The Complex Interplay between BDSM and Childhood Sexual Abuse: A Form of Repetition and Dissociation or a Path Toward Processing and Healing?

In this theoretical paper the authors explore the connections between BDSM (i.e., practices involving bondage, discipline, dominance, submission, sadism, masochism) and CSA (childhood sexual abuse) in order to investigate the potential unconscious mechanisms at play and the therapeutic functions of BDSM practices among CSA victims. Drawing on the embodiment framework, the authors address how BDSM may serve as a form of unconscious repetition of traumatic experiences for certain CSA victims, with the aim of processing trauma and healing. A review of the empirical evidence regarding the links between BDSM and CSA trauma, along with the potential of BDSM to trigger trauma and elicit dissociation, guilt, or shame, is conducted. Finally, BDSM practices are reviewed through the concept of trauma-play, which involves deliberate rescripting. In short, the complex relationship between BDSM and CSA is highlighted, as well as its implications for understanding and potentially addressing trauma experiences in therapy.

The effect of pre-match sexual intercourse on football players' performance: a prospective cross over study.

BACKGROUND: Current research suggests that pre-competition sexual intercourse does not influence athletes' performance. Yet, high quality studies in this field are scarce. METHODS: We aimed to investigate whether sexual activity negatively influences physiological performance. We conducted a prospective cross over study, which enrolled active players from the first team of a football club in the Israeli Football Premier League during the 2018-19 season. We gathered participants' physiological performance using GPS driven data per match. In addition, we assessed sexual activity the night before using telephone interviews at the end of every match. We used a linear mixed models methodology, accounting for each player as a cluster. RESULTS: We enrolled 14 participants who participated in 88 football matches. The mean age was 29.7 (±3.8) years and the majority were in permanent relationships for longer than 6 months (78.6%). We identified sexual intercourses the night before the match in 9 (10.2%) cases. The average speed during the match was slower when participants had pre-match intercourse (6.5 vs. 6.0 Km/h, P=0.02). The results remained consistent when using linear mixed models analysis adjusted for age, for previous belief that a pre-match sexual intercourse may affect match performance and for player as a cluster (P=0.02, 95% C.I -0.85- -0.07). Other parameters were not associated with pre-match intercourse. CONCLUSIONS: To the best of our knowledge, this study is the first to show that sexual intercourse the night before a football match may have a negative influence on players' performance.

Lessons learned from the 2009-2010 H1N1 outbreak for the management of the 2013 silent polio outbreak.

BACKGROUND: The Israeli Ministry of Health (MoH) encountered two substantial outbreaks during the past decade: the H1N1 swine flu outbreak during 2009-2010 and the silent polio outbreak during 2013. Although both outbreaks share several similar characteristics, the functioning of the Israeli MoH was different for each case. The aim of this study was to identify factors that contributed to the change in the MoH response to the polio outbreak in light of the previous 2009-2010 H1N1 outbreak. METHODS: We conducted a qualitative research using semi-structured interviews with 18 Israeli policymakers from the MoH, relevant specialists and politicians. Each interview was transcribed and a thematic analysis was conducted independently by two researchers. RESULTS: Three main themes were found in the interview analysis, which reflect major differences in the MoH management policy during the polio outbreak. 1) clinical and epidemiological differences between the two disease courses, 2) differences in the functioning of the MoH during the outbreaks, 3) differences in the risk communication strategies used to reach out to the local health community and the general public. Most interviewees felt that the experience of the 2009-2010 H1N1 outbreak which was perceived as unsuccessful, fueled the MoH engagement and proactiveness in the later polio outbreak. CONCLUSION: These findings highlight the importance of learning processes within health care organizations during outbreaks and may contribute to better performance and higher immunization rates.

Ethical issues in medical cannabis use.

The increasing use of medical cannabis (MC) in the past decade raises several ethical considerations for the clinician. Regulatory issues stem from a gap between MC registration and certification in each country. Professional issues derive from the lack of sufficient knowledge of MC characteristics and the intersection between the physician, the patient and commercial interests. Finally, there are medical and psychological implications which are related to the use of MC regimens. We will discuss these issues in the light of the current era, in which policy has rapidly shifted toward legalization of cannabis, which influences the decisions of both clinicians and patients.

The use of pathological grief outcomes in bereavement studies on African Americans.

Pathological bereavement outcomes (i.e., complicated grief, traumatic grief, prolonged grief disorder) are a robust and growing research area in the psychological and medical sciences. Although grief is considered to be a universal phenomenon, it is well documented that grieving processes and outcomes are culturally and contextually bound. The objectives of this study were: (a) to examine representations of African Americans in the grief and mourning literature and to assess the extent to which this research utilizes pathological grief outcomes; and (b) to examine the characteristics of pathological grief constructs in the literature to assess their relevance for African American populations. We conducted comprehensive searches of three scientific databases including PsycNET, Medline, and CINAHL, which contain the majority of grief and mourning literature published between January 1998 and February 2014. We found 59 studies addressing grief and mourning in African Americans. Thirteen of these studies used pathological grief outcomes. Pathological grief outcomes that were constructed and validated on White populations were frequently used as outcome variables with African American participants. We discuss the implications for the grief and mourning field and argue that the failure to use culturally sensitive outcome measures in research studies is a form of epistemological violence that may have negative research and clinical implications for African Americans and other ethnic minorities.

