Unit IISexuality over the Lifespan

Dean Owen, Ph.D., LPCCProfessor EmeritusDepartment of Foundational and Graduate Studies in Education

EDGC 682

Counseling Issues in Sexuality

The only time sex should be taken seriously is when you’re not getting any. George Carlin (1937-2008)

Individual patterns of sexual orientation probably develop as the result of the interaction among biological, social, cultural, and psychological factors. The process is called psychosexual development.

Prior to the writings of Sigmund Freud, most in the western world regarded children as asexual beings.

With the publication of his work Three Essays on the Theory Sexuality in 1905 Freud was the first to seriously address the issue of child sexuality.

He did so by postulating the existence of:

1. A stage theory of psycho-sexual development which he suggested had life long effects on psychological development.

2. Libido: a source of sexual energy or drive that is the prime motivator of all sexual behavior

3. Erogenous Zones (and fixation)

Biological instinct

Biological instinct

Name Age Principle Task

Oral Stage Birth to 18 months Weaning

Anal Stage 18 months to 3-4 yrs Toilet Training

Phallic Stage 3-4 yrs to 5-7 yrs Sexual Identity

Latent Stage 5-7 yrs to Puberty Learning

Genital Stage Puberty onwards Genital Intercourse

Freud’s Psychosexual Stages

Libido: a source of sexual energy or drive that is the prime motivator of all sexual behavior

Biological Drive…..

1. Erogenous Zones (and fixation)

Love isn’t an emotion or

an instinct….it’s an art.

Mae West

Actor (1893-1980)

Many theories emphasize the importance of socialization (interactions with others) in the psychosexual development. Erik Erikson described eight stages each of which is associated the a crisis that must be resolved.

1902-1994

Erik Erikson

1. Infancy: Gaining trust in self and environment vs. feeling mistrust and wariness of others.

2. Ages 1 ½ to 3: Achieving a sense of automomy vs. shame and doubt over one’s ability to be independent.

3. Ages 3-5 ½ : Learning how to take initiative comfortably vs. Feeling guilty over motivations and needs.

4. 5 ½-12: (Time when school and other external forces gain more significance) Gaining a sense of industry and competence vs. feeling inferior and inept.

Erik Erikson

Eight Stages of Development

5. Adolescence: Forming a sense of one’s identity vs Role confusion and self-questioning.

6. Young adulthood: Achieving intimacy and connection with others vs. Isolation and lonliness.

7. Middle adulthood: Generativity vs stagnation.

8. Late adulthood: Integrity vs despair

Erik Erikson

Eight Stages of Development

Learning Theorists purport to explain much of human sexual behavior as the result of complex interactions of stimuli, reinforcement and punishers….

Classical conditioning or respondent learning….Operant conditioning or instrumental learningSocial learning

Sex is learned

I can remember when the air was clean and sex was dirty.

George BurnsUS actor & comedian (1896 - 1996)

Classical Learning(aka Pavlovian or Respondent Conditioning.)

Ivan Pavlov

Classical Learning(aka Pavlovian or Respondent Conditioning.)

A form of associative learning first demonstrated by Ivan Pavlov

Classical Learning(aka Pavlovian or Respondent Conditioning.)

The Model

UCS UCR

Sex and classical conditioning….

?????

To err is human, but it feels divine.

Mae West, Actor , 1893-1980

John B. Watson

The Little Albert study of 1920

John B. Watson:

The Little Albert experiment was an experiment showing empirical evidence of classical conditioning. This study was also an example of stimulus generalization. It was conducted in 1920 by John B. Watson along with Rosalie Rayner, his assistant whom he later married. The study was done at Johns Hopkins University.

John B. Watson, after observing children in the field, was interested in finding support for his notion that the reaction of children, whenever they heard loud noises, was prompted by fear. Furthermore, he reasoned that this fear was innate or due to an unconditioned response. He felt that following the principles of classical conditioning, he could condition a child to fear another distinctive stimulus which normally would not be feared by a child.

John B. Watson:

Loud sound (Unconditioned Stimulus) -> Fear (Unconditioned Response) Natural response.

Rat (Neutral Stimulus) + Loud sound (Unconditioned Stimulus)-> Fear (Unconditioned Response) During pairing them.

Rat (Conditioned Stimulus) -> Fear (Conditioned Response)

The fear response later generalized to ….. (Stimulus Generalization)

White Rabbit (17 days post conditioning….)

