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Sexual Infantilism in Adults: Causes and Treatment Part 7


Section 7 of Thomas John Speaker's Masters thesis "Sexual Infantilism in Adults: Causes and Treatment"

I am researching the experiences of adults who wear diapers. Please answer this questionnaire and return it to the address given on the bottom of page 2. ALL ANSWERS WILL BE KEPT STRICTLY CONFIDENTIAL. If you have any questions or would like more details of the study, add your questions to the end of the survey and I will write you. Thank you for your help -- Tom Speaker.

1. Age: 2. Sex: M__F__ 3. Occupation: _______________________

4. Marital Status: Married or Living with Partner ___(Check one)

Divorced ___

Single ___

5. Do you have any brothers or sisters? Yes___ No___. If yes, what age were you when they were born?___________________

6. How long have you been wearing diapers?_____________________

7. If there have been intervals in your life when you did not wear diapers, please describe how long, and the reasons you began wearing them again.

8. How often do you wear diapers now? _______________________

9. Besides diapers, do you regularly use any other baby items such as rubber pants, bibs, bottles or baby food? Yes__ No__. If yes, which items do you use and how often?

10. Do you wear diapers because of incontinence problems?Yes__No__. Please explain.

11. Do you find wearing diapers sexually exciting? Yes__ No__. Please explain.

12. Do you ever masturbate while wearing diapers? Yes__No__. If yes, approximately how often?

13. Have you ever had sexual experiences with a partner without the use or presence of diapers or baby items? Yes__No__. If yes. Please describe your experiences:

14. Have you ever had sexual experiences with a partner which included the use of diapers or baby items? Yes__No__. If yes, please describe your experiences:

15. Are you currently involved in a sexual relationship? Yes__No__ If yes. is your primary partner male or female?Male__Female__.

16. Have you ever read books or magazines dealing with 'infantilism' or 'adult babies'? Yes__No__. If yes. please list which publications and how often you buy them:

17. Has your use of diapers ever caused problems for you, either in personal life or in a relationship? Yes__No__. If yes, please explain:

18. Has your use of diapers ever been helpful to you, either in personal life or in a relationship? Yes__No__. If yes, please explain:

19. Has your use of diapers ever caused you to seek counseling or therapy? Yes__ No__. If yes, please describe your experiences:

20. Do you have any additional comments or questions?

Please return the completed survey to: Tom Speaker

c/o Psychology Dept.

Ben Trowbridge

Southern Oregon State College

Ashland, OR 97520

Examined: 9 April 1980| HTML conversion: 4 June 2010


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