Psychiatric manifestations of aids spectrum disorders - Vomvouras, S. (Southern Medical Journal, 1989)
This paper reviews the proposed etiology and epidemiology of the acquired immunodeficiency syndrome (AIDS). It summarizes the psychiatric symptoms associated with members of high-risk groups, patients who have AIDS-related complex (ARC) or AIDS, and patients who are seropositive yet asymptomatic. It differentiates between psychiatric manifestations predating and following prodromal symptoms of immunodeficiency and elucidates diagnostic criteria that may assist in this differentiation process. The importance of diagnostic distinction between premorbid, reactive, functional, and neuropsychiatric manifestations is emphasized. A brief description of suggested treatment and management regimens for the various forms of AIDS-related psychopathology then follows. © 1989 Southern Medical Association.

Acquired immunodeficiency syndrome and adolescents: Knowledge, attitudes, beliefs, and behaviors in a New York City adolescent minority population - Goodman, E.; Cohall, A.T. (Pediatrics, 1989)
In this survey, the knowledge, attitudes, beliefs, and behaviors concerning acquired immunodeficiency syndrome (AIDS) in a group (n = 196) of innercity adolescents in New York City were assessed. Sexual activity was the major risk factor for AIDS in this population; 58% of the adolescents had engaged in sexual intercourse; 12% of these had never used contraception. There were small reported rates of homosexuality, anal intercourse, and prostitution. Of respondents, 22% reported alcohol use and 22% had tried recreational drugs. None had ever taken drugs intravenously. Knowledge of human immunodeficiency virus (HIV) transmission was generally good, although there were prominent misconceptions. For example, 52% of the adolescents believed that donating blood could transmit HIV. Of respondents, 47% 'never' or 'rarely' worried about the disease. Of the total group, 39% reported behavior changes because of concern about AIDS in the previous 6 months. Those who changed behaviors tended to have a greater perceived risk, worry more frequently about the disease, and have a better knowledge of means of HIV transmission. Of those reporting behavior changes, 66% (25% of the total study group) claimed to be using condoms currently, and 16% (6% of the total study group) claimed to be abstemious. More black adolescents than Hispanic adolescents instituted behavior changes. Of black female adolescents, 71% were sexually active, as compared with 30% of Hispanic female adolescents. Assessment of beliefs in methods of risk reduction indicated that although female adolescents were more likely to believe that condoms were a good way to decrease their risk of acquiring HIV, those who were sexually active were less likely than men to institute the behavior change of insisting on condom use or of having their partners use condoms the last time they had sexual intercourse. Of sexually active female adolescents, 73% did not insist on condom use the last time they had sexual relations, whereas 51% of sexually active male adolescents did use a condom. These adolescent women were not using their knowledge concerning HIV transmission and protection to alter behavior effectively and thereby decrease their risk. Also, 21% of respondents spontaneously claimed that they would commit suicide if they tested positive for the HIV antibody. Other motivational and educational strategies besides education, targeting female adolescents, must be used and the consequences of the use of the HIV antibody test must be carefully considered in this age group.

Company halting health plan on some 'life style' illnesses. - Noble, K.B. (The New York times, 1988)

Psychosocial differences between dutch male and female transsexuals - Verschoor, A.M.; Poortinga, J. (Archives of Sexual Behavior, 1988)
One-hundred sixty-eight male and 55 female transsexuals, in hormonal treatment at the Gender Foundation in Amsterdam, were compared with respect to psychosocial characteristics. Results indicated that females more frequently had displayed cross-gender behavior during childhood than males, that they cross-dressed more often, and that, contrary to males, none had married in her anatomical sex. Females also applied for surgical gender reassignment at an earlier age than did males. More of the females lived in a stable relationship with a partner of their own biological sex. Relations with the parental home were better for females than for males, and the former were more often employed or enrolled in a study. No significant differences existed with respect to psychiatric treatment, substance abuse, or attempted suicides. It is concluded that unambiguous cross-gender behavior is more common in female than in male transsexuals and that the social conditions of the female are more satisfactory. However, a relatively high incidence of psychiatric treatment and attempted suicides indicates severe psychological problems in both the male and female groups. © 1988 Plenum Publishing Corporation.
Keywords: psychosocial characteristics; transsexualism

AIDS: a guide to suicide assessment. - Hall, J.M.; Stevens, P.E. (Archives of psychiatric nursing, 1988)

Mental health issues of gay and lesbian adolescents - Gonsiorek, J.C. (Journal of Adolescent Health Care, 1988)
The mental health concerns of gay and lesbian adolescents are best understood within the context of cultural limitations, including a problematic conceptualization of adolescence, homophobia, and erotophobia. Within this framework, background information about homosexuality is presented; and the special social pressures and psychologic problems of gay and lesbian youth are discussed, with particular attention paid to internalized homophobia, developmental issues, and the "coming-out" process. Differences between gay and lesbian mental health issues are highlighted. Finally, practical suggestions regarding treatment planning are provided. © 1988.
Keywords: Homophobia; Homosexuality; Mental health; Psychotherapy; Suicide

Gay clients with AIDS: New challenges for hospice programs - Andersen, H.; MacElveen-Hoehn, P. (Hospice Journal, 1988)

Homosexuality, Suicide, and Parasuicide in Australia - Buhrich, N.; Loke, C. (Journal of Homosexuality, 1988)

A Shoestring Operation for Sexually Abused Children - Burkart, J. (Early Child Development and Care, 1988)
The title of this paper refers to how resources were gathered to provide a therapy group for latency aged children who had been sexually abused. In one way it is a sad commentary on how society treats children who have been victimized; on the other hand, this account shows how volunteers with a will can harness the energies of social agencies to help provide a needed service that was not yet established. The history of social work is replete with accounts of generous individuals who stepped forward to do the necessary. Social work, like nursing, had its origins in volunteerism. Even today lacunae in public welfare are filled by volunteers, and while not all efforts become institutionalized the trend toward innovation and compassion is still strong in contemporary society (Newsweek, “A 51 Gun Salute to Everyday heroes” pp 62–79 July 6 1987). Within the profession, there are always fields of service that are on the cutting edge of human needs—witness industrial social work, divorce mediation, services to lesbian/gay clients, Al Ds victims, etc. Often these special programs, or the recognition of special populations within an agency's service area are first made by employed professionals within the agency. If the innovative professional has success, the program or method is gradually extended to other agencies and finally adopted by the government. While the connection between individual innovation and public policy is too complex to be described here, it is sufficient to say that the current American program of AFDC had its origins from the experience of juvenile court judges who were faced with the prospect of removing dependent children from their widowed mother. The common sense of these officials and other child advocates saw the wisdom of preserving the family at state expense (Trattner, 1974, pp 185–186). Whether the situation is that of orphaned or abused children, the process is slow that defines the fact into a social problem. Sometimes, without much fanfare or rhetoric, an individual professional or a volunteer will attempt a remedy either with spontaneous effort or a small scale program. These small efforts can emerge despite the bureauracy that controls the bulk of public welfare; sometimes the new remedy becomes part of received wisdom and public policy. Whether it is continued or not the program has responded to human need in a changing world. Social work in industry, among refugees, displaced homemakers, gay people are some of the instances in which small scale operations came before “public” help. The problem of sexually abused children has been around a long time; any kind of sexual activity with a child is harmful (Conte 1981, pp 601-602.). An unknown number of child victims grow up without psychological help that could prevent painful memories as an adult. It was to prevent this emotional scaring that the “shoestring operation” was launched. © 1988 Gordon and Breach Science Publishers, Inc.
Keywords: Child Sexual Abuse; low cast therapy

Amnesia as a Consequence of Male Rape: A Case Report - Kaszniak, A.W.; Nussbaum, P.D.; Berren, M.R.; Santiago, J. (Journal of Abnormal Psychology, 1988)
A male patient suffering from a generalized functional retrograde amnesia, for all autobiographical information, was admitted to a psychiatric inpatient facility. Psychological testing indicated possible sexual assault. Following five hypnotic sessions, the patient regained his memory, and a violent sexual attack by two males was validated. The amnesia is discussed in terms of the constructs of implicit versus explicit memory, and reasons why a male rape victim might suffer such an extreme reaction.

A Relation Called Father Part 2: The Father and his Children - Samuels, A. (British Journal of Psychotherapy, 1988)
SUMMARY. In Par, I an analysis was made of the neglect of the father in depth psychology. This was followed by an attempt to find meaning and purpose in incestuous fantasy and behaviour. The role of the father in the formation of gender identity in his sons and his daughters was discussed. In Pan 2 it is proposed that clinicians begin to think of an optimally erotic relation between Lather and daughter, and of the father as transforming the aggression of the son. A further new concept is introduced, that of unconscious‘gender certainty’. The paper includes some reflections on the general cultural aspects of the ideas raised. Copyright © 1988, Wiley Blackwell. All rights reserved

Risk factors for infection with human immunodeficiency virus among intravenous drug abusers in New York City - Marmor, M.; Des Jarlais, D.C.; Cohen, H.; Friedman, S.R.; Beatrice, S.T.; Dubin, N.; El-Sadr, W.; Mildvan, D.; Yancovitz, S.; Mathur, U.; Holzman, R. (AIDS, 1987)
We report here the results of a survey of 308 intravenous drug abusers recruited from hospital-based methadone maintenance or drug detoxification programmes located in Manhattan, New York City. Complete interviews and serological analyses for antibodies to human immunodeficiency virus (HIV) using both enzyme-linked immunosorbent and Western blot assays were obtained from 290 (94%) of the subjects. HIV antibodies were found by both assays in 147 (50.7%) of the tested subjects; conflicting results were found in three (1%) of the subjects; and negative results on both tests were found in 140 (48.3%) of the subjects. Logistic regression analysis identified significant relative risks for HIV infection associated with the frequency of drug injection and the proportion of injections in 'shooting galleries'. Additional risk among men was associated with a history of homosexual relations. Traditional efforts taken by subjects to clean syringes between uses, such as washing with water or alcohol, showed no evidence of being protective. Programmes aimed at prevention of HIV infection should focus on reducing use of shooting galleries and sharing of needles and syringes as well as reducing intravenous drug abuse generally.

Suicide risk among gay men and lesbians: A review - Saunders, J.M.; Valente, S.M. (Death Studies, 1987)
Without adequate death statistics from completed suicide data, the suicide risk for gay men and lesbians must be determined from, empirical studies and from a theoretical understanding of suicide risk. Three large, well designed studies found that gay men and lesbians attempt suicide two to seven times more often than heterosexual comparison groups. Gay men and lesbians have significantly high rates of risk factors that increase suicide risk such as suicide attempts, alcohol abuse, drug abuse and interrupted social ties. Durkheim suggests that groups with low social status and integration who are denied society’s usual privilege and rights are at risk for alienation and anomic suicide unless protected by internal cohesion, religion or antisuicide norms. Durkheim’s theory applied to gay men and lesbians illustrates how the extensive and diverse alienation reported may lead to suicide. Diverse groups of gay people have not yet successfully decreased alienation or suicide. Empirical evidence, risk factors and Durkheim’s theory of anomic suicide thus supports the proposition that gay men and lesbians are at high risk for suicide. The need for sensitive research methodology, decreased heterosexual bias, creative network network sampling strategies, and confidentiality are discussed. Future research should clarify the completed suicide rates among diverse groups of homosexuals of different age, sex, race, and demographic variables. © 1987 by Hemisphere Publishing Corporation.

Suicide Among Homosexual Adolescents - Kourany, R.F.C. (Journal of Homosexuality, 1987)
Little attention has been given in the professional literature to suicide among homosexual adolescents. Sixty-six adolescent psychiatrists responded to questionnaires on the subject. Results from this survey suggest that many experts are not working with homosexual adolescents. On the other hand, the majority of those treating them considered them to be at higher risk for suicide and agreed that their suicidal gestures were more severe than those of other adolescents. © 1987 Taylor & Francis Group, LLC.