Furry Dog

Seal Skin Coat

Santa Claus beard composed of white cotton balls….

Operant Conditioning

B.F. Skinner

Operant ConditioningOperant conditioning is the use of consequences to modify the occurrence and form of behavior. Operant behavior "operates" on the environment and is maintained by its consequences, while classical conditioning deals with the conditioning of respondent behaviors which are elicited by antecedent conditions. Behaviors conditioned via a classical conditioning procedure are not maintained by consequences.

Operant Conditioning

This is where superstitious behavior is learned!

Key Terms:

Reinforcement

Shaping

Acquisition

Free Operant

Punishment

Extinction

Spontaneous recovery

Post hoc ergo propter hoc!

Operant ConditioningReinforcement: Any consequence of a behavior that enhances the likelihood of a future occurrence of the behavior.

Positive reinforcement occurs when a behavior (response) is followed by a favorable stimulus (commonly seen as pleasant) that increases the frequency of that behavior. In the Skinner box experiment, a stimulus such as food or sugar solution can be delivered when the rat engages in a target behavior, such as pressing a lever.

Negative reinforcement occurs when a behavior (response) is followed by the removal of an aversive stimulus (commonly seen as unpleasant) thereby increasing that behavior's frequency. In the Skinner box experiment, negative reinforcement can be a loud noise continuously sounding inside the rat's cage until it engages in the target behavior, such as pressing a lever, upon which the loud noise is removed.

Operant ConditioningReinforcement: Any consequence of a behavior that enhances the likelihood of a future occurrence of the behavior.

Primary Reinforcer: A consequence such as food, water that satisfies a fundamental biological.

Secondary Reinforcer: A consequence such as social approval or money that has acquired reinforcement properties through previous learning. A symbolic or representational reward that could be exchanged for a more primary reinforcer.

Extrinsic Reinforcer: A reward that is provided externally to the individual.

Intrinsic Reinforcer: a reward that one gives to oneself…..the behavior in which one is engaging generates a drive to continue…..

Operant ConditioningPunishment: Any consequence of a behavior that reduces the likelihood of a future occurrence of the behavior.

Positive punishment (also called "Punishment by contingent stimulation") occurs when a behavior (response) is followed by an aversive stimulus, such as introducing a shock or loud noise, resulting in a decrease in that behavior.

Negative punishment (also called "Punishment by contingent withdrawal") occurs when a behavior (response) is followed by the removal of a favorable stimulus, such as taking away a child's toy following an undesired behavior, resulting in a decrease in that behavior.

Operant Conditioning

Shaping: Selectively reinforcing behaviors that are closer and closer to a desired goal. (Successive approximations). The is roughly akin to learning in stages or in steps. How do you teach a mouse to press a bar….or a chicken to peck a target???

Operant ConditioningExtinction: The gradual decay of a learned behavior as the result of a failure to reinforce it. Behavior that is not reinforced generally does not persist.

Reinforcement Schedules determine how easily behavior can be extinguished.

Fixed, Variable, or intermittant, or random.

Operant ConditioningSpontaneous Recovery: The temporary reemergence of learned behavior following extinction.

Operant ConditioningOperant Conditioning set the stage for what has become known as “Behavior Modification” and for a branch of therapy known as behavioral counseling. It’s all about controlling contingencies and what is reinforced and what is punished.

Operant ConditioningIntrinsic Motivation

DefinitionsPeople often choose to invest considerable time in activities without apparent reward. The cause underlying such behaviors is intrinsic motivation. Intrinsic motivation is defined as engagement in actions for their own sake with the only tangible benefit being outcomes such as pleasure, learning, satisfaction, interest, or challenge. On the other hand, extrinsic motivation occurs when learners engage in activities for the purpose of attaining rewards, such as praise or high grades (Alderman, 1999). Engaging in behavior to avoid punishment is also regarded as an extrinsic motivation.

Operant ConditioningEnhancing Intrinsic Motivation

Some researchers believe that intrinsic motivation can be enhanced through the use of particular strategies, and have sought a correlation between the design of specific educational materials and an increase in learning performance. Thus far, studies have found no evidence to establish that the interest value of material is a determinant--as opposed to a consequence--of learning (Parker & Lepper, 1992). However, some useful strategies that can promote intrinsic motivation have been proposed.

