Inappropriate Sexual Behavior Research Articles

Sexuality and the Older Adult

This paper provides an overview of biopsychosocial components of sexuality in older adults, sexual expression in older LGBTQ and cognitively impaired adults, and inappropriate sexual behaviors (ISBs) in dementia. Sexual expression of older adults is influenced by diverse psychosocial and biologic determinants including ageist beliefs. Although the prevalence of sexual dysfunction increases with age, studies of sexual satisfaction reveal that only a minority experience significant distress. Stigma against sexual expression in LGBTQ older adults may cause concealment of sexual orientation from family or care providers due to fears of rejection. Cognitive impairment affects frequency of and satisfaction with sexual activity, as well as capacity to consent. Staff biases about sexuality can negatively impact sexual expression in healthcare settings. Dementia-related inappropriate sexual behaviors (ISBs) are common and distressing. Recent research has focused on early identification and prevention of ISB, in addition to management through non-pharmacologic and pharmacologic approaches. Sexuality remains integral to quality of life for many older adults and informed consideration of their needs is critical to healthcare delivery and institutional service planning. A comprehensive understanding of older adults' sexuality can enhance education, research, policy, and clinical care for this growing population.

Sex offender treatment professional perceptions of Fetal Alcohol Spectrum Disorder (FASD) in the Midwest

Fetal Alcohol Spectrum Disorder (FASD) is a neurodevelopmental condition that is precipitated by prenatal alcohol exposure. Typified by cognitive, social, and adaptive functioning impairments, FASD places impacted individuals at an elevated risk for involvement in the criminal justice system. In particular, it has been reported that some individuals diagnosed with FASD engage in inappropriate sexual behaviors. Because professionals working in the field of sexual offender treatment have the potential to strongly influence their clients, this study surveys professionals that provide treatment services to sexual offenders. Topics queried include knowledge of FASD, the role of FASD in criminal behavior, and training opportunities. The key findings from this study include that the respondents readily recognized symptoms, deficits, and consequences of FASD, but had very few opportunities to receive advanced training on FASD in the context of inappropriate sexual behavior. Findings suggest there is a strong need to develop educational and training programs that better equip professionals with the skills to assist clients with FASD in treatment settings for inappropriate sexual behavior.

Inappropriate Sexual Behavior in Women with Dementia

Inappropriate Sexual Behavior in Women with Dementia

Validación de un instrumento de evaluación del comportamiento sexual de personas con discapacidad intelectual para padres (ECS-PA)

La reciente normalización de la sexualidad y de los derechos sexuales entre las personas conDiscapacidad Intelectual (DI) ha hecho que se incremente el número de iniciativas dirigidas a mejorar sus conocimientos y habilidades mediante programas de educación afectivo-sexual pero dichos programas requieren instrumentos de evaluación fiables que permitan identificar sus necesidades y puedan ser sensibles al cambio tras la intervención. En dicha valoración deben confluir sus percepciones, las de los profesionales que se ocupan de ellos y las de sus padres para asegurar la veracidad de la información obtenida, pero lamentablemente carecemos de instrumentos psicométricos válidos y fiables tanto autoinformados, debido a que en muchos casos carecen de habilidades verbales suficientes para expresar sus deseos y vivencias, como heteroinformados, pues los existentes se centran fundamentalmente en el estudio de las actitudes hacia la sexualidad de este colectivo. El objetivo de este trabajo ha sido construir y validar un cuestionario para obtener información de los padres acerca de la sexualidad de las personas con DI leve o moderada. El instrumento fue administrado a 118 padres de personas adultas con DI. Se realizó un Análisis Factorial Exploratorio seguido de un Análisis Factorial Confirmatorio que ofreció una estructura compuesta de 3 factores: (F1) Comprensión de la privacidad y normas sociales (13 ítems), (F2) percepción de los conocimientos sobre sexualidad que tiene su hijo/a (10 ítems), y (F3) preocupación por un comportamiento sexual inadecuado (9 ítems). El modelo obtenido con estos tres factores presenta un buen ajuste como muestran los principales indicadores (Chi2 S-B/df = 1,14, RMSEA = 0,035, CFI = 0,910 y TLI = 0,902). El ECS-PA se muestra como un instrumento que permite obtener información válida y fiable sobre la sexualidad de las personas con DI leve o moderada.

