Hypersexuality and limbic system seizures

Hypersexual behavior was induced in adult male cats by repeatedly evoked limbic system seizures. Accentuation of Dopaminergic activity with drugs was used to facilitate development of the seizure induced hypersexuality. Hypersexuality consisted of biting knap of neck, mounting, thrusting and coital intromission. The gradual development and eventual disappearance of hypersexuality was correlated with the progressive prolongation of the seizures in their evolution. There are three stages of seizure evolution in relation to sexuality. First stage-normal sexuality, intermediate stage-hypersexuality and late stage-hyposexuality. A theoretical “hypersexual growth and decay curve” was constructed in relation to the evolution of limbic seizure durations in the intermediate stage. It was suggested that the observed hypersexuality was related to the early discharge activation of hypothalamic, preoptic and basal ganglia neurohumeral facilitatory mechanisms for sexuality, and the late effects were related to discharge activation of brain stem serotonergic inhibitory mechanisms. The discussion attempts also to use these experimental findings to explain clinically observed hyposexuality and hypersexuality. It was suggested that either hypersexuality or hyposexuality may be associated with psychomotor seizures and that the predominating sexual state at a given moment is dependent upon the evolutionary stage of the seizure at that moment. Consequently, psychomotor seizures with associated hypersexuality should not be considered a clinical anachronism. In fact, these observations support the impression that rape may be a manifestation of a psychomotor seizure.     

Neuropsychiatry of hypersexuality

Relatively few studies of the psychobiology of hypersexuality have been undertaken. Nevertheless, the literature does suggest the possibility of a neurobiology of hypersexuality. Three cases of hypersexual behavior are presented in the context of neuropsychiatric disorders, and the literature on this phenomenon is briefly reviewed. These case studies and the literature provide evidence that different brain systems may play a role in this disorder. Frontal lesions may be accompanied by disinhibition, including impulsive hypersexual response to external cues, while striatal lesions may be accompanied by repetitive triggering of internally generated response patterns. Temporal-limbic lesions may be accompanied by disturbances in sexual appetite itself, including change in the direction of sexual drive. These case studies demonstrate that a neurobiology of hypersexuality may prove of some heuristic value in the clinic. However, further research is required to consolidate the literature in this area.     

Hypersexuality in inpatient children and adolescents: recognition, differential diagnosis, and evaluation

We describe a 17-year-old girl with hypersexuality resulting from virilization, the latter a consequence of polycystic ovary syndrome, and we review the literature pertinent to hypersexuality in children and adults. Inappropriate sexual behavior (a common cause of disruption among children who are hospitalized for psychiatric disorders) may be caused either by hypersexuality or by simply ill-regulated behavior: a definition of hypersexuality is proposed that can be applied at the bedside (namely, sexual behaviors or fantasies that have abruptly increased in frequency by comparison with a previous baseline, are of sufficient excessiveness to disrupt expected or usual social, academic, or occupational functioning, or constitute a source of distress), so that this distinction can be made promptly, and we present a differential diagnosis for hypersexuality to direct its evaluation. Virilization does not seem to be a common cause of hypersexuality in children and adolescents, but it should not be overlooked when it does exist. The differential diagnosis of hypersexuality in adults, which we present for comparison, is much larger than it is in children.     

Assessment of Problematic Situations and Coping Strategies in Women with Eating Disorders: Initial Validation of a Situation-Specific Problem Inventory

The current study examined the psychometric properties of the Anorexia and Bulimia Problem Inventory (ABPI; Eason, 1983) in women with and without diagnosed eating disorders. The ABPI was initially constructed in accordance with the Behavior-Analytic model of instrument development (Goldfried & D'Zurilla, 1969). In this investigation, the ABPI was refined to consist of 38 audiotaped problematic situations, including those related to eating and weight, academic, family, and interpersonal relationship issues, and scoring criteria to rate the effectiveness of responses. Convergent and discriminant validity were established between ABPI-R scores and the Eating Disorder Inventory (EDI; Garner, Olmsted, & Polivy, 1983) scales. As evidence of disciminative validity women with eating disorders received less ratings indicating less effective problem-solving on the ABPI-R scales than women without eating disorders. A significant increase in effective coping as measured by the ABPI-R was found for women following an 8-week outpatient eating disorders treatment program. Potential uses of this measure in research and clinical practice are discussed.     

