Psychological Problems Research Articles

New masculinities in uro-oncology: A social theory that contributes to the mental health of patients with penile cancer.

Sociocultural, the penis has represented an essential element in the identity and masculinity of Western men. Therefore, its injury, damage, or loss leads to psychosocial problems affecting these people's health and well-being. Penile cancer is a rare malignancy (it represents 1.44% of the cases of genitourinary cancers) that has direct effects on the genitals, and its treatment consists of penectomy (removal of the penis). The loss of the penis due to this disease has a profound impact on the survivors. It is associated with higher rates of depression, anxiety, and loss of male identity, some even feeling like "castrated animals" or fewer men, having not only biological but also social and psychological problems, leading to the loss or decrease of sexual activity, self-esteem, and ability to relate to others. The new masculinities (a social theory much discussed these days) is offered as an alternative to understanding the behavior of men concerning what represents the penis, and the construction of their identity, focusing on the need to reconstruct the idea of masculinity and unlink the identity of men outside their genitals, the discussion of such social elements can be offered alternatives to help improve the psychological condition of patients who have survived the penectomy and contribute significantly to their health and quality of life, especially in improving your mental health.

Relationship between mindfulness and meaning in life among university students: roles of social support and the experience of being left behind

University students, particularly those with experiences of being left behind, face difficulties dealing with the many changes that cause psychological problems, and meaning in life plays a protective role in this process. Mindfulness and social support have emerged as potential factors influencing meaning in life. Although previous studies have revealed a link between mindfulness and meaning in life, few studies have examined this relationship from the perspective of the experience of being left behind. A sample comprising 1205 university students was used for the study. Self-report questionnaires were administered to assess the degrees of mindfulness, social support, meaning in life, and the experience of being left behind. We established four moderated mediation models to test the moderation and mediation effects. The results of a moderated mediation analysis revealed that social support and its dimensions mediated the effect of mindfulness on meaning in life. The impact of family support on meaning in life was moderated by the experience of being left behind, and friend support and other types of support had no significant moderating effects. Specifically, the moderating effect of the experience of being left behind significantly attenuated the impact of family support on meaning in life, whereas no significant weakening effect was observed for friend support or other types of support. Therefore, psychological education should emphasize the compensation role of friend support and other social connections in the psychological problems caused by the experience of being left behind, and appropriate mindfulness intervention is suggested.

Associations among psychological health problems, intimate-relationship problems, and suicidal ideation among United States Air Force active-duty personnel

ABSTRACT Linkages among psychological health problems, intimate relationship distress, and suicide risk have been widely studied, but less is known about how these factors interact, especially in military populations. With steady increases in suicide rates among active military and post-service members (SMs), it is critical to better understand the relation among known risk factors. The current study addresses this gap by testing a model hypothesizing that the association between intimate-relationship problems and suicidal ideation is mediated by individual mental health symptoms. We tested this model on a sample of 862 active-duty Air Force members in committed relationships. The sample consisted of 35.0% women and 64.8% men, with an average age of 21.9 years and a mean relationship length of 2.8 years. Findings supported the hypothesized statistical mediation model. Results indicated that relationship problems contribute to psychological health problems, which, in turn, are related to suicidal ideation. These findings may help direct suicide intervention and prevention protocols that consider intimate relationship distress as a significant risk factor. Limitations and further implications for policies regarding suicide prevention in the armed forces are discussed.

Network analysis of childhood maltreatment and internet addiction in adolescents with major depressive disorder.

Childhood maltreatment (CM) is closely linked to internet addiction (IA), especially in adolescents with Major Depressive Disorder (MDD). Previous studies have shown that adolescents who experience CM are more likely to develop IA and other psychological problems. This study aims to explore the complex relationship between CM and IA through network analysis, particularly identifying the core symptoms and bridge symptoms to better understand the development of IA in these adolescents. A cross-sectional study was conducted in seven hospitals in Anhui Province, China, involving 332 adolescents diagnosed with MDD using DSM-5 criteria. The Childhood Trauma Questionnaire - Short Form (CTQ-SF) and the Internet Addiction Test (IAT) were used to assess CM and IA symptoms, respectively. Gender-based network analysis was also performed. Network analysis constructed a CM-IA network and identified core and bridge symptoms. "Depress/moody/nervous being offline", "Request an extension for longer time", "Sleep loss due to late-night logins", and "emotional abuse" emerged as central symptoms within the CM-IA network. Additionally, "emotional abuse", "sexual abuse", and "complaints about online time" were identified as key bridge symptoms linking CM and IA. These symptoms demonstrated significant connectivity, underscoring their critical role in linking CM and IA. The findings highlight the complex relationship between CM and IA in adolescents with MDD. Specific symptoms, such as emotional abuse and online-related symptoms, play important roles in understanding and intervening in adolescent IA. Future interventions should target these core and bridge symptoms for more effective prevention and treatment.