Dysfonctions sexuelles après traumatisme crânien : revue systématique de la littérature

Sexual dysfunction (SD) is common in the general population, up to 50% in women and with no clearly defined prevalence in men but up to 30% in erectile dysfunction. Sexual dysfunctions (SD) are common after a traumatic brain injury (TBI) but remain underrated in clinical practice, yet it is a crucial aspect of the person with consequences for the relationship with the other, psychological wellbeing and quality of life. To determine, through a systematic literature review, the epidemiology, assessment tools and treatment of SD in the TBI population. (keywords, languages): Medline, COCHRANE and OVID databases were used with specific keywords (MeSH), combined with Boolean operators: "sexual dysfunction", "sexuality", "erectile dysfunction" and "traumatic brain injury". Only studies published in French or English, and with full-text available, have been included. Articles have been independently reviewed and extracted. Of the 199 articles reviewed after exclusion of duplicates, 86 articles were reviewed in their full text. A total of 40 studies were included in the final analysis. After TBI, 6% to 83% of patients report SD: decreased frequency of sexual intercourse (47-62%), desire and/or arousal (24-86%), erectile dysfunction (24,2-57%), difficulties with orgasm (29-40%), inappropriate sexual behaviour (8,9%). There is no consensus method for evaluating SD in this population, with 16 tools identified. Among them, only two questionnaires were validated in this population, the Brain Injury Questionnary of Sexuality-not validated in French-and the Overt Behavior Scale, the latter being intended for the evaluation of sexual behaviour disorders. Several factors are significantly and positively associated with SD: age (P≤0.01), severity of TBI (P≤0.002), depression (P<0.001), anxiety (P<0.001), and fatigue (P=0.042). Others are negatively associated: time since injury (P=0.01), perceived physical health status (P<0.001) and social participation (P<0.001). There is little data on the treatment of SD outside of case studies. Quantitative analysis could not be performed due to differences in the studies included in their design, evaluation tools, choice of TBI severity criteria, and post-TBI timeframes. Four unavailable articles could not be consulted. SD are common after TBI but remain poorly evaluated in clinical practice, despite their impact on patients and their partners. Their evaluation and treatment should be part of the overall management of patients after TBI. Nevertheless, there is currently no validated tool in French to evaluate these SD, nor are there any guidelines on their treatment.

Prevalence of and Preparedness to Address Inappropriate Sexual Behavior from Patients During Psychiatry Training: a Pilot Study.

Mental health providers experience inappropriate sexual behavior from patients. It is unclear if training programs adequately prepare trainees to respond to such behaviors. Additionally, trainees may not seek support and guidance from supervisors after an incident. This is an exploratory study to document the prevalence of and assess the preparedness of trainees to deal with inappropriate sexual behavior. A survey was administered to 58 psychiatry residents and 14 psychology interns at the NYU School of Medicine. A total of 22 questions were asked regarding participants' experiences with inappropriate sexual behavior, including prevalence of, and preparedness during, and support received after the behavior. Of those who completed the survey, 89% of respondents had experienced inappropriate sexual behavior. Seventy percent said they had no training in responding to inappropriate sexual behavior, and 95% wanted more training. A minority of respondents consistently sought support after these events, and of those who did, only 60% of trainees did so with a supervisor. Experiences involving inappropriate sexual behavior are prevalent among the mental health trainees surveyed, but most trainees did not feel that they received adequate training in preparation for or supervision after their experiences. Creating training or establishing protocols to respond to inappropriate sexual behavior may help trainees feel more capable and safer. Further studies are needed to understand inappropriate sexual behavior's impact on trainees and patient care, as well as to assess the efficacy of training and protocols developed to manage inappropriate sexual behavior.

Risk Factors Associated with Sexual Misconduct in the Canadian Armed Forces: Does It Vary by Sex and Environmental Command?

Using the Survey on Sexual Misconduct in the Canadian Armed Forces (n = 43,440) we examined risk factors associated with the experience of sexual misconduct in the Canadian Armed Forces (CAF). We used logistic regression models to identify predictors of being a target of sexual misconduct among CAF members. We also examined whether risk factors associated with sexual misconduct vary by sex and environmental command (Army, Navy, Air Force, or Military Personnel). The proportions of CAF members who experienced sexual assault, inappropriate sexualized behavior, or discriminatory behavior on the basis of sex and sexual orientation or gender identity in the past year were 2%, 18.4%, and 5.9%, respectively. The odds ratio of being the target for sexual assault or inappropriate sexual behavior and discriminatory behavior in the past year among females compared to males was 4.75 (95% confidence interval [CI] = 4.14 to 5.44), 2.55 (95% CI = 2.41 to 2.71), and 4.67 (95% CI = 4.3 to 5.08), respectively. Being a victim of one or more of the three types of sexual misconduct in the past year was associated with one or more of the following factors: younger, single, Indigenous, disabled, lesbian, gay, bisexual or transgender, highly educated, or junior non-commissioned members of the CAF. Results were generally consistent when we stratified our analysis by sex and environmental command. These results suggest that sexual misconduct is a problem within the CAF. There is a need for change within the CAF to prevent sexual misconduct among at-risk members.