Operant ConditioningLepper and Hodell (1989) suggest four methods for enhancing intrinsic motivation: Challenge: Design challenging activities which convey the message to the learners that they have competitive skills. It is essential to find a balance between learner competence and the difficulty of the goals. Overly difficult goals are unlikely to increase learner motivation to continue the task if the learners perceive they will never reach the goal. Likewise, goals that are too easily attained do not sufficiently challenge learners to encourage skill development.

Operant ConditioningCuriosity: Activities that create disequilibria for the learners can elicit curiosity. Presenting discrepant ideas--those that conflict with their prior knowledge or beliefs--can prompt students to seek information that will resolve the discrepancy. As with challenge, moderate discrepancies are most effective because they are easily incorporated into an individual's mental framework; large discrepancies may be rapidly discounted (Pintrich & Schunk, 1996, p.277). Control: A sense of responsibility will be better fostered in learners if they are allowed to make meaningful choices in the learning process.

Fantasy: The design of simulations and games that involve fantasy canto encourage skill development.

Social Learning TheoryObservational learning…

Monkey see, Monkey do!

Social Learning TheoryThe social learning theory of Bandura emphasizes the importance of observing and modeling the behaviors, attitudes, and emotional reactions of others. Bandura (1977) states: "Learning would be exceedingly laborious, not to mention hazardous, if people had to rely solely on the effects of their own actions to inform them what to do.

(Learning to drive a car could be a real trip!!!)

Social Learning Theory

Fortunately, most human behavior is learned observationally through modeling: from observing others one forms an idea of how new behaviors are performed, and on later occasions this coded information serves as a guide for action." (p22). Social learning theory explains human behavior in terms of continuous reciprocal interaction between cognitive, behavioral, an environmental influences., including external, vicarious and self reinforcement.

Social Learning TheoryThe component processes underlying observational learning are:

(1) Attention, including modeled events (distinctiveness, affective valence, complexity, prevalence, functional value) and observer characteristics (sensory capacities, arousal level, perceptual set, past reinforcement),

(2) Retention, including symbolic coding, cognitive organization, symbolic rehearsal, motor rehearsal),

(3) Motor Reproduction, including physical capabilities, self-observation of reproduction, accuracy of feedback, and

(4) Motivation, including external, vicarious and self reinforcement.

Social Learning TheoryThe most common (and pervasive) examples of social learning situations are television commercials. Commercials suggest that drinking a certain beverage or using a particular hair shampoo will make us popular and win the admiration of attractive people. Depending upon the component processes involved (such as attention or motivation), we may model the behavior shown in the commercial and buy the product being advertised.

This may be the most powerful of all psychological behavior modification strategies. Marketing is basically an attempt to influence an individual in such a way as to create a need that can only be satisfied through the purchase of the marketer’s product.

Social Learning Theory

1. The highest level of observational learning is achieved by first organizing and rehearsing the modeled behavior symbolically and then enacting it overtly. Coding modeled behavior into words, labels or images results in better retention than simply observing.

2. Individuals are more likely to adopt a modeled behavior if it results in outcomes they value.

3. Individuals are more likely to adopt a modeled behavior if the model is similar to the observer and has admired status and the behavior has functional value.

Social script theory teaches that human behavior is controlled by complex social scripts that integrate sexual behavior. According to Gagnon and Simon (1973) nearly all human behavior is controlled by social scripts which are assimilated from the wider culture.

A unified model of sexual development considers three crucial strands that eventually integrate to form adult sexuality:

1. Gender identity: (core gender identity) is the gender(s), or lack thereof, a person self-identifies as. It is not necessarily based on biological fact, either real or perceived, nor is it always based on sexual orientation. The gender identities one may identify as include male, female, both, somewhere in between, or neither.

A unified model of sexual development considers three crucial strands that eventually integrate to form adult sexuality:

1. Gender identity: (core gender identity) is your own sense or conviction of maleness or femaleness.

2. sexual response and orientation (Identifying one’s own sexual orientation involves prelabling, self-labeling and social labeling)

and,

3. the capacity for dyadic intimacy.

Infant Sexuality

In infancy and childhood the sex organs respond to many types of stimuli.

Babies are sensitive over the entire surface of their bodies and what is characteristic of the process of maternal bonding is that babies appear to learn and appreciate the touch of their mothers.

