Biofeedback and reinforcement to increase heterosexual arousal in homosexuals

Relatively few procedures exist for developing heterosexual arousal in the treatment of sexual deviation (Barlow, 1973) although several recent studies suggest this is a necessary component of treatment (Feldman and MacCulloch, 1971; Bancroft, 1970; Barlow, 1974).In recent years, biofeedback techniques have been applied to many types of disorders (Blanchard and Young, 1974). Basic to biofeedback technology is the notion that providing a person with feedback (or immediate information) of a bioelectric response enables him to learn (gain) self-control of that response. These responses traditionally have been considered involuntary and include heart rate (Scott et al., 1973a). blood pressure (Benson et al., 1971), stomach acid pH (Welgan. 1972), and electroencephalographic activity (Sterman, 1972), In the present experiments, biofeedback and its attendant technology was applied to the problem of generating heterosexual arousal in homosexual males.Frequently, in biofeedback research, reinforcement has been used in addition to feedback in attempting to teach self-control of a response. In fact, an alternate way of conceptualizing and describing the biofeedback research is in terms of operant conditioning (e.g., Weiss and Engel, 1971: Scott et al., 1973b). In one sense, however, feedback and reinforcement are inextricably confounded: the delivery or non-delivery of a reinforcer provides the S with information about the rightness or wrongness of his response and hence, binary feedback about it. Likewise, if feedback or knowledge of whether the response has reached a criterion level or not is effective in leading to a change in the response, then feedback functions as a reinforcer. Reinforcement, however, may be viewed as providing both information about the response (feedback) plus an incentive to change it in the desired direction in addition to any incentive provided by successful performance of a task. Thus, if one provides Ss with a separate, functionally defined reinforcer in such a way that no additional information about the response is conveyed, it becomes possible to detect additive effects of reinforcement over feedback effects. Such was the second purpose of this study.Several recent analogue experiments with volunteers have reported success in modifying erections through feedback and/or reinforcement. Price (1973) found that heterosexual volunteers who received analogue visual feedback as well as binary feedback, provided by a colored light once the needle had passed a pre-set criterion, showed a shorter latency to peak erection and maintained criterion erection longer than a control group receiving no feedback. Both groups were listening to erotic audio tapes. Rosen (1973) demonstrated significant suppression of tumescence in a group of heterosexual volunteers provided with response contingent signal lights. A group receiving non-contingent feedback did not show this effect. In a technical paper, Laws and Pawlowski (1973) have suggested audio feedback of tumescence as a treatment for deficits in sexual arousal.In the clinic, Harbison, Quinn and McAllister (1970), in an uncontrolled case study, reported increasing heterosexual responsiveness in homosexuals through reinforcement of erection. In one of their homosexual patients they were able, over a long series of trials, to increase erection to a heterosexual stimulus (female slide) through rewarding progressively larger responses with sips of iced lime after the patient was water deprived. In addition to the reinforcement, this S was given feedback, of sorts, in that a light was flashed for each successful trial. A second homosexual patient was similarly rewarded for maintaining progressively longer and clearer fantasies of heterosexual behavior. Since other treatments were also applied and no experimental analysis was performed, it is not possible to evaluate the effectiveness of the procedure.In the present experiment the separate effects of feedback and reinforcement to increase heterosexual arousal in homosexuals was experimentally evaluated using single case experimental design methodology (Barlow and Hersen, 1973). Since each experiment was somewhat different in design and purpose, each will be described separately.     

Heterosocial-skills training and covert sensitization. Effects on social skills and sexual arousal in sexual deviants

There are few experimental investigations of the effects of social-skills training (SST) on sexual deviation. This study used a multiple baseline across 4 subjects with undesired sexual arousal to investigate the effects of heterosocial-skills training and covert sensitization on heterosocial skills and sexual-arousal patterns. SST produced large increases in heterosocial skills but it had unclear effects on sexual arousal. Subsequently, covert sensitization tended to reduce remaining deviant arousal but did not increase appropriate arousal significantly. These data generally support the view that individual components of sexual arousal require separate assessment and intervention.     