HIV-infection in forensic autopsy cases - Püschel, K.; Lieske, K.; Hashimoto, Y.; Karch, H.; Laufs, R.; Racz, P.; Janssen, W. (Forensic Science International, 1987)
Sudden and unexpected death and violent death of persons with a high risk of acquiring HIV-infections, especially homosexual males and intravenous drug abusers, have to be investigated by forensic autopsies. Therefore every forensic pathologist has to be aware of this infection and should try to make the proper diagnosis. Three typical cases are described: (1) suicide by hanging, (2) homicide by cutting the throat and (3) intravenous heroin overdose. Merely retro-spectively it could be cleared up that the deceased were homosexual but did not manifestly suffer from AIDS. The morphological findings in the lymph nodes and the postmortem serological findings are described in detail. © 1987.
Keywords: AIDS; HIV-infection (autopsy cases); Lymph node histology; Postmortem serology

Gender identity and gender transposition: Longitudinal outcome study of 24 male hermaphrodites assigned as boys - Money, J.; Norman, B.F. (Journal of Sex and Marital Therapy, 1987)
The longitudinal case histories of 24 male-assigned male hermaphrodites aged 18 or older were indexed and abstracted for the presence or absence of variables related to gender transposition, namely, bisexual- ism, homosexuality, or sex reassignment to live as a female. The sample was biased in favor of cases (N = 20) not showing signs of gender transposition. In these cases, there was no gender transposition even if the following variables were in evidence; neonatal ambivalence in announcing the sex; cosmetic inadequacy of masculine genital appearance; sitting posture for urination; and feminizing (N = 9) instead of virilizing (N = 11) puberty. Despite the small size of the minority subsample (TV = 4), it showed a trend toward an association between gender transposition and sitting to urinate, and being stigmatized in childhood. This trend is consistent with the association between stigmatization and gender transposition found in a counterpart study of male hermaphrodites announced and reared as girls. Freedom from gender transposition did not prevent suicidal depression, drug or alcohol addiction, marital failure, or death from testicular cancer. © 1987 Brunner/Mazel, Inc.

Suicide and alcoholism - Frances, R.J.; Franklin, J.; Flavin, D.K. (American Journal of Drug and Alcohol Abuse, 1987)

Risk-Taking behavior, substance abuse disorders, and the acquired immune deficiency syndrome - Flavin, D.K.; Frances, R.J. (Advances in Alcohol and Substance Abuse, 1987)
The Acquired Immune Deficiency Syndrome (AIDS) has rapidly emerged as a public health crisis of unusual proportion. Despite the attention given to the association of AIDS and parenteral substance abuse, the relationship between AIDS and other aspects of substance abuse disorders such as risk taking, disinhibition and lack of self care has not been emphasized. In vitro and in vivo evidence of immune suppression as a result of substance abuse, coupled with behavioral disinhibition and co-existent psychiatric problems make the relationship between these two public health problems a likely area of concern. Substance abuse, increased risk taking and self destructiveness are co-factors involved in the transmission of AIDS which need to be studied epidemiologically. The authors address the relationship between the addictions and disinhibiton, suicidal behavior, and the clincal and therapeutic needs of patients, their families and staff. © 1987 by The Haworth Press, Inc. All rights reserved.

Stranger homicide in Canada: A national sample and a psychiatric sample - Langevin, R.; Handy, L. (Journal of Criminal Law and Criminology, 1987)
Using data from both a national and a psychiatric survey, it is apparent that stranger killers, in most respects, are similar to acquaintance killers. Stranger killer tended to be somewhat younger, perhaps reflecting the urgency of sexual needs prominent in some cases, and robbery and sexual assault seemed to be the most important motives for the homicides which they committed. Stranger killers were also more likely to use excessive force on a victim who had not provoked them. This result may reflect the tendency of stranger killers to maintain higher levels of freefloating anxiety and confused thinking. The amount of force used in the homicide may also reflect sexual excitement. Stranger killers were less likely to have attempted suicide than acquaintance killers, but the former group tended to hallucinate more often at the time of the offense. As a group, the stranger killers had poorer interpersonal and sexual relationships than the acquaintance group members. This result may reflect the presence of underlying anomalous and sadistic sexual preferences. Members of both groups of killers were similar in their abuse of alcohol and drugs, disturbed family backgrounds, and histories of excessive violence. The exploration of sexual motivation for homicide and robbery, which is, perhaps, related to sexual or power needs, appears to be the most fruitful area to explore in further differentiation of stranger and acquaintance homicides.

Physicians assessment of deficiencies and desire for training in adolescent care - Blum, R. (Journal of Medical Education, 1987)
Over the past decade, there has been growing awareness among medical educators and care providers of the deficits in the training of primary care physicians to meet the health care needs of adolescents. The study reported here is the first national survey of primary care physicians perceptions of their competency in dealing with adolescents health concerns. In the survey, 351 internists, family practitioners, and pediatricians rated their competency in 19 areas of adolescent health care. Approximately three-quarters or more of the internists indicated deficits in all 19 areas. In areas related to gynecologic concerns, more pediatricians reported deficits than family physicians; but more family physicians than pediatricians reported deficiencies in managing acute conditions of youth (growth and developmental problems, endocrinopathies, school-based problems, and chronic illnesses). All physicians indicated deficiencies in dealing with high-risk health behaviors: eating disorders, drug and alcohol abuse, homosexuality, and delinquency. Finally, more than 45 percent of the physicians overall reported deficiencies in areas related to social and/ or emotional concerns, including suicide, depression, and family conflicts. Despite these acknowledged deficits, most of the primary care physicians did not indicate adolescents to be the least desirable age group with which to work. However, few of the physicians expressed a desire to improve their skills. Overall, in none of the 19 areas did more than 30 percent of the physicians who had reported deficiencies in an area express interest in improving their competency. © 1990 The American College of Obstetricians and Gynecologists.

Physicians' assessment of deficiencies and desire for training in adolescent care - Blum, R. (Academic Medicine, 1987)
Over the past decade, there has been growing awareness among medical educators and care providers of the deficits in the training of primary care physicians to meet the health care needs of adolescents. The study reported here is the first national survey of primary care physicians' perceptions of their competency in dealing with adolescents' health concerns. In the survey, 351 internists, family practitioners, and pediatricians rated their competency in 19 areas of adolescent health care. Approximately three-quarters or more of the internists indicated deficits in all 19 areas. In areas related to gynecologic concerns, more pediatricians reported deficits than family physicians; but more family physicians than pediatricians reported deficiencies in managing acute conditions of youth (growth and developmental problems, endocrinopathies, school-based problems, and chronic illnesses). All physicians indicated deficiencies in dealing with high-risk health behaviors: eating disorders, drug and alcohol abuse, homosexuality, and delinquency. Finally, more than 45 percent of the physicians overall reported deficiencies in areas related to social and/or emotional concerns, including suicide, depression, and family conflicts. Despite these acknowledged deficits, most of the primary care physicians did not indicate adolescents to be the least desirable age group with which to work. However, few of the physicians expressed a desire to improve their skills. Overall, in none of the 19 areas did more than 30 percent of the physicians who had reported deficiencies in an area express interest in improving their competency. © 1987 Association of American Medical Colleges.
Keywords: Adolescent; Adolescent medicine (education); Attitude of health personnel; Clinical competence; Education, medical; Education, medical, continuing; Human; Primary health care; Support, U.S. gov't, p.h.s; United States

Lending an ear. - Armstrong, J. (Nursing times, 1986)

In state-funded project, ex-drug addicts take AIDS warnings to the streets. - Shane, S. (Sun (Baltimore, Md. : 1837), 1986)
This article describes a state-funded project in Baltimore, Maryland, that uses former drug addicts as outreach workers in the fight against acquired immunodeficiency syndrome (AIDS). The outreach workers distribute educational materials about AIDS to intravenous drug abusers, prostitutes, and street people, with particular emphasis on the dangers of needle sharing. To date, 15% of AIDS cases in Maryland have involved intravenous drug abusers who contracted the disease through contaminated needles. Part of the popularity of "shooting galleries" in Baltimore neighborhoods is the availability of the "tools" necessary to inject drugs, even though the syringes may have been used by many other addicts. In addition to AIDS prevention education, the outreach workers are administering a questionnaire intended to assess abusers' level of knowledge about AIDS. Initial results suggest that many drug addicts still regard AIDS as a disease of homosexuals. The Street Outreach AIDS Prevention Project is funded by an US$85,000 grant from the state Drug Abuse Administration to the Health Education Resource Organization (HERO), the Baltimore AIDS education and support group. A total of 5 outreach workers, recruited from drug treatment programs, have been hired.

San Diego Suicide Study: Comparison of Gay to Straight Males - Rich, C.L.; Fowler, R.C.; Young, D.; Blenkush, M. (Suicide and Life‐Threatening Behavior, 1986)
ABSTRACT: Previous large studies of completed suicides have not considered sexual orientation in their data analyses. In this study, data from the known homosexual subpopulation (13 males, aged 21–42) in a series of 283 suicides were examined. They were compared with all other aged male suicides 21–42 (n = 106). Both groups showed considerable substance abuse plus a variety of other psychiatric diagnoses. Both also had a high frequency of relationship difficulties near the time of death. Gays who committed suicide did not have a history of more police trouble and were no more likely to be living alone than the comparison group. They did not have more prior suicide attempts or previous psychiatric treatment. We conclude that, among the factors examined here, there appears to be little difference between gay and heterosexual male suicides. 1986 The American Association for Suicidology

The acquired immune deficiency syndrome (AIDS) and suicidal behavior in alcohol-dependent homosexual men - Flavin, D.K.; Franklin, J.E.; Frances, R.J. (American Journal of Psychiatry, 1986)
Three alcohol-dependent homosexual men with suicidal ideation and behavior consciously attempted to contract the acquired immune deficiency syndrome (AIDS) as a means of committing suicide. The authors briefly examine the interrelationship among alcoholism and substance abuse, homosexuality, suicidal behavior, and AIDS; implications for the substance abuse treatment setting are noted. Early diagnosis and treatment of depression and substance abuse in homosexual men or parenteral drug abusers may prevent the spread of AIDS and reduce hidden suicidal potential.

Suicide and Alcoholism - FRANCES, R.J.; FRANKLIN, J.; FLAVIN, D.K. (Annals of the New York Academy of Sciences, 1986)

The snowball effect of the "real-life test" for sex reassignment - Oppenheim, G. (Journal of Sex Education and Therapy, 1986)
The period during which a transsexual is required to live full time in the desired sex role has long been thought of as the “real-life test.” Practitioners have assumed that, unlike the final sex-reassignment surgery, the role change is reversible. In this author's experience, that assumption is not always correct. Events that inevitably take place, starting even before the full-time role switch, seem to lead in some cases to a powerful impetus to continue on this path, even when the patient has serious doubts or a complete change of mind about switching sex. In such cases, safeguards may fail. The patient may bypass the required evaluations for surgery and go to doctors who will perform the operation for all comers. The result in some cases can be the tragedy of living in the wrong gender role or, in some cases, suicide. Such cases would seem to point up the need for greater caution, not only in clearing candidates for sex-reassignment surgery, but even for launching them on hormone therapy and the real-life test—or prolonging that test unduly. © 1986 Taylor & Francis Ltd.

16 PF Research into addiction: Meta-analysis and extension - Tuite, D.R.; Luiten, J.W. (Substance Use and Misuse, 1986)
Meta-analysis of 3z4 studies on Cattell's 16PF test reveals ragged egos (C-), guilt (O), distrust (L), frustration (Q4), alienation (G-), vague identity (Q3-), alarm (H-), resentment (Q1), quasi-autism (M), scattered intellect (B-), grandiosity (E), autonomy (Q2), infantilism (I), avoidance (A-), and deviousness (N). The aberrant scores on E, G, I, Q1, and Q2 discriminate addicts from suicidals and the chronically ill or unemployed. We found nine types of addicts in our developmental study of 83 members of Alcoholics Anonymous. On the more stable second-order 16PF factors, 43% were highest on Autonomous, 37% on Desperate, 16% on Tough Poise, and 4% on Extravert. Profiles differed more by sexual preference than by gender. Recidivism was highest among homosexual men (38% and the desperate (25% Only the Fourth and Fifth Steps of the AA program seem crucial to recovery. Treatment programs based on these and tailored to sexual preference and the second-order personality types seem highly advisable. © 1986 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

Insiders and outsiders: Discourses of oppression in giorgio Bassani’s gli occhiali d’oro - Cicioni, M. (Italian Studies, 1986)
Bassam s Gli occbiah d oro (which was first published in 1958 and later revised) is set in 1937.1 Its historical references are less explicit than those in three of the Cinque storie ferraresi which chronologically precede it (Una lapide in via Mazzini, Gli ultimi anni di Clelia Trotti and Una notte del '43, written between 1953 and 1955 and published in 19 5 6). Yet it is in this novel, and not, as Giorgio Cusatelli believes,2 3 4 in Gli ultimi anni di Clelia Trotti, that Bassani’s ideological insight is most acute. A clear understanding of the political reasons for the isolation of the two main characters (the homosexual Doctor Fadigati and the nameless Jewish narrator) emerges from both the structure of the novel and the interplay between the discourses - the linguistic representations of ideology - of heterosexuals, homosexuals, Gentiles and Jews. The dominant discourse - that of Gentile heterosexuals - is completely internalized by Fadigati, with the logical consequence of his suicide, and almost completely internalized by the narrator, with the result that the latter’s attempts at constructing an alternative (Jewish) discourse are sporadic and subjective, and are thus doomed to failure. © 1986 Maney Publishing.

