Psychological treatment of pedophiles

The main treatment problem of pedophilia is motivating the offender to change. Reasons for the perpetrator's resistance to therapy and strategies for motivating them to change are discussed. Current assumptions about the etiology of this sexual anomaly are examined. Results from a databank of sex offenders are reviewed to show that it is uncommon for pedophiles to be victims of sexual abuse, including incest, and few need pornography as stimulants. Therapeutic difficulties include the egocentric, egosyntonic, and erotically gratifying nature of pedophilia to the perpetrator, his unwillingness to give up his behavior, his tendency to rationalize his acts, and to see the child as consenting. Group therapy and a variety of clinical imagery procedures with case examples are discussed as ways of overcoming the poor motivational state of pedophiles for treatment.     

Emotion Regulation Therapy for Generalized Anxiety Disorder

Despite the success of cognitive behavioral therapies (CBT) for emotional disorders, a sizable subgroup of patients with complex clinical presentations, such as patients with generalized anxiety disorder, fails to evidence adequate treatment response. Emotion Regulation Therapy (ERT) integrates facets of traditional and contemporary CBTs, mindfulness, and emotion-focused interventions within a framework that reflects basic and translational findings in affect science. Specifically, ERT is a mechanism-targeted intervention focusing on patterns of motivational dysfunction while cultivating emotion regulation skills. Open and randomized controlled psychotherapy trials have demonstrated considerable preliminary evidence for the utility of this approach as well as for the underlying proposed mechanisms. This article provides an illustration of ERT through the case of “William.” In particular, this article includes a case-conceptualization of William from an ERT perspective while describing the flow and progression of the ERT treatment approach.     

The predictive capacity of self-reported motivation vs. early observed motivational language in cognitive behavioural therapy for generalized anxiety disorder

ABSTRACT

Client motivation to change is often considered a key factor in psychotherapy. To date, research on this client construct has largely relied on self-report, which is prone to response bias and ceiling effects. Moreover, self-reported motivation has been inconsistently related to treatment outcome. Early observed client in-session language may be a more valid measure of initial motivation and thus a promising predictor of outcome. The predictive ability of motivational factors has been examined in addiction treatment but has been limited in other populations. Addressing this lack, the present study investigated 85 clients undergoing cognitive behavioural therapy (CBT) alone and CBT infused with motivational interviewing (MI-CBT) for severe generalized anxiety disorder. There were two aims: (1) to compare the predictive capacity of motivational language vs. two self-report measures of motivation on worry reduction and (2) to examine the influence of treatment condition on motivational language. Findings indicated that motivational language explained up to 35% of outcome variance, event 1-year post-treatment. Self-reported motivation did not predict treatment outcome. Moreover, MI-CBT was associated with a significant decrease in the most detrimental type of motivational language compared to CBT alone. These findings support the importance of attending to in-session motivational language in CBT and learning to respond to these markers using motivational interviewing.     

Incentive learning following reinforcer devaluation is not conditional upon the motivational state during re-exposure

Three experiments analysed the effect of re-exposure to the reinforcer following aversion conditioning on instrumental performance. In the first experiment, groups of hungry and thirsty rats were trained to press a lever for sucrose, which was then followed by a single injection of lithium chloride (LiCl). On the following day, half the animals in each motivational condition received re-exposure to the sucrose solution; the remaining animals were not re-exposed. In a subsequent extinction test animals that had received re-exposure to the sucrose pressed less than animals that were not re-exposed. Moreover, the effect of re-exposure to the sucrose solution was similar following training under hunger and thirst. In the remaining studies, animals were trained to lever-press for sucrose while either hungry or thirsty. They were then injected with LiCl and re-exposed to the sucrose while either hungry or thirsty, i.e. in the same or different motivational state employed during training, or they were not re-exposed. Lever pressing was then tested in extinction in the training motivational state. As in the first experiment, re-exposure to the reinforcer after aversion conditioning enhanced the magnitude of the reinforcer devaluation effect. More importantly, re-exposure to the sucrose produced a comparable effect on instrumental performance, whether re-exposure was given under the same or different motivational state to that employed during training. These results suggest that the instrumental reinforcer devaluation effect depends upon a process of incentive learning, but that this process is not conditional upon the current motivational state of the animal.     

