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The goal of the study is to develop a structured play therapy intervention model to mitigate the effect of childhood sexual abuse. South Africa has one of the highest prevalence rates for child sexual abuse, and professionals working with children are consequently faced with the phenomenon on an increasing scale. Many professionals find themselves ill-equipped to address the effect of sexual abuse on the child, and the lack of an integrated understanding of the phenomenon seems to exacerbate this need. In order to effectively address the effect of sexual abuse on the child, professionals need a holistic understanding of this phenomenon and its effects, as well as a clear outline of the necessary interventions. The thesis consists of five sections, which can be outlined as follows: Section A consists of the problem statement, the research questions, the research objective, the general theoretical assumption and the theoretical approach. It includes the research methodology, the limitations of the research, definitions of the key terms and the selection and structure of the dissertation. The research focused on the following specific objectives stemming from the problem statement: -To conduct a thorough literature study on various aspects pertaining to childhood sexual abuse in order to form a holistic, well-researched perspective on the phenomenon of childhood sexual abuse and the available evidence-based interventions in the sexual abuse of children; -To develop a structured play therapy intervention model to mitigate the effect of childhood sexual abuse; -To subject the prototype of the proposed intervention model to peer review in order to determine its strengths and weaknesses and make the necessary adaptations to the model prior to its final dissemination. Section B consists of four articles, in which the goals of the research, the outcomes of the literature study and the empirical study are reported. Each article is dealt with as a self-contained unit focusing on a specific aspect of the research and contributing to the collection of data necessary for the design and evaluation of the proposed intervention model. Article 1 Knowledge of the legislation pertaining to sexual abuse is imperative for health care professionals working with a child who has been sexually abused. This article provides a critical analysis of those aspects of the Criminal Law (Sexual Offences and Related Matters) Amendment Act, 32 of 2007, relevant to the health care professional. The shortcomings of the Act and the practical implications of these for healthcare professionals is pointed out. Focus also falls on the relevant sections of the Childcare Act, 38 of 2005 and how these sections complement the Criminal Law (Sexual Offences and Related Matters) Amendment Act, 32 of 2007). Article 2 In order to effectively help traumatised children to achieve positive outcomes, professionals must have a clearly-defined methodology, underpinned by theory and based on an integrated approach. The first step towards this is clearly to redefine the phenomenon of child sexual abuse. As sexual abuse is both a legal and a psychosocial phenomenon, the authors are of the opinion that a more integrative definition is necessary in the South African context. The information in this article therefore aims to provide health care professionals with an integrative definition that takes into account both the South African legal definition of sexual abuse and the underlying psychosocial factors associated with it.Article 3 Sexual abuse is a phenomenon with far-reaching effects. This article provides a holistic look at the effects of sexual abuse from an ecological systems perspective. The effect of sexual abuse on the child as the focus of the microsystems is emphasized, as well as the effects on the parents or the child’s caregiver as the mesosystem. The article further considers the interactive dynamics between the different systems and explains how each system can contribute to either mitigating or exacerbating the effects of abuse on the child. Article 4 The research goal of this article is to develop and evaluate a structured play therapy intervention model to mitigate the effects of child sexual abuse. The intervention model was developed from the results of the previous articles as well as an in-depth literature study on existing therapeutic interventions. To fulfil the aim of this article, the following objectives are set: -To give an outline of the research methodology underlying the study; -To discuss the problem analysis and project plan; -To outline the intervention model for mitigating the effects of child sexual abuse; -To discuss the research findings on the proposed model. Section C gives a summary of the most important findings and conclusions regarding the research in general. It also contains recommendations and points to the contribution made to the specific field of study. Section D consists of the addenda to the research report, for example, the different instruments of measurement and the questionnaires. Section E concludes the thesis with summarized references. / PhD (Social Work), North-West University, Potchefstroom Campus, 2015