Excess mortality among psychiatric patients. The importance of unnatural death, substance abuse disorders, antisocial personality and homosexuality - Martin, R.L. (Acta Psychiatrica Belgica, 1986)
Excess mortality was largely attributable to unnatural causes in a 7 year follow-up study of 500 psychiatric outpatients. Suicide and homicide rates were particularly elevated. Unnatural mortality was associated with secondary but not primary affective disorders, and with substance abuse (both alcoholism and drug addiction), antisocial personality, and homosexuality. These disorders were often multiply present in unnatural death victims. The findings may attest to a lack of effective treatments for these disorders, while improved diagnostic and treatment strategies are now available for affective disorders uncomplicated by coexisting disorders. The importance of scrutinizing for intercurrent disorders when assessing mortality risks in patients with affective syndromes is underscored.

AIDS Health Education for Intravenous Drug Users - Friedman, S.R.; Des Jarlais, D.C.; Sotheran, J.L. (Health Education & Behavior, 1986)
Intravenous (IV) drug users are the second largest risk group for AIDS and the main source of infection for heterosexual partner and pediatric AIDS cases. IV drug users have an addiction and a subculture that make risk reduction difficult; for example, to refuse to share needles can endanger personal relationships, and carrying clean works (rather than renting them in a shooting gallery) risks arrest. In New York City, at least, knowledge about AIDS transmission is widespread among IV drug users, and most drug injectors report having changed their drug use practices to reduce their risks. The main functions of health education in areas where IV drug users have this level of knowledge are to disseminate news of new discoveries; reach those drug users who have not yet learned AIDS basics; reinforce what is already known; and provide in formation about new programs to help drug users deal with AIDS-related problems. To encourage behavior change requires going beyond simple education, however; it entails trying to change IV drug user subculture. Drug user groups in the Netherlands and in New York City are attempting to do this from within the subculture. Outside intervention requires repeated messages from multiple sources; face-to-face, interactive communication; and perhaps the use of ex-addicts as health educators. © 1986, Sage Publications. All rights reserved.

Micropenis: Gender, erotosexual coping strategy, and behavioral health in nine pediatric cases followed to adulthood - Money, J.; Lehne, G.K.; Pierre-Jerome, F. (Comprehensive Psychiatry, 1985)
In nine cases of micropenis followed from pediatric age until adulthood (aged 22 to 31) the adult penis size was 2.5 SD below the mean or smaller, with one exception. Pubertal virilization was inadequate in six cases, in five of which there was also a history of neglecting follow-up and androgen-replacement therapy. In six cases there was a low incidence of erotosexual activity. In three there was a long-term pair-bonded attachment. There was one case of homosexual hustling, one of homosexual pair-bondedness, and one of homosexual attraction frustrated by the concealment of a skin-grafted phalloplasty. In the latter two cases, there was a history of agonizing over the option of possible sex reassignment and contemplating death by suicide. In one other case there was a history of paraphilic sadomasochism, in fantasy only, with a woman victim. The juvenile experience of micropenis in the family, the clinic, and the community may dislocate what should be the normal juvenile erotosexual rehearsal play and fantasy of uncomplicated heterosexual differentiation. © 1985.

Intravenous Drug Abusers and the Acquired Immunodeficiency Syndrome (AIDS): Demographic, Drug Use, and Needle-Sharing Patterns - Friedland, G.H.; Harris, C.; Butkus Small, C.; Shine, D.; Moll, B.; Darrow, W.; Klein, R.S. (Archives of Internal Medicine, 1985)
We studied the demographic characteristics, drug use patterns, and sexual habits of intravenous (IV) drug abusers to further define this population at risk for acquired immunodeficiency syndrome (AIDS). Sixteen IV drug abuser patients with AIDS, 24 IV drug abuser patients with AIDS-related complex (ARC), and 14IV drug abuser controls without evidence of AIDS or ARC were evaluated. The subjects in each group were similar demographically, in drug use practice, and in sexual orientation and experience. Of the AIDS and ARC patients, 34 (88%) of 40, including all seven homosexual men, shared needles, as did all drug abusers without AIDS or ARC. Seventy-four percent of patients, including all homosexual men, attended “shooting galleries,” where anonymous multiple-partner needle sharing took place. Needle sharing supports the hypothesis of AIDS transmission by a blood-borne route, can explain the spread of AIDS and the high rate of seropositivity to the putative AIDS agent among IV drug abusers, and is a logical link between IV drug abusers and male homosexuals, the two largest groups with AIDS. © 1985, American Medical Association. All rights reserved.

Changes of inner space - Stewart, H. (International Journal of Psycho-Analysis, 1985)

Mortality in a Follow-up of 500 Psychiatric Outpatients: II. Cause-Specific Mortality - Martin, R.L.; Cloninger, C.R.; Guze, S.B.; Clayton, P.J. (Archives of General Psychiatry, 1985)
In a six- to 12-year follow-up study of 500 psychiatric outpatients, death from natural causes occurred 11/3 times the expected rate, although the excess was not significant. Death from unnatural causes occurred 31/2 times the expected rate, a significant elevation. Suicide and homicide rates were particularly excessive. Unnatural mortality was excessive among younger, but not older, patients, and among all sex-race groups except black women, none of whom died unnaturally. Initial psychiatric diagnoses highly predictive of unnatural death included alcoholism, antisocial personality, drug addiction, and homosexuality. Secondary affective disorder was predictive of excess unnatural mortality, but in all cases of such death one of the four disorders associated with excess mortality antedated the affective disturbance. No patient with an index diagnosis of primary affective disorder died of an unnatural cause. Despite a frequent history of suicide attempts, hysteria was not associated with excess unnatural mortality. © 1985, American Medical Association. All rights reserved.

Androgyny and the Perception of Television Violence as Perpetrated by Males and Females - Gunter, B.; Furnham, A. (Human Relations, 1985)
This study examined British viewers' perceptual judgments of violent TV scenes from three categories of programming: British crime detective series, American crime detective series, and science fiction series in which either a male assailant attacked a female victim or a female assailant attacked a male victim. Violence took the form either of a shooting or a fist fight/physical struggle which were balanced equally across male and female violence. Each scene was rated by a panel of viewers for the perceived seriousness of its content along eight evaluative scales. Respondents also filled out the Bem (1974) Sex Role Inventory (BSRI). Results showed that male violence on a female victim was rated as more serious than female violence on a male victim, but only in a contemporary British crime drama context. In contemporary American crime or futuristic, science fiction contexts, the reverse was true. High masculinity scores on the BSRI were associated with the belief that male victimization by a female assailant was more violent and disturbing than female victimization by a male assailant, while high femininity scorers found female victimization the more violent and disturbing of the two. These relationships held following separate analysis for male respondents and female respondents and indicate the importance of self-perceived masculinity-femininity as well as actual sex as mediators of viewers' judgments about TV violence. © 1985, Periodicals Service Company. All rights reserved.

Teen theaters grapple with issues. - Pugni, J.L. (Planned parenthood review, 1984)
At this time there are about 20 Planned Parenthood teen theater groups throughout the US. The idea originated in New York in 1973, when the staff of the Family Planning Division of the New York Medical College needed an effective way to reach adolescents about important issues. FOCUS, a teen family life theater sponsored by Planned Parenthood of Greater Charlotte, performs skits about life as seen from the teenager's perspective. The teenagers do not use a script but create their performances from their own experiences, expressed through carefully learned improvisational techniques. This approach gives the presentations an authentic flavor that enables the troupe to connect with the audience. The topics dealt with vary. For example, 1982-83 shows included peer pressure, divorce, teenage pregnancy, drinking, teenage suicide, parent-teen relationships, and loneliness. The performances do not offer absolute answers but rather pose important questions to the audience. Following the performance the actors and actresses return to the stage, still portraying their characters, and invite the audience to ask questions and discuss possible alternatives for the characters. THE SOURCE is the Teen Council of Planned Parenthood of Southwest Florida. It works to inform the community of problems teenagers face by presenting short plays, written, directed, and cast by teens themselves. Through education, honest answers, healthy building of self esteem, and parent support, SOURCE members reach a higher level of self awareness. They then share what they learn with their families, peers, and the community through performance and special events. THE SOURCE, formed in October 1980, grew out of Planned Parenthood's belief that if teens feel self worth, their decision-making process will be affected less by peer pressure and negative social influences. The Youth Expression Theater (YET) of Cambridge is an education outreach project of the Planned Parenthood League of Massachusetts (PPLM). It grew out of the belief that improvisational drama, by permitting teens to portray their conflicts, is a more creative educational tool than a lecture series by adult professionals. YET productions deal with teen pregnancy, parenting, sexual responsibility, and decision making, alcohol and drug abuse, birth control, homosexuality, divorce, abortion, suicide, and sex-role stereotyping. In Dallas, Texas, Elena Love and Jim Roderick established the Teen Perspective Theater (TPT) as an arm of the Planned Parenthood of Greater Dalls education program. An acting company of 11 students aged 13-18 was drawn from public and private schools. Rehearsals began the end of July and included educational sessions as well as performance skill workshops. The presentation follows the format established by other Planned Parenthood theater groups: brief improvisational skits, in-character exchange with the audience, and personal exchange with the audience.

Increasingly ruth: Toward understanding sex reassignment - Levine, S.B.; Shumaker, R.E. (Archives of Sexual Behavior, 1983)
Both the clinician and the patient present accounts of a 44-year-old male's search for a comfortable gender identity. The juxtaposition of these two perspectives illustrates many of the dilemmas inherent in the therapy of gender dysphoria. Ruth underwent sex reassignment surgery in 1976-one year after the assumption of a full-time female gender role. Six months after surgery, she made a serious suicide attempt. At age 50, she has now consolidated her feminine gender identity and has become a thoughtful, unusually honest, articulate person. The physician's "objective" and the patient's retrospective perspectives provide evidence of the psychodynamic nature of transsexualism and the limitations of evaluation criteria for sex reassignment surgery. © 1983 Plenum Publishing Corporation.
Keywords: gender identity; sex reassignment; sexual identity; transsexualism

Adolescents' grief reactions and self-concept perceptions following sibling death: A study of 33 teenagers - Balk, D. (Journal of Youth and Adolescence, 1983)
Thirty-three teenagers were interviewed regarding their grief reactions and self-concept perceptions following sibling death. The teenagers also completed the Offer Self-Image Questionnaire for Adolescents (OSIQ). Grief reactions investigated were emotional responses, extent of preoccupations with thoughts of the dead sibling, effects on sleeping and eating habits, anniversary reactions, hallucinations of the dead sibling, thoughts of suicide, and effects on grades and study habits. In addition to OSIQ data, self-concept measures included self-concept in common contexts, perceptions of personal maturity, lessons learned from the sibling's death, relationship with the sibling prior to the death, and importance of religious beliefs. Results of t tests on OSIQ standard scores indicated that the participants were as adjusted as same-age same-sex norm groups. Chi-square analysis and univariate F tests of group differences identified emotional responses significantly associated with sex and age characteristics of the participants. Statistically significant results emerged regarding effects on grades and study habits, perceptions of personal maturity, and increased importance of religious beliefs. Discriminant analysis indicated that specific emotional responses were influenced by perceptions of family closeness and by perceptions of personal communication with family members. Two case descriptions highlight some of the typical patterns which the teenagers experienced. © 1983 Plenum Publishing Corporation.