Santrock, 2008

Infant Sexuality (Male)

Calderone (1983) reported that ultrasound images confirmed that male fetuses experience spontaneous erections.

Lively & Lively (1991) reported that infant boys experience erections easily and seem to enjoy stimulation. A number of male infants seem to experience orgasms as evidenced by a sequence of tension building, rhythmic muscular contractions, and pelvic thrusting, culminating in what appears to be pleasurable sensations and relaxation.

Kinsey (1948) reported orgasms in 32% of subjects under one year of age and 57% between ages 2-5.

Santrock, 2008

Infant Sexuality (Female)

Less well documented is the sexual response of female infants. It is known that for a period of about one month after birth a girl’s genitalia may become somewhat swollen and inflamed because of maternal hormones still present in the child’s bloodstream. This seems to cause a temporary early maturation of the female sex organs including temporary vaginal secretions and cell maturation. Observations by parents and professional suggest that infant females are also capable of experiencing some form of orgasmic release (Langfeldt, 1981)

Santrock, 2008

Childhood Sexuality

Children are naturally curious about their bodies and sexual functions — they wonder where babies come from,they notice anatomical differences between males and females, andmany engage in genital play (often mistaken for masturbation).

Child sex play includes exhibiting or inspecting the genitals.Many children take part in some sex play, typically with siblings or friends.

Sex play with others usually decreases as children go through their elementary school years, yet they still may possess romantic interest in their peers. Santrock, 2008

Difficulties in understanding childhood Sexuality

There is a severe lack of reliable information regarding childhood sexuality primarily because of ethical reasons.

The Kinsey reports (1948 and 1953) included references to the physical sexual response of children, including pre-pubescent children. A common criticism of these reports is that some of the data in the reports could not have been obtained without observation or participation in child sexual abuse, or with the collaborations with child molesters (Salter, 1988).

In 2000, Swedish researcher IngBeth Larsson noted that "It is quite common for references still to cite Alfred Kinsey", due to the paucity of subsequent large-scale studies of child sexual behavior (Larsson, 2000).

Sources of information about childhood Sexuality

Empirical knowledge about child sexual behavior is not usually gathered by direct interviews of children, partly due to ethical considerations. Information about child sexual behavior is gathered by the following methods:

• Observing children being treated for problematic behavior, such as use of force in sex play, often using dolls having genitals.

• Recollections by adults.

• Observation by caregivers.

Larsson (2000)

Normal Childhood Sexual Behavior

Early childhood

From the ages of 3 to 7, the following behaviors are normative among children:

• Children are curious about where babies come from.

• Children may explore other children's and adults' bodies out of curiosity.

• By age four, children may show significant attachment to the opposite-sex parent.

• Children begin to have a sense of modesty and of the differences between private and public behaviors.

• For some children, genital touching increases, especially when they are tired or upset.

Normal Childhood Sexual Behavior

Early school age covers approximately ages five to seven.

Children become more aware of gender differences, and tend to choose same-sex friends and playmates, even disparaging the opposite sex.

Children may drop their close attachment to their opposite-sex parent and become more attached to their same-sex parent.

During this time, children, especially girls, show increased awareness of social norms regarding sex, nudity, and privacy. Children may use sexual terms to test adult reaction. "Bathroom humor" (jokes and conversation relating to excretory functions), present in earlier stages, continues.

Masturbation continues to be common.

Normal Childhood Sexual Behavior

Middle childhood

'Middle childhood' covers the ages from about six to nine, depending on the methodology and the behavior being studied,individual development varies considerably.

As this stage progresses, the choices of children picking same-sex friends becomes more marked and extending to disparagement of the opposite sex.

Normal Childhood Sexual Behavior

Pre-teen years

Planned Parenthood in the USA recommends that pre-teen children should learn, among other things:

• The general stages of sexual development in young humans of each sex and the general timing of normal development (including emotional changes).

• That sex is not only for having babies and is also done for pleasure.

• Knowledge about aspects of sex in society, including prostitution, rape and exploitative relationships.

• How to avoid pregnancy and prevent sexually transmitted infections.

Human Sexuality—What children need to know and when they need to know it.

