A learning approach to the treatment of homosexuality

‘Aversive’ techniques in the treatment of homosexuality provide practical and ethical difficulties for the therapist. A technique involving ‘imaginary’ aversive therapy and a discrimination learning task is described. It is felt that such an approach following on classical desensitization of neurotic disturbances which may underly the homosexual disorder, offers hope of early symptom removal and lasting improvement.     

“I Took the Trouble to Make Inquiries,So I Refuse to Accept Your Instructions”: Religious Authority and Vaccine Hesitancy Among Ultra-Orthodox Jewish Mothers in Israel

Journal of Religion and Health - Voluminous scholarship has shown that religious leaders play an important role in helping patients cope with health issues. There is, however, little research on...     

Perceived control over the medical procedure and its association with adjustment to a low-control situation: the case of infertility

Illness perceptions were shown to be related to emotional and physical outcomes, as proposed by Leventhal’s self-regulation model. These perceptions include the illness identity, its timeline, consequences, causes, and controllability, which later research found to include self-control and treatment control. The current study aimed to examine the role of a third type of perceived control: Control over the treatment procedures. We hypothesized that this type of control would be important for women undergoing infertility treatments, which are characterized by high uncertainty and low personal control. The sample included 194 Israeli women who were undergoing infertility treatments, 70% recruited in hospitals and the remainder in a fertility counseling center and website. All participants were married religious Jewish women, which added to the stress inherent in infertility. Study measures included the Illness Perception Questionnaire-Revised (IPQ-R), adapted to infertility, with an additional subscale assessing control over the procedure, and infertility-specific distress and well-being scales. Exploratory and confirmatory factor analyses supported the factor structure, including the distinct new subscale. A structural equations model showed that perceived consequences were most strongly related to distress and well-being. The three types of control were positively intercorrelated but differed in their associations with distress and well-being: Self-control over the problem and treatment control were unrelated to either measure while self-control over the procedure was related to greater well-being. These findings suggest that when control over the condition or the treatment outcomes is impossible, individuals may still benefit from control over external factors such as their health care. Healthcare providers can support them by seeking ways to increase their control over their treatment procedures, which may contribute to better psychological adjustment. Future studies should examine the role of perceived control over the procedures in other low-control situations (e.g., newly diagnosed cancer; aging-related declines).     

Multiple Belief Systems in Psychotherapy: The Effects of Religion and Professional Beliefs on Clinical Judgment

This study examined the effects of religious and professional beliefs on clinical judgment. Eighty-seven psychotherapists completed a religious belief survey and a professional belief survey, as well as a questionnaire concerning internal conflict between professional and religious beliefs. The subjects then read two brief vignettes, describing a religious and a non-religious patient, and rated the patients with regard to optimism or pessimism concerning responsiveness to treatment. The results showed that there was no significant relationship between religious and professional beliefs. However, the strength of religious beliefs predicted optimism for the religious patient. In addition, there was a significant interaction effect between strength of religious beliefs and strength of professional beliefs on clinical ratings.     

Turning it Upside Down: Areas of Preserved Cognitive Function in Schizophrenia

Patients with schizophrenia demonstrate marked impairments on most clinical neuropsychological tests. These findings suggest that patients suffer from a generalized form of cognitive impairment, with little evidence of spared performance documented in several large meta-analytic reviews of the clinical literature. In contrast, we review evidence for relative sparing of aspects of attention, procedural memory, and emotional processing observed in studies that have employed experimental approaches adapted from the cognitive and affective neuroscience literature. These islands of preserved performance suggest that the cognitive deficits in schizophrenia are not as general as they appear to be when assayed with clinical neuropsychological methods. The apparent contradiction in findings across methods may offer important clues about the nature of cognitive impairment in schizophrenia. The documentation of preserved cognitive function in schizophrenia may serve to sharpen hypotheses about the biological mechanisms that are implicated in the illness.     

Hierarchically organized behavior and its neural foundations: a reinforcement learning perspective

Research on human and animal behavior has long emphasized its hierarchical structure—the divisibility of ongoing behavior into discrete tasks, which are comprised of subtask sequences, which in turn are built of simple actions. The hierarchical structure of behavior has also been of enduring interest within neuroscience, where it has been widely considered to reflect prefrontal cortical functions. In this paper, we reexamine behavioral hierarchy and its neural substrates from the point of view of recent developments in computational reinforcement learning. Specifically, we consider a set of approaches known collectively as hierarchical reinforcement learning, which extend the reinforcement learning paradigm by allowing the learning agent to aggregate actions into reusable subroutines or skills. A close look at the components of hierarchical reinforcement learning suggests how they might map onto neural structures, in particular regions within the dorsolateral and orbital prefrontal cortex. It also suggests specific ways in which hierarchical reinforcement learning might provide a complement to existing psychological models of hierarchically structured behavior. A particularly important question that hierarchical reinforcement learning brings to the fore is that of how learning identifies new action routines that are likely to provide useful building blocks in solving a wide range of future problems. Here and at many other points, hierarchical reinforcement learning offers an appealing framework for investigating the computational and neural underpinnings of hierarchically structured behavior.     

Social consequences of personality disorders: probability and timing of marriage and probability of marital disruption

The associations between DSM-IV personality disorders and probability of marriage, early marriage, and marital disruption were evaluated among people that participated in the National Epidemiologic Survey on Alcohol and Related Conditions, which is a nationally representative face-to-face survey of 43,093 respondents, 18 years and older. Participants completed a structured interview for the diagnosis of seven personality disorders, and provided information about the occurrence and timing of marriage and marital disruption. Results suggest that personality disorders were associated with decreased probability of marriage, increased probability of early marriage, and increased probability of marital disruption. These findings suggest that personality disorders have substantial consequences for the probability and timing of marriage and probability of marital disruption.