Life at risk: markers of suicidality in depression. - Agren, H. (Psychiatric Developments, 1983)
One hundred and ten patients with Research Diagnostic Criteria (RDC) diagnoses of major depressive disorders were assessed for present or recent suicidal ideation and behavior and for suicidal acts earlier in life before current depression using the Schedule for Affective Disorders and Schizophrenia (SADS). Suicidal scores were correlated uni- and bivariately with levels of CSF monoamine metabolites (HVA, 5HIAA, MHPG), urinary MHPG, the proportion post-/predexamethasone plasma cortisol at 1100 h, and platelet MAO activity (all standardized to same sex, age, height and weight). Results indicate that all 3 monoamine metabolites and their interactions are involved in various aspects of suicidality, at least in unipolar patients. MHPG and 5HIAA (both low or both high) were involved in current or recent suicidal ideation, and low HVA was mainly associated with past potential lethality of suicidal acts. Current hypercortisolism was found in patients that earlier in life had tried to commit dangerous suicides. Bipolar patients (depressives with a history of manic or hypomanic episodes) had earlier in life significantly more, and more dangerous, suicidal attempts than the unipolars.

Homicide Followed by Suicide: Los Angeles, 1970–1979 - Allen, N.H. (Suicide and Life‐Threatening Behavior, 1983)
A study of 104 homicide‐followed‐by‐suicide events in Los Angeles during 1970–1979 are reported and compared, in part, to the findings of D. J. West for Wales and England, 1954–1961. Variables discussed are age, ethnicity, sex distribution of both offenders and victims, relationship between them, methods by which victims were killed, alcohol content in victims and offenders, suicide notes, depression, and physical illness. 1983 The American Association for Suicidology

Scandal in Hong Kong - Johnson, H. (Medico-Legal Journal, 1983)

Diagnosing homosexuality in a State Department of Mental Health - Shachar, S.A.; Hagan, B.J.; Evenson, R.C. (Psychological Reports, 1983)

Brain purinergic activity linked with depressive symptomatology: Hypoxanthine and xanthine in CSF of patients with major depressive disorders - Ågren, H.; Niklasson, F.; Hällgren, R. (Psychiatry Research, 1983)
The purine metabolites hypoxanthine and xanthine were analyzed in cerebrospinal fluid (CSF) of 70 patients with major depressive disorders (diagnosed according to Research Diagnostic Criteria) and, for reference, in 26 nonpsychiatric individuals. In the patient group, levels adjusted by analysis of covariance to same sex, age, height, and weight were univariately and multivariately correlated with both depressive subdiagnoses and individual depressive symptoms. Results indicate that raw CSF levels in depressed patients are significantly correlated with the four variables used in adjustment (for hypoxanthine mainly negatively with height; for xanthine mainly positively with age). Hypoxanthine and xanthine both appear to be linked with the expression of depressive symptomatology: lower levels of hypoxanthine are associated with anger and suicidal tendencies, and higher levels are related to memory disturbance; lower xanthine levels characterize patients with subjective feelings of depression, and in patients with higher levels appetite is poor. © 1983.
Keywords: cerebrospinal fluid; depression; hypoxanthine; multivariate analysis; Purines; xanthine

Depression and somatosensory evoked potentials: II. Correlations between SEP and depressive phenomenology - Agren, H.; Osterberg, B.; Franzen, O. (Biological Psychiatry, 1983)
In 32 patients with major depressive disorders according to Research Diagnostic Criteria (RDC), symptomatology was rated using the Schedule for Affective Disorders and Schizophrenia (SADS), and somatosensory evoked potentials (SEP) elicited by tactile fingertip stimuli were recorded at the vertex of the scalp. Patients were drug-free except for benzodiazepines. Amplitudes and amplitude/stimulus intensity slopes were adjusted to same sex, age, height, and weight. Uni- and multivariate correlations revealed associations between the N140-P200 amplitude and hypothyroidlike aspects of depression with symptoms such as poor appetite and indecisiveness, and between P100-N140 slope and intrapunitive aspects of depression with symptoms such as negative self-evaluation and suicidal attempts. Neither attention level nor benzodiazepine medication were reflected in these relationships.

Transsexualism and the family: an interactional explanation - Jones, S.L.; Tinker, D. (Journal of Family Therapy, 1982)
Descriptive data are presented from home interviews of the families of origin of 14 transsexual patients who presented to a Gender Identity Clinic requesting surgery. The findings show that the relationship between family dynamics and transsexualism is interactional. Critical junctures are identified where the parents react to the child's gender dysphoric behaviour and the child then reacts to the parents' reaction. Parents were initially not worried about the gender inappropriate behaviour in the child; thus, they did not discourage the behaviour and at times encouraged it. At a later point they discouraged the behaviour. The child then became more desparate in his or her attempts to pursue the transsexual feelings. The most intense symbolic action on the part of the transsexual‐prone child was a suicide attempt. Copyright © 1982, Wiley Blackwell. All rights reserved

Self-performed bilateral orthiectomy in transsexuals - Krieger, M.J.; McAninch, J.W.; Weimer, S.R. (Journal of Clinical Psychiatry, 1982)
This paper reviews three cases of self-performed bilateral orchiectomy seen within a 2-year period at San Francisco General Hospital. All three cases were male to female transsexuals. The patients were not considered psychotic by the psychiatric consultant, although two patients admitted to past suicide attempts and psychiatric treatment. The patients' histories and treatment are reviewed and suggestions for diagnosis, management, and treatment planning are offered.

Homosexual incest - Kaslow, F.; Haupt, D.; Arce, A.A.; Werblowsky, J. (Psychiatric Quarterly, 1981)
Within the past two years, we have encountered two cases where homosexual incest seemed to be a potent predisposing factor in extreme pathological behavior. In order to better understand what we were contending with, an extensive search and review of the literature was undertaken and the two case histories analyzed in detail. Our conclusions include:(1) that homosexual incest is at times unrecognized by therapists and therefore not dealt with to alleviate torment and sometimes to avert tragic consequences; and (2) that it is underreported so that information is lacking and essential dialogue on dynamics and treatment rarely occurs. It is hoped that this article will stimulate awareness of the phenomenon and foster exchange of ideas regarding etiology, psychodynamics, and intervention. © 1981 Human Sciences Press.

Partnership in transsexualism. Part I. Paired and nonpaired groups - Huxley, P.J.; Kenna, J.C.; Brandon, S. (Archives of Sexual Behavior, 1981)
In a group of 72 transsexuals, 26 out of 55 male-to-female transsexuals had partners and 9 out of 17 female-to-male transsexuals had partners. Forty percent of the group of 35 paired transsexuals had been married, but most of these marriages had ended in divorce or separation. Six male patients were still married at the time of the enquiry. The two groups differed significantly in several respects. Those with partners (the paired group) had more fathers or heads of family in social classes I-III, while those without partners (the nonpaired group) were more often without their father in the first decade of life. Significantly more of the paired group received psychiatrists' rating of stable social adjustment. There was a tendency for the paired group to have a more successful employment history since leaving school and to change their National Insurance cards more often in order to obtain employment in their adopted gender. The groups did not differ in the amount of social drift, self-confessed criminal behavior, age at referral, history of prostitution, or incidence of rejecting parents. There were also no significant differences on the following psychological tests: Wechsler Bellevue, Progressive Matrices, Mill Hill Vocabulary Scale, Maudsley Personality Inventory, Slater Selective Vocabulary-except that the nonpaired group knew fewer male words. Any differences between the two groups are perhaps best described in terms of social adjustment rather than any background social factors, personality, or clinical differences. © 1981 Plenum Publishing Corporation.
Keywords: gender identity; sex roles; transsexualism

A follow‐up study of operated transsexual males - Sørensen, T. (Acta Psychiatrica Scandinavica, 1981)
The opportuneness of operating on transsexuals has often been discussed but it has obviously been the only form of treatment they wish themselves. Most transsexuals in Denmark have been assessed at the Rigshospital prior to surgery. Since 1951, when the first operation on a transsexual took place, we have had a thorough pre‐operative knowledge of a total of 29 transsexual males who have all obtained official status as females and who have subsequently been followed up. A phenomenologically based clinical theory of the dynamic coherence of the symptomatology of transsexuals has been advanced. A special core group of transsexual males has been described as characterized by a stable defence in the form of a pseudofeminine narcissism, a stable ego strength, an intact reality testing and a poor genital interest. These patients are expected to have a relatively stable life postoperatively. Of the 29 operated transsexual males six were not interviewed, three had committed suicide and two refused to take part in the follow‐up. These last five did not belong to the core group, whereas one patient, who emigrated to Canada after sex‐reassignment, belonged to the core group. The remaining 23 have all been interviewed, of these 14 belonged to the core group. The average for the follow‐up period is 6 years. The operations turned out not to be resocializing, rather the contrary. The majority had no occupation at follow‐up and the number of persons with disablement pension had increased considerably. About 66% lived alone and the majority of those with sexual relationships had had problems. Both before and after operation the majority felt socially isolated. About 66% were satisfied with the surgical outcome, nevertheless 50% wished for supplementary plastic surgery. None of the patients showed signs of more severe psychic sufferings or psychoses postoperatively. Psychically, 83% felt better after than before sex‐reassignment. The majority have had complications and subjective trouble in connection with plastic surgery leading to reoperations of the vagina in most of them. Almost 75% have had sexual relationships postoperatively but not without difficulties. Characteristic of the persons in the core group is a better economy, a better adjustment to the environment and less problems with neighbours, they are more satisfied with the surgical outcome and have had fewer surgical corrections and also have a better psychic condition than the rest. It is the general impression at follow‐up that the advantages of sex‐reassignment outweigh the disadvantages where the core group is concerned. But among the persons who do not belong to the core group subjective and objective problems seem so pronounced that operation must be advised against in spite of the often extremely, subjectively unsatisfactory condition of these patients preoperatively. Copyright © 1981, Wiley Blackwell. All rights reserved
Keywords: follow‐up; Gender identity; male transsexualism; sex‐reassignment

The Pink Triangle - Lautmann, R. (Journal of Homosexuality, 1981)
Having analyzed the fragmentary records of Nazi concentration camps, the author reports on the number and treatment of male homosexual prisoners. The total number of inmates officially defined as homosexual is estimated as about 10,000, although the number incarcerated varied greatly from camp to camp and as the war progressed. Pink-triangle prisoners had low social status, often were isolated for other inmates, and, as compared to political and JehovahÆs Witnesses, more frequently were given the most difficult work assignments and less frequently were assigned to light duties. They had a higher death rate and a lower survival rate upon release. Suicide rates were not significantly different from those of the other inmate groupÆs studies. Pink-triangle prisoners were not subjected to exceptionally cruel treatment in all camps and at all times, however, and were not the only group of prisoner subject to extreme abuse. © 1981 Taylor & Francis Group, LLC.

Self-inflicted ocular mutilation - Yang, H.K.; Brown, G.C.; Magargal, L.E. (American Journal of Ophthalmology, 1981)
Self-inflicted mutilation of the eyes is an uncommon but fairly distinct entity. Patients are typically young men; they often have criminal records and histories of drug abuse. Underlying schizophrenia is a common feature. The patients frequently suffer from castration fears, oedipal conflicts, repressed homosexual impulses, severe guilt, and a need for punishment. We treated two patients with this disorder. The first, a 26-year-old prison inmate convicted of murdering his grandfather, cut his eyes with a razor blade. He had previously attempted to commit suicide, suffered from delusions, and experienced auditory hallucinations. Surgical repair of his injuries improved his visual acuity to R.E.: 6/15 (20/50) and L.E.: 6/30 (20/100). The second patient, a 24-year-old inmate of a mental institution, had previously undergone a lensectomy for a hypermature cataract induced by a self-inflicted lye burn in his left eye. One year later, he was treated for lacerations of his right eye and partial amputation of his tongue. In the year between admissions, he had enucleated his left eye. Visual acuity in his remaining eye was no light perception, so no surgery was performed. © 1981.