Temperament and creativity – implications for mental health and education

Creativity is a complex phenomenon, which level is affected by variables such as intellectual competence, temperament, personality and emotions. Research shows that patients with bipolar affective disorder have a higher level of creativity than healthy controls. The model of affective temperament developed by Hagop Akiskal enables the research on relationships between predispositions to bipolar disorder and creativity. Previous studies on the relationship between affective temperament and creativity are conducted by comparing temperaments of representatives of creative professions and people outside this group, as well as by studying the relationship between affective temperament and creativity assessed both subjectively and through objective tests. However, the temperamental traits contributing to creative potential have their downside, as they have been linked to higher risk of psychological and emotional problems. They may also be related to poorer educational and academic achievement. The article presents up to date research on the relationship between affective temperament and creativity, as well as mechanisms explaining them. It also discusses the relationship between temperament, mental health, and educational achievement, as well as its implications for psychological and pedagogical interventions.

HIV facial lipodystrophy treatment by polylactic acid – a literature review

Human immunodeficiency virus (HIV) is a disease that negatively affects the immune system, requiring chronic, regular antiretroviral therapy, associated with numerous side effects. Lipodystrophy is one of them and is a serious clinical, psychological and social problem for patients affected by the problem. Volume loss and the formation of deep tissue defects in the facial area are caused by skeletal resorption and the redistribution of fat compartments, which progress with age but are also significantly exacerbated prematurely in the course of HIV and applied antiretroviral therapy. For a large group of patients, this constitutes a significant cosmetic defect, often leading to discontinuation of necessary, antiretroviral treatment. Various forms of treatment for this condition are currently available worldwide, including the implantation of non-permanent tissue fillers, such as hyaluronic acid-based fillers, or autologous fat cell transplants. The use of polylactic acid in the treatment of lipodystrophy is a therapeutic method with proven efficacy, effectiveness and a high safety profile, which will be discussed in this article.

Teenage pregnancy in rural Ethiopia : The case of Jima Arjo District, East Wallaga, Western Ethiopia

ABSTRACT Background : Teenage pregnancy is a major public health concern in developing nations like Ethiopia. Many psychological, financial, and health problems are associated with it. Objective : To determine the magnitude and associated factors of teenage pregnancy among teenagers visiting public health facilities in Jima Arjo district, East wallaga, Western Ethiopia, 2022. Methods: A facility-based cross-sectional study was conducted on 421 teenage females(10 to 19 years) in Jima Arjo District from February 15 to May 30, 2022. Data were collected , cleaned and analayzed using Epidata version 3.1. Level of significance of association was determined at a P- value?<?0.05. Results: In this study, the magnitude of teenage pregnancy was 17.1%. Married participants, attending secondary school, no awareness on family planning, not living with parents, and having a sister with the history of teenage pregnancy were significantly associated with teenage pregnancy. Conclusion: This study found that the magnitude of teenage pregnancy was high. Key stakeholders should work on prevention of early marriage, raise awareness on family planning, and encourage females’ education. Keywords: magnitude, associated factors, teenage pregnancy, Jima Arjo, East Wallaga

Children and depression: A view of a pediatrician. A review

Mental disorder is characterized by clinically significant impairment of cognitive function, emotional regulation or human behavior. Rapid development of technical progress, introduction of digital technologies into everyday life with daily processing of a large flow of heterogeneous information have led to a significant increase in the load on the nervous system of children and adolescents. Psychological problems are based on intrafamily and intrapersonal conflicts, so a specialist needs to build interaction with the maximum number of interested family members. The article provides information on the competencies of a pediatrician in identification of risk factors and diagnosing depression in children.

