Sex and genes,part 2: A biopsychosocial approach to assess and treat challenging sexual behavior in persons with intellectual disabilities including fragile X syndrome and 22q11.2 deletion syndrome

Individuals with intellectual disabilities (IDs) – and specifically those with genetic disorders – are more prone to medical and psychological challenges that affect their sexual development, experiences, and fertility. In this review paper we first provide an overview of the biopsychosocial (BPS) model and then explain how the model can guide and improve the assessment and treatment of challenging sexual behaviors by persons with IDs. We discuss two genetic conditions – fragile X syndrome and 22q11.2 deletion syndrome – in case studies, showing how the BPS model can be used to assess and treat the sexual problems of individuals with various types of ID. We conclude with BPS-formulated treatment considerations in three key domains: biomedical treatment (e.g., medication side effects; stopping or changing medications), psychological treatment (e.g., providing psychological therapies), and socio-environmental interventions (e.g., providing socio-sexual education and staff training). Together, these treatment interventions can aid clinicians to prevent and/or treat problematic sexual behaviors of people with IDs.     

Some hazards to neutrality in the psychoanalysis of candidates

The author looks at the challenges confronting psychoanalysts as they attempt to approach a desirable goal of neutrality in the treatment of psychoanalytic candidates and others who will become or are professional colleagues. Many such hazards are embedded in the interlocking relationships that inevitably exist between the analytic institute and its personnel, its training analysts, and its candidate-analysands. The author considers difficulties in the crucial analysis of aggression in training analyses. The analysis of aggression plays a determinative role in the personal and professional lives of analysands, and vitally affects the health and creativity of analytic institutions and the future of psychoanalysis.     

Affirmation of personal values buffers neuroendocrine and psychological stress responses

Stress is implicated in the development and progression of a broad array of mental and physical health disorders. Theory and research on the self suggest that self-affirming activities may buffer these adverse effects. This study experimentally investigated whether affirmations of personal values attenuate physiological and psychological stress responses. Eighty-five participants completed either a value-affirmation task or a control task prior to participating in a laboratory stress challenge. Participants who affirmed their values had significantly lower cortisol responses to stress, compared with control participants. Dispositional self-resources (e.g., trait self-esteem and optimism) moderated the relation between value affirmation and psychological stress responses, such that participants who had high self-resources and had affirmed personal values reported the least stress. These findings suggest that reflecting on personal values can keep neuroendocrine and psychological responses to stress at low levels. Implications for research on the self, stress processes, health, and interventions are discussed.     

Electrocortical measures during a lexical decision task: a comparison between elementary school-aged normal and dyslexic readers and adult normal and dyslexic readers

The authors examined the differences in performance between 30 dyslexic readers in 4th grade, 30 dyslexic readers attending university, and age-matched normal readers for both groups on a lexical decision task to evaluate the underlying factors of dyslexia that persist into adulthood. In both age groups, the dyslexic readers were significantly less accurate and slower than were the normal readers when reading word lists and in connected text. Electrophysiological data showed 2 main distinguishing components. Results supported the hypothesis that the dyslexia phenomenon is characterized by inaccurate and slow word-recognition skills. In addition, the authors found slow performance speed among all dyslexic readers in all stages of processing.     

Decreased latent inhibition is associated with increased creative achievement in high-functioning individuals

Reductions in latent inhibition (LI), the capacity to screen from conscious awareness stimuli previously experienced as irrelevant, have been generally associated with the tendency towards psychosis. However, "failure" to screen out previously irrelevant stimuli might also hypothetically contribute to original thinking, particularly in combination with high IQ. Meta-analysis of two studies, conducted on youthful high-IQ samples. demonstrated that high lifetime creative achievers had significantly lower LI scores than low creative achievers (r(effect size) = .31, p = .0003, one-tailed). Eminent creative achievers (participants under 21 years who reported unusually high scores in a single domain of creative achievement) were 7 times more likely to have low rather than high LI scores, chi2 (1, N = 25) = 10.69, phi = .47. p = .003.     

