The formation of romantic relationships and the engagement in sexual behaviours are considered normative and salient developmental tasks for adolescents and young adults. These developmental tasks are increasingly viewed from an ecological perspective, thus not only as individual processes, but also as strongly embedded in different social contexts, including the proximal social domains of parents, peers, and partners. This special issue brings together seven recent empirical studies on adolescents’ and young adults’ romantic relationships and sexuality in the context of relationships and interactions with parents, peers, and partners. In this editorial introduction,we describe two important recent changes in the theoretical perspectives on emerging romantic relationships and sexual activity: from risky behaviours to normative tasks, and from individual to contextualized processes. We then discuss recent advances in empirical research on romantic relationships and sexuality of adolescents and young adults. After that, we review the seven studies in this special issue, and discuss the contributions of these studies to the existing literature.Finally, we discuss directions for future research regarding how the interrelational perspective can be further incorporated into empirical research, andhowthe gap between the research fields on romantic relationships and sexuality may be bridged.

Romantic relationships and sexuality in adolescence and young adulthood : The role of parents, peers and partners

The influence of romantic relationships on mental wellbeing for people who experience psychosis: A systematic review.

A considerable body of literature reports that individuals with psychotic disorders often suffer from sexual dysfunctions (SDs), with these representing a major unmet need. Long-term antipsychotic drug treatment may be the main cause for SDs in psychotic patients, through a plethora of different mechanisms, including prolactin dyscrasia, histamine-mediated sedation, and serotonin-induced sexual demotivation. However, a few pieces of evidence treat sexuality in patients at risk or the onset of psychosis. For this purpose, we systematically reviewed literature of the last 10 years in order to investigate sexuality in ultra-high risk (UHR) for psychosis and first-episode psychosis (FEP). We included in our review 34 articles fitting our research criteria on SDs in UHR and FEP. Evidence of SDs in the transition from UHR to FEP emerges through the selected studies. In FEP, sexuality is affected by the severity of the psychotic symptoms and, in some cases, by the iatrogenic effects of psychopharmacological treatment. Further experimental and clinical studies should systematically investigate the role of sexual functioning in the transition from UHR to FEP and, consequently, clarify whether or not SDs could be considered a possible marker for the onset of psychosis in at-risk populations. Moreover, psychiatrists and clinical psychologists should take into consideration the role of sexual life in young people with prodromal mental symptoms or at the onset of psychosis. Focusing on a thorough sexual evaluation might be a major challenge that could break down barriers of mental health promotion among young people with schizophrenia-spectrum disorders and therefore achieve better clinical outcomes.

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Sexuality in Ultra-High Risk for Psychosis and First-Episode Psychosis. A Systematic Review of Literature

The experience of psychosis and associated discrimination can be a barrier to forming and maintaining romantic relationships. Sexual health interventions within mental health services often focus on contraception and reducing risk. There are no known studies that seek to understand what support, if any, people who experience psychosis want regarding psychosocial aspects of intimate relationships. To address this gap in the literature, qualitative data was collected to investigate how people with experience of psychosis conceptualise romantic relationships and what support they would like in this area of their lives. Semi-structured interviews were conducted with 10 mental health service users (four women, six men) with experience of psychosis. Interviews were analysed from a critical realist social constructionism perspective using thematic analysis. Stigma was a prominent theme, described as impacting numerous aspects of romantic relationships. Power imbalance within services meant participants were wary of having conversations about relationships with professionals and identified a therapeutic alliance as a prerequisite. However, abusive relationships were highlighted as a needed area for support by services. Services should be trauma-informed and help those in abusive relationships. The power and autonomy of people with experience of psychosis should be maintained in any discussions or interventions regarding intimate relationships. A strong therapeutic alliance is essential for any work in this area.

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"Sex isn't everything": views of people with experience of psychosis on intimate relationships and implications for mental health services.

This qualitative study reports on the sexuality and sexual experiences of community-based forensic mental health participants. The findings indicate that these participants feel the need for intimacy and want to engage in sexual activity more often than their neurotypical Australian peers. Participants identified their mental health and the side effects of compliance with prescribed psychotropic medications were barriers to achieving their desired level of sexual activity. Participants supported the notion that mental health teams were positioned to assist patients navigate the psychological, cultural, education and physical barriers to achieving sexual health and wellbeing. We propose several interventions to support these participants and other community forensic mental health patients in attaining healthy relationships, understanding their sexual health, and gaining more fulfilling sexual experiences. These interventions, which include sex education, upskilling in socialization and communication, and regular medication reviews, could be delivered as part of the holistic care provided by mental health teams. Mental health clinicians should be offered appropriate training to assess patients and have discussions related to sexuality, sexual experiences and sexual health needs.

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A Qualitative Study on Sexuality and Sexual Experiences in Community Forensic Mental Health Patients in Queensland, Australia

For individuals with a psychotic disorder, dating can present several challenges and lead many to be excluded from intimate relationships. These difficulties may stem from a number of factors, including impairments in social and sexual functioning. Although scientific interest in this topic is mounting, the last quantitative review of the literature dates back to 2003. Objectives The aim of this systematic review was to collect, evaluate, and synthesize quantitative data from studies published in the last 15 years on romantic relationships and sexuality in the context of a psychotic disorder. Methods Articles were retrieved from PsycINFO, PubMed, Web of Science, and ProQuest databases and were retained if they met the following inclusion criteria: (a) original research or meta-analysis, (b) complete or partial sample with a psychotic disorder diagnosis, (c) provision of quantitative data specific to the population of interest, and (d) studies focusing on romantic relationship and/or sexuality variables as correlates, predictors, mediators, or outcomes. Study quality was evaluated using PRISMA criteria. Results 43 studies were identified, 24 of which were categorized as obstacle-related (e.g., focusing on negative aspects of intimacy, such as risky behaviors) and 19 of which were deemed neutral or recovery-oriented (e.g., focusing on positive aspects of intimacy, such as marital functioning). Conclusions and implications for practice Results highlight a need for greater communication and assistance in the areas of intimacy and sexuality for persons with psychotic disorders. Better access to resources such as dating skills and couples therapy programs as well as more consumer-oriented research is needed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Alexandra Ghostine

Papers

Romantic relationships, sexuality, and psychotic disorders: A systematic review of recent findings.