The goal of the study is to develop a structured play therapy intervention model to mitigate the effect of childhood sexual abuse. South Africa has one of the highest prevalence rates for child sexual abuse, and professionals working with children are consequently faced with the phenomenon on an increasing scale. Many professionals find themselves ill-equipped to address the effect of sexual abuse on the child, and the lack of an integrated understanding of the phenomenon seems to exacerbate this need. In order to effectively address the effect of sexual abuse on the child, professionals need a holistic understanding of this phenomenon and its effects, as well as a clear outline of the necessary interventions. The thesis consists of five sections, which can be outlined as follows: Section A consists of the problem statement, the research questions, the research objective, the general theoretical assumption and the theoretical approach. It includes the research methodology, the limitations of the research, definitions of the key terms and the selection and structure of the dissertation. The research focused on the following specific objectives stemming from the problem statement: -To conduct a thorough literature study on various aspects pertaining to childhood sexual abuse in order to form a holistic, well-researched perspective on the phenomenon of childhood sexual abuse and the available evidence-based interventions in the sexual abuse of children; -To develop a structured play therapy intervention model to mitigate the effect of childhood sexual abuse; -To subject the prototype of the proposed intervention model to peer review in order to determine its strengths and weaknesses and make the necessary adaptations to the model prior to its final dissemination. Section B consists of four articles, in which the goals of the research, the outcomes of the literature study and the empirical study are reported. Each article is dealt with as a self-contained unit focusing on a specific aspect of the research and contributing to the collection of data necessary for the design and evaluation of the proposed intervention model. Article 1 Knowledge of the legislation pertaining to sexual abuse is imperative for health care professionals working with a child who has been sexually abused. This article provides a critical analysis of those aspects of the Criminal Law (Sexual Offences and Related Matters) Amendment Act, 32 of 2007, relevant to the health care professional. The shortcomings of the Act and the practical implications of these for healthcare professionals is pointed out. Focus also falls on the relevant sections of the Childcare Act, 38 of 2005 and how these sections complement the Criminal Law (Sexual Offences and Related Matters) Amendment Act, 32 of 2007). Article 2 In order to effectively help traumatised children to achieve positive outcomes, professionals must have a clearly-defined methodology, underpinned by theory and based on an integrated approach. The first step towards this is clearly to redefine the phenomenon of child sexual abuse. As sexual abuse is both a legal and a psychosocial phenomenon, the authors are of the opinion that a more integrative definition is necessary in the South African context. The information in this article therefore aims to provide health care professionals with an integrative definition that takes into account both the South African legal definition of sexual abuse and the underlying psychosocial factors associated with it.Article 3 Sexual abuse is a phenomenon with far-reaching effects. This article provides a holistic look at the effects of sexual abuse from an ecological systems perspective. The effect of sexual abuse on the child as the focus of the microsystems is emphasized, as well as the effects on the parents or the child’s caregiver as the mesosystem. The article further considers the interactive dynamics between the different systems and explains how each system can contribute to either mitigating or exacerbating the effects of abuse on the child. Article 4 The research goal of this article is to develop and evaluate a structured play therapy intervention model to mitigate the effects of child sexual abuse. The intervention model was developed from the results of the previous articles as well as an in-depth literature study on existing therapeutic interventions. To fulfil the aim of this article, the following objectives are set: -To give an outline of the research methodology underlying the study; -To discuss the problem analysis and project plan; -To outline the intervention model for mitigating the effects of child sexual abuse; -To discuss the research findings on the proposed model. Section C gives a summary of the most important findings and conclusions regarding the research in general. It also contains recommendations and points to the contribution made to the specific field of study. Section D consists of the addenda to the research report, for example, the different instruments of measurement and the questionnaires. Section E concludes the thesis with summarized references. / PhD (Social Work), North-West University, Potchefstroom Campus, 2015

published_or_final_version / abstract / Social Work and Administration / Doctoral / Doctor of Philosophy