Staff responses to residents exposing their genitals in public in long-term care settings: The gap between common and perceived best practices.

To explore staff reactions to residents' behaviour consisting in exposing their genitals in public, and to differentiate between what is perceived as common practice (what most staff do) and best practice (the best possible approach). The presence of inappropriate sexual behaviours (ISBs) in long-term care facilities poses practical and ethical dilemmas since they may impinge on the rights of others (staff and residents) and thus need to be adequately monitored and managed. However, no studies have focused on how staff handle ISBs, and particularly exposing oneself in public. A total of 2,175 people working in 152 Spanish LTC facilities participated in the study. They were presented with a vignette describing a resident exposing his/her genitals in public, and they were asked what they think most of their workmates would do and what they think should be done in that situation. The STROBE checklist was used to enhance the quality and transparency of the research. Approximately one-third of participants (32.4%) reported having experienced behaviours such as the one described in the vignette. Staff reactions underline the predominance of restrictive practices. However, if prompted to think in terms of best practice, supportive reactions increased in frequency. Finally, factors such as work position have an influence on perceived common and best practices, with care assistants generally holding more restrictive views than directors or technical staff. Around one-third of staff members, and particularly those in managerial or technical positions, had witnessed residents exposing their genitals in public. However, there is no common ground among staff regarding the best way to handle the situation. Our findings stress the importance of organisational policies and workplace training in the management of challenging behaviours such as exposing oneself.

Children’s rights and teachers’ responsibilities: reproducing or transforming the cultural taboo on child sexual abuse?

Enhancing young learners’ knowledge about appropriate and inappropriate sexual behaviour is crucial for the protection of children’s rights. This article discusses teachers’ understandings of their practices and approaches to the topic of child sexual abuse in Norwegian upper secondary schools, based on phone interviews with 64 social science teachers. Countering child sexual abuse is a political priority for the Norwegian government, and the Committee on the Rights of the Child acknowledges several state initiatives to counter child sexual abuse through education. Nevertheless, this study finds that teachers do not address this topic adequately, indicating that cultural taboos regarding talking about and thus preventing such abuse, including rape among young peers, still prevail in Norwegian classrooms. Furthermore, emotional obstacles, including concerns about re-traumatising and stigmatising learners, hinder some teachers from addressing this topic thoroughly. Additional explanatory factors include heavy teacher workloads, little preparation in teacher education programmes, insufficient information in textbooks, and an ambiguous national curriculum.

Inappropriate Sexual Behaviours as Perceived by Students in the Institute of Education, Delta State University, Abraka: Implication for Counselling

The purpose of this study was to examine the perception of students in the Institute of Education on the incidence of inappropriate sexual behaviours among students at Delta State University, Abraka. A total of 334 students in Business Education and Library Science Education completed a questionnaire with items on pre-marital sex, pornographic materials, sexual abuse and indecent dressing. The instrument for the study was a 22 &amp;ndash; item &amp;ldquo;Youth Assessment of Inappropriate Sexual Behaviour Interest Inventory&amp;rdquo; (YASPII). The instrument had acceptable content and face validity. It had a Cronbach alpha reliability index of .75. Four research hypotheses were tested. Findings of the study revealed that pre-marital sex, pornographic films and indecent dressing were perceived by students as common forms of inappropriate sexual behaviour. There was however disparity in their perception of sexual abuse as a form of inappropriate behaviour. It was recommended that sexuality education be scaled up in Nigerian higher education institutions.Counselors and other stakeholders should sensitize students on the consequences of viewing pornographic materials, engaging in pre-marital sex and wearing indecent clothing.

MANAGEMENT OF INAPPROPRIATE SEXUAL BEHAVIORS IN DEMENTIA USING MULTIDISCIPLINARY TEAMS IN THE CONTINUUM OF CARE: Session 210

Behavioral disturbances are seen in over 80% of individuals with dementia. Although inappropriate sexual behaviors in dementia (ISBD) are not as common as some of the other behavioral symptoms in dementia, these behaviors can cause immense distress to all those affected by them. Currently, there are no randomized trials evaluating the effectiveness of management strategies for these behaviors, but the available data suggest efficacy for some commonly used treatment modalities. In this symposium, we will discuss the epidemiology, neurobiology and the differential diagnosis for ISBD. We will then provide an overview of the evidence-based assessment and management of these behaviors. We will end by describing the role of multidisciplinary teams in the continuum of care for the optimum management of ISBD.

