Personality Pathology among Adults with History of Childhood Sexual Abuse: Study of the Relevance of DSM-5 Proposed Traits and Psychobiological Features of Temperament and Character.

BACKGROUND: The main aim of this study was to determine whether childhood sexual abuse (CSA) is reflected in the pathological traits of the alternative model of personality disorders (AMPD) in section-III of DSM-5 and Cloninger's temperament and character profiles. METHODS: The Persian versions of Personality Inventory for DSM-5 (PID-5), Temperament and Character Inventory (TCI-125), and Structured Clinical Inventory for DSM-IV-TR-Axis II-Screening Questionnaire (SCID-II-SQ) were administered to 43 Iranian college students who reported a history of CSA and 390 participants who did not. Bivariate Pearson correlations and general linear model repeated measures (GLMRM) were used to compare results. RESULTS: Bivariate correlations indicated that both the PID-5 and TCI-125 were significantly associated with their relevant personality disorders. Profile analysis showed that the pathological trait domains of the PID-5, except for negative affectivity, were significantly greater in those with an experience of CSA. Of the seven dimensions of TCI-125, novelty seeking and persistence were higher in those with an experience of CSA, but reward dependence, self-directedness, and cooperativeness were lower. CONCLUSIONS: These results confirmed a correlation between CSA and personality dysfunction. The pattern of dysfunction was complex and somewhat different from the two facet measures used.

Why, Mrs. Robinson? The seduction of teenage boys by women in classic films.

Utilizing three classic films, and psychoanalytic developmental theory, this paper explores the conscious and unconscious reasons why older women become sexually involved with teenage boys. After a presentation of aspects of young adult and midlife female development and a psychodynamic explanation for the developmental similarities between adolescence and menopause, each of the three films is summarized. The dynamics behind the women's behavior, as presented in the films, are discussed. The third section of the paper discusses similarities and differences among the three women and the negative effects on the boys' development.

The central masturbation fantasy in heterosexual males across the life cycle: masturbation fantasies across the normality-pathology spectrum.

Moses Laufer described the central masturbation fantasy as an essentially adolescent phenomenon that leads to the final sexual organization. In this paper the central masturbation fantasy, formulated during the preoedipal and oedipal years, consolidated in adolescence, and in a process of continuous evolution across the life cycle, is considered an essential concept for understanding sexuality in heterosexual males. Sex and aggression, as posited in Freud's dual theory of the drives, are core components of all masturbation fantasies, across the diagnostic spectrum, from the most normal/neurotic to the most criminally bizarre. Clinical examples illustrate both points. The tendency among clinicians, particularly clinical associates, to avoid analyzing all aspects of masturbation is discussed.

Death, rejuvenation and immortality in film: On Golden Pond (1981), Cat on a Hot Tin Roof (1958) and Cocoon (1985).

This paper seeks to highlight the developmental tasks of late adulthood with the help of three Hollywood movies. These tasks include: (i) struggling to maintain physical integrity, (ii) handling the "wound of mortality", (iii) maintaining activity and sexuality, and (iv) becoming wise. Among other challenges faced by an individual during this phase of life are loss of love objects, illness and possible compromise of mental functions, de-cathexis of material possessions and coming to terms with one's approaching death. All sorts of healthy and unhealthy psychosocial maneuvers come to the surface as a result of these stresses. This paper illustrates these dilemmas and their potential solutions via a discussion of three movies.

The relentless past: The effect of chronic sexual abuse in childhood on fifty years of adolescent and adult development.

Four sisters, now in their late fifties and early sixties, were sexually abused during childhood over a four-year span by the same priest. Until recently they told no one about their experience and never received any psychological diagnostic evaluations or treatment. The author conducted detailed psychiatric evaluations of each of the four women while serving as the plaintiffs' expert witness during their lawsuits against the Catholic Church. The suits have been settled, and the women have given written permission to tell their stories. This unique clinical material provides a rare opportunity to describe and understand the ongoing, pervasive effects of untreated, chronic childhood sexual abuse on developmental processes over half a century. In each instance the women were describing the details of the abuse and the effects on their development for the first time. The severity of the pathology and the intense shame and anxiety associated with discussing their experiences after so many years raises questions about the choice of treatment and technique, particularly in regard to transference and countertransference issues.

Transience during midlife as an adult psychic organizer: the midlife transition and crisis continuum.

The intent of this paper is to add to the psychoanalytic understanding of midlife by exploring the relationships among transience, uncertainty and time limitation; and their effect on intra-psychic conflict and change. After a presentation of definitions and relevant midlife development tasks, the focus shifts to a discussion of two of Freud's papers, "On Transience" (1916 [1915]) and "The Uncanny" (1919) in which Freud introduced important concepts that provide a foundation for psychoanalytic exploration of attitudes toward transience, uncertainty and death. A major focus of the paper is a conceptualization of a developmental continuum from midlife transition to midlife crisis, rather than dichotomizing the midlife developmental process as either transition or crisis, followed by a discussion of three basic ways of processing the continuum and six common ways in which midlife pathology and/or more normative developmental progression are expressed. Two detailed, clinical examples illustrate the theoretical concepts and focus, in particular on clinical presentation and transference and counter-transference. The intention is to link theory with clinical understanding and technique.

The absence of a future: the effect of past experience and current developmental conflicts on a midlife analysis.

The four-year analysis of Mr. T, a highly intelligent, successful professional who entered analysis primarily because of a depression is presented; he had had no previous therapeutic experience but was very curious about analysis. The analytic work led to the discovery of a deeply held unconscious conviction of premature death that was related to interaction among the effects of a traumatic parental divorce during childhood, estrangement from both parents prior to their deaths, and signs of aging and illness in midlife. Before this analytic work the patient was unable to conceptualize, let alone plan for, late-life developmental experiences such as retirement and grandparenthood. Transference-countertransference themes are discussed, as is the importance of an understanding of midlife developmental concepts to successful analytic work with patients in this age group.

The evolution of paternal identity in late adulthood.

The experience of fatherhood in late adulthood has received little attention in the psychoanalytic literature. After a presentation of the literature on fatherhood and a consideration of the developmental tasks of late adulthood in which the experience of fatherhood is embedded, the dynamically charged, developmentally conflicted nature of the relationships between late-life fathers and their children is explored. A basic premise is that the changing nature of these relationships inevitably confronts the elderly patriarch with considerable intra-psychic turmoil, reflection, and conflict that must be engaged and mastered if these most significant relationships are to be maintained and sustained for both generations. Clinical examples illustrate the theoretical points presented.