the parents of a demographically diverse school sample of 355 girls and 333 boys aged 6 to 10 years. Evidence supporting each of three theoretical positions in gender assessment--unidimensional bipolar, two-dimensional unipolar, and multidimensional--was provided. Effect sizes were unusually large for gender, but small for age, socioeconomic level, and race/ethnicity.

Estimated condom failure and frequency of condom use among gay men.

OBJECTIVES: Condoms are designed to bar transmission of the human immunodeficiency virus (HIV), but they sometimes fail. This paper explores the effect of experience with condoms on condom failure among gay men. METHODS: Risk of condom failure (breakage or slippage) on a single occasion is estimated for four sexual acts reported over 12 months by a sample of gay New York City men (n = 741). The estimation procedure assumes that each episode in which a condom is used is an independent event. Evidence is offered to support this assumption. RESULTS: Risk of condom failure in a single episode was fairly high, particularly in anal intercourse, for men who had engaged in each act only a few times in the previous year. It declined rapidly with experience (e.g., to below 1% for receptive anal intercourse after about 10 episodes in the previous year). Condoms failed less often in oral than anal sex, but estimated risk of failure also decreased with experience. CONCLUSIONS: Gay men should be especially cautious the first few times they use a condom; after moderate experience, however, they may expect a low risk of condom failure.

The prevalence of gender-atypical behavior in elementary school children.

OBJECTIVE: To supplement the few small-scale studies on convenience samples of boys with an epidemiological study on the prevalence of gender-atypical behaviors (GABs) in boys and girls and to assess the influence of variation of age, ethnicity, and socioeconomic status. METHOD: The present study, a postal questionnaire survey, used an existing pool of GAB items for boys, developed comparable GAB items for girls, and analyzed parent-reported frequencies of GABs in a demographically heterogeneous community sample of 687 boys and girls age 6 to 10 years. RESULTS: The majority of GABs were quite rare, but there was considerable variability in their prevalence. Nevertheless, many children show multiple GABs although each individual GAB at low frequency; for instance, 10 or more different GABs were exhibited by 22.8% of boys and 38.6% of girls. Only few GABs varied significantly with age, ethnicity, or socioeconomic status. CONCLUSIONS: These data are of relevance to clinicians counseling parents who are worried about the occurrence of GABs in their children.

The Child Behavior Checklist nonclinical standardization samples: should they be utilized as norms?

The Child Behavior Checklist (CBCL) is an extensively standardized parent-completed checklist of competencies and behavior problems of children and adolescents. Clinicians and researchers frequently assume that the published scale scores for the CBCL nonclinical sample are stable even across demographically heterogeneous populations. The present study, a school-based postal questionnaire survey, was designed to compare the CBCL nonclinical sample with a different community sample collected in the U.S. The parents of 530 children, 6 to 10 years of age (73% of the eligible sample), attending one public school system in northern New Jersey were recruited. Mean total behavior problem scores for both sexes in the school sample were dramatically higher than the CBCL nonclinical sample even after removing clinically referred cases from the analyses. Additionally, in contrast to the manual, marked race/ethnicity effects were found in the male subsample. These results, in conjunction with those from other studies, raise serious questions about the common practice of using the CBCL norms as a yardstick for sample comparisons.

Impairment in the epidemiological measurement of childhood psychopathology in the community.

The desirability of incorporating a measure of impairment to the categorization of childhood psychopathology in the community is examined. The use of the Children's Global Assessment Scale (CGAS) for this purpose is recommended. The choice of 61 (definite case) and 71 (probable case) as cutpoints on the Children's Global Assessment Scale is supported empirically by the data on service utilization, parental perceived need, and behavior problem scores obtained in the Puerto Rico Child Psychiatry Epidemiological Study.

Reliability and validity of screening scales: effect of reducing scale length.

Self-report measures are often useful as the first phase of a multiphase case identification procedure for estimating rates of untreated disorder, but such measures are susceptible to several sources of unreliability. The reliability of respondents' reports can be greatly improved by employing a well-established screening scale composed of multiple replicate items. A practical question that arises is whether interview time can be saved by using only a portion of the original scale. The cost of shortening established scales in terms of the sensitivity and specificity of the screen is modelled statistically, and the robustness of the model is assessed using mental health data obtained on samples of psychiatric patients and community controls. Both the statistical model and the empirical examples suggest that items from highly reliable measures can be dropped without much loss in sensitivity or specificity. Suggestions are made for selecting subsets of items when shortening a screening scale and these are illustrated with screening scales for depression.

The psychiatric status schedule as a measure of dimensions of psychopathology in the general population.

The Psychiatric Status Schedule (PSS) is a widely used interview that was designed to improve the research value of clinical judgments. Although it was developed with psychiatric patients, its authors hoped it could be used to evaluate nonpatients, a capability that would make it a much needed tool for epidemiologic research. The present study tests the internal consistency reliability of scales drawn from the PSS in both a general population sample (n. = 133) and a patient sample (n. = 100). Like the PSS's authors, we found a wide variety of clinically meaningful scales reliable for use with patients. In striking contrast, however, most of these proved unreliable in the general population sample. Speculative explanations are offered for the failure of most of the PSS scales in the general population sample and for the success of a few.