Antidepressants are associated with sexual side effects (Clayton, Keller, & McGarvey, 2006). Sexual side effects are associated with non-compliance or discontinuance of antidepressants (Werneke, Northey, & Bhugra, 2006). Despite this, there are few empirically supported treatments for antidepressant side effects. However, in laboratory studies, exercise immediately before sexual stimuli improved sexual arousal of women taking antidepressants (Lorenz & Meston, 2012). I evaluated if exercise improves sexual functioning in women experiencing antidepressant-induced sexual side effects. Fifty-two women reporting antidepressant sexual side effects were followed for 3 weeks of sexual activity only. They were randomized to complete either three weeks of exercise immediately before sexual activity (3x/week) or 3 weeks of exercise separate from sexual activity (3x/week). At the end of the first exercise arm, participants crossed to the other. I measured sexual functioning, sexual satisfaction, depression and physical health. Completers showed modest improvements in sexual functioning and satisfaction. For women taking selective serotonin and norepinephrine reuptake inhibitors, exercising immediately before sexual activity was superior to exercise in general. As well as known effects in improved physical and psychological health, exercise may help improve sexual health and pleasure in women taking antidepressants. These findings have important implications for public health, as exercise is accessible, cheap, and does not add to burden of care. / text

OBJETIVO: Determinar las actitudes y prácticas sexuales según trimestre del embarazo en las gestantes que acuden al Centro de Salud Carlos Cueto Fernandini en el año 2015. METODOLOGÍA: El estudio es de tipo observacional, descriptivo comparativo, prospectivo de corte transversal. Para este trabajo se obtuvo una muestra de 217 gestantes de los tres trimestres de gestación del Centro de Salud Carlos Cueto Fernandini, sin embargo se excluyeron 27 encuestas que no cumplieron con los criterios de inclusión. Para el análisis descriptivo de las variables cuantitativas se estimó medidas de tendencia central (promedio) y medidas de dispersión (desviación estándar). Para el análisis de variables cualitativas se estimó frecuencias absolutas y porcentajes (frecuencias relativas). Las gráficas fueron diseñadas en Microsoft Excel 2013, se utilizaron las herramientas graficas: diagramas barras. RESULTADOS: El 36.8% de los embarazos son del II trimestre, el 32.6% pertenecen al III trimestre y el 30.5% son del I trimestre. El 96.6% de las gestantes que cursan el I trimestre de embarazo, el 65.7% de las gestantes que cursa el II trimestre y el 77.4% de las gestantes que cursa el III trimestre de embarazo tiene una actitud sexual negativa. La práctica sexual más frecuente en las gestantes del I trimestre son besos y caricias (62%), relaciones coitales vaginales (55%) y manipulación de zonas excitables (34.3%), en las gestantes del II trimestre son las relaciones coitales vaginales (60.1%) y los besos acompañados de caricias (25.7%), en las gestantes del III trimestre son las relaciones coitales (51.6%) y los besos con caricias (41.9%). El 69% de las gestantes del I trimestre de gestación prefieren como prácticas sexuales los besos con caricias, y el 30.8% la manipulación de zonas excitables, el 45.7% de las gestantes que cursan el II trimestre de gestación optan por las relaciones sexuales vaginales y el 40% por los besos con caricias, al igual que las gestantes del III trimestre quienes prefieren las relaciones coitales vaginales (48.4%) y los besos con caricias (41.9%). Respecto a las posiciones sexuales, el 69% de las gestantes del primer trimestre prefiere la posición del hombre encima o denominada “misionero” y el 27.5% prefiere la penetración de lado. El 34.3% de las gestantes que cursan el II trimestre optan por la posición de penetración desde atrás y el 31.5% la pose de penetración de lado. Asimismo el 45.1% de las gestantes del III trimestre prefieren la pose sexual de penetración de lado y el 35.5% la penetración vaginal desde atrás. Referente a las variantes sexuales, en las gestantes del I trimestre el 27.5% realiza la masturbación mutua y el 20.7% sexo oral hacia la pareja, en el II trimestre el 28.6% realiza la masturbación mutua y el 17.1% realiza sexo oral hacia la pareja, en el III trimestre el 26% opto por las relaciones orales hacia la pareja.