Measuring Inappropriate Sexual Behavior Among University Students: Using the Randomized Response Technique to Enhance Self-Reporting.

This article analyzes the efficacy of the randomized response technique (RRT) in achieving honest self-reporting about sexual behavior, compared with traditional survey techniques. A complex survey was conducted of 1,246 university students in Spain, who were asked sensitive quantitative questions about their sexual behavior, either via the RRT (n = 754) or by direct questioning (DQ) (n = 492). The RRT estimates of the number of times that the students were unable to restrain their inappropriate sexual behavior were significantly higher than the DQ estimates, among both male and female students. The results obtained suggest that the RRT method elicits higher values of self-stigmatizing reports of sexual experiences by increasing privacy in the data collection process. The RRT is shown to be a useful method for investigating sexual behavior.

Inappropriate Patient Sexual Behavior When Working in Sensitive Areas of the Body: Results From a National Physical Therapy Survey

Inappropriate Patient Sexual Behavior When Working in Sensitive Areas of the Body: Results From a National Physical Therapy Survey

Expresión sexual y regulación de la sexualidad en residencias de personas mayores

ObjectivesThe study had three objectives: (a) To determine how staff perceives the frequency of different sexual expressions in long-term care facilities for older people; (2) to quantify policies aimed at guaranteeing residents’ sexual rights in such institutions, and (3) to determine factors influencing the presence of these kind of policies. MethodsA total of 160 Directors of Nursing and 623 technical staff from Spanish long term care residential facilities completed a self-administered questionnaire including ítems to assess the experience and estimated frequency of different sexual expressions, an inventory of policies regarding sexual expression, and the Spanish version of the Person-Centred Care Assessment Tool. ResultsCertain sexual behaviours, such as kisses and hugs, or masturbation, are very frequent in nursing homes. Many participants have reported to staff members on having witnessed inappropriate sexual behaviours, such as exhibitionism (39%) or unwanted touching (27%). Policies in relation to guaranteeing residents’ sexual rights were the most frequently mentioned. In contrast, there were fewer participants who mentioned policies regarding training or availability of helpful materials and resources. Factors such as occupational level (Directors of Nursing vs.technical staff), personal education, the centre commitment to person-centred care, and estimated frequency of sexual behaviour were associated with a higher presence of sexual expression policies. ConclusionAlthough sexual behaviours among residents are quite frequent, there is still room for improvement in policies that support residents’ expression of sexuality. Person-centred care models might help to guarantee sexual rights of older people living in long-term care facilities.

Mirtazapine for Inappropriate Sexual Behaviors in Autism

Mirtazapine for Inappropriate Sexual Behaviors in Autism

Seksualność w socjotechnice dyscyplinowania

The paper ponders the subject of utilizing human sexuality in the process of social discipline. The author perceives this process as a modern form to subjugate an individual primarily on the basis of symbolic coercion. Making reference to the classical works of Michel Foucault the author emphasizes the factors that allow sexuality to be used for social programming. Foucault was critical of the idea that we experience the repression of a natural sexual drive, at least in its traditional meaning. In his opinion, multiplied knowledge of sex should be noted in Western societies, which leads to the hyper-development of sexual discourse, theory and the science of sexuality. He questioned the stereotypical understanding of sexual repressiveness, which determines a way of thinking in terms of a simple retaliation taken for inappropriate sexual behavior. He suggested that less observable programming control be introduced instead, based on disciplining. The limits of discourse are established by the admissible sexual relations. Whatever goes beyond this discourse, whatever is not contained within it, becomes abnormal and, potentially, repressed. The objectives of programming control and the limits of discipline are decided not only by the church and state, but also by business and media concerns, which fill the discourse with certain subjects thus deciding what dimensions of sexuality are permissible. Confessions that used to be confined to confessionals and psychoanalysts’ surgeries have become media commodities used not only marginally by pornography, but formatted to excite, fill voyeuristic needs and experience vicarious sensations. Discourse is becoming an area of apparent freedom, whereas in fact it is a means to discipline society. This seeming expansion of discourse limits to a lesser degree concerns the realm of problems and to a greater degree – accessibility. What used to be an object of communicative interest reserved for the elite has been included in mass discourse because this is the requirement of modern democracy and a liberal economy.