Relationship between priming and recognition in deterministic and probabilistic sequence learning

Exposure to a repeating sequence of target stimuli in a speeded localization task can support both priming of sequence-consistent responses and recognition of sequence components. In 3 experiments with both deterministic and probabilistic sequences, the authors used a novel procedure in which measures or priming and recognition were taken concurrently and asked whether these measures can be dissociated. In all of these experiments, both measures were above chance at the group level and no evidence of dissociation was found. Item-level analyses of the data in Experiment 3 did reveal dissociations in that (a) recognition judgments were affected by response speed independently of old-new status and (b) items that were not discriminated in recognition nonetheless showed priming. However, the authors show that these data, together with the group-level results, are compatible with a formal model in which priming and recognition are based on a single common memory variable.     

Complementarity of Linguistic and Prosodic Processes in the Intact Brain

Despite considerable speculation in the research literature regarding the complementarity of functional lateralization of prosodic and linguistic processes in the normal intact brain, few studies have directly addressed this issue. In the present study, behavioral laterality indices of emotional prosodic and traditional linguistic speech functions were obtained for a sample of healthy young adults, using the dichotic listening method. After screening for adequate emotional prosody and linguistic recognition abilities, participants completed the Fused Rhymed Words Test (FRWT; Wexler & Halwes, 1983) and the Dichotic Emotion Recognition Test (DERT; McNeely & Netley, 1998). Examination of the difference in ear asymmetries for these measures within individuals revealed a complementary pattern in 78% of the sample. However, the correlation between laterality quotients for the FRWT and DERT was near zero, supporting Bryden's model of "statistical" complementarity (e.g., Bryden, 1990).     

AUGMENTING SIMPLIFIED HABIT REVERSAL IN THE TREATMENT OF ORAL-DIGITAL HABITS EXHIBITED BY INDIVIDUALS WITH MENTAL RETARDATION

We investigated whether a simplified habit reversal treatment eliminates fingernail biting and related oral-digital habits exhibited by individuals with mild to moderate mental retardation. Although simplified habit reversal did little to decrease the target behaviors for 3 of 4 participants, simplified habit reversal plus additional treatment procedures decreased the behavior to near-zero levels for all participants. These procedures included remote prompting, remote contingencies involving differential reinforcement plus response cost, and differential reinforcement of nail growth. Limitations of habit reversal for individuals with mental retardation along with directions for future research involving therapist-mediated treatment procedures, particularly those involving remote prompting and remote contingencies, are discussed.     

Psychologists' and counsellors' perspectives on prolonged grief disorder and its inclusion in diagnostic manuals

Introduction: In this research, proposed criteria for what has been termed ‘Prolonged Grief Disorder’ (PGD) (more recently termed, ‘Persistent Complex Bereavement‐Related Disorder’ (PCB‐RD) in the proposed DSM‐V), were presented to psychologists and counsellors. Method: Participants were asked about their views on the ‘disorder’ and whether they considered its inclusion in diagnostic manuals was justified. A total of 185 participants, (147 psychologists, specialist and general, and 38 counsellors) responded to an online survey (part of a larger research project), concerning their attitudes, choices and activities regarding bereavement therapy. In this part of the research, therapists’ perspectives about pathological grief, the recognition of PGD and its inclusion in diagnostic manuals were explored. Fifty‐nine participants took the option of adding written remarks to the survey to expand on their opinions regarding PGD. Results/Conclusions: Tentative support for the inclusion of PGD in diagnostic manuals was given; however many therapists indicated considerable reservations about potential negative repercussions of using such a diagnosis. One‐way between‐groups analysis of variance was undertaken to determine whether participants' opinions varied according to main occupation or specialism; however, no significant difference was found. This research was conducted prior to the latest update to the proposed revision and diagnostic category concerning bereavement in the DSM‐5 of April 2012, but many observations and recommendations concerning PGD made by the therapists participating in this research can be seen to be applicable to PCB‐RD. Implications: The implications of this research for assessing and diagnosing grief, and ways of working with bereaved clients, are discussed.