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Sexually active women have only recently had the ability to make a conscious decision to delay or refrain from bearing children. This is not only the result of the availability of effective contraceptive methods but also due to attitudinal changes in society and individuals. These reproductive choices may result, for some women, in conflict over the use of contraceptives, and the decision or timing of pregnancy. However, infertility imposed by nature in the form of inability to conceive, miscarriage or stillbirth removes the woman's sense of control over this important aspect of her life and frequently results in severe distress. The psychological issues surrounding these reproductive choices and events are reviewed and discussed.

Postpartum thyroiditis has been suggested as a cause of psychosis following pregnancy. However, 30 hospitalized psychotic postpartum women and 30 control subjects matched for age and time since delivery showed no significant differences in thyroid function or the presence of thyroid antibodies.

We analyzed questionnaires filled out by 23 mothers with careers and rated them as to degrees of autonomy; 26% received a '1' (least autonomous) rating, 39% a '2', 22% a '3' and 4% (1 person) received a '4' (most autonomous). Psychoanalyst Dr. Elizabeth Zetzel (1) stated "The healthy woman should be able to combine successful marriage and motherhood with some sort of personal career." It would seem that the woman who is most effective at doing so is one who is highly autonomous and, therefore, feels free to construct a non-traditional role for herself. Unfortunately, in our study, these women were very much in the minority. In keeping with our hypothesis, the mere fact that a woman is combining a career and family is not a guaranteed indicator that she is highly autonomous.

The ability of insect colonies to adjust the division of labor among workers in response to changing environmental and colony conditions, coupled with research showing genetic effects on the division of labor in honey bee colonies, led to an investigation of the role of genetics and the environment in the integration of worker behavior. Measurements of juvenile hormone(JH) titers and allozyme analyses of worker honey bees suggest that two processes are involved in colony-level regulation of division of labor: (i) plasticity in age-dependent behavior is a consequence of modulation of JH titers by extrinsic factors, and (ii) stimuli that can affect JH titers and age-dependent behavior do elicit variable responses among genetically distinct subpopulations of workers within a colony. These results provide a new perspective on the developmental plasticity of insect colonies and support the emerging view that colony genetic structure affects behavioral organization.

Postpartum blues, postpartum neurotic depression and puerperal psychoses have distinct clinical features; they affect women in all social classes and in all cultures, and despite numerous studies they have not been linked definitively with any biologic or psychosocial variables. The only possible exception is puerperal psychosis, which emerges much more often in women with a personal or family history of a bipolar affective disorder than in women without, a finding that probably explains the reluctance of some researchers to recognize puerperal psychotic episodes as distinct from psychotic episodes at other times. If postpartum blues last longer than 2 weeks and are disabling they are classified as neurotic depression and warrant treatment, often requiring both psychosocial approaches and psychotropic drug therapy. Antidepressants, major tranquillizers, electroconvulsive therapy and lithium have proved effective in the treatment of postpartum psychoses, depending on the symptoms. Both lithium and diazepam have been reported to cause deleterious side effects on breast-fed infants, and as the side effects of other psychotropic drugs given to a nursing mother are imperfectly understood, bottle feeding seems prudent.

The professional maturation process through which every dental student sould pass involves perception and identification of his professional role. The process is complicated at many points by conflicts between the student's own professional role expectations and the expectations of his teachers or of society. Confrontation is described as occurring daily in the dental-school environment; many confrontational situations occur on an impromptu basis in the course of interaction between the student and his classmates, his patients, and the faculty. Other confrontational situations can be arranged deliverately by the dental educator in order to provide clinical and social experiences for the student which ordinarily would not be included in the dental curriculum. By taking advantage of the particular student-instructor relationship existing during these confrontational situations, the dental educator can reap perhaps the greatest reward to be realized from an academic career--that of being able to take an active role in the professional maturation process of his students.

Forty-five pregnant childless women with a mean age of 36.6 years (+/- 1.7) were compared with 42 nulliparous pregnant women with a mean age of 26.7 years (+/- 2.8). Initial interviews determined the basic demographic data, the reasons for delaying pregnancy, attitudes to pregnancy, and plans concerning careers. Psychological tests were given to measure anxiety, depression, anger, marital intimacy, sense of autonomy, and role expectations. These psychological tests were applied to all patients at 12 to 16 weeks' gestation and again at 28 to 32 weeks' gestation. The demographic information from the two groups was remarkably similar. Although their ages differed by 10 years, their career goals, their family incomes, reasons for delaying pregnancy, and reasons for now getting pregnant revealed minimal differences. The Maffer Feminine Identity Scale revealed that the younger women held more traditional attitudes toward a woman's roles than the older group. The Sociotrophy-Autonomy Scale indicated that the older women were more independent than the younger pregnant patients. The Symptom Checklist indicated that the older group were less troubled by pregnancy than the control group, and although their level of distress increased as the pregnancy progressed, they remained better adjusted as they entered the last trimester of their pregnancies.

Pregnancy is seen as a period of psychological maturation during which old conflicts related to sexuality, aggression, dependency, autonomy and motherhood are rekindled and old solutions reworked. Anxiety associated with these conflicts may threaten to overwhelm the pregnant woman's ability to cope in an adaptive fashion and may result in the denial of pregnancy as a defense. Denial and rationalization of symptoms and denial of pregnancy may result in inadequate behavioural responses at the time of childbirth, and may result in the death of the newborn. The denial may also extend to the patient's social network and may continue through the post-partum period. The strength of the denial may be so great as to thwart attempts at psychotherapeutic intervention.

The prevalence of sexually transmitted disease (STD) in adolescent girls aged 15-19 attending a department of genitourinary medicine was compared for the years 1972 and 1982. Data were obtained from the confidential register using the coding of the clinic returns to the Department of Health (form SBH 60). There were 1373 patients in 1972 and 1799 in 1982, 6.4% and 7% respectively of the total female clinic population. The prevalence of syphilis, gonorrhoea, and infection with Trichomonas vaginalis, herpes simplex virus, and warts was almost unchanged. Other conditions, which are not classified as STD, were largely responsible for the increase in new attendances, the prevalence of these conditions having nearly doubled over the ten year period. Thus an epidemic of STD has not been shown in this adolescent female population over the past decade.