Planned Parenthood Federation of America

Premature Sexualization

It has been argued thatover recent decades children have been subject to a premature sexualization as indicated by a level of sexual knowledge or sexual behaviour inappropriate for their age group. The causes of this premature sexualization that have been mentioned include:

1. portrayals in the media of sex and related issues, especially in media aimed at children;

2. the marketing of products with sexual connotations to children, including clothing;

3. the lack of parental oversight and discipline;

4. access to adult culture via the internet; and

5. the lack of comprehensive school sex education programs. For girls and young women in particular, studies have found that sexualization has a negative impact on their “self-image and healthy development".

Kaeser, 2001

Premature Sexualization

When an adult or older adolescent uses a child for sexual stimulation, that is a form of child abuse known as child sexual abuse. This can also bring on the premature sexualization of the child. Other effects of child sexual abuse include:

1. depression;

2. post-traumatic stress disorder and anxiety,

3. propensity to further victimization in adulthood, and

4. physical injury to the child, among other problems.

Child sexual abuse by a family member is a form of incest, and can result in

more serious and long-term psychological, especially in the case of parental

incest.

APA, 1999

Sexual contact among sibling

In 1980, a survey of 796 undergraduates, 15% of females

and 10% of males reported some form of sexual

experience involving a sibling; most of these fell

short of actual intercourse. Approximately one quarter of

these experiences were described as abusive or

exploitative.

Finkelhor, 1980

Adolescent Sexuality

Puberty is a biological term which represents a time in life when reproductive capacity develops and secondary sex characteristics appear.

Adolescence is a social term referring to the time of emotional, social, psychological and physical transition from childhood to adulthood.

Kelly, 1994

Adolescent SexualityAdolescence begins with the onset of puberty (11 for girls, 13 for boys)

Goulston (1988) reported that some fathers may experience guilt over “noticing” their daughter’s developing body and may become less affectionate which causes some confusion for daughters.

Secondary sex characteristics emerge

It is a time for exploring masturbation and relationships.

McGinn, 1991

Adolescent SexualityAdolescence learn more about sex and develop their sexual values and attitudes through interactions with peers, by contact with the media and in their own sexual experimentation. Dating, going steady, and less formal relationships develop during this period of life.

Adolescent SexualityEarly adolescence often sees the beginnings of sex play, erotic fantasies, and other sexual behaviors. Boys are somewhat more sexually active that girls for reasons that are not yet fully understood. Perhaps as a result of both physiology and social media, sexual expression become far more frequent during adolescence.

Question: How sexually active are teenagers?

Answer: There has been a downward trend since the early 1990’s and now less than ½ of high school students (47.8%) have had sex by the time of graduation. The National Youth Risk Behavior Survey (YRBS) 1991-2007. US Centers for Disease Control and Prevention. 2007

Adolescent Sexuality

The forms of this sexual activity are changing slightly perhaps as a means of avoiding pregnancy.

For adolescents 15-19

55% report having engaged in oral sex.

50% report having engaged in vaginal sex

11% report having engaged in anal sex.

For more information you are encouraged to visit: http://www.guttmacher.org/pubs/JAH_Lindberg.pdf

Adolescent SexualitySame gender sexual activity among adolescents may be experimental or may reflect later sexual orientation. A significant proportion of adolescents have at least on same-gender sexual experience.

Adolescents 13-18 yearsMales 5%-14%Females 6%-11%Haffner (1993)

Kinsey studies in 1948 & 1953 reported60% Males33% Females

Adolescent SexualityMasturbation is particularly prevalent among adolescents, more so among males than in females. The frequency of masturbation varies a great deal among individuals.

58% males and 39% females (Sorensen, 1973)

77% males and 17% females reported masturbating twice or more each week. (Gagnon et al., 1970)

About 11% of males and 60% of females report that they have never masturbated. (Atwood & Gagnon,1987)

Adolescent Sexuality

Prevalence of STIs

18.9 million new cases of STI’s are reported each year and 9.1 million of them occur among 15-24 year olds (48%).

The CDC estimates that at any one time, 1 in 4 teen girls has at least one STI.

Adolescent SexualityAdolescent sexual health has become a more pressing concern with the risk of HIV infection, increased prevalence of STDs and the high rate of unintended pregnancy. While some are calling on sexual abstinence, others believe we need a more realistic and positive approach to sexuality education for teenagers. There are complex biological, psychological, and social forces involved in sexual health issues.

