Search

A number of unresolved issues in sexology research and practice are reviewed. Penile volume assessment of sexual arousal has consistently proved more sensitive than penile circumference assessment and requires much shorter exposure to the erotic stimuli eliciting the arousal, reducing the subjects' ability to modify their responses. Failure to acknowledge this has allowed acceptance of evidence based on penile circumference assessment that behavioral treatments such as directed masturbation can increase the ability of sex offenders to be heterosexually aroused and aversive therapy can reduce their deviant urges whereas penile volume assessment indicates these procedures are ineffective. A randomized controlled trial of relapse prevention versus no treatment for sex offenders found more treated than untreated subjects reoffended after a mean follow-up period of 4 years. Researchers and therapists accepted that a post hoc statistical manipulation of the results provided evidence of a treatment effect. Subsequently it has been recommended that randomized controlled evaluations of treatments of sex offenders be abandoned. Meta-analysis of outcome studies has been used uncritically. The majority of men and women who report homosexual feelings and/or behavior report predominant heterosexual feelings and behavior and do not identify as homosexual. These consistent findings remain ignored. Studies of the etiology and development of homosexuality and heterosexuality treat them as distributed categorically rather than dimensionally and investigate only self-identified homosexuals and heterosexuals. With this methodology the predominantly heterosexual majority are excluded or misclassified. The belief that the European concept of the homosexual is a late 19th-century invention is based on an inadequate reading of literature. Limitations of the DSM classification of sexual and gender identity disorders are pointed out. The validity of self-report of sexual behavior has been questioned on the basis that men report a markedly higher average number of sexual partners than women. Possible sex differences in reporting the number of partners who are of the same sex, casual, or perpetrators or victims of sexual coercion and child abuse have not been taken into account. Failure of sexology to progress due to lack of resolution of conflicting issues may contribute to the low impact factor of its journals. [ABSTRACT FROM AUTHOR]

The value of randomized controlled trials in evaluation of sexual offender treatment has been questioned. Concern was expressed that randomization fails to produce equivalent samples, without apparent appreciation this is inevitable when variables are distributed by chance; lack of equivalence is controlled by use of tests of significance. A further uncriticized and inappropriate procedure in treatment evaluation is separation of the results of subjects who did not complete treatment from those who did, when the outcome of the former group was known. Despite an APA Task Force recommendation, no attention has been given to the consistent finding that no treatment is less effective than placebo psychological therapies. The significance of Type II errors is discussed and the recommendation criticized that within-treatment research be encouraged as an alternative to outcome research. Demonstrating a within-treatment response when that response is associated with a better outcome does not necessarily mean that the treatment was effective. Subjects with a good prognosis could be more able to demonstrate a within-treatment response to the treatment. Nonrandomized matched samples do not adequately control all sample differences. The post hoc statistical reversal of a reported trend for sexual offenders treated with relapse prevention to show a worse outcome than untreated offenders, in order to correct lack of equivalence of the two groups, is considered inappropriate. That relapse prevention was found less effective than no treatment raises the possibility that it has a negative effect. To continue the use of relapse prevention other than in randomly controlled evaluative studies would appear to be unethical. [ABSTRACT FROM AUTHOR]

This article explores whether the use of behavioral modification in relation to homosexuality is morally and ethically warranted among behavior therapists. The notion that the ultimate governing principle of behavioral intervention is the making of judgment, is in itself a disastrous moral legacy. The aim of any significant human enterprise is the undertaking of what is right to do, not what makes someone happy or anxiety free. It is believed that behavior therapy does not alter could not alter homosexual orientation but if an aspect of homosexuality has escaped from a person's control and that person has what appears to be rational grounds for wishing to regain control of this aspect then the use of behavior therapy can be considered justifiable.