Sexual Function and Satisfaction among Women Undergoing In Vitro Fertilization (IVF) in the West of Iran: A Cross-Sectional Study

Background: We haven’t found any reported study that addressed sexual function and satisfaction in infertile women who are undergoing IVF treatment in the west of Iran. Objective: The present study was conducted to investigate sexual performance and satisfaction among women undergoing in vitro fertilization (IVF) in Western Iran. Methods: This cross-sectional study was conducted on 170 women from December 2022 to March 2023. The participants were selected by convenience sampling until the sample size was reached. The participants were included in the study as available sampling. Women completed the demographic questionnaire, FSFI (female sexual function index), and Linda Berg’s Sexual Satisfaction Questionnaire. For data analysis, we used the Stata version 14 (StataCorp, College Station, TX) and we considered the P-value less than 0.05 significant. Result: There was a significant relationship between husband occupations, economic status, marriage duration, period of infertility, cause of infertility, and intercourse times with sexual satisfaction (P<0.05). The highest percentage of the obtained score was related to pain (51.6%) and the lowest was related to desire (38%). All of the patients with weak sexual function had weak sexual satisfaction and 60.19% of the patients with good sexual function had good sexual satisfaction (P<0.001). Conclusion: Women with weak sexual function had weak sexual satisfaction. Policymakers should consider strategies, such as counseling and psychological support for women during the treatment process to help them cope with their problems, especially psychological problems.

The Frequency of Health Anxiety, Coronavirus Anxiety and Anxiety Disorder in Patients With Tinnitus During the COVID-19 Pandemic and the Impact of Pandemic on Tinnitus.

This study aimed to examine the frequency of anxiety disorder, coronavirus anxiety and health anxiety in tinnitus patients during the pandemic and also, determined the psychophysiological impact of COVID-19 on tinnitus. This cross-sectional study was conducted in a tertiary central pandemic hospital from 15 July 2021 to 15 December 2022. In total, 124 patients with tinnitus and 77 healthy controls participated in the study. The sociodemographic data, a set of valid and reliable assessment instruments were used to measure outcomes of anxiety disorder, coronavirus anxiety, health anxiety and severity of tinnitus. Patients with tinnitus were found to experience higher levels of coronavirus anxiety, health anxiety and anxiety disorder than controls (p < 0.05). In tinnitus patients, the frequency of coronavirus anxiety was 22.6% and anxiety disorder was 18.5%. Notably, the levels of tinnitus severity were moderate to severe in more than half of the patients (51.6%) and also most of them (81.3%) reported that the severity of tinnitus during the pandemic was higher compared with the pre-pandemic. Tinnitus patients had high levels of anxiety disorder, coronavirus anxiety and health anxiety. In line with these findings, it was evaluated that there was a relationship between the COVID-19 pandemic with psychological problems and tinnitus. Therefore, the predominance of tinnitus symptoms at presentation should not lead the clinician to neglect the underlying psychopathological problems in these patients.

Interventions for left-behind children in Mainland China: A scoping review

BackgroundAs the discussion of Chinese left-behind children (LBC) continues, intervention programs dedicated to this population increase and diversify. While reviews have summarized intervention programs promoting LBC’s health and psychological wellbeing, there is no synthesis depicting a comprehensive picture. This scoping review systematically examines interventions tackling LBC’s various issues and identifies their design and foci. MethodWe performed a systematic literature search to extract intervention studies from four English (i.e., Web of Science, Scopus, Embase, & PsycINFO) and one Chinese (i.e., CNKI) database. The quality of the studies was assessed using the Mixed Methods Assessment Tool (MMAT). Two main rounds of deductive coding were performed on Nvivo 12 plus to identify the design and foci of the interventions. ResultsThirty-three articles were identified for our final review. Twenty-six were published in Chinese and seven in English. Existing interventions have tackled multiple psychological, social, physical, developmental, and sexual problems or needs of Chinese rural left-behind children. Among them, LBC’s psychological wellbeing has drawn the most attention. The majority of the reviewed studies performed a randomized controlled trial (N=20). Quantitative evaluation is prevalent, with only one study applying a purely qualitative evaluation. In addition, only two studies adopted validated interventions, while the others are self-designed. ConclusionsThe review results indicate several gaps in intervention studies for LBC. First, many existing interventions have considered LBC’s psychological and social wellbeing, while little effort has been paid to address their educational and intellectual development. Further, while existing interventions are concerned with LBC’s temporary needs, their long-term life planning, as well as their current self-efficacy and self-concept driving their actions towards future self, were neglected. As for the intervention design, empirically validated interventions are recommended for future studies for their verified efficacy and evidence-based standardized practice. In addition, a qualitative evaluation should be considered because it might be more powerful in eliciting realistic and viable solutions to improve the effectiveness and reliability of the interventions from the participants.