Public health officials express concerns that STDs and risky behaviors that include "anything but intercourse" are "rampant" among teens. Of the 18.9 million new cases of STIs each year, 9.1 million (48%) occur among 15- to 24-year-olds, even though this age group represents only one-quarter of the sexually active population. According to a 2008 study by the an estimated 1 in 4 teen girls has at least one STD at any given time. (CDC, 2009)

http://www.pregnantteenhelp.org/articles64.html

Adult Sexuality

When I was a young man I loved 19 year old girls, and now that I am old, I find that my

tastes haven’t changed a bit.

George Burns

Adult SexualityAdult sexuality involves establishing intimacy with others and the exploration of the place of sex in intimate relationships. The majority of adults will have experienced shared sexual activity by the mid-twenties.

What is the meaning of intimate??

Lots of intimate relationships…only some are sexual!

Adult Sexuality

Most people in the U.S. will eventually marry and some 2.9 million are cohabitating. Cohabitating couples are more likely to divorce if they subsequently marry.

Adult SexualityWhile monogamy is still accepted as the most socially appropriate type of relationship some level of extramarital activity has been reported by substantial numbers of both husbands and wives.

Adult SexualityUp to 60% of marriages may end in divorce with many divorced individuals going on to subsequent marriages.

Older Adult Sexuality

When I was a young man I loved 19 year old girls….and now that I am old, I realize that my tastes have not changed at all.

George Burns

Actor, Comedian, (1896-1996)

Older Adult Sexuality

Even though older people retain their interests and physical capacities for sexual expression, our youth-oriented culture often fails to recognize it. Many older adults continue to be sexually active and to report that they are sexually satisfied.

Older Adult Sexuality

In nursing homes and institutions for the elderly, the lack of privacy and policies of sex segregation may be problematic for the expression of sexual needs.

http://www.youtube.com/watch?v=nl5Uog-MDGo&feature=related

Older Adult Sexuality

How sexually active an older person is depends upon:

level of sexual activity as a younger person;

partner availability;

Physical health and;

knowledge and attitudes of sexuality.

Older Adult Sexuality

The desire for intimacy does not decrease with age, and there is no age at which intimacy, including physical intimacy, is inappropriate. However, the disorders and emotional changes that often occur with aging can interfere with developing and maintaining an intimate relationship. Aging can also change the way intimacy is expressed.

Older Adult SexualityIntimacy, particularly physical intimacy, may be lost because of the following:

Loss of a partner: Loss or absence of a partner is probably the most common age-related barrier to intimacy.

Disorders: Various disorders that become more common with aging can interfere with physical intimacy. Vascular disorders and diabetes can cause erectile dysfunction; arthritis can limit movements and make them painful. The pain, discomfort, drugs, and worry associated with a disorder can dampen the desire for intimacy. For the partner, the stress and demands of caregiving may interfere with intimacy.

Use of drugs: The elderly are more likely to take drugs (eg, antihypertensives, psychoactive drugs) that can cause problems affecting intimacy (eg, erectile dysfunction, reduced libido).

Intimacy, particularly physical intimacy, may be lost because of the following:

Age-related changes: Levels of sex hormones decrease, causing changes (eg, vaginal atrophy, reduced vaginal lubrication) that make sexual intercourse uncomfortable or difficult. Libido may decrease.Reluctance to discuss effects of aging: If elderly people develop problems that interfere with physical intimacy or if they feel embarrassed about changes in their body (eg, wrinkles, sagging flesh), they may not want to discuss these changes with their partner or with a health care practitioner, who may be able to suggest solutions.Negative stereotypes about sexuality in the elderly: Even healthy elderly people may have internalized negative stereotypes and think sexuality is inappropriate or abnormal after a certain age.

Intimacy, particularly physical intimacy, may be lost because of the following:

Discrepancy in expectations of partners: One partner may want certain physical expressions of intimacy, but the other does not.Lack of privacy: Elderly people who live with family members or in a long-term care facility have fewer opportunities for privacy, which are necessary for physical intimacy.Shift to other forms of intimacy: Passions may mellow after years of living together. Sexual intercourse may become less frequent or stop. Many couples—most without paying much attention to it—grow comfortable with other forms of intimacy (eg, touching, massaging, kissing, verbal expressions of affection) that express familiarity, caring, or engagement with their partner.

Nonetheless, many elderly people continue to have a healthy sexual relationship. Intimacy, particularly physical intimacy, can help prevent depression and improve self-esteem and physical health. If elderly people have a new sex partner, they should practice safe sex. Acquiring sexually transmitted diseases, including AIDS, is a risk, regardless of age.