Motivational Counseling: Implications for Counseling Male Juvenile Sex Offenders

Juvenile sex offenders (JSOs) often appear unmotivated to change, which thus necessitates a therapeutic approach that matches “resistant” client characteristics. In this article, the authors review common traits of JSOs, introduce motivational counseling as an effective treatment modality, and offer a case illustration.     

Motivational control of second-order conditioning

Two experiments examined the motivational specificity of the associations that support 2nd-order conditioning. In the 1st phase of each experiment rats were exposed to 2 visual conditioned stimuli (CSs) paired with either a saline or food pellet unconditioned stimulus (US) prior to exposure to 2nd-order conditioning using 2 auditory CSs, 1 paired with each visual CS. Rats' motivational state was then shifted prior to a test such that if and only if specific motivational features of the 1st-order training US played a role in the 2nd-order associative structure would responding to the 2nd-order cues shift appropriately with the state change. Even when the US was irrelevant to the training motivational state, shifts in state revealed that it was encoded within the associative structure supporting 2nd-order responding.     

Defining motivation and cognition in animals

Motivation in an automaton, whether it be artificial or animate, is simply that aspect of the total state that determines the behaviour. In an autonomous agent, which has a degree of self‐control, the motivational state includes a cognitive evaluation of the likely consequences of possible future behaviour. Such evaluation implies optimization with respect to some motivational criterion.     

Does Motivation Impact OCD Symptom Severity? An Exploration of Longitudinal Effects

Understanding the role of patient motivation in OCD treatment is of clinical importance given the requisite autonomous role of patients in Exposure and Response Prevention. The present study investigated state- and trait-like relations between three variables: two previously established motivational constructs, readiness to change (RTC) and committed action (CA), derived from the University of Rhode Island Change Assessment, and OCD symptom severity as measured by the self-report Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR). Utilizing a random-intercept cross-lagged panel model (RI-CLPM) design, we assessed autoregressive, within-time correlations, and cross-lagged effects of RTC, CA, and Y-BOCS-SR scores at admission, month 1 of treatment, and discharge from an intensive/residential treatment program for OCD. Results revealed significant autoregressive (i.e., state-like) effects for CA and Y-BOCS-SR, negative within-time correlations between state CA and Y-BOCS-SR across all time points, a positive within-time correlation between state CA and RTC at admission, and a cross-lagged effect between state Y-BOCS-SR at month 1 of treatment and state RTC at discharge. Results also demonstrated that the stability of the RTC variable was attributable to trait-like factors in the present sample. This study is novel in its use of RI-CLPM in an OCD sample and represents an important addition to the literature on the longitudinal impacts of dynamic constructs of motivation. Our findings may provide future researchers with strategies to supplement ERP with CA-driven motivational interviewing.     

The Challenge of Amoralism

According to unconditional motivational internalism, there is an a priori constraint on an agent's forming a sincere moral judgement, namely that she is, at least to some minimal extent, motivated to act as it dictates. In order to undermine this internalist position, proponents of motivational externalism typically appeal to the possibility of the amoralist—i.e. an individual who makes sincere moral judgements, but who is completely unmoved to act accordingly. This strategy is known as the challenge of amoralism. Against this strategy, I will argue that in order to represent a genuine case of amoralism, and a credible counterexample to unconditional motivational internalism, an agent would have to simultaneously satisfy an epistemically inconsistent set of conditions. Thus, the conclusion I will attempt to defend in this paper is that the challenge of amoralism does not succeed in posing a legitimate threat to unconditional motivational internalism.     