Can positive emotional writing improve the emotional health level of international medical students? Evidence from a randomized controlled trial

BackgroundDepression and anxiety are common psychological issues among international medical students in universities, which have serious negative impacts on their learning and life. The present study aimed to evaluate the efficacy of positive emotional writing in alleviating symptoms of anxiety and depression, as well as enhancing subjective well-being among this population.MethodThis study was conducted at an international college of a comprehensive university in central China. A total of ninety-two participants who met the inclusion criteria were recruited to participate in a single-blind randomized controlled trial, in which participants were not aware that there was an experimental group and a control group. Participants in control received daily psychological care weekly for 8 weeks (n = 46). Correspondingly, participants in experimental group received the positive emotional writing intervention on the basis of daily psychological care. Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS) and General Well-being Scale (GWB) were used to evaluate the effect of the intervention. Data from 89 students who completed the entire study (experimental group, n = 44; control group, n = 45) were analyzed.ResultsAfter the intervention, the scores of SDS and SAS in the experimental group significantly decreased, while the subjective well-being score significantly increased. Although the SAS score of the control group after intervention was significantly lower than before, the decrease in SDS and SAS scores, as well as the increase in GWB score, were significantly greater in the experimental group than in the control group.ConclusionThe findings suggest that positive emotional writing can effectively reduce the depression and anxiety of international medical students, and significantly enhance their subjective well-being, providing ideas for management to solve the psychological problems of international medical students.Trial registration numberChiCTR2400087815. Registered at Chinese Clinical Trial Registry.

Göç Olgusunun Göçmen Bireyler Üzerindeki Ruh Sağlığına Etkisi

Migration is a complex structure that has existed throughout human history of individuals and units. There are different types of migration. Internal migration means displacement within the borders of the country. Emigration means leaving the regions they belong to for certain reasons. Brain drain, on the other hand, occurs when people who have developed their own personality are academically educated elsewhere due to the country's conditions. As a result of this move, immigrant individuals are affected by spiritual and emotional changes. The psychological effects of immigration on immigrants are known. Immigrant individuals may experience difficulties in three different categories: before migration, during migration and after migration. As a result of research on common pathologies seen in immigrants, post-traumatic stress disorder, anxiety disorders, self-alienation, schizophrenia, somatization disorder, and increased psychotic features have been expressed. It is known that the life disruption of immigrants has also been reduced. There are definitions of these immigrant types, as well as the psychological transitions of immigrant individuals and the common problem seen in immigrants. Literature research is included in their content. It can be stated that the results of the research showing that migration disrupts the daily life of the students and that psychological problems arise in their lives in a negative way can be expressed. Keywords: Types of migration, migrants, psychology, mental health, trauma.

Aesthetic rehabilitation of a complex crown-root fracture by fragment reattachment with a fiber-reinforced post: A case report

Complex crown-root fractures are characterized by the involvement of both crown and root with pulp exposure. They pose aesthetic, functional, and psychological problems for the patient. Furthermore, they can pose technical difficulties for the practitioner. The purpose of this case report is to describe the management of a complex crown-root fracture of the right upper central incisor with subgingival limit by reattaching the tooth fragment with fiber-reinforced post. We considered a coronal elongation (gingivectomy and osteoplasty) to recreate the biological space and to expose the limit of the fracture line to guarantee the quality of the bond.