The use of a linkage analysis as evidence in the conviction of the Newcastle serial murderer,South Africa

The linking of a series of crimes to one individual has always been problematic, especially in the absence of eyewitness or forensic evidence. During the investigation, another means whereby this can be done is through linkage analysis. Yet a linkage analysis can also play a role during the trial of a serial offender. This paper examines the use of a linkage analysis report as evidence during the trial of the Newcastle serial murderer in South Africa. The linkage analysis examined the circumstances of the crime, modus operandi, and signature behaviour of the offender, to come to the conclusion that all the offences were committed by one individual, despite the lack of eyewitness or forensic evidence linking the suspect to two of the four incidents. This evidence was admitted by the court and the presiding officer concurred that the accused was guilty of committing the crimes during the third and fourth incidents. Copyright © 2006 John Wiley & Sons, Ltd.     

The Association Between Psychological Well-Being and Problematic Use of Internet Communicative Services Among Young People

Previous studies on problematic Internet use have focused almost exclusively on the fact that presence of negative functioning, such as social anxiety, depressive symptoms, or loneliness, represents a risk factor for unhealthy use of the web. For this reason the aim of the present study was to investigate the association between psychological well-being dimensions and problematic use of Internet communicative services. In the current study 495 undergraduate students were recruited. The Italian adaptations of the Psychological Well-being Scales and the Generalized Problematic Internet Use Scale 2 (GPIUS2) were used to assess psychological well-being dimensions and generalized problematic Internet use, respectively. Psychological well-being dimensions explained a significant portion of variance for the GPIUS2 total score levels, after controlling for sex, age, and occupational status. The levels of Autonomy, Environmental Mastery, and Positive Relations with Others acted as significant negative predictors of the tendency to use the web for regulating negative feelings, compulsive use of the web, and the negative outcomes that can arise as a result. The overall findings of the present study provide preliminary evidence that low psychological well-being is associated with problematic use of Internet communicative services.     

Problematic mobile phone use as impulsive choice: Development and empirical verification of a reinforcer-pathology model

Problematic mobile phone use is characterized by its “impulsive” nature; users engage in it despite their negative attitude toward it. From a behavioral-economic perspective, this attitude–behavior discrepancy is generated by competing contingencies that involve smaller-sooner social reinforcers associated with mobile phone use and larger-later prosocial reinforcers potentially compromised by phone use. Based on this conceptualization, the reinforcer-pathology model of problematic mobile phone use is proposed, which posits that such phone use stems from excessive delay discounting of the social and prosocial reinforcers and/or excessive demand for the social reinforcers. A secondary data analysis of previously published studies was conducted, with the novel addition of principal component analysis and hierarchical cluster analysis of these data. The results generated evidence that supports the reinforcer-pathology model proposed in this article. Based on the theoretical analyses and accumulated empirical evidence, theory-driven prevention and intervention strategies for problematic mobile phone use are proposed. Overall, the reinforcer-pathology model of problematic mobile phone use provides a comprehensive framework for understanding and addressing this growing issue.     

Generic,Disease-Specific and Individualised Approaches to Measuring Health-Related Quality of Life Among People With Heart Disease - A Comparative Analysis

Increasing emphasis is being placed on the evaluation of health-related quality of life. However, there is no consensus on the definition of this concept and as a result there are a plethora of existing measurement instruments. Head-to-head comparisons of the psychometric properties of existing instruments are necessary to facilitate evidence-based decisions about which instrument should be chosen for routine use. Therefore, an individualised instrument (the modified Patient Generated Index (PGI)), a generic instrument (the Short Form 36) and a disease-specific instrument (the Quality of Life after Myocardial Infarction questionnaire) were administered to patients with ischaemic heart disease ( n = 117) and the evidence for the validity, reliability and sensitivity of each instrument was examined and compared. The modified PGI compared favourably with the other instruments but none of the instruments examined provided sound evidence for sensitivity to change. Therefore, any recommendation for the use of the individualised approach in the routine collection of health-related quality of life data in clinical practice must be conditional upon the submission of further evidence to support the sensitivity of such instruments.     

