Theoretical problems of aversion therapy

Some limitations of the conditioning theory are discussed and attention is drawn to significant pieces of evidence which are still lacking. The shortcomings of the associated 2-factor theory are also considered.

Seven types of explanation are given in summary form and the evidence in favour and against each of the 7 is described. Finally, a partial theory based on changes in general state is adumbrated in an attempt to clarify some phenomena and to predict others.     

Feelings of mental pollution subsequent to sexual assault

This paper describes an investigation of the phenomenon of mental pollution in a sample of 50 female victims of sexual assault. Feelings of mental pollution were assessed using an interview and a questionnaire. An experimental procedure was employed to determine if feelings of dirtiness and the urge to wash could be provoked by deliberate attention to the assault memory. Thirty (60%) of the 50 participants reported some feelings of mental pollution subsequent to the assault, and feelings of mental pollution were related to post-assault washing behaviour. Deliberate recall of the assault resulted in stronger feelings of dirtiness and the urge to wash than did deliberate attention to a pleasant memory or scene. Nine women reported washing their hands in response to deliberate recall of the assault. These findings suggest that feelings of mental pollution may be prominent in victims of sexual assault.     

Vulnerability to mental contamination

Mental contamination refers to feelings of contamination that arise without physical contact with a contaminant. Mental contamination has been documented among sexual assault victims, some of whom report feeling dirty and wanting to wash in response to memories of the assault. This study examined variables associated with increased vulnerability to mental contamination. Female undergraduates (n=100) filled out a series of questionnaires and listened to an audiotape that instructed them to imagine experiencing a forced kiss by an undesirable male. Controls (n=20) imagined a consensual kiss by a desirable male. Women in the non-consensual condition reported stronger feelings of dirtiness and urge to wash than those in the consensual condition. Twenty-seven women in the non-consensual condition spontaneously rinsed in order to alleviate physical sensations evoked by the tape. Regression analyses revealed that significant predictors of dirtiness included contact contamination fear and disgust sensitivity, and there was a trend for anxiety sensitivity to predict dirtiness. Contact contamination fear was also a significant predictor of urge to wash. Prior experience with unwanted sexual contact was a significant predictor of rinsing, and there was a trend for fear of negative evaluation to predict rinsing. Discussion focuses on the implications of these findings for our understanding of mental contamination.     

Match and mismatch in the prediction of fear--I

An experiment was carried out on 44 fearful Ss in order to find out how accurately people can predict their fear responses, and whether they become more accurate with practice. We also examined the effects on predicted and reported fear of correct matches, over-predicted mismatches and underpredicted mismatches. The Ss tended to over-predict their fear responses, and did learn to predict more accurately with practice. Predicted fear tended to increase after under-predictions, and tended to decrease after over-predictions. After a correct match, predictions of fear remained unchanged. Reports of fear declined steadily, and showed little relation to the occurrence of correct or incorrect matches.     

Treatment of obsessions: A randomized controlled trial

This study tested Rachman's cognitive behavioral method for treating obsessions not accompanied by prominent overt compulsions. The cognitive behavioral treatment was compared to waitlist control and an active and credible comparison of stress management training (SMT). Of the 73 adults who were randomized, 67 completed treatment, and 58 were available for one-year follow-up. The active treatments, compared to waitlist, resulted in substantially lower YBOCS scores, OCD-related cognitions and depression as well as improved social functioning. Overall, CBT and SMT showed large and similar reductions in symptoms. Pre-post effect sizes on YBOCS Obsessions for CBT and SMT completers was d = 2.34 and 1.90, respectively. Although CBT showed small advantages over SMT on some symptom measures immediately after treatment, these differences were no longer apparent in the follow-up period. CBT resulted in larger changes on most OCD-related cognitions compared to SMT. The cognitive changes were stable at 12 months follow-up, but the differences in the cognitive measures faded. The robust and enduring effects of both treatments contradict the long-standing belief that obsessions are resistant to treatment.