Establishing dimensionality of sexual behaviours in patients with regional brain dysfunction

ABSTRACTObjective: To develop a validated, caregiver-based measurement scale to assess sexual changes across several domains in a sample of 86 patients with penetrating traumatic brain injury (TBI) and 65 patients with neurodegeneration due to frontotemporal dementia and corticobasal syndrome.Methods: A new measure, the Sexual Symptoms in Neurological Illness and Injury Questionnaire (SNIQ), was constructed. Dimensionality, monotonicity, item discrimination power, and scalability were evaluated using nonparametric Mokken item response theory (IRT) methodology.Results: Three primary domains were established. The domains presented with sufficient reliability (rho .70 to .80), while meeting the Mokken IRT criteria of medium scalability. The domains were labeled ‘Prosocial sexual behaviour’ (H = .42), ‘Sexual interest’ (H = .50), and ‘Inappropriate sexual behaviour’ (H = .41). A fourth dimension emerged, ‘Detachment’ (H = .47), but with very few items.Conclusions: Construct validity was established for groups of items pertaining to three unique aspects of sexuality. These findings support further use of the SNIQ in assessing and researching sexual behaviours in patients with dementia and brain injury.

Knowledge and attitudes on unsafe abortions among the state university undergraduates in Western Province

Abstract Objective: To describe the knowledge and attitudes on unsafe abortions among undergraduates in the state universities of the Western Province. Methods: A descriptive cross sectional study was conducted among 1575 second and third year undergraduates using stratified cluster sampling of the selected universities. Pre-tested self-administered questionnaire was administered to assess socio-demographic factors, knowledge and attitudes on unsafe abortions. The responses to the knowledge and attitude questions were scored and graded. Percentage of knowledge categories and attitudes were calculated. The associations of knowledge categories with selected variables were assessed. Results: A majority (53.3 %, n=839) of respondents had good knowledge on unsafe abortions while 30.5% (n=480) had satisfactory knowledge and minority (16.3%) had poor knowledge. Females (55%, n=509) had more good knowledge than males (51%, n=329, P>0.05). Those who studied in Bio-Science stream (70.2%, n=174, P 0.05) had more good knowledge than the others (P<0.001). The majority (68.5%, n=1074) agreed that the legal restrictions would drive people to unsafe abortions and making abortion services through the government health facilities could increase the inappropriate sexual behaviors (63.7%,n=998). Only a very few (7.1%, n=111) of undergraduates agreed that abortion was a convenient form of contraceptive and 47.7% (n=747) agreed to be restricted to save mother’s life. A majority (53.2%, n=833) agreed that it should be a right of a pregnant woman to decide whether she wants an abortion or not. Conclusion A majority of undergraduates had good knowledge on unsafe abortions. Most of the undergraduates wanted not to fully liberalize abortion policies due to inappropriate usage and merely it is a right of a pregnant mother.

Aripiprazole for the Treatment of Inappropriate Sexual Behavior: Case Report of an Alzheimer's Disease Patient Known as Heterosexual with Recently Shifted Sexual Orientation to Same Gender.

Although inappropriate sexual behavior in dementia is not common, it can be extremely troublesome for healthcare professionals and caregivers as well as patients themselves. There is paucity of data in the literature for the management of these behaviors, but the limited available data suggest efficiency of some commonly used treatment modalities. Herein, we present a 74-year old Alzheimer’s disease (AD) patient, known to be heterosexual throughout her past life, presenting with a recent display of same-sex inappropriate sexual behavior six years after the initial diagnosis of her disease. This new clinical picture of hypersexuality responded well to aripiprazole and her symptoms gradually diminished and eventually disappeared after onset of medication. This report also constitutes the first reported case of an AD patient in the published literature presenting with hypersexuality of shifted sexual orientation during the course of the disease.

Sexual Situations in Spanish Long-Term Care Facilities: Which Ones Cause the Most Discomfort to Staff?

This study aimed to explore which kinds of residents’ sexual expressions cause the most discomfort to staff and to determine the situational circumstances that might be related to this perception of discomfort. The sample was made up of 1895 front-line care staff employed at 152 Spanish long-term care facilities. Participants’ answers to an open-ended question regarding the sexual situation that caused them the most discomfort were content-analyzed. Results showed that most participants were able to mention at least one sexual situation that had caused them discomfort. Moreover, the range of sexual situations mentioned by our participants clearly goes beyond the typical behaviors associated with inappropriate sexual behaviors in dementia. Situational circumstances were related to participants’ perception of discomfort. Our results suggest the importance of including sexual issues on the formal training of staff and developing explicit guidelines and institutional policies regarding sexual expression in long-term care facilities.