Sexual anomie, social structure, societal change - Tiryakian, E.A. (Social Forces, 1981)
Although relegated to a minor place in his writings, Durkheim did consider aspects of sexuality and sexual regulations as basic features of social organization. This paper begins with an examination of sexual anomie in Suicide. Durkheim uncovered some unexpected data as to which sex really benefits from the institution of marriage but did not draw out the implications of his findings because, we suggest, the findings were too anomalous in terms of the bourgeois worldview of his period. Yet the notion of sexual anomie is heuristic in approaching features of contemporary society that involve transformations in sexual relations and sexual identity. In addition to structural changes and deregulations in sexual relations, attention is also given to ideological ones, such as expressions of an ideology of "androgyny." We conclude that the question and meaning of sexual relations will become a central concern for the social order of advanced modernity, and therefore should be reconsidered as a major variable in societal change. © 1981 The University of North Carolina Press.

Psychotherapy, responsibility, and homosexuality: Clinical examination of socially deviant behavior - Meredith, R.L.; Riester, R.W. (Professional Psychology: Research and Practice, 1980)
Focuses on professional and ethical issues in the treatment of individuals with problems of a socially deviant nature, specifically homosexuality. Public and professional attitudes toward homosexuality and an overview of the various models of deviancy and operational criteria (psychological test results and interview data) of psychopathology are reviewed, suggesting that (a) differences are readily identifiable between homosexual and heterosexual individuals and other comparison groups; (b) differences are not always deficits; (c) differences exist within the broad group of homosexuals; (d) some homosexuals evidence psychopathological personality traits; (e) some homosexuals are at greater risk with respect to problem drinking, drug abuse, and suicidal attempts; and (f) some homosexuals appear to be adjusting quite effectively. Professional responsibility at 3 levels (client, society, self) is discussed in detail. Guidelines are presented that may facilitate resolution of various professional and ethical issues in working with individuals whose problems are of a socially deviant nature. (42 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1980 American Psychological Association.
Keywords: ethical issues, treatment of homosexuals &; other individuals with socially deviant problems, clinical practitioner; professional responsibility &

A case study of autocastration - Pabis, R.; Mirza, M.A.; Tozman, S. (American Journal of Psychiatry, 1980)
Although transsexual surgery has received considerable attention, autocastration remains a rarity. Self-castration is usually performed in a state of psychotic confusion, except for those few men throughout history who castrated themselves for religious reasons. This case report describes a man with minimal psychotic confusion, although elements of psychotic depression were evident, who committed autocastration in a premeditated and carefully thought out manner, possibly as a substitute for suicide.

A Comparison of Three Psychological Testings of a Transsexual - Hill, E.F. (Journal of Personality Assessment, 1980)
This case illustrates the use of psychological testing in assessing change over a period of eight years. Evaluations were done six years before transsexual surgery, after surgery, and at the completion of psychotherapy. The initial tests were rife with morbid suicidal and pathological content. Psychotherapy in a residential setting was recommended and accepted. Psychological testing after surgery revealed identity conflicts, guilt, and underlying depression. The final evaluation revealed remarkable changes. Her ego was good. She was not handicapped by defenses. She was using her intelligence for systematic thinking. Her anxiety level was within normal limits, and concerns were realistic to her situation. © 1980, Taylor & Francis Group, LLC. All rights reserved.

The risk of breakdown during outpatient psychotherapy - Parsons, M. (American Journal of Psychotherapy, 1980)
It is important to know how often patients break down during psychotherapy and to identify those at risk of it, but there is a lack of information about this. A retrospective case-note survey covering one year's intake into an analytically orientated outpatient psychotherapy unit is reported. Of patients entering therapy 8.4% suffered breakdown during it. The following characteristics have been believed to put patients at greater risk of breakdown, but patients with them in fact broke down no more frequently than others: past psychiatric hospital admissions or suicide attempts, drug or alcohol abuse, antisocial behaviour, homosexuality or other deviations, hypochondriasis or psychosomatic symptoms, a positive psychiatric family history, a disturbed childhood. Duration of symptoms bore no relation to breakdown. Patients with a previous psychiatric history but who had been treated for only six months or less, did break down more often. These findings are shown to be applicable also in selection of patients for psychotherapy.

Childhood and Adolescent Development of Ten Female Prostitutes - MacVicar, K.; Dillon, M. (Journal of the American Academy of Child Psychiatry, 1980)
The study of ten adolescent and young adult female prostitutes revealed that three of them had schizophrenic psychoses, while the remainder had borderline character structures. The psychotic adolescents participated in prostitution in an attempt to preserve some vestige of object relationships. The borderline adolescents, all of whom had chaotic family histories, had severe splits in the world of self and object, with the result that all-good and all-bad images were kept apart. The all-good image was that of the pimp, while the all-bad image was that of the customer. Other aspects of prostitution such as the high incidence of suicide attempts, homosexuality, and the use of money are also discussed. © 1980, The American Academy of Child Psychiatry. All rights reserved.

The aging gender dysphoria (transsexual) patient - Lothstein, L.M. (Archives of Sexual Behavior, 1979)
Ten aging gender dysphoria patients (eight men and two women, average age 52 years) were the subjects of this study. All had presented to the Gender Identity Clinic at Case Western Reserve University requesting sex-reassignment surgery. A psychiatric-psychological profile of the patients, their sexual functioning, problems with aging, diagnostic issues, and follow-up are discussed. The aging gender dysphoric patient presents in acute crisis, that is, exhibiting marked depression, increased suicidal ideation and behavior, and urgent perception of time. Diagnostic and treatment recommendations for aging gender dysphoria patients and their depressions are provided. Furthermore, guidelines are suggested for differentiating the aging transvestite with transsexual symptoms and the aging transsexual for whom sex-reassignment surgery may be indicated. Specific treatment strategies for an aging population, including sexual surgery, are also discussed. © 1979 Plenum Publishing Corporation.
Keywords: aging; gender dysphoria; homosexuality; transsexualism; transvestism

The MMPI as a primary differentiator and predictor of behavior in prison: A methodological critique and review of the recent literature - Gearing, M.L. (Psychological Bulletin, 1979)
Evaluated 71 investigations of MMPI usage in prison work. Additional studies were examined to provide a methodological basis for the comparisons of the research, which were made within sections on (a) sampling procedures, (b) sources of variance and their effects on test results, (c) protocol validity, and (d) methods of profile interpretation. Several methodological shortcomings and various differences in procedure across studies limit the generalizability of the findings. Research in the hostile-assaultive section, however, has produced preliminary MMPI indicators for a type of violently aggressive behavior pattern that is otherwise difficult to detect. Other areas in which the MMPI shows promise include homosexuality, recidivism, and the classification of psychopathologic behavior. More research is needed in the areas of institutional adjustment and suicide. Recommendations for future investigations prescribe adequately controlled sampling procedures, modifications in the interpretation of protocol validity, investigation of certain methodological questions in their own right, consideration of more than one aspect of profile data, the use of base-rate probabilities in predictive studies and the pursuit of longitudinal studies with thorough follow-up procedures. (31/2 p ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1979 American Psychological Association.
Keywords: MMPI as primary differentiator & predictor of behavior in prison, methodological critique & literature review

Two shootings - Palframan, D.S. (Canadian Journal of Psychiatry, 1979)
These two cases illustrate varying ways in which paranoid states can result in violence. The first case is a non-schizophrenic, non-alcoholic lifestyle, and the second shows the more classical paranoia associated with immigration, symptomatic use of alcohol, homosexual fears, and schizophrenic thought disorder.

Mother-daughter incest - Goodwin, J.; DiVasto, P. (Child Abuse and Neglect, 1979)
Reports of mother-daughter incest are conspicuously absent from the extensive literature on the sexual abuse of children. When homosexual incest has been reported, the relationship usually involves father and son. In some reported cases of father-daughter incest, the mother had an active role in the sexual act. There is one reported case of grandmother-grand-daughter incest. In the present case, the victim, L., entered psychotherapy because of migraine headaches. She was a university student, struggling, ambivalently, to separate from a jealous and possessive mother. She had been involved in several homosexual affairs which had ended with L. rejecting her partner. Early in therapy, she made a self-mutilating suicide attempt. L. was the only child of an older, lower middle class couple. Father was a passive, ineffectual man, overshadowed by L. 's mother. Soon after L. was born, mother and father began sleeping in separate bedrooms. When L. was six years old, mother invited her to share her bed. L. had a room of her own, but was allowed to sleep there only when mother entertained her homosexual lover. L. recalls being extremely jealous of her mother's lover. Starting at age 8, L. recalls awakening to find mother kissing L. on the lips or fondling her breasts. L. thinks that genital fondling also took place while L. was asleep. At age 14 L. insisted that she sleep alone because she felt there was "something wrong" with her relationship with mother. After two years of psychotherapy, L. was able to separate successfully from mother. Soon after this, she rekindled a relationship with a male friend and later married. It can be difficult to distinguish a sexually exploitative mother-daughter relationship from a normal physical closeness that occurs between mothers and female children. This closeness is critical in the development of mothering behaviors in the daughter. Seductive behavior in mothers is more socially tolerated than similar behavior in male caretakers. In some cultures, mothers actively masturbate their nursing infants. In the case of L., the sexual relationship between mother and daughter parallels the patterns seen in father-daughter incest. The incest behavior occurred in the context of a deteriorated husband-wife relationship. L. was confused about whether to relate to mother as a parent or as a sex partner. Sexual contact began when the patient was pre-pubertal and consisted mainly of fondling. L's memories of this contact are vague and dreamlike, and were revealed after a substantial therapeutic relationship had been established. L's subsequent homosexual encounters were a repetition of her seduction by her mother. Less explicit maternal seductions have been implicated in the pathogenesis of female homosexuality. As more women with homosexual life-styles take on the single parenting of daughters, reports of mother-daughter incest may become more common. © 1979.

Peptic ulcer in childhood. Psychological factors - Christodoulou, G.N.; Gargoulas, A.; Papaloukas, A.; Marinopoulou, A.; Rabavilas, A.D. (Psychotherapy and Psychosomatics, 1979)
Thirty children (20 girls and 10 boys, aged 6-16 years) with primary peptic ulcers, matched in pairs for age, sex and socio-economic standard to a group of 30 ulcer-free controls, were submitted to a structured psychiatric interview, a structured 'present psychiatric state' examination and to personality and intelligence tests. With one exception all patients suffered from duodenal ulcer; 3 male patients had personalities with psychopathic elements, 7 patients had nicknames, 5 suffered from psychiatric disorders, 3 had attempted suicide in the past, and 3 had had homosexual experiences. These parameters were negative in all controls. The patients had lower mean IQ, worse scholastic adaptation, more anxious and overprotective parents, higher frequency of faddiness in food and lower frequency of nail-biting than the controls. Psychotraumatic events had preceded the onset of ulcer symptomatology in 11 cases. The findings are discussed and the contribution of psychological factors in the pathogenesis of childhood peptic ulcer is stressed.

Violent sex and suicide - Danto, B.M. (Mental Health and Society, 1978)
Early literature on sexual disorders and suicidology are reviewed in this paper in the light of relationships between sexual problems, especially violent sexual ones, and suicide. The relationship between guilt feelings and suicide is viewed from the standpoint of current observations about sexually violent behavior and suicide. It was postulated that sexual perversions constitute a defensive means of coping with internal stress. Suicide is viewed as serving the same aim. Specific violent sexual behaviors such as sexual asphyxia and rape are discussed in terms of suicide. Transsexuality and transvestism are treated similarly. It is concluded that sexual violence and perversion in general are forms of self-destruction in themselves.

Suicide attempts in a female-to-male transsexual. - Herschkowitz, S.; Dickes, R. (American Journal of Psychiatry, 1978)

The clinical profile of male transsexuals living as females vs. those living as males - Langevin, R.; Paitich, D.; Steiner, B. (Archives of Sexual Behavior, 1977)
The clinical profiles of five male groups were compared: transsexuals who live as females (FEM), those who live as males (MAL), homosexual patients (HOP), homosexual controls (HOC), and heterosexual controls (CON). The MAL group showed psychotic features on the MMPI and a greater frequency of suicide attempts than the other groups. Their sexual behavior was incongruous in that they have had substantial sexual contact with men but less often desired sexual contact with men. They also less often desired to handle the penis of an adult man or to kiss him on the lips. They were more likely to find handling another's penis disgusting. However, they showed considerable involvement of their penis in sex relations with men. The FEM group, in contrast, had MMPI profiles suggestive of character disorders and tended to engage in antisocial behavior. Both MAL and FEM groups were similar in MMPI and 16 PF "femininity." The HOP group showed overall similarity to MAL but was not as pathological. The HOC and CON groups were similar in being normal but their sexual behavior differed, as expected. The paradoxical behavior of MAL is discussed as well as the parallel of the FEM group's behavior to that of criminals. © 1977 Plenum Publishing Corp.
Keywords: cross-dressing; homosexual; masculinity-femininity; personality; transsexual

Epidemiological studies of female prisoners: Iv. homosexual behavior - Climent, C.E.; Ervin, F.R.; Rollins, A.; Plutchik, R.; Batinelli, C.J. (Journal of Nervous and Mental Disease, 1977)
The existence of homosexual behavior in female offenders is investigated not only as an adaptive process but as an established behavior existing prior to detention. Ninety-five prisoners from the Framingham Institution for Women were included: 26 were self-reported homosexuals, 42 were considered homosexuals by prison staff, and 27 were nonhomosexuals. Suicidal thoughts, suicidal attempts, psychiatric problems during menstruation, and a history of violent crimes against persons were characteristic of the homosexual group, whereas a history of crimes against self and property as well as history of alcoholism were common in the nonhomosexual group. Violent behavior together with suicidal attempts in homosexual female prisoners support the hypothesis that aggressive impulses may be expressed either externally or toward the self, the problem being one of impairment in control mechanisms. The findings also support the idea that violent behavior, as shown by this group of incarcerated homosexual females, is multidetermined. The factors that influence its appearance and expression could include a history of family violence, impulse control as children, neurological abnormality, sex role identification problems, biochemical abnormalities (manifested as menstrual irregularities), and impulse control problems as adults. A better understanding of human violence must be based on the recognition of the multidimensional nature of the problem using the tools and insights from many disciplines. © 1976 by The Williams & Wilkins Co.

Primary peptic ulcer in childhood : PSYCHOSOCIAL, PSYCHOLOGICAL AND PSYCHIATRIC ASPECTS - Christodoulou, G.N.; Gargoulas, A.; Papaloukas, A.; Marinopoulou, A.; Sideris, E. (Acta Psychiatrica Scandinavica, 1977)
Twenty‐five children with radiologically confirmed primary peptic ulcers were investigated. All patients suffered from duodenal ulcer and there was an unexpected female preponderance. The frequency of introverted personalities was greater in the patients than in the controls. Five patients suffered from psychiatric disorders, three had histories of suicidal attempts and three reported homosexual experiences. Six patients had nicknames. Eight patients had been operated on for appendicitis. The above parameters were negative in all control cases. The patients had lower mean IQ, worse adaptation to school, more anxious and overprotective parents, higher frequency of faddiness in food and lower frequency of nail‐biting than the controls. The onset of symptoms was preceded by psychotraumatic events in eight cases. The findings suggest that the manifestation of the genetic background of duodenal ulcer is strongly influenced by environmental factors and factors associated with the personality of the patients. Copyright © 1977, Wiley Blackwell. All rights reserved
Keywords: duodenal ulcer in childhood; Peptic ulcer; psychosocial, psychiatric, psychological factors

Conditions predisposing to suicide: A review - Miles, C.P. (Journal of Nervous and Mental Disease, 1977)
By reviewing causes of death among cohorts of various major disease entities or conditions, one may infer that a large majority of suicides are associated with a relatively small number of conditions. From the available follow-up studies, we might estimate that the following percentage of affected individuals will die by suicide: Primary (endogenous) depression, 15 per cent; reactive (neurotic) depression, 15 per cent; alcoholism, 15 per cent; schizophrenia, 10 per cent; psychopathic personality, 5 per cent; opiate addiction, 10 per cent or more. Rough estimates of the number of suicides per year in the United States attributable to each condition might be as follows (using low incidence figures): Depression, 12,900; alcoholism 6,900; schizophrenia, 3,800; psychopathy, 2,000 (?); drug addiction, 900. © 1977 by The Williams & Wilkins Co.

Psychoanalysis in search of Pirandello: Six Characters and Henry IV - Roland, A.; Rizzo, G. (Psychoanalytic Review, 1977)

Training crisis intervention specialists and peer group counselors as therapeutic agents in the gay community - Enright, M.F.; Parsons, B.V. (Community Mental Health Journal, 1976)
This paper describes the development of a training program to provide unique services to homosexuals in crisis. The focus of the program was on the utilization of gay nonprofessionals as therapeutic agents in specific crisis situations and the development of a follow-up program to prevent future crises. Emphasis was placed on many aspects of the social milieu to provide comprehensive community intervention. © 1976 Human Sciences Press.

Transsexualism and social attitudes. A case report. - Jonas, S.P. (Psychiatria clinica, 1976)
After a brief review of the literature, a case of a male-to-female transsexual, with a 4-year follow-up, is presented. The etiological factors and some social responses to this pathology are discussed.

MALE TRANSSEXUALS: A Long‐Term Follow‐Up After Sex Reassignment Operations - Sturüp, G.K. (Acta Psychiatrica Scandinavica, 1976)
Since 1953 the Danish law permitting castration has been applied to transsexuals. Case histories are here reported on ten cases, operated up to 19 years before the follow‐up. Six of these presented typical syndromes. In some of the early cases the reluctance on the part of therapists to adopt an active therapy has ben too great. Two subjects had died before the follow‐up investigation, but both had formerly reported satisfaction with the treatment to their therapists. One case ‐ happily married ‐ had emigrated with the husband. At the interviews the three others confirmed happiness and satisfaction with their female way of life. They are living in rasonably good social circumstances. Three cases were not typical. A promiscuous massive sexual activity exhibited by these patients ha made it very difficult to endorse a surgical solution to their strongly presented with to obtain sex reassignment. At the follow‐up all three were very satisfied with their female role. After several years in their new sex role, two of these were still promiscuous. The last case presents unusually complicated sex role problems. He continues o live as a male, but he still insists 19 years after castration, that the operation saved his life. In spite of his handicap, he claims to be satisfied that he obtained the permit. None of the operated cases committed sucide, but one cae ‐ not operated but living as a female ‐ dveloped a paranoid reaction resulting in sucide. Copyright © 1976, Wiley Blackwell. All rights reserved
Keywords: castration; demasculinization; sex reassignment; Transsexuals

Psychological Adjustment and Life Style of Single Lesbians and Single Heterosexual Women - Oberstone, A.K.; Sukoneck, H. (Psychology of Women Quarterly, 1976)
The Minnesota Multiphasic Personality Inventory (MMPI) and a 60‐item structured interview questionnaire were administered to 25 white single homo‐sexually‐oriented women and 25 white single heterosexually‐oriented women between the ages of 20 and 45 years in order to investigate their psychological adjustment and current life styles. Groups were equivalent on age, marital status, educational and occupational levels, and other demographic variables. Groups did not differ in total psychological adjustment as measured by scale scores on the MMPI nor as evaluated by blind expert raters using the MMPI profiles. Groups differed significantly on the Masculinity‐Femininity (Mf) scale (p <.001) and the Hypomania (Ma) scale (p <.05). On the interview questionnaire, which included current living situations, roles and relationships, behavior and friendship patterns, and drinking, drug, and suicidal behavior, no major differ ences between groups were found. Differences between groups were found only on items directly related to sexual orientation. The findings clarify some of the myths and misconceptions about lesbianism. Copyright © 1976, Wiley Blackwell. All rights reserved

Hospitalized Suicidal Adolescents: Two Generations - Schneer, H.I.; Perlstein, A.; Brozovsky, M. (Journal of the American Academy of Child Psychiatry, 1975)

Student suicide: Death as a life style - Hendin, H. (Journal of Nervous and Mental Disease, 1975)
This is a study of the psychology of college students who are seriously suicidal. Fifty college students who had made suicide attempts were studied in detail over a 5-year period. Short term therapy was administered in most cases and long term therapy in some. Psychological tests (Wechsler. Adult Intelligence Scale, Rorschach, Thematic Apperception Test, Sentence Completion, Figure Drawing, and Word Association) were performed and used as an independent check on the data derived from the interviews. The study indicates the ways in which death has become a way of life for these students-an integral, ongoing part of their adaptation. It traces the origin of this adaptation in a family relationship that the students perceived as requiring their emotional extinction. These students are tied to their parents in a kind of death knot and have become overtly suicidal when life-coming to college, graduating, becoming seriously involved with another person-threatens to unravel this knot. © 1975 by The Williams & Wilkins Co.

Psychiatric problems in the hospital emergency room - Snodgrass, R.E. (Journal of the Indiana State Medical Association, 1974)

Youth aids youth - Donnelly, F.C. (New Zealand Medical Journal, 1974)
The work of Youthline, a telephone counselling service in Auckland, is described. Young people between the ages of 18 and 25 act as youth counsellors under supervision. Since the scheme started in 1971 there have been some 2000 telephone calls a year. Two thirds of the callers were female. The greatest number of calls were at weekends in the 6-8pm period. The three commonest categories of call were family conflict, boy/girl relationships and social isolation. The implications of this counselling are discussed. Youthline represents a useful contribution to remedial work among disturbed young persons.

Sexual crimes and the Medical Examiner - Helpern, M.; MacNamara, D.E.J. (Medical Aspects of Human Sexuality, 1974)
A substantial number of cases are seen in which homicide is associated with the sexual assault of both men and women, both homosexuals and heterosexuals. Brutal, multiple wounds in an unmarried man almost automatically lead to the assumption that a homosexual victim and a homosexual attacker are involved. It is very difficult to rape a robust woman who does not want to have sexual relations. On the other hand, if a man points a gun at her or puts a knife to her throat she usually becomes terrified and submits. This is the most sensible thing to do, because otherwise she may be killed.

A case of manifest homosexuality with acute paranoid trends accompanied by depressions and suicidal tendencies - Bhatia, R.P. (Samiska, 1974)
The main purpose of presenting this case is not to work out fresh conclusions and theoretical considerations regarding paranoia and its relation to homosexuality, but to indicate that many of these paranoia cases can be treated by psychoanalytical psychotherapy without much modification either in the technique or in the nature of interpretations.

Spatial representations and psychopathology - Roth, D.; Blatt, S.J. (Journal of the American Psychoanalytic Association, 1974)

A follow up study of female narcotic addicts: variables related to outcome - D'Orban, P.T. (British Journal of Psychiatry, 1974)
Sixty six female narcotic addicts first examined in 1967-68 were followed up 4 yr later by reference to Home Office records. 36% had became abstinent, 32% had remained addicted and 15% had died. Comparisons were made on 8 variables between those with a good outcome and those with a poor outcome. Outcome was assessed in terms of continued addiction and delinquency and in terms of addiction status alone. The number of previous convictions showed a significant inverse relationship to abstinence; this association may be worth validating in prospective studies of both sexes.

Being in love and object loss - Bak, R.C. (International Journal of Psycho-Analysis, 1973)
'Being in love' is a uniquely human, exceptional emotional state, which is based on undoing the separation of mother and child. The feeling state is directed towards undoing this separation, as well as undoing later separations and losses of important objects. Therefore it is comprehensible that it is often triggered by object loss and aims to undo it, to restitute and regain the lost object. This trend is directed towards deep regression with the aim of fusion with the object. The regression is further facilitated by the sexualization of several ego functions, first of all perception. The undoing of separation is equally valid for both sexes, and it takes place in the orgasm. At the height of the complete orgastic experience, self and object are fused; libido and aggression are simultaneously discharged in instinctual fusion and the ego is capable of tolerating a momentary extinction of the self in which it returned to undifferentiation.

'I was nineteen and I wanted to die'. (Nursing times, 1973)

Suicide by shooting in the mouth - Fross, G.H. (Journal of the American Institute of Hypnosis, 1973)

Unintentional shootings, highway crashes and acts of violence-A behavior paradigm - Waller, J.A.; Whorton, E.B. (Accident Analysis and Prevention, 1973)
Characteristics of Vermont residents involved as shooters in unintentional shootings of all degrees of severity were compared with those of residents whom they shot and residents of same sex and similar age, most of whom owned guns but who were not involved in shooting incidents. In comparison with the other two groups, the shooters more often were previously known to the police, had arrests for violence, had arrests involving alcohol, and crashes and traffic citations during the previous 3 years and during their lifetimes. A behavior model is suggested, commonly involving alcohol, in which poor control of aggressive tendencies results in intentional acts of violence, and unintentional injury both on the highway and elsewhere. © 1973.

Dogmatism and opinions about mental illness - Hood Jr, R.W. (Psychological Reports, 1973)

Suicidal and depressive feelings among college students - Murray, D.C. (Psychological Reports, 1973)
A questionnaire concerning their suicidal and depressive thoughts was administered to a sample of university students. Over 40% had thought of killing themselves and less than 10% denied at least having felt deeply discouraged and unhappy. Religion was related to the presence of suicidal thoughts, and sex to reported frequency of such thoughts. Students were most likely to tell a friend of such thoughts, and, at a significant level, the friend was of the same sex as the respondent. Scores on locus of control, social desirability, and test anxiety measures were unrelated to suicidal and depressive thoughts. Results are compared with findings from other studies. The utility of reported depressive and suicidal thoughts as predictors of suicidal behavior is questioned.

Psychiatric disorders among aborigines of the Australian Western Desert. Further data and discussion - Jones, I.H.; de L. Horne, D.J. (Social Science and Medicine, 1973)
This paper describes a psychiatric survey of 959 Australian Western Desert and Kimberley aborigines. This group contains some of the most primitive to be found in Australia now. That is, it contains many of those least affected by western influences and may thereby give some indication of psychiatric disorders pertaining among these people at a time when they were nomadic-now there are virtually no fully nomadic aborigines left. The survey was conducted in a similar manner to two other surveys among similar people and conclusions have been drawn from a population of 2360 people. The prevalence of psychiatric illness appears to be somewhat lower than that found in western communities, however the types of illness, with certain exceptions, are similar. We have found cases of dementia, schizophrenia, puerperal psychosis, depression, hysterical states, personality disorders, organic brain syndromes, mental deficiency and childhood behavioural disorders. There are negative findings which could be of relevance: we have found only one case of overt anxiety and this was in a very westernized individual. No cases of suicide or homosexuality have been found among tribal aborigines although these two forms of behaviour have been found among aborigines who have lost a great part of their indigenous culture. A possible explanation for these negative findings in terms of cultural differences is discussed. © 1973.

Suicide attempts and psychiatric diagnosis. - Woodruff Jr., R.A.; Clayton, P.J.; Guze, S.B. (Diseases of the nervous system, 1972)

Youthful Male Homosexuality: Homosexual Experience and the Process of Developing Homosexual Identity in Males Aged 16 to 22 Years - Roesler, T.; Deisher, R.W. (JAMA: The Journal of the American Medical Association, 1972)
Interviews with young men ages 16 to 22 who had had at least one homosexual experience to orgasm revealed that certain significant events over a period of time usually preceded the individual's self-designation, “I am a homosexual.” These events include (1) early sex play (whether prepuberty or postpuberty) the individual recalled as homosexual in nature, (2) actually seeking persons for homosexual contact (as adolescents), and (3) “coming out” (participating in the gay world). Four years separated the mean ages of first homosexual experience to orgasm14 and self-designation as a homosexual.18 This period was, for many, one of extreme emotional turmoil. Of 60 subjects, 29 (48%) had visited a psychiatrist and 19 (31%) had made what they considered to be a significant suicide attempt. © 1972, American Medical Association. All rights reserved.

A comparison with the heterosexual patient - Swanson, D.W.; Dale Loomis, S.; Lukesh, R.; Cronin, R.; Smith, J.A. (Journal of Nervous and Mental Disease, 1972)
The clinical characteristics of a group of female homosexuals who sought treatment were compared with those of a control group of nonhomosexual female psychiatric patients. The lesbian patients in our series were like lesbians generally, except that they had less stable homosexual relationships. Lesbians in our series differed significantly from control subjects in the following ways: Increased paternal abusiveness and alcoholism, different vocational choice, an expected indifference toward men, and increased drug abuse. A trend toward more suicidal behavior was noted in the homosexual group. No major historic factors were related specifically to homosexuality, and the conflict over homosexuality was only one factor (not a primary one) that caused the patient to seek treatment. © 1972 by The Williams & Wilkins Co.

Dual suicide in homosexuals - Swartzburg, M.; Schwartz, A.H.; Lieb, J.; Slaby, A.E. (Journal of Nervous and Mental Disease, 1972)
Although it has been reported that approximately 5 per cent of all joint suicides involve homosexuals, a detailed case study of a suicide pact involving homosexuals has not appeared in the literature. This paper attempts to fill this gap by reporting a joint suicide attempt involving two male homosexuals. One of the men involved had an extremely conflictual relationship with his mother and in the past had attempted to arrange a dual suicide with female acquaintances. Unable to find a girl who would agree to this, he turned to a fellow homosexual. The other individual accepted the proposition more out of a desire to play out homosexual and aggressive fantasies than out of any real desire to die. The episode ended when this person called for help following the joint overdose. Ernest Jones and Sadger have noted the presence of homosexual urges and the desire for eternal union with the maternal figure in cases of dual suicide. Contemporary theorists have discussed the role in homosexuality of a primary conflict involving both the desire for and the dread of union with the mother. Such dynamics are clearly demonstrated to be operative in the young man who initiated the suicide pact. The paper further discusses the role of murderous wishes and sexual fantasies as important factors in the second young man’s participation in the suicide pact and calls attention to the role of aggression in homosexuality. It is conceivable that dual suicides among homosexuals may be more common than has been reported. In fact, the authors have been informed of other cases appearing in the emergency rooms of big city hospitals that have not been reported. It is hoped that this article will stimulate further investigation. © 1972 by The Williams & Wilkins Co.

Septal stimulation for the initiation of heterosexual behavior in a homosexual male - Moan, C.E.; Heath, R.G. (Journal of Behavior Therapy and Experimental Psychiatry, 1972)
A 24-year-old male, overt homosexual, repeatedly hospitalized for chronic suicidal depression and found to have temporal lobe epilepsy, underwent a program of septal stimulation which resulted in subjectively reported and behaviorally observed states of pleasure, euphoria, relaxation, confidence, and sexual motivation. These responses were subsequently used to initiate heterosexual arousal and behavior. The findings have important implications for the treatment of some psychological disorders. © 1972.

Focal suicide: self-enucleation by two young psychotic individuals. - Rosen, D.H.; Hoffman, A.M. (The American journal of psychiatry, 1972)

Psychiatric disorders among Aborigines of the Australian Western Desert (II) - Jones, I.H. (Social Science and Medicine, 1972)
A psychiatric survey of 300 full blood Aborigines of the Australian Western Desert living on 2 separate Missions was carried out and these results were compared with similar surveys undertaken among other communities in the Western Desert. No evidence of suicide or homosexuality was found. Only one example of "free floating" anxiety was seen. Two examples of hysterical fits were described but depression was not seen in contrast to the Warburton Range report. Personality disorders were similar at all four Missions, the most prominent being excessive aggressive behaviour. Hypochondriacal symptoms are prominent and these complaints are related to possession states but reporting of this type of symptom seems to be markedly influenced by the attitude of the local medical authorities. The reason for these apparent differences between western and Aborigine communities is briefly discussed. © 1972.

Bondage and Suicide - Litman, R.E.; Swearingen, C. (Archives of General Psychiatry, 1972)
“Bondage” is a well-established category of deviant sexual behavior. It includes practices for erotic pleasure of being humiliated, enslaved, and physically bound and restrained. Life is threatened when, as is common, neck binding or partial asphyxiation forms part of the behavior. In the United States there are yearly about 50 such deaths, sometimes suicide, usually by accident. We report two fatal cases rich in details provided by the now deceased. In addition, we interviewed nine men and three women who responded to a notice in the underground press. Subjects were diverse in character and varied in the details of their bondage behavior. All of the men were isolated, depressed, and oriented toward death. Their masochism was first a challenge, then an invitation to death. When they see psychiatrists (for depression), the sexual problems are minimized. © 1972, American Medical Association. All rights reserved.

Psychosis Associated with Cannabis Smoking - Davison, K.; Wilson, C.H. (British Journal of Addiction to Alcohol & Other Drugs, 1972)
While the debate en whether cannabis is harmless or not continues it is helpful to record the casualties of its increasingly widespread use. A report is given of the occurrence of a prolonged psychosis in a University student in which cannabis smoking was thought to be a significant aetiological factor. Copyright © 1972, Wiley Blackwell. All rights reserved

Toward a general theory of psychosocial deviance: The case of aggressive behavior - Kaplan, H.B. (Social Science and Medicine, 1972)
The outline of a general theory of psychosocial deviance is described. The core of the theory consists of two propositions. First, antecedent self-derogation increases the probability of subsequent adoption of modes of psychosocial deviance. Second, adoption of deviant patterns tends to decrease the degree of preexisting self-derogation. The emerging theoretical model is discussed with reference to studies relating to several specific modes of deviant behavior. A partial confirmation of the generality of the theory was provided by a consideration of the literature relating to agressive behavior. Two sets of propositions were discussed: those concerning the reciprocal relationship between self-attitudes and aggressive behavior; and, those dealing with influences toward the adoption of aggressive behavior patterns in particular given the general predisposition to adopt some form of deviant behavior. © 1972.

A statewide computerized psychiatric system: Demographic, diagnostic and mental status data - Sletten, I.; Schuff, S.; Altman, H.; Ulett, G. (International Journal of Social Psychiatry, 1972)
Since 1966, the Missouri Division of Mental Diseases and the Department of Psychiatry of the University of Missouri Medical School at Saint Louis have jointly developed programs to standardize entries in the psychiatric clinical record and to develop computer methods to process such information. Demographic data and mental status findings have been standardized and data gathered since 1967. Psychiatric and social history, nurses observations, psychological test data, relatives reports and other data are also being collected on new patients as they receive care in the Division of Mental Diseases facilities. This report concerns the relationships and correlations among the variables in the demographic data, mental status findings and the psychiatric diagnoses found on 4,156 patients. Multiple regression, multiple discriminant analysis, and per cent frequency counts and chi square tests of significance were used to evaluate the data. Many correlations of interest were found. This data and the statistical formulae enable the computer to assign diagnoses to patients with accuracy comparable to that of the clinical psychiatrist. Also with these methods the computer can identify patients with a high likelihood of having assaultive ideas (one chance in three) suicidal thoughts (one chance in two) and other ideation of clinical interest. We will further test these approaches and findings in the Missouri Division of Mental Diseases as we build a Standard System of Psychiatry. Our goals are to maximally use the computer and electronic data processing techniques to establish clinical facts and relationships and to provide computer generated suggestions to the clinician on a timely basis as he cares for his patients. © 1972, Sage Publications. All rights reserved.

Effects of Marihuana on Adolescents and Young Adults - Kolansky, H.; Moore, W.T. (JAMA: The Journal of the American Medical Association, 1971)
The large amount of marihuana smoking (12 million to 20 million people) in this country was reviewed, as well as some of the literature concerning adverse effects. Thirty-eight individuals from age 13 to 24 years, all of whom smoked marihuana two or more times weekly, were seen by us between 1965 and 1970, and all showed adverse psychological effects. Some also showed neurologic signs and symptoms. Of the 20 male and 18 female individuals seen, there were eight with psychoses; four of these attempted suicide. Included in these cases are 13 unmarried female patients who became sexually promiscuous while using marihuana; seven of these became pregnant. © 1971, American Medical Association. All rights reserved.

Demographic and mental status profiles - Patients with homicidal, assaultive, suicidal, persecutory and homosexual ideation - The Missouri automated Standard System of Psychiatry - Altman, H.; Sletten, I.W.; Eaton, M.E.; Ulett, G.A. (The Psychiatric Quarterly, 1971)
Using 87 demographic and mental status variables from the Missouri Division of Mental Diseases automated record file, equations to predict five clinically important types of ideation (i.e., homicidal, assaultive, suicidal, paranoid, and homosexual) were developed and cross-validated on 4,156 inpatients. The multiple correlations found ranged from .25 to .48 on cross validation and were all statistically significant. Zero-order correlations for the 10 strongest predictors of each type of ideation are presented and the clinical implications of the correlations are discussed. The prediction equations developed should make it possible for clinicians to improve the accuracy of their assessments of the true status of their patients for these five types of ideation. © 1971 The Psychiatric Quarterly.