Barbara J. Berkman, DSW/PhD; Daniel B. Kaplan, MSW

Source: http://www.merckmanuals.com/professional/geriatrics/social_issues_in_the_elderly/intimacy_and_the_elderly.html

References

APA (1999).Guidelines for psychological evaluations in child protection matters. Committee on Professional Practice and Standards, APA Board of Professional Affairs. The American Psychologist 54 (8): 586–93.

Atwood, J.D. & Gagnon, J. (1987). Masturbatory behavior in college youth. Journal of Sec Education and Therapy, 13(2), 35-42. Calderone, M.S. (1983). Fetal erection and its message to us. SIECUS Report, 11(5/6), 9-10. Bell, A., Weinberg, M.S., & Hammersmith, S.K. (1981. Sexual Preference: Its development in men and women. Bloomington: Indiana University Press.

Borneman, E. (1983). Progress in empirical research on childhood sexuality. SIECUS Report, 12(2), 1-5.

Brecher, E.M. (1979). The sex researchers (rev.ed.). San Francisco: Specific.

Dickinson. R.L., (1932). A thousand marriages. Baltimore: Williams & Wilkins.

Finkelhor, D. (1980). Sex among siblings: A survey on prevalence, variety and effects. Archives of Sexual Behavior. Volume 9 (3), 171-194.

References

Gagnon, J.H. & Simon, W. (1973. Sexual Conduct. Chicago: Aldine

Goldman, R. & Goldman, J. (1982). Children’s sexual thinking. Boston: Routledge & Kegan Paul.

Kaeser, Fred (2001). The effects of increasing sexualization on children. Towards a Better Understanding of Children's Sexual Behavior. NYU Child Study Center. http://aboutourkids.med.nyu.edu/aboutour/articles/sexual.html#effects. Retrieved September, 7, 2010. Kelly, G.F. (1994). Sexuality today. Guilford, Connecticut: Dushkin Publishing.

Kinsey, A.C., Pomeroy, W.B., & Martin, C.E. (1948). Sexual behavior in the human male. Philadelphia: Saunders.

Haffner, D.W. (1993). Toward a new paradigm on adolescent sexual health. SIECUS Report (21(2), 1-7.

Hallett, J.P. & Skinner, M.B. (1997). Review of Roman Sexualities: Princeton, NJ: Princeton University Press.

References

Hite, S. (1977). The Hite report. New York: Dell.

Hite, S. (1981). The Hite report on male sexuality. New York: Knopf.

Langfeldt, T. (1981). Sexual development in children. In Cook, M., & Howells, K. (Eds.), Adult sexual interest in children. London:Academic.

Larsson, IngBeth. Childhood sexuality and sexual behavior. (2000, Swedish National Board of Health and Welfare (report), Article number 2000-36-001. English translation (Lambert & Tudball) Article number 2001-123-20.

Lively, V. & Lively, E. (1991). Sexual development of young children. Albany, NY: Delmar Publishers.

Money, J. (1994). The concept of gender identity disorder in childhood and adolescence after 39 years‘. Journal of Sex and Marital Therapy, 20,: 163-177.

Salter, Ph.D., Anna C. (1988). Treating Child Sex Offenders and Victims: A Practical Guide. Sage Publications Inc. pp. 22–24.

Bell, A., Weinberg, M.S., & Hammersmith, S.K. (1981. Sexual Preference: Its development in men and women. Bloomington: Indiana University Press.

Borneman, E. (1983). Progress in empirical research on childhood sexuality. SIECUS Report, 12(2), 1-5.

Brecher, E.M. (1979). The sex researchers (rev.ed.). San Francisco: Specific.

Dickinson. R.L., (1932). A thousand marriages. Baltimore: Williams & Wilkins.

Hallett, J.P. & Skinner, M.B. (1997). Review of Roman Sexualities: Princeton, NJ: Princeton University Press.

Goldman, R. & Goldman, J. (1982). Children’s sexual thinking. Boston: Routledge & Kegan Paul.

Hite, S. (1977). The Hite report. New York: Dell.

Hite, S. (1981). The Hite report on male sexuality. New York: Knopf.

References

Santrock, J.W. (2008). A Topical Approach to Life-Span Development (4thed.). New York: McGraw-Hill.

Sorensen, R.C. (1973). Adolescent sexuality in contemporary American. New York: World.