Effects of mindfulness intervention on competition state anxiety in sprinters—a randomized controlled trial

ObjectivesWith the rapid growth of China’s sprint program’s international competitiveness, the psychological problems of sprinters have become a common concern in sports training theory and practice. Hence, the study examined the impact of a 7-week Mindfulness training program on competition state anxiety in Chinese sprinters.MethodsTwenty-four sprinters (Mage = 22.46 ± 1.351) were selected in a 2 × 3 mixed design, with the group (mindfulness/control) as the between-subjects variable and test time (pre-test/mid-test/post-test) as the within-subjects variable. The dependent variables corresponded to the mindfulness score and competition state anxiety score. One 60-min session was conducted once a week for 7 weeks, and the control group did not undergo any psychological training. The mindfulness group received mindfulness training, and the control group received regular psychological guidance. The subjects filled in the Five Facet Mindfulness Questionnaire (FFMQ) and the Competition State Anxiety Scale at baseline, followed by additional assessments 3 weeks and 7 weeks later.Results(1) In terms of competition state anxiety, there were no significant differences in the pre-test between the mindfulness group and the control group. There were significant differences in sprinters’ competition state anxiety after mindfulness intervention in terms of time, group, and the interaction between time and groups (p = 0.03, 0.004, and 0.009). (2) In terms of the mindfulness level, the difference between the mindfulness group and the control group was not significant in the pre-test. The sprinters’ mindfulness level was significant in the interaction between groups and that between groups and time after mindfulness intervention (p = 0.027 and 0.028).ConclusionMindfulness training alleviated sprinters’ competition anxiety by reducing sprinters’ somatic state anxiety (SSA) and cognitive state anxiety (CSA), as well as improving state self-efficacy. The results provide guidance and references for Chinese sprinters’ psychological problems.

대학 집단상담 분야의 연구 동향 분석

Objectives The purpose of this study is to examine the research trends on group counseling in universities, and to provide implications for future research. Methods For this study, 150 domestic journal papers on university group counseling published from 2000 to April 2024 were analyzed for basic elements, research topics, research subjects, research methods, research types, and types of group counseling. Results The research results are as follows. First, as a result of analysis as a research topic, it was classified into counseling theory, career development, self-development, interpersonal relationships, emotions, subjective well-being and learning development. Second, most of the subjects of the study were general college students, and in addition, there were college students in specific majors such as education and nursing. And college students who had disability problems, psychology, and learning problems were the subjects. Third, as a result of analysis by research method, it was classified into quantitative research, qualitative research, and literature research. Quantitative research included methods such as difference test, variance analysis, and nonparametric test, and qualitative research included content analysis, phenomenological research, grounded theory, and FGI. Fourth, research types were classified into counseling effect research, process research, development research, meta research, and research trend survey. Among them, counseling effect research accounted for the largest proportion. Fifth, as a result of analyzing the types of group counseling programs, face-to-face counseling was the most common in the form of counseling, structured counseling was the most common in the counseling structure, and counselor-centered counseling was the most common in group leaders. Conclusions It was discussed the importance of applying various perspectives and methods when studying group counseling research in universities. In addition, implications for the development and implementation of an effective university group counseling program for college students were presented.

Differences in Body Mass Index, Physical self-concept, and self-confidence in adolescent boys and girls

Background and Study Aim. Adolescence is characterized as a critical stage in the development of health-related habits, whose importance extends beyond this period, as they predict health-related behaviors in adulthood. The main objective of this study was to analyze differences in body mass index, physical self-concept, and self-confidence of adolescent boys and girls. Materials and Methods. This is a comparative research. The population in this study was adolescents aged 13-19 years with a random sampling technique of 94 people (male 53, female 41). Inclusion criteria for adolescent students in this study include the absence of any disease-related limitations. The instruments used were Body Mass Index, Physical Self-Perception Profile (PSPP), and a self-confidence questionnaire. The statistical analysis technique used the Statistical Package for Social Science (SPSS) version 21 software. The level of statistical significance was set at p-value &lt; 0.05. Results. The results of the analysis showed that: (1) Body Mass Index of adolescent girls is higher than boys (p-value &lt; 0.05). (2) Physical Self-Concept of adolescent girls is higher than that of boys (p-value &lt; 0.05). (3) Self-Confidence of adolescent boys is better than that of girls (p-value &lt; 0.05). Conclusions. The results of this study are expected to be a guideline for schools and health agencies to pay attention to the psychological health conditions of adolescents. Adolescents are expected to improve their body image with a confident attitude in order to avoid psychological problems.

The Efficacy of Laughter Therapy on Psychological Symptoms in People With Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Studies.