Schema Therapy in Sex Therapy: A Theoretical Conceptualization.

Schema therapy is an integrative approach of psychotherapy developed by Jeffrey E. Young. Its aim is to help clients explore and understand their deep emotional needs and meet them in a healthy manner. It is suitable for complex pathologies, such as comorbidities and personality disorders. In sex therapy, schema therapy can serve as a method for a deep, evidence-based, integrative conceptualization of a client's difficulties and needs. However, its principles have never been demonstrated in sex therapy. In this paper, we briefly review schema therapy and introduce schema domains. We bring a case study of a couple undergoing sex therapy from the cognitive-behavioral perspective. We then return to the same case study, in order to demonstrate the usefulness of a schema therapy conceptualization.

[PHYSICAL SYMPTOMS AMONG FEMALE ISRAELI MEDICAL STUDENTS - THE EFFECT OF DEPRESSION AND SOCIAL SUPPORT].

INTRODUCTION: Female physicians, residents and medical students commonly suffer from stress. In a preliminary study, high levels of depressive symptoms were found among female medical students at Ben-Gurion University of the Negev. OBJECTIVES: To examine whether social support moderates the effect of depressive symptoms on physical symptoms. METHODS: A total of 145 female medical students and residents from all the Israeli medical schools were assessed regarding their depressive symptoms, social support and physical symptoms. RESULTS: Depressive symptoms significantly predicted physical symptoms. In addition, a significant 2-way interaction was found between depressive symptoms and social support in predicting physical symptoms: among participants high on depressive symptoms, increased social support significantly predicted decreased physical symptoms. CONCLUSIONS: Female medical students may silence or hide depressive symptoms that might be expressed by physical symptoms. In addition, social support inside and outside the medical system may serve as a way to reduce depressive and physical symptoms among female medical students, interns and residents.

Representations of African Americans in the Grief and Mourning Literature from 1998 to 2014: A Systematic Review.

The authors examined representations of African Americans in the grief literature to assess (a) frequencies; (b) content; and (c) use of universalist or a contextualized framework. They conducted searches in 3 databases that target the grief literature published in the last 15 years. Fifty-nine articles met the criteria. There are a small number of studies published on African Americans and these tend to focus on homicide. Many studies had incomplete methods. Comparison studies were common and pathological grief outcomes that were validated on White populations were used as outcome variables with African American participants.

The prospective associations between depression and sexual satisfaction among female medical students.

INTRODUCTION: The direction of the relationships between depression and sexual dissatisfaction is unclear. Possibly, these relationships are influenced by different elements/components of depression represented by different measures (i.e., Center for Epidemiologic Studies Depression Scale [CES-D], which highlights mood, vs. Beck Depression Inventory version II [BDI-II], which focuses on cognition and physical symptoms). High-achieving women--such as female medical students, interns, and residents--might be particularly prone to both depression and sexual dissatisfaction. AIM: The aim of this study is to examine the direction of the longitudinal associations between depressive symptoms and sexual dissatisfaction in high-achieving, romantically involved female Israeli medical students and interns/residents using both CES-D and BDI-II. METHODS: One hundred ninety-four female medical students from the first, fourth, and seventh (internship) years from all medical schools in Israel who were currently involved in romantic relationships were assessed twice over a 1-year interval using both CES-D and BDI-II. Cross-lagged structural equation modeling analyses were employed. MAIN OUTCOME MEASURES: Depressive symptoms were measured by the CES-D and the BDI-II. Sexual satisfaction was assessed by the "partner-satisfaction" factor of the Pinney Sexual Satisfaction Inventory. RESULTS: Elevated levels of CES-D-measured depression were found (26% at T1 and 13% at T2 above the stricter cutoff point). The direction of the longitudinal association between depressive symptoms and sexual dissatisfaction changed according to the depression measure used: baseline CES-D-measured depression predicted an increase in sexual dissatisfaction over time (ß = 0.148, P = 0.016). Baseline sexual satisfaction predicted an increase in BDI-II-measured depression (ß = 0.136, P = 0.045). CONCLUSION: High-achieving, "fully-functioning" female medical students suffer from elevated levels of CES-D-measured depressed mood. Depressed mood might lead to sexual dissatisfaction, which in turn is likely to bring about "clinical," BDI-II-measured depression. We recommend a routine assessment of depressed mood and sexual dissatisfaction in this population, as well as increased access to tailored intervention for both clinical challenges.

Depression and sexual satisfaction among female medical students: surprising findings from a pilot study.

We report surprising findings from a pilot study aimed at assessing the psychological price paid by female medical students who are also involved in serious romantic relationships. Sixty female medical students were assessed as to their depressive symptoms, level of self-criticism, sexual satisfaction, role commitment, and perceived rewards derived from their professional, marital, and domestic roles. The high levels of depressive symptoms found among participants in this study were the sole predictor of low sexual satisfaction. Professional role reward was positively associated with depressive symptoms. Consistent with the notion of multiple roles conflict among self-critical students, role commitment and reward in the professional and domestic domains interacted to predict depressive symptoms. Results suggest that female medical students involved in romantic relationships pay a high emotional price for their conflicting role demands.