Temptation and Fidelity: Research on Protecting Relationshps

New York Times
Why do some men and women cheat on their partners while others resist the temptation?

To find the answer, a growing body of research is focusing on the science of commitment. Scientists are studying everything from the biological factors that seem to influence marital stability to a person’s psychological response after flirting with a stranger.

Their findings suggest that while some people may be naturally more resistant to temptation, men and women can also train themselves to protect their relationships and raise their feelings of commitment.
Read more...

Inside the Mind of a Pedophile

By Michael Cochran & Meghan Cole, Neuroanthropology.net

Most people imagine pedophiles as ugly old men dressed in trench coats, hiding in the bushes, waiting to snatch young children off the street. However, recent television shows, such as To Catch a Predator, have exposed pedophiles as local neighbors, trusted friends, clergy, babysitters, teachers, and even family members.

Conceptions about pedophiles have been changing rapidly, and pedophilia has recently become a topic of increased awareness and concern. Not only do television shows expose pedophiles, but there are new sexual offender disclosure laws, websites that track convicted sexual offenders, and more investigations of pedophilia, especially after the sex abuse scandal in the Catholic Church. Yet children still remain vulnerable to sexual offenders regardless of their public façade.

The increasing attention on pedophilia has caused many Americans to question what this disorder entails, its characteristics, and what type of treatment should be sought for abusers. What is pedophilia? Do people choose to be pedophiles or are they born that way? This post will address these questions.

Pedophilia

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defines pedophiliaas recurrent sexually arousing fantasies, impulsive desires, or behaviors involving sexual acts with a child and that occur over a period of at least six months. In most cases, the pedophile is at least sixteen years of age and at least five years older than the child. Those who suffer from pedophilia have a compulsion to abuse young children.

Categorizing Pedophiles

Pedophiles can be classified in several ways. Pedophilia can be characterized as either exclusive or non-exclusive. Exclusive pedophiles are attracted only to children. They show no interest in sexual partners who are not prepubescent children. This desire prolongs even when they are not in the presence of children. Non-exclusive pedophiles are attracