Isabel Leal

Women's Motivations for Sex: Exploring the Diagnostic and Statistical Manual, Fourth Edition, Text Revision Criteria for Hypoactive Sexual Desire and Female Sexual Arousal Disorders

INTRODUCTION There are problems with the existing definition of hypoactive sexual desire disorder (HSDD) in that desire for sex and sexual fantasy are not a universal experience. AIMS To explore: (i) womens motivations to engage in sexual activity; (ii) frequency and predictors of sexual fantasies; (iii) sexual arousal; (iv) recognition of sexual arousal; and (v) association between relationship duration and these variables. METHODS Three thousand six hundred eighty-seven women completed a web-based survey of previously pilot-tested items. MAIN OUTCOME MEASURES Investigator-derived self-report questions of sexual desire and arousal, and sexual fantasies. RESULTS Among women who easily became aroused, 15.5% reported only engaging in sex if they felt sexual desire at the outset whereas 30.7% typically or always accessed desire only once they were aroused. Women in longer-term relationships engaged in sex with no sexual desire more often (42%) than women in short-term relationships (22.4%) (P < 0.001). The percentage of women that reported fantasies only sometimes was 52.5%. A logistic regression revealed that religion (odds ratio [OR] = 1.45; P < 0.001), difficulty getting aroused (OR = 0.511; P < 0.001), responsive desire (OR = 0.919; P < 0.05), and frequency of orgasm (OR = 1.11; P < 0.05) were significantly associated with sexual fantasy. After controlling for age, relationship duration was negatively associated with frequency of initiating sex (r = -0.116, P < 0.001), womens satisfaction with their own sexuality (r = -0.173, P < 0.001) and sexual satisfaction with the partner (r = -0.162, P < 0.001). CONCLUSIONS Results reflect diversity in womens motivations for sex, and there is evidence that responsive desire occurs in women with and without arousal difficulties. We strongly recommend relationship duration as well as adequacy of partner sexual stimulation to be recognized in any future diagnostic framework of dysfunction. Clinical implications as well as those for future diagnostic nomenclature are considered.

Beyond the body image: a qualitative study on how adults experience lower limb amputation

Objective: To explore adults’ experiences of lower limb amputation, focusing on the changes in self-identity related to the impairment. Design: A cross-sectional and qualitative study, using semi-structured interviews. Interviews were transcribed, coded and analysed by two independent researchers. Setting: A rehabilitation medicine service from a general public hospital. Participants: A convenience sample of 42 patients with lower limb amputation performed after the age of 18 and followed up in the physical medicine and rehabilitation department of a general hospital. Main outcome measures: A semi-structured interview, addressing three core areas: the emotional impact of amputation; the adjustment process; and the relation with the external resources. Results: Eight themes emerged from interviews: reactions and feelings about becoming amputee; changes in own life; problems in well-being; relation with the prosthesis; self-perceptions; aims related to the rehabilitation and future plans; relation with the rehabilitation; and perceived social support. These results supported a theoretical model for the self-identity changes related to limb loss. Conclusions: The self-identity changes after a lower limb amputation appear beyond the patient’s body image and functioning, affecting the patient’s awareness of the impairment, biographical self and any future projections.

Qualidade de vida e bem-estar em crianças e adolescentes

The Portuguese team “Aventura Social” Project carried on during 2006, the translation and adaptation process of Kidscreen instruments (children/adolescents version and parents version). The aim of Kidscreen European project was built a standardized instrument, to estimate the subjective quality of life in children and adolescents and their parents. A sample of 3195 children and adolescents and their parents (n= 2256) were inquired. Questionnaires were applied in classroom setting, after a random selection of classes and schools, through the all country. The present study focus only in the Kidscreen children and adolescents versions. The results showed a good internal consistency, between auto-perception dimension (±= 0, 60) and economical issues (±= 0, 88). By using ANOVAs analyses were identified gender, age, and socio-economic status and nationality differences concerning the perception about their Health-Related quality of life. This study intends to increase the knowledge about Health-Related Quality of Life, the identification of risk factors and promote specific intervention programs (individual, interpersonal and in the community), contextualized and assessed

University students' attitudes toward same-sex parenting and gay and lesbian rights in Portugal

The purpose of this study was to explore university students’ attitudes toward same-sex parenting and toward gay and lesbian rights. A total of 292 participants, aged between 18 and 27 (M = 21) responded to a questionnaire measuring attitudes toward parenting by gay men and lesbians, gay and lesbian rights, and beliefs about the etiology of homosexuality. Results revealed that the majority of students were against gay and lesbian parenting, gay and lesbian equal rights, and believed that homosexuality has a social/environmental basis. It was found that sexual prejudice is highly prevalent in Portuguese university students, and implications of these findings are discussed.

Masturbation among women: associated factors and sexual response in a Portuguese community sample.

Masturbation is a common sexual practice with significant variations in reported incidence between men and women. The goal of this study was to explore (a) the age at initiation and frequency of masturbation, (b) the associations of masturbation with diverse variables, (c) the reported reasons for masturbating and associated emotions, and (d) the relation between frequency of masturbation and different sexual behavioral factors. Participants were 3,687 women who completed a web-based survey of previously pilot-tested items. The results reveal a high reported incidence of masturbation practices among this convenience sample of women. Among the women in this sample, 91% indicated that they had masturbated at some point in their lives, and 29.3% reported having masturbated within the past month. Masturbation behavior appears to be related to a greater sexual repertoire, more sexual fantasies, and greater reported ease in reaching sexual arousal and orgasm. Women reported many reasons for masturbation and a variety of direct and indirect techniques. A minority of women reported feeling shame and guilt associated with masturbation. Early masturbation experience might be beneficial to sexual arousal and orgasm in adulthood. Further, this study demonstrates that masturbation is a positive component in the structuring of female sexuality.

Portuguese Norms for the Waterloo-Stanford Group C (WSGC) Scale of Hypnotic Susceptibility

Abstract Portuguese norms for the Waterloo-Stanford Group C (WSGC) scale of hypnotic susceptibility are presented. A Portuguese translation of this scale was given to 625 Portuguese college students. Score distribution, item analysis, and reliability of the WSGC are presented and compared to three North American samples. The findings show that normative data from the Portuguese sample are congruent with the reference samples. The only significant difference obtained was a lower proportion of participants scoring within the high range of hypnotic suggestibility on the WSGC.

Internalized Homonegativity, Disclosure, and Acceptance of Sexual Orientation in a Sample of Portuguese Gay and Bisexual Men, and Lesbian and Bisexual Women

The purpose of this study was to assess internalized homonegativity and its correlates in a sample of Portuguese self-identified gay and bisexual men, and lesbian and bisexual women. Five hundred eighty participants, aged between 18 and 76 (M = 31, SD = 10), responded to an online questionnaire that included a demographic questionnaire and the Internalized Homophobia Scale. Results revealed that though lesbians revealed the lowest levels of internalized homonegativity and were the most likely to disclose to parents and friends, bisexual men scored the highest on levels of internalized homonegativity and were the most likely to hide their sexual orientation.

Psychometric Properties of a Brief Version of the Escala de Satisfação com o Suporte Social for Children and Adolescents

The main objective of this study was to develop a brief version of the Escala de Satisfação com o Suporte Social for children and adolescents (Ribeiro, 1999). A representative sample of 3195 children and adolescents was obtained from 5th and 7th graders throughout all five Portuguese regions. The results showed a good internal consistency for the social support satisfaction factor, alpha = 0.84; acceptable for the necessity for activities connected to social support factor, alpha = 0.69. By using ANOVA, gender, age and socioeconomic status related differences were identified. A confirmatory factorial analysis was done and an adjusted model was found by taking off item 5. The concurrent validity was inspected with measures related to social support, such as optimism, self-worth and perceptions of health related quality of life. With this analysis, we verified that women and younger participants (< 12 years) showed a higher social support satisfaction. Medium-high socioeconomic status participants showed a higher negative social support satisfaction. These results suggest the validity of the scale in assesing perceptions of social support.

What Predicts Older Adults’ Adjustment to Aging in Later Life? The Impact of Sense of Coherence, Subjective Well-Being, and Sociodemographic, Lifestyle, and Health-Related Factors

The aim of this study was to build a structural model to explore the predictors of adjustment to aging (AtA) in a community-dwelling older population. A community-dwelling sample of 1,270 older adults aged between 75 and 102 years answered a questionnaire to determine sociodemographic (sex, age, professional and marital status, education, household, adult children, familys annual income, living setting, and self-reported spirituality), lifestyle, and health-related characteristics (perceived health, recent disease, medication, and leisure). Several instruments were used to assert psychological variables, namely AtA, sense of coherence, and subjective well-being. Structural equation modeling was used to explore a structural model of the self-reported AtA, encompassing all variables. Significant predictors are self-reported spirituality (β = .816, p < .001); perceived health (β = .455, p < .001); leisure (β = .322, p < .001); professional status (β = .283, p < .001); income (β = .230, p = .035); household (β = –.208, p = .007); sense of coherence (β = −.202, p = .004); and adult children (β = .164, p = .011). The variables explain, respectively, 60.6% of the variability of AtA. Self-reported spirituality is the strongest predictor of AtA. Other predictors are perceived health, leisure, professional status, income, household, sense of coherence, and adult children. This study emphasizes the need for deepening the variables that influence older adults’ AtA—in particular, perceived health and further lifestyle-related characteristics—as being relevant for promoting aging well in later life, within a salutogenic context for health care.

Parent-child Perceptions of Quality of Life: Implications for Health Intervention

Abstract The KIDSCREEN-52 is an instrument that assesses 10 dimensions of health-related quality of life (HRQoL). It was developed as a result of studies by the European KIDSCREEN Group, University of Berlin (www.kidscreen.org; see also Bisegger et al., 2005). During the Portuguese validation process, a model was developed to examine the perceptions of children and their parents on these dimensions. Structural equation modelling was used in order to estimate the fit of this model, in both cases according to gender and age. The specific aim of the present study was to examine the extent to which results differ by gender and age. An additional aim was to explore differences between the child and parent versions of the instrument, globally as well as by gender and age of the children. The results are based on a nationally representative sample of 3195 children from 5th and 7th grades. Data from each child were paired with data from their parents (2256 matched sets of data were generated). Most of the subscales exhibited good internal consistency in both the children’s and parent’s versions of KIDSCREEN-52, with values of the alpha coefficient approaching or above .80 for most scales. The exception was the subscale concerned with self-perception where the coefficient was approximately .64 for both children and parents. Subscale scores for children’s and parents’ versions correlated moderately strongly in the sample of matched pairs. This indicates that children and their parents view their health-related quality of life consistently, although parents tend to perceive their children’s quality of life as better than their children do. Analysis of variance suggested that there were small differences in scores associated with gender and age. The results confirm that the KIDSCREEN-52 questionnaire is a relevant instrument to estimate the perception of quality of life both in children and their parents. The findings that parents are not totally aware of their children’s subjective health-related quality of life perceptions and that parents have different perceptions according to the gender and the age of their children, have implications for professional practice and intervention with families of school-aged children.