Cancer patients generally have high stress levels, which often leads to depression, anxiety and other psychological problems. Laughter therapy has been used to relieve stress, depression and anxiety in cancer patients, but its efficacy is uncertain. The study aims to summarize evidence on the efficacy of laughter therapy on psychological symptoms of people with cancer. A search was conducted in 10 electronic databases for randomized controlled trials (RCTs) reported before May 2023. This systematic review was reported based on the PRISMA 2020 statement. The evaluation of methodological quality and risk of biases were conducted by the Cochrane Risk of Bias Assessment tool version 2, and evidence evaluation was conducted using the GRADE pro online assessment tool. Statistical analysis adopted the Review Manager version 5.4 software. A total of eight studies were included involving 543 participants. Meta-analysis showed that laughter therapy plus routine nursing produced more positive effects than routine nursing in relieving stress (SMD=-1.18, 95% CI -1.73, -0.62, p<0.0001), depression (SMD=-1.05, 95% CI -1.30, -0.81, p<0.00001) and anxiety (SMD=-0.81, 95% CI -1.20, -0.43, p<0.0001). Laughter therapy could effectively relieve stress, depression and anxiety of cancer patients. Future studies should improve the methodological quality of randomized controlled trials, conduct appropriate follow-up, and report details of follow-up. Additionally, it should perform multi-center and large-sample studies, and combine both subjective and objective outcome indications to enhance the persuasiveness of evidence supporting the effectiveness of laughter therapy. PROSPERO register: CRD 42023452739.

Perspective of Fulfilling The Social Needs of Children Affected to The Mountain Semeru Eruption: Qualitative Study

Indonesia is an archipelagic country located at the confluence of four tectonic plates and there are volcanic arcs along the islands of Sumatra-Java-Nusa Tenggara-Sulawesi. This condition causes Indonesia to be in a condition prone to natural disasters, especially volcanic eruptions. Disasters have a more serious impact on vulnerable groups. Semi-structured interviews were used to collect research data. Researchers collected demographic data at the research stage and then conducted direct interviews with research informants through in-depth interviews and Focus Group Discussion. A total of 24 participants were involved in this study which were taken using purposive sampling. The research was conducted on preschool and school aged children (3-12 years) who were affected by the eruption of Mount Semeru in Lumajang Regency, Indonesia. The Mount Semeru eruption disaster resulted in psychological problems in children because peer separation, behavior, and borderline personality disorder have been widely reported in volcanic eruption disasters. Good social support is an important aspect in the process of recovering children after a disaster. Rapid life changes encourage parents to adapt immediately to meet the needs of children.

Gender identity disorder and its relations to avoidance symptoms among homosexuals

Gender identity refers to the way humans view themselves and perceive themselves to be attractive both sexually and romantically. It is an individual's appreciation and satisfaction of being heterosexual, bisexual, homosexual, or cisgender. It refers to an individual's sexual understanding of himself and is part of one's identity, which is different from the sexual understanding of oneself. Gender identity disorder means a robust desire of pertinence towards the opposite sex and robustly insistence on this otherness. Avoidance is classified within the framework of cluster 3 of personality disorders, which is identified by The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Hence, one can argue those who have this kind of personality disorder may appear in them withdrawal behavior; and they view themselves as restless, and they feel that they are rejected and despised by others. The researcher argues that homosexuals in Kurdish society are not accepted, and a large majority of people see them as sick, and others as victim due to their vulnerability to social and psychological problems. This study aims at finding relations between gender identity disorder and symptoms of avoidance in homosexual persons. The descriptive and relational methodology is used to intentionally select 108 subjects, 84 males and 24 females. Based on literatures and contemporary studies in the field, the researcher prepares the items of the gender identity disorder, yet for symptoms of avoidance, the researcher relies on and takes its terminologies from The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The terminologies in both variables are presented to groups of experts in education, psychology, and psychiatrics, and for extracting stability from both the measures, (split-half) and (alpha Cronbach’s) is used. After applying the last measures on individuals from the sample of the study, statistics of the data is analyzed using Statistical Package for the Social Sciences (SPSS). The study concludes that there is a robust, positive and significant correlation between gender identity disorder and avoidance symptoms among homosexuals. Based on the results recommendations are also given.