Eighteen pathological gamblers reporting abstinence at a 2-9-year follow-up period were classified into two samples; those reporting complete abstinence, or chose abstinent with intermittent relapse episodes. Results indicated that both samples improved significantly on post-treatment psychological and demographic measure,, and did not differ from each other. It was concluded chat a subgroup of gamblers may experience intermittent brief relapses that are not invariably associated with a continued return to addictive gambling habits. Complete abstinence as a criterion for successful treatment outcome may be too stringent in that it fails to acknowledge the possibility of continued abstinence following brief episodes of relapse. [ABSTRACT FROM AUTHOR]

A structured gambling interview schedule, the Eysenck Personality Questionnaire, Spielberger's State-Trait Anxiety Inventory, Zuckerman's Sensation Seeking Scale and Beck Depression inventory were administered to 63 out of 120 pathological gamblers who had 5 years previously completed a behavioural treatment for uncontrollable gambling behaviour. Results indicated that both abstinence and controlled gambling outcomes were associated with continued improvement in serf-report and psychological indices of social functioning and psychopathology. Response to treatment was associated with a reduction in arousal levels, anxiety and depression. Uncontrolled gamblers failed to show post-treatment changes on parameters of improvement. It was concluded that abstinence is not the only possible therapeutic outcome in behavioural treatment and further, that controlled gambling is not a temporary response which is followed by a return to continued uncontrollable gambling. [ABSTRACT FROM AUTHOR]

The construct of impulsivity has to date remained relatively unexplored in the pathological gambling literature. This is in spite of recent claims suggesting that impulsivity may be an important feature characterizing a subgroup of pathological gamblers who are claimed to suffer from a Multi-Impulse Personality Disorder. The present study examined the potential role of impulsivity using the Eysenck Impulsivity Scale among 115 pathological gamblers. Results indicate that heightened impulsivity is associated with the degree of severity of psychological and behavioural change in pathological gamblers. However, the findings also indicate that impulsivity closely mirrors components contained in Eysenck Personality Questionnaire Psychoticism Scale, the California Personality Inventory Socialization Scale and DSM-III Antisocial Personality Disorder. This is manifest both in terms of high intercorrelations between the measures of psychopathy and impulsivity and in their predictive relationship to the level of psychological distress suggesting a uniform impulsivity/psychopathy construct. Thus, the research supports a model of pathological gambling in which the severity of associated behavioural and psychological disturbance is mediated by a impulsivity/ psychopathy construct. [ABSTRACT FROM AUTHOR]

Data once accepted in the scientific literature tend to resist evidence demonstrating that they are incorrect and continue to be accepted. In relation to rapists and paedophiles this has resulted in their continuing to be individually assessed by the invalid procedure of penile circumference plethysmography and to be treated by procedures which aim to modify their sexual preferences despite evidence that such modification is not possible. Relapse prevention continues to be the currently most widely accepted treatment, despite the only well‐controlled evaluation demonstrating it to be ineffective if not harmful. [ABSTRACT FROM PUBLISHER]

Zuckerman's Sensation Seeking Scale, the Eysenck Personality Questionnaire and the Spielberger's State-Trait Anxiety Inventory were administered to 51 pathological gamblers seeking treatment to investigate the hypothesis that arousal associated with gambling was related to a general sensation seeking personality trait. Pathological gamblers as compared to the general population were found to have elevated Psychoticism, Neuroticism, State and Trait anxiety scores but contrary to expectation, significantly lower Sensation Seeking scores. It was argued that pathological gamblers were not necessarily sensation seekers but that avoidance or reduction of noxious physiological states or dysphoric mood, in conjunction with a behaviour completion mechanism, was a major factor in explaining persistence in gambling. [ABSTRACT FROM AUTHOR]

A 32 item Addiction Scale derived from the Eysenck Personality Questionnaire was administered to 60 pathological gamblers, 25 male and 26 female heroin addicts and 27 male and 25 female controls. The purpose of the study was to replicate Gossop and Eysenck' s (1980) finding that the scale differentiated drug addicts from controls and to test the hypothesis that pathological gambling is an addictive disorder and that pathological gamblers would show a profile similar to substance addicts. Gossop and Eysenck's findings were replicated. Results also supported the present hypothesis. Male addicts and gamblers had significantly higher Addiction, Neuroticism and Psychoticism scale scores than controls. Female addicts scored significantly higher on the Addiction and Psychoticism scales than their female counterparts. As items composing the scale load on anxiety and depression it was concluded that any similarities between pathological gamblers and substance addicts may reflect a general factor of affective disturbance. The role of excitement and arousal as the addictive agent in pathological gambling is discussed. [ABSTRACT FROM AUTHOR]