This thesis reports on a discourse analysis of thirteen qualitative interviews with male survivors of sexual abuse. My analysis focuses on participants' changing experiences and understandings of what it means to be 'masculine', and how they saw these having been influenced by the experience of being abused. An important finding was that many participants expressed concern regarding their invisibility as male survivors, noting that contemporary discourses on violence typically position men as its perpetrators, rather than its victims. I analyze the significance of the absence of a discourse of male victimization in terms both of its practical implications for male survivors and its theoretical implications for critical work on hegemonic masculinity. Based on the premise that hegemonic masculinity is a cornerstone of patriarchal systems, I conclude by using the experiences of my participants as a means of exploring the potential for men to experience 'oppression' under patriarchy.

Despite ongoing changes in the national sociopolitical landscape, negative attitudes toward non-heterosexuals continue to permeate throughout our society. Not only is sexual prejudice still prevalent, but experiencing it can have severe and far-reaching effects on LGBT individuals’ mental and physical health. Additionally, previous research has consistently found sexual prejudice to be a predictor of aggression directed toward sexual minorities. In fact, the recurrence and consistency of this finding has motivated researchers to suggest the development of intervention programming for the reduction of sexual prejudice. One major prospect for intervention involves interpersonal contact with sexual minorities. Evidence in favor of the contact hypothesis has been found with a wide variety of target minority groups, including sexual minorities. However, a review of the literature in this area reveals a significant measurement gap. Overall, most studies across all areas of contact research have neglected to follow the proper procedures necessary for the development and refinement of measures. This study sought to address this gap by validating a more robust psychometric measure of intergroup contact with sexual minorities developed by Daboin and Peterson (2012). Since this measure was previously constructed, this validation study relied on secondary data analyses. To achieve the purpose of this study, a series of analyses were conducted including exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and path analysis, as well as reliability and validity analyses. Results indicated that the CSMQ has an underlying structure of three factors: “Quantity of Casual Contact and Contact with Male Sexual Minorities,” “Quantity of Intimate Contact and Contact with Female Sexual Minorities,” and “Overall Perceived Quality of Contact with Sexual Minorities.” These three factors are significantly correlated with one another and negatively correlated with both negative attitudes toward gay men and lesbians. Additionally, results showed that the revised CSMQ and its resulting subscales have excellent internal consistency, and provided supporting evidence for their convergent, discriminant, and criterion-related validity.

Proximal and Distal Indirect Influences on Adolescent Sexual Activity and Post Risky Sexual Behaviors INTRODUCTION: Prior literature has revealed a correlation between adolescent sexual debut and parenting behaviors. However, most existing studies has only focused on parental monitoring and control. This limitation, in addition to small, cross-sectional studies, has resulted in inconsistent and limited findings. These gaps are addressed in this present paper by investigating how family connectedness contributes to the age of sexual debut. It is hypothesized that adolescents who are 13 years of age and have a lack of family connectedness engage in high-risk behaviors sooner than their 13-year-old peers with greater family connectedness. METHODS: Data were drawn from the 1997 National Longitudinal Survey of Youth. This paper focused on adolescents born in the year 1983 who had no sexual debut at baseline. Those selected were initially interviewed for baseline family connectedness and prospectively followed up to adulthood. Family connectedness was measured using five aspects: shared activities, parent-adolescent communication, parent admiration, parental support and the presence of family dinners. SAS 9.4 was used to perform survival analyses to examine the rate of teenage sexual debut by family connectedness. RESULTS: Findings suggest that family connectedness, specifically weekly family dinners and parent-child communication were significant familial factors that delayed adolescent sexual behavior. The hazards ratio of having an adolescent sexual debut at any time for an individual who had family activity at least once a week was 0.91 (95CI: 0.74, 1.14), having weekly family dinner (HR 0.70; 95CI: 0.53, 0.93), communication with parents (HR 0.78; 95CI: 0.68, 0.91), perceived parental support (HR 1.04; 95CI:0.91, 1.02), think highly of parents (HR 1.08; 95CI 0.93, 1.25). CONCLUSION: This study attempted to observe other factors outside of the parental monitor and control that could contribute to adolescent sexual activity. However, family connectedness was found to be a protective factor only among family weekly dinner and parent-child communitcation. Public health policy and interventions aimed at family connectedness alone will unlikely influence adolescent sexual behaviors. Therefore, other factors along with family connectedness should be further assessed to discover its true correlation on sexual debut.