Abbreviations: APA, american psychiatric association; AB, adult baby; SB, sissy babies'; DL, diaper lovers; CBT, cognitive behavioral therapy; SSRIS, selective serotonin re-uptake inhibitors; PTSD, posttraumatic stress disorder Introduction: An overview of paraphilic infantilismParaphilia refers to the intense and persistent sexual interest and arousal towards objects, situations or individuals which are atypical, equal to and/or greater than normophilic sexual interests.1 Paraphilic disorders in the DSM-5 include exhibitionism, fetishism, peadophilia, sexual masochism, sexual sadism, transvestic fetishism and voyeurism possess a formal diagnostic criteria (APA, 2015). However, paraphilic infantilism is classified as a sexual disorder under, 'other specified paraphilic disorder'. 1 It was during the 1960's that reference to clients' exclusive wearing of diapers as a means of attaining sexual arousal became documented. Tuchman & Lachman 2 reported a child sex offender, who had been molesting his 4 and 6 year old daughters. He would wear rubber pants over his diaper and enjoyed urinating and masturbating in them. Malitz 3 describes a 20 year old male who had broken into a house with the sole intention of wearing diapers and defecating in them and subsequently reaching orgasm. Dinello 4 provided a diagnostic understanding of a 17 year old male who wore diapers, had eaten baby food, drank from a baby bottle and masturbated whilst wearing a diaper.During the 1980's, Money 5 termed the paraphilic condition of impersonating a baby, autonepiophilia, diaperism or paraphilic infantilism. Money 6 distinguished between infantilism, autonepiophilia and paraphilic diaper-wearing, stating that the latter is a paraphilic fetish involving an erotic attraction to an article of clothing whilst the former is a non-fetishistic paraphilia aimed at regressive age identity role play. Paraphilic infantilism was described as an individual acting as an infant including associated behaviours of drinking from a baby bottle, being fed baby food, being breast fed, wearing baby cloths, wearing diapers and sleeping in a crib. This may have involved the assistance of a 'nanny', 'daddy' or 'mommy' to accommodate the infantilists requirements. 6,7 When role play involves regressing back to an infant state the individual is referred to as an adult baby (AB). The AB's like to dress up as a baby, get baby fed, have diaper changes and so forth.7 'Sissy babies' (SB) are adults who also play the infant role however, the role played is the opposite gender and may involve cross dressing SBs. Those who only engage in wearing diapers, as a sexual fetish, without the regressive fantasies are referred to as diaper lovers (DL). 7Those who experience both the sexual aspect of wearing diapers and the enjoyment of engaging in infantile play are referred to as adult baby/diaper lovers (AB/DL). 7Money 6 also referred to paraphilic juvenilism or age play. Age Play predominately involves adults who role play at being babies, children or younger adults. Money 6 examin...

There has been little consideration of how adolescents experience parental terminal illness (PTI) and death and any continuing impact it may have on their lives. In particular, limited attention has been given to this group’s perceptions and experiences of support during this period. This study explores the retrospective experiences of six individuals who had a parent diagnosed with a terminal illness (TI) during late adolescence. Their experiences are qualitatively explored in terms of their understanding, processing and adjustment to their parent’s TI and death; both as an individual, and in the context of their wider family and social setting. Interpretative Phenomenological Analysis was employed to analyse participant data. Participants were individuals who had a parent diagnosed with a terminal illness aged 16-18. Four superordinate themes emerged from the data. These were: changing family dynamics, grappling with adolescence and adjustment to loss, barriers to feeling/being supported and living with the consequences. Participants relate the profound impact that PTI during adolescence has had and continues to have on their lives. Study findings provide clinically useful information for healthcare professionals working with bereaved young people and those presently experiencing PTI. Implications are discussed in terms of service provision and design, including therapeutic recommendations for counselling psychologists and other professionals working with this group.

The following two case reports discuss the effect of grief on their drug-use behaviour. Both case descriptions of substance use disorders are comorbid with depression and/or an anxiety-related disorder. Case 1 and 2 have a history of childhood sexual and physical abuse and report multiple drug relapses as a consequence of unresolved grief associated with the abuse. The maladaptive grief process of case 1 and 2 had presented itself in the subjective belief of having after death communications with the deceased. The application of cognitive behavioural techniques driven by psychodynamic insights, revealed a relationship between the grief experienced, childhood abuse and the use of prescription medication and illicit drug use. The case descriptions of grief are discussed in the context of substance misuse, mental health and the triggers associated with relapse in an attempt to further our understanding of substance abuse and therapy.

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