Transsexuals are defined as subjects who have a sustained feminine gender identity combined with a wish to alter their bodily appearance towards the feminine. The results of this study indicate that they can be differentiated into two clinically discrete groups. In an investigation of 29 transsexuals who sought a change of sex operation it was found that those who had experienced fetishistic arousal were significantly more likely to be older, to have experienced heterosexual intercourse, to be married and to show penile responses to pictures of men and women indicative of a more heterosexual orientation. They had less experience of homosexual contact to orgasm as compared transsexuals who had not experiennced fetishistic arousal , but this difference was not statistically significant. Frequency of cross-dressing, strenght of feminine gender identity and intensity of desire for a sex change operation did not discriminate the two groups. The fact that desire for a sex change operation may be associated with experience of fetishistic arousal could be one reason for the higher incidence transsexualism in men than in women. [ABSTRACT FROM AUTHOR]

In four studies homosexual patients were randomly allocated to receive either different forms of aversive therapy; or aversive therapy or a positive conditioning procedure. Before and after therapy the patients' sexual orientation was determined by measuring their penile volume responses to moving pictures of nude men and women. The aversive therapies produced reduction in homosexual feelings and behaviour. In the fourth study the reduction was significantly greater following the aversive compared with the positive conditioning procedure. No significant change in measured sexual orientation occurred in the patients who received aversive therapy compared with those who received positive conditioning. The measured sexual orientation of the homosexual patients after treatment differed significantly from that of heterosexual patients who received aversive therapy for sexual anomalies. [ABSTRACT FROM AUTHOR]

Of 120 pathological gamblers randomly allocated to imaginal desensitisation (ID) or to other behavioural procedures (60 to each group, all procedures administered over one week) 63 subjects were contacted two to nine years later. Twenty-six of the 33 who received ID reported control or cessation of gambling compared with 16 of 30 who received other behavioural procedures. This difference was significant, indicating ID had a specific effect additional to that of the other behavioural procedures. It is suggested the other procedures could be regarded as placebos. As the response at a mean of over five years to one week of ID is comparable with that reported to more intensive therapies, after briefer follow-up, it is suggested ID is a cost-effective therapy for pathological gambling, and is worth considering when resources are limited. [ABSTRACT FROM AUTHOR]

Brain ERPs were recorded in ten unmedicated schizophrenic patients and age- and sex-matched healthy controls during a multidimensional listening task. Patients showed a marked reduction in a long-duration attention-related negative ERP component, termed 'processing negativity' (PN), which was elicited by attended stimuli. The amplitude of PN was significantly correlated with SANS and SAPS scores of schizophrenic symptoms. The P300 component was also reduced in amplitude in patients, and was significantly correlated with SANS ratings of negative thought disorder. These findings provide neurophysiological evidence of impairment in the maintenance of selective attention and the cognitive processes associated with target detection among schizophrenic patients. The reduced PN in schizophrenics implicates frontostriatal pathways in the aetiology of attentional deficits in schizophrenia. [ABSTRACT FROM AUTHOR]

Twenty compulsive gamblers were randomly allocated, half to receive aversion-relief therapy and half to receive imaginal desensitization; both groups were followed-up for one year. Compared with those who received aversion-relief, gamblers who received imaginal desensitization reported a significantly greater reduction of gambling urge and behaviour; they also showed a significant reduction in trait anxiety at one year and in state anxiety at one month and one year following treatment. A high level of state anxiety at one month following treatment predicted failure to respond to treatment at one year in the subjects who received imaginal desensitization, but not in those who received aversion-relief. The relationship between reduction in anxiety and in gambling urge in response to imaginal desensitization was predicted from the theory that compulsive gambling is driven by aversive tension. [ABSTRACT FROM AUTHOR]

The article cites a study which found that there is no significant difference in efficacy between classical therapy, avoidance therapy and backward conditioning therapy in the treatment of homosexuality. The aim of the study is to know the efficacy of the three kinds of aversion therapy in treating homosexual patients. Forty-six homosexual patients were shown a film which contains pictures of nude women preceded by pictures of a red circle and of nude men preceded by a green triangle. The penile volume and galvanic skin responses were measured. The study covered that backward conditioning was not less effective than the other two types of aversion therapy, supporting the contention that the classical and avoidance therapy does not act by setting up conditioned reflexes.

The article presents a study which aims to determine the relationship between loose or allusive thinking and conditioning performance. It examines the theoretical proposition that looseness of thinking is associated with weak internal inhibition of autonomic responses in classical conditioning. Two classical conditioning procedures were designed to maximize internal inhibition and both uses delayed conditioning. The study found out that the amplitude of conditioned responses correlates with the amplitude of the associated unconditioned responses. The results indicated that allusive thinkers differed significantly from non-allusive thinkers wherein they showed a slower rate of conditioning, less inhibition of delay and less ability to suppress irrelevant responses.

The article presents a study which aims to determine the relationship between penile volume responses to female and male film sequences and sexual orientation in heterosexual and homosexual males. It also aims to examine the relationship between aversive and appetitive conditioned responses in hetero-sexual males. They have described a method of determining the sexual orientation of male subjects by recording penile volume changes while slides of female and male nudes were shown. In this study, the amplitude of conditioned changes in penile volume were found to correlate strongly and positively with the amplitude of the associated unconditioned responses.

The article focuses on the study on the subjective and penile plethysmograph reactions to aversion-relief therapy for homosexuality. It is indicated that over 40 patients, who wanted to lessen their homosexual impulses, received injections of apomorphine in random allocation. The treatment also involves electric shocking of patients while watching nude films and reading aloud phrases on aspects of homosexual behavior. After a two-week treatment, results show that majority of the patients experienced an increase in penile volume to nude pictures of male while a decrease to pictures of females.

The article investigates controlled studies of desensitization with phobic patients. Results reveal a trend for half of the subjects treated with desensitization to show marked improvement, while just one-fourth of control subjects treated with other therapies do so. This trend seldom results in a significant difference with the number of patients used in these studies. Evidence from these studies and from those with phobic students suggests that at follow-up, patients with agoraphobia show a better response to behavior therapy than do those with more specific phobias.

The article presents the study on the subjective and penile plethysmograph responses following aversion-relief and apomorphine aversion therapy for homosexual impulses. The subjects, 40 males who were aware of having homosexual impulses and wished to have them reduced or eliminated, were given therapy while hospitalized for one week. Changes in penile responses to moving pictures of male and female nudes in 20 subjects at two weeks following therapy were compared with the changes in such responses in 20 subjects over the same period of time but without treatment intervening. Results showed significant changes in the hetero-sexual direction in the treated group. However, some subjects who showed a heterosexual orientation before treatment showed a change in the homosexual direction.

The article presents a study that determines familial relationships of allusive thinking in students and their parents. In this study, 101 Psychology students of Sydney university were volunteered to take part in the investigation. The Object Sorting Test (OST), which provides a measure of the presence of allusive thinking, and Minnesota Multiphasic Personality Inventory (MMPI) F Scale were used. It has been suggested that high OST scores are associated with evidence schizophrenic pathology. No evidence was found for this suggestion using the MMPI F Scale score and examination performance as evidence of schizophrenic pathology.

The article cites a study on the correlation of clinical features of out-patients suffering from depressive states treated with amitriptyline and protriptyline. The clinical features were correlated with response to amitriptyline, which have been previously reported to correlate with response to imipramine and to electroconvulsive therapy. It suggests that to relate prognosis to individual clinical features as to classification of patients suffering from endogenous or reactive depression is to provide more reliable data than that provided by past attempts.

The article presents the research on independence of neurotic and endogenous depression, a replication of a former study in 1963 about endogenous depression. According to the author, clinical data were obtained on patients treated during a double-blind controlled clinical trial comparing the effects of amitriptyline and protriptyline on patients suffering from depressive condition. The author states that the investigation reflects the impossibility of finding the symptoms diagnosed in endogenous depression in neurotic depression and vice versa.

A letter to the editor is presented about depressive illnesses in late life.

The article presents an abstract of the study "Classical, Avoidance and Backward Conditioning Treatments of Homosexuality." 46 male homosexual patients were randomly allocated to receive classical, avoidance or backward aversive conditioning. The study found that aversion therapy for homosexuality does not act by setting up conditioned response.

A letter to the editor is presented in response to an article about actuarial versus clinical prediction in psychiatric research that was published in the February 1970 issue.