Barry Taylor

I respond to an argument made by Gunnar Björnsson and Ragnar Francén Olinder against motivational internalism. Björnsson and Olinder present a hypothesis in which all of us are selfishly motivated to act in accordance with our moral judgments. The conceivability of such a possibility, they argue, rules out motivational internalism. I argue that this is not the case, and that, according to one dominant view about moral judgments, the agents in the hypothesis do not make genuine moral judgments. One therefore cannot argue decisively against motivational internalism without arguing against this view about moral judgments.     

Motivational states influence effort-based decision making in rats: The role of dopamine in the nucleus accumbens

Decision-making policies are subject to modulation by changing motivational states. However, so far, little is known about the neurochemical mechanisms that bridge motivational states with decision making. Here we examined whether dopamine (DA) in the nucleus accumbens core (AcbC) modulates the effects of motivational states on effort-based decision making. Using a cost–benefit T-maze task in rats, we examined the effects of AcbC DA depletions on effort-based decision making, in particular on the sensitivity of effort-based decision making to a shift from a hungry to a sated state. The results demonstrated that, relative to sham controls, rats with AcbC DA depletion in a hungry as well as in a sated state had a reduced preference for effortful but large-reward action. This finding provides further support for the notion that AcbC DA regulates how much effort to invest for rewards. Importantly, our results further revealed that effort-based decision making in lesioned rats, as in sham controls, was still sensitive to a shift from a hungry to a sated state; that is, their preferences for effortful large-reward actions became lower after a shift from a restricted to a free-feeding regimen. These finding indicate that AcbC DA is not necessarily involved in mediating the effects of a shift in motivational state on decision-making policies.     

The EMG gradient as a reflection of metamotivational state

The significance of motivational statedominance in everyday life and actual motivational state during task performance was investigated in relation to skeletal muscle tension patterns during performance in the continuous preceptual-motor task paradigm. Subjects were recruited to form seriousminded (telic) and playful (paratelic) extreme groups according to their responses to the Telic Dominance Scale (6 subjects in each group). They all performed a continuous perceptual-motor task twice in a neutral context (N1, N2), once with threat of aversive shock at poor performance (T), and once with promise of monetary reward for good performance (R); T and R being balanced around N 2. Measures of tonic (slow) EMG activation were derived from the "passive" forearm, and structured (blind) interview assessed motivational state. It was concluded that motivational state, rather than statedominance, was associated with EMG activation. The telic state was significant to high EMG activation for the N I and T treatments in particular.     

Does happiness function like a motivational state?

According to Brehm's intensity of emotion theory, if an emotion has motivational properties, its intensity should be non-monotonically affected by factors similar to those determining the intensity of motivational states. These factors are called deterrents. In the case of emotion, one category of deterrents consists of factors that can potentially interfere with feeling the emotion, such as reasons for not feeling the emotion. Two experiments were carried out to examine whether happiness is a motivational state and, thus, if its intensity is non-monotonically determined by the importance of reasons for not feeling happy. We expected happiness to be reduced by a low importance reason for not feeling happy, to remain high in the presence of a moderately important reason, and to be reduced or eliminated by a very important reason. Both experiments supported the cubic function that results from these expectations, and when the results of the two studies were combined, each of the individual legs of the cubic function was found to be reliable along with the cubic function itself. The theoretical implications of these results are discussed.     

Acute mood responses to a 15-minute long walking session at self-selected intensity: effects of an experimentally-induced telic or paratelic state

In the present controlled experiment, we examine the influence of opposite states of mind (the "telic" vs. "paratelic" state) on mood response to a 15 min long walk at self-selected pace. Fifty-five first-year students were randomized to a telic (n = 22) or paratelic (n = 33) motivational environment. These opposed motivational environments were created using established reversal theory based procedures to induce the telic versus paratelic state. More than 90% of participants walked within a motivational state corresponding to the environment they were allocated. No significant mood changes (neither positive, nor negative) occurred pre- to postexercise in participants who walked with the telic state operative (p > .05). This has important implications when considering the use of exercise to relieve depression in clinical populations. Also, our findings shed new light on the reasons why not all individuals respond in the same way to moderate exercise. Practically, these results suggest that motivational state should be considered to optimize the mood enhancing effects of aerobic exercise.     

Motivational influences on cognitive control: Behavior,brain activation,and individual differences

What changes in brain activity are associated with changes in motivational state? The present study addressed this question by having participants perform a cognitive task (AX variant of the Continuous Performance Test; AX-CPT) under three different blocked motivational conditions (reward-incentive, penalty-incentive, and baseline). Behavioral data showed that the incentive conditions modulated task performance, potentially by altering participants’ cognitive control strategy. Neuroimaging data indicated that the reward condition was associated with a sustained increase in a primarily right-lateralized network that included parietal and prefrontal cortex. Additionally, individual differences were observed, such that activation in both reward-related brain regions and frontopolar cortex was linked to the degree of motivation-induced performance enhancement and to motivation-related personality variables. These results suggest that changes in motivational state may modulate performance through sustained activity in cognitive control regions and that the effect of incentives may be affected by the personalities of the participants.     

SPINOZA'S THEORY OF MOTIVATION

Abstract:  On the basis of 3p9s and 3p39s of the Ethics , it might seem that, for Spinoza, a judgment about something's goodness or badness is motivationally inert and, moreover, that value judgments essentially reflect an individual's pre-existing motivational states. However, in this paper I show that Spinoza holds that under certain conditions a motivational state results from a value judgment. Spinoza's theory of motivation consists of two accounts of the psychological order of value judgments and motivational states: an account of their order in those in bondage as well as an account of their order in those who are free.     

Toward a general theory of motivation: Problems,challenges, opportunities,and the big picture

Motivation theories have tended to focus on specific motivations, leaving open the intellectually and scientifically challenging problem of how to construct a general theory of motivation. The requirements for such a theory are presented here. The primacy of motivation emphasizes that cognition, emotion, agency, and other psychological processes exist to serve motivation. Both state (impulses) and trait (basic drives) forms of motivation must be explained, and their relationship must be illuminated. Not all motivations are the same, and indeed it is necessary to explain how motivation evolved from the simple desires of simple animals into the complex, multifaceted forms of human motivation. Motivation responds to the local environment but may also adapt to it, such as when desires increase after satiation or diminish when satisfaction is chronically unavailable. Addiction may be a special case of motivation—but perhaps it is much less special or different than prevailing cultural stereotypes suggest. The relationship between liking and wanting, and the self-regulatory management of motivational conflict, also require explanation by an integrative theory.     

Modular Treatment for Children and Adolescents With Problematic School Absenteeism: Development and Description of a Program in Germany

Problematic school absenteeism is defined as absence from school occurring with a clinical-level mental disorder. It represents a higher-order term for school refusal, school truancy, and the combination thereof and is associated with an increased risk for school dropout, prolonged mental disorders, and unemployment. This article describes the manualized modular treatment of problematic school absenteeism (MT) by a multiprofessional team. The manual was developed to target a broad spectrum of mental disorders characterized by internalizing but also externalizing behavior. The therapeutic focus is on the reintegration into school and on the cognitive behavioral treatment of the mental disorder. The MT is based on a multilevel model of problematic school absenteeism. The treatment is informed by an extensive case-conceptualization and addresses motivational aspects by offering a low-threshold therapeutic design and motivational interviewing. Core interventions are represented in four modules: cognitive behavioral therapy, family counseling, school counseling, and a psychoeducational physical exercise program. A case vignette provides an illustration of the treatment and the specific graduated approach for school reintegration. The current modular approach is discussed in relation to other cognitive-behavioral manuals targeting a broad spectrum of mental disorders or school refusal.