Male and female homosexuality: Natural history - Saghir, M.T.; Robins, E. (Comprehensive Psychiatry, 1971)
The aim of our study was to describe the natural history of the homosexual phenomenon through describing its development and characteristics from early childhood and into adult life. Our findings indicate that the homosexual orientation develops very early in life and that the prehomosexual child displays behavioral characteristics that are more typical of the opposite sex than of his own biologic sex. The homosexual male begins his sexual involvement in early adolescene, while the homosexual female starts her homosexual involvement several years later. There was no significant difference in the prevalence of neurotic disorders between homosexuals and heterosexuals. However, homosexual males and females had more depression, suicide attempts, and usually abused alcohol more often. Still, the majority of the homosexuals functioned adequately and were productive, with no significant disabilities. © 1971.

Attempted suicide. - Short, C.A. (Nursing times, 1970)

Sudden death in the gay world - Rupp, J.C. (Medicine, Science and the Law, 1970)

Homosexuality. IV. Psychiatric disorders and disability in the female homosexual. - Saghir, M.T.; Robins, E.; Walbran, B.; Gentry, K.A. (The American journal of psychiatry, 1970)

Homosexuality. 3. Psychiatric disorders and disability in the male homosexual. - Saghir, M.T.; Robins, E.; Walbran, B.; Gentry, K.A. (The American journal of psychiatry, 1970)

The curse: study in family communication. - Raybin, J.B. (The American journal of psychiatry, 1970)

Dreams of a dying patient - GREENBERG, H.R.; BLANK, H.R. (British Journal of Medical Psychology, 1970)

The civilian psychiatrist and the draft. - Frank, I.M.; Hoedemaker, F.S. (The American journal of psychiatry, 1970)

Suicide pacts. - Hemphill, R.E.; Thornley, F.I. (South African Medical Journal, 1969)

Suicide clues in psychotic patients. - Singer, R.G.; Blumenthal, I.J. (Mental hygiene, 1969)

Black Suicide - Hendin, H. (Archives of General Psychiatry, 1969)

Investigations on a case of male transsexualism - Dellaert, R.; Kunke, T. (Psychotherapy and Psychosomatics, 1969)
The problem of Transsexualism, i. e. the obsessional urge to undergo a surgical change of sex, is discussed in its general context, followed by an investigation of a case of transsexualism in which psychiatrist and clinical psychologist co-operated. The psychiatrist, R. Dellaert, performed a successful psychotherapy on a case of male transsexualism The patient is the son of an overprotective, domineering mother and of an insignificant father. Therapy showed that during the patient's early childhood, when the father still played an active role, the child identified with the sexually passive mother. The mother educated the boy as if lie were a girl, thus preventing him from developing beyond this phase. Later, when the mother became the only authority in the family, he identified with the active side of the mother's character. When, as a young man, the patient was confronted with adult life and the mother tried to drive him into a marriage, it came to a crisis. He was obsessed by the idea of undergoing a surgical change of sex in order to become such a perfect woman as the girl he was supposed to marry. By a thorough analysis of the various aspects of the negative and the positive Oedipus complex a complete recovery was achieved. The result of the therapy pleads for a psychogenic etiology of transsexualism. The psychologist, Th. Kunke, gained an identical insight into the patient's problems independently from psychiatric investigation. The Rorschach was applied three times at intervals of two years each. From the first testing, consisting of the Rorschach and Phillipson's Object Relations Technique, the personality structure of the patient and the dynamism of his transsexualism were elaborated independently from the psychiatrist. These results were formulated in a range of suppositions which were, after termination of therapy, fully confirmed by a comparison with the psychiatrist's therapy notes. © 1969 S. Karger AG, Basel.

Transsexualism: Considerations regarding sexual reassignment - Hoopes, J.E.; Knorr, N.J.; Wolf, S.R. (Journal of Nervous and Mental Disease, 1968)
The present discussion reviews some of the historical aspects of transsexualism, explores possible reasons for previous neglect of this major problem and attempts characterization of the transsexual patient on the basis of information contained in correspondence from individuals seeking evaluation and treatment. The primary deterrent to physician involvement in the transsexual problem is a self-protective one, namely fear of censure and considerations regarding reputation. Correspondence has been received by the Gender Identity Clinic from more than 700 individuals requesting evaluation and management. This report is based on the unsolicited information contained in letters from the initial 500 persons requesting evaluation and attempts characterization of the individuals on the basis of geographical distribution; age, sex and race distribution; age of onset; public dressing; psychiatric therapy; suicide and self-mutilation; hormone therapy; marital status; and occupation. Appeals for medical assistance from transsexual individuals are deserving of thorough consideration. Transsexualism and related sexual problems represent neglected areas of medical investigation. © Williams & Wilkins 1968. All Rights Reserved.

Suicide during an LSD reaction. - Keeler, M.H.; Reifler, C.B. (The American journal of psychiatry, 1967)

Chemiluminescent radiation from the far wake of hypersonic spheres - Reis, V.H. (AIAA Journal, 1967)
Radiation from the far wake of hypersonic spheres launched from a light-gas gun was measured with filtered photomultiplier radiometers. Projectile velocities ranged between 14,700 and 22,000 fps, with test section pressures of 30 to 220 torr. In all cases, the spectral distribution of the far-wake radiation was found to be consistent with the chemiluminescent recombination reaction NO + O → N2 + hv. Further, various features in the radiative wake profile (intensity per unit wake length vs distance behind the body) were found to be correlated with the appearance of wake turbulence in schlieren photographs. The experiments indicate that the NO2 chemiluminescence is coupled to both the wake fluid dynamics and wake chemistry, and it is suggested that the NO2 chemiluminescence measurement represents an excellent observable with which hypersonic wake theories may be compared. The possibility of scaling the chemiluminescent results to larger bodies is briefly considered, and it would appear that all the quantitative features of NO2 wake radiation cannot be scaled because of important nonbinary processes occurring in the far wake. © 1967 American Institute of Aeronautics and Astronautics, Inc., All rights reserved.

Common problems in the treatment of schizophrenia in adolescents - Green, M.R. (The Psychiatric Quarterly, 1966)

THE CONCEPT OF THE SELF: ITS SIGNIFICANCE IN THE ETIOLOGY AND THERAPY OF PSYCHIC DISORDERS. - BRESSLER, B. (Psychoanalytic review, 1965)

D-Lysergic acid diethylamide (LSD): A review of its present status - Hoffer, A. (Clinical Pharmacology and Therapeutics, 1965)
This is a review of an important but controversial subject, written by one of the important figures involved in the controversy. It was not possible to get a review in depth by someone who was not also involved in the controversy. With this in mind, this review was accepted for publication because it was written by an authority actively engaged in the problem and because it was thought important to bring details of the subject to the attention of a large readership. Correspondence is invited. © 1965 American Society for Clinical Pharmacology and Therapeutics.

SEX-ROLE REVERSAL FOLLOWING CASTRATION OF A HOMOSEXUAL TRANSVESTITE WITH KLINEFELTER'S SYNDROME. REPORT OF AN UNUSUAL CASE. - MILLER, A.; CAPLAN, J. (Canadian Psychiatric Association journal, 1965)

PSYCHOTHERAPY USING TWO THERAPISTS - GREENBANK, R.K. (American journal of psychotherapy, 1964)
Keywords: ADOLESCENCE; HOMOSEXUALITY; NEUROSES, OBSESSIVE COMPULSIVE; PSYCHOANALYTIC THERAPY; SCHIZOPHRENIA; SOCIOPATHIC PERSONALITY; SUICIDE

HOMOSEXUAL PANIC WITH HALLUCINATIONS--A CASE STUDY. - LONDON, L.S. (Medical times, 1964)

Homosexuality alitv as a defense against feminine strivings: A case report - Lipkowitz, M.H. (Journal of Nervous and Mental Disease, 1964)

PSYCHOPATHIC PERSONALITY - ANNESLEY, P.T. (The Medico-legal journal, 1963)
Keywords: ANXIETY; CRIMINOLOGY; DELUSIONS; DEPRESSION; DRUG ADDICTION; HOMOSEXUALITY; SEX DEVIATION; SOCIOPATHIC PERSONALITY; SUICIDE

A case of narcissism with auto-fellatio - Gorham, D.R. (The Psychiatric Quarterly, 1954)
This paper makes reference to the first and second recorded cases of auto-fellatio, and a third is presented. The first subject was overtly homosexual, the second had strong latent homosexual tendencies, the third has had homosexual panic states which led to suicidal attempts. Selected parts of the patient's own notes on 76 psychotherapy sessions are presented to provide a basis for understanding his unusual practice in the light of his total personality developmental picture. This patient illustrates in actuality some of the end points of personality maladjustment which were hypothecated by the former investigators. © 1954 The Psychiatric Quarterly.

Differential psychotherapy of borderline states - Eisenstein, V.W. (The Psychiatric Quarterly, 1951)
The class of patients who are descriptively neurotic but dynamically psychotic makes up a large proportion nowadays of those seeking psychiatric treatment, particularly in private practice. These patients present not only the challenge of differential diagnosis, but the resultant problem of differential treatment which avoids the danger of precipitating frank psychosis. This paper considers the special therapeutic problems of the borderline group; illustrates differences in the technical handling of given material in these as against true neurotics on the one hand and frank schizophrenics on the other; and outlines the rationale for a comprehensive plan of differential treatment. The premises on which the outline of psychotherapy is based are discussed in relation to the nature of the therapist's relationship, the kind of interpretations given and the goal of treatment. Attention is called to selective measures required in regard to (1) fantasy, (2) hostility, (3) homosexual material, (4) acting out, and (5) suicidal impulsions. Specific auxiliary measures are presented in relation to work with families of such patients. The differential therapeutic procedures outlined in this plan can be utilized, to a large extent, by therapists of diverse theoretical orientations. © 1951 State Hospitals Press.

Parents as the makers of social deviates - Bonney, M.E. (Social Forces, 1941)
HENRY is a delinquent, John is an alcoholic, George is a homosexual, Jack is a radical, and Joe committed suicide. Is there anything these individuals have in common which played an important role in causing them to deviate from social norms? At first glance it might seem that such diverse forms of behavior could have no relation to each other. They do, however, have some very significant common factors in their childhood backgrounds. The formula runs about as follows: They have experienced some form of rejection by one or both of their parents or they have had excessive emotional ties with one of the parents—usually the mother, while at the same time lacking even normal relationships with the other parent. This rejection and this abnormal pulling of the child toward one side of the parental axis results in various forms of personality distortion such as a sense of inferiority, a deep-seated desire for revenge, an immature and confused love life, and an expectation of greater pleasure without effort or responsibility than the world affords© 1941, Oxford University Press. All rights reserved.

A contrast in psychoanalysis: Three cases - Williams, T.A. (Journal of Abnormal Psychology, 1914)
Reports 3 clinical cases to illustrate that: (1) Freudian analysis does not lead to a cure (2) cure may be affected without a complete analysis, and (3) that readjustment may be accomplished without any reference to the sex. The first case, shows the complete therapeutic failure of the Freudian analysis of the anxiety state, in which a homosexual woman's (aged 30 yrs) sadistic impulses were revealed. The second case, of a man of 22 yrs, shows the therapeutic success of an explanatory analysis without any resort to the doctrines which implies subconscious mechanisms. The third case, of a lawyer of 28 yrs, exhibited the power of enlightenment in an affective situation of which the patient was not sufficiently aware of the genesis. Detailed case histories are provided, along with genesis and treatment of the 3 cases. (PsycINFO Database Record (c) 2006 APA, all rights reserved). © 1914 American Psychological Association.
Keywords: Attempted suicide; Chronic fear; Psychoanalysis

Bird protection - Littler, F.M. (Emu, 1901)
ALL lovers of our native birds view with dread the wanton destruction that goes on year by year in every state of Federated Australia. They feel that the time has arrived when united and strenuous efforts must be made if we wish our feathered friends, and even those we count as enemies, to survive and brighten our bush wilds with their gay plumages. Small boys, with their “ catapults ” and “ pea-rifles,” are not the greatest offenders; it is that class of persons who ought to know better against whom we have to contend. An inborn, insatiable desire to kill something is one of the worst traits of Australian youths. They take their guns into the bush and are not content with legitimate game but must try their prowess on all and sundry that come across their path. They appear to feel that it is dependent on them to “slay, and slay, and slay.” © 1901, CSIRO. All rights reserved.