Slippage of contact lenses and other artefacts in relation to fading and regeneration of supposedly stable retinal images

After-image experiments reveal that scleral-fitting contact lenses slip through several minutes of arc. Experiments in which they have been used to procure “stabilized” retinal images must therefore be reinterpreted. Light-weight, suck-on, limbal-seating cups are much better, but complete stabilization cannot be relied upon. Other possible artefacts in stabilized image work are described and are thought to be responsible for certain features of previous accounts of the appearance of stabilized images. Discounting features caused by artefacts, the image appears to blur, losing detail, and fade, losing contrast, within the first few seconds. Contrast and detail are not regained, but the milky, textureless image that remains fluctuates in appearance for a minute or so. Finally the fluctuations die out and a very blurred, cloudy version of the original scene persists.     

Methodological Strategies in Child Clinical Trials: Advancing the Efficacy and Effectiveness of Psychosocial Treatments

The present paper reviews issues of treatment efficacy (i.e., potency) and effectiveness (i.e., clinical utility) in applied clinical child research. Threats to treatment evaluation are reviewed in the context of these two dimensions. It is proposed that treatment outcome research faces new challenges stemming from the ever increasing emphasis on generalization of gains and dissemination of interventions outside of clinical research settings. Issues and approaches proposed as warranting further development and attention include development, flexibility, acceptability, and disseminability of psychosocial assessment and treatment methods. A research emphasis is promoted that balances experimental control with the need for treatment generalization and delivery outside of the research setting, in order to maximize the utility of clinical research.     

Cross-Informant Agreement in the Assessment of Social Phobia in Youth

In the present study involving children and adolescents with a principal diagnosis of social phobia, we measured parent–child agreement regarding social anxiety symptoms. Additionally, we examined variables related to the severity of the children's social phobia symptoms as reported by children and as rated by clinicians. Examination of cross-informant agreement indicated little difference between mean parent and children ratings of the children's social fears. In contrast, there was a significant difference in parent and children ratings of the children's avoidance, with parents endorsing greater degrees of social avoidance. Children's report of social avoidance was negatively related to scores on a measure of self-presentational concerns (i.e., social desirability). Clinicians' determination of the severity of the children's social phobia was also influenced by the children's self-presentation as well as parent report of social avoidance and children's depression scores. Thus, this differential weighting by the clinician of parent versus child report may be related to the finding that children's self-reported social avoidance was negatively related to their concerns regarding positive self-presentation. Results suggest the need to consider the impact of social desirability when examining clinical characteristics of children and adolescents with social phobia.     

Ethnicity in America and feeling "American"

Ethnic group acculturation remains a concern in the United States today. In the present study, the authors explored the extent to which members of three ethnic groups (White American women, African American women, and Cuban American women) perceived themselves to be "American," how much each group felt that its members were perceived as being American by White Americans, and how these perceptions related to beliefs about their own group's economic and social status. The results showed that African Americans felt American but felt that they were not perceived as such by White Americans. African Americans also reported feeling economically and socially excluded. In contrast, Cuban Americans reported neither feeling they were American nor believing they were perceived as such by White Americans, but feelings of inclusion increased with length of residence. Implications of these results for the common ingroup identity model are discussed.     

Instructions to focus upon or distract from internal cues during exposure treatment of agoraphobic avoidance

Instructions to focus upon feared somatic sensations were compared to instructions to engage in distracting tasks, while practising in vivo exposure to feared agoraphobic situations. Thirty individuals assigned a primary diagnosis of Panic Disorder with moderate to severe Agoraphobia were assigned randomly to one of the two treatment conditions. Assessments were conducted pre, post and 6 months following treatment completion, using subjective, behavioral and clinician-rated measures of change. Composite outcome criteria indicated a trend for distracted exposure to yield a higher percentage of improvement than focused exposure, at post assessment. However, focused exposure group members improved to a greater extent over the follow-up interval than members of the distracted group. These trends were relatively weak, given the absence of significant group by time interactions in terms of individual variable analyses. The results were discussed with reference to the role of distraction in fear reduction.