Sexual desire,not hypersexuality,predicts self-regulation of sexual arousal

A person's ability to control their own sexual arousal is important both to reduce the risks associated with some sexual behaviours and to respond sexually with intimate partners. A lack of control over sexual urges is a proposed feature of “hypersexual disorder”, though some evidence suggests that sexual desire predicts the self-regulation of sexual arousal better than hypersexuality. In the current study, a sample (N = 116) of men and women recruited from community ads viewed a series of 20-second neutral and sexual films. Before each sexual film, participants were instructed to increase their sexual arousal, decrease their sexual arousal or respond as usual. Higher levels of desire for sex with a partner consistently predicted failures to downregulate sexual arousal. Hypersexuality was unrelated. These findings replicate Winters et al.'s study and extend their findings by including upregulation, women, a new measure of hypersexuality and a higher-trial design.     

Psychopathology depression superfactors measured in the clinical analysis questionnaire

In the area of psychometric measurement of depression, the most comprehensive multidimensional instrument is the Clinical Analysis Questionnaire (CAQ). This self-report inventory is purported to measure some 28 normal and abnormal personality source traits. In particular, seven separate depression primaries are claimed to have a measurement basis in the CAQ. Clearly, despite the apparent comprehensiveness of the instrument, there are too many primary factors in the CAQ for practical use in many contexts. In order to simplify interpretation of CAQ scores, it seems desirable to utilise a smaller number of more reliable superfactors wherever possible. The present investigation explores this issue and findings suggest that depression is a complex phenomenon even at the superfactor level. Findings also suggest that traditional psychiatric labels may need to be reworked in the light of the present evidence on superfactors within the psychopathological domain.     

The anxiety sensitivity index: item analysis and suggestions for refinement.

Anxiety sensitivity is the fear of anxiety-related sensations, and is measured by the 16-item Anxiety Sensitivity Index (ASI). Despite the popularity and utility of the ASI in research, a number of studies have provided evidence for the inadequacy of several items, and item-to-scale correlations for the ASI have not been published. In this study, a converging set of analyses to evaluate the item adequacy and factor structure of the ASI was used. The results of these multiple analyses converged nicely suggesting that Items 1, 5, 7, 8, and 13 should be considered for removal from the instrument. The impact of removing these problematic items from the scale was explored through the reanalysis of data from 3 previously published studies that compared the original ASI with the new 11-item version (the ASI minus the 5 problematic items). The results of these analyses suggest that the 2 scales function comparably in many respects but that the new version may be a more precise measure of anxiety sensitivity. The 11-item ASI appears to tap 2 primary aspects of anxiety sensitivity: fears of somatic sensations of anxiety and fears of loss of mental control. Suggestions for further development of the ASI are offered.     

Book reviews

This paper reports findings from a study of the psychometric properties of a newly developed measure, the Spiritual Issues in Supervision Scale (SISS). The instrument was originally conceived in response to the growing need within the helping professions to understand the role of spirituality within clinical practice and supervision. While evidence supporting the internal consistency of the measure was obtained through a preliminary study, the present investigation provides a more detailed examination of the measure. Results reflect that the instrument in addition to being reliable, measures four dimensions of supervision that related to spirituality. Based on the findings of this study, conclusions are provided pertaining to the potential utility of the instrument.     

The Shedler-Westen Assessment Procedure-200 as a basis for modifying DSM personality disorder categories

The Shedler-Westen Assessment Procedure-200 (SWAP) is a Q-sort instrument designed to assess personality pathology on the basis of clinician ratings. On the basis of research with the SWAP, its creators have proposed a group of 12 personality disorder (PD) diagnoses that can be used to replace or modify current Axis II categories of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The authors discuss conceptual and empirical issues that require clarification before this proposal can be properly evaluated. They identify problematic psychometric features of the SWAP, including its unrepresentative normative sample, its reliance on a fixed skewed distribution, and anomalies in its T-score approach to diagnoses. In addition, a review of research on SWAP-based PD categories indicates that important information regarding diagnostic coverage, validity, and temporal stability is presently lacking. The authors conclude that research evidence is currently insufficient to justify the use of SWAP-based PD categories to guide revision of the DSM.     

Psychological predictors of problem mobile phone use.

Mobile phone use is banned or illegal under certain circumstances and in some jurisdictions. Nevertheless, some people still use their mobile phones despite recognized safety concerns, legislation, and informal bans. Drawing potential predictors from the addiction literature, this study sought to predict usage and, specifically, problematic mobile phone use from extraversion, self-esteem, neuroticism, gender, and age. To measure problem use, the Mobile Phone Problem Use Scale was devised and validated as a reliable self-report instrument, against the Addiction Potential Scale and overall mobile phone usage levels. Problem use was a function of age, extraversion, and low self-esteem, but not neuroticism. As extraverts are more likely to take risks, and young drivers feature prominently in automobile accidents, this study supports community concerns about mobile phone use, and identifies groups that should be targeted in any intervention campaigns.     

Interactive scaling with individual subjects

A metric multidimensional scaling (MDS) procedure based on computer-subject interaction is developed, and an experiment designed to validate the procedure is presented. The interactive MDS system allows generalization of current MDS systems in two directions: (a) very large numbers of stimuli may be scaled; and (b) the scaling is performed with individual subjects, facilitating the investigation of individual as well as group processes. The experiment provided positive support for the interactive MDS system. Specifically, (a) individual data are amenable to meaningful interpretation, and they provide a tentative basis for quantitative investigation; and (b) grouped data provide meaningful interpretive and quantitative results which are equivalent to results from standard paired-comparisons methods.This report was supported in part by a PHS research grant, No. M-10006, from the National Institute of Mental Health, in part by a Science Development grant, No. GU-2059, from the National Science Foundation, both granted to the Psychometric Laboratory at the University of North Carolina, and in part by a PHS research grant, No. MH-16474, from the National Institute of Mental Health, Public Health Service, granted to the second author. The major portion of this research was performed while the second author was the L. L. Thurstone Distinguished Fellow at the Psychometric Laboratory of the University of North Carolina while on leave from the University of Southern California. The authors are indebted to Amnon Rapoport and Thomas S. Wallsten for their critical evaluations of an earlier version of this report. While this paper was entirely a cooperative effort on the part of both authors, the first author was primarily responsible for the algorithms, and the second for developing the mathematical model.     

青少年智能手机问题性使用与焦虑的交叉滞后分析

对393名高中生进行10个月的纵向追踪,采用问卷法考察青少年智能手机问题性使用与焦虑之间的关系。结果发现：青少年智能手机问题性使用与焦虑水平随着时间推移有增加的趋势;青少年智能手机问题性使用与焦虑显著正相关;前测焦虑水平能够显著预测后测智能手机问题性使用程度,而前测智能手机问题性使用程度不能显著预测后测焦虑水平,且这一预测关系存在性别差异。     

Combining Trait Models of Impulsivity to Improve Explanation of Substance Use Behaviour

The UPPS‐P model of impulsivity is gaining popularity among personality and substance use researchers, but questions remain as to whether its five facets have incremental validity in explaining substance use over a more parsimonious model specifying only two facets: reward drive and rash impulsiveness. In three cross‐sectional studies (total N = 486), we investigated whether the novel components of the UPPS‐P model (negative Urgency, Premeditation, Perseverance, Sensation seeking, Positive urgency) predicted typical and problematic alcohol and cannabis use after accounting for reward drive, rash impulsiveness and trait neuroticism (assessed with the Eysenck Personality Questionnaire). Reward drive and rash impulsiveness scores were calculated using principal components analysis of multiple scales, including UPPS‐P premeditation and sensation seeking. Results showed that rash impulsiveness was a robust predictor of typical and problematic substance use. The novel facets of the UPPS‐P did not improve prediction of typical substance use. The urgency scales inconsistently predicted problematic use. Specifically, negative urgency predicted one of three measures of negative consequences from alcohol use, and positive urgency only predicted negative consequences from cannabis use. Results suggest that the three novel facets of the UPPS‐P model add little over a two component model in explaining substance use, although may provide preliminary evidence for the utility of a revised global urgency construct in explaining problematic substance use. Copyright © 2017 European Association of Personality Psychology     

Impulsivity as a precedent factor for problematic Internet use: How can we be sure?

Previous research has suggested that problematic Internet use (PIU) is associated with impulse control disorder. Although researchers have suggested that impulsivity is a risk factor for PIU, the literature lacks longitudinal evidence on the relationship between impulsivity and PIU. We aimed to use a cross‐lagged analytic framework to identify temporal order effects and hypothesised that impulsivity was the precedent factor for PIU. In a panel sample of college students (N = 367), trait impulsivity and PIU were measured in the spring of freshman year and in their junior year. The measures included a self‐developed PIU Scale and the revised Impulsiveness Scale based on Barratt's concept. We found that “non‐planning impulsivity” was not associated with PIU. The “motor impulsivity” subfactor was thus adopted in the cross‐lagged model. The results suggest that motor impulsivity and PIU were stable across time. Motor impulsivity at Time 1 positively predicted PIU at Time 2, but PIU at Time 1 did not predict motor impulsivity at Time 2. A further investigation using gender as a moderator found a gender difference in the temporal relationship. Because motor impulsivity is a risk factor for PIU, potential prevention strategies based on this result are suggested.     

Diagnosing a male hysteric: Don Juan-type

The aim of this paper is to provide a clinical account of a male hysteric, Don Juan-type, taken from the early stages of treatment. The patient presented with a relationship problem but there soon emerged a form of compulsive sexuality or hypersexuality in his love relations that became a central feature of the clinical picture. This hypersexuality expressed itself in a compulsive need to stage, or to stage-manage, interpersonal scenaria of a sexual or sexualised nature. These scenaria, which were repeated in different variations and with different personnel, are seen by the author as a dramatisation of the primal scene with the patient taking up the position of the oedipal father. Explanations for the disappearance of male hysteria are given, including a new theory which claims that an imbalance in psychoanalytic theory itself led to the feminisation of hysteria. This critique allows certain forms of hypersexuality in men to be promoted as a form of hysteria, the most common example being Don Juanism-a form of compulsive sexuality that encompasses normative, conversion and character features. The paper also examines the male hysteric's developmental agenda. What the patient's compulsive sexual tableaux exposed was that he had never faced a separation that was not a triangular experience. This meant that his separations were experienced as two developmental agonies telescoped into one-separation (pre-oedipal) and exclusion (early oedipal). This combination, the author suggests, is so frightening in a particular group of men as to explain the choice of hysteria as opposed to some other choice of neurosis.     

Psychometric properties of the 12-item General Health Questionnaire (GHQ-12) in Chinese women during pregnancy and in the postnatal period

The GHQ-12 is a widely used instrument designed to screen for psychological disturbance (defined as the inability to carry out normal psychological functions and/or the emergence of new distressing phenomena), in a wide variety of clinical groups. The Chinese version of the GHQ-12 is widely used in Hong Kong to screen women during pregnancy and in the postnatal period. The underlying factor structure of the GHQ-12 has been extensively investigated and there is strong evidence to suggest that the instrument is multi-dimensional. The current investigation explored the psychometric properties of this instrument using confirmatory factor analysis, logistic regression and reliability analysis in Chinese women during the third trimester of pregnancy and in the postnatal period. Two- and three-factor models offered superior fit to the data compared to the presumed uni-dimensional structure. However, a four-item sub-scale from an eight-item two-factor model was found to be a significant antenatal predictor of postnatal GHQ-12 assessed caseness. Further evaluation of the clinical utility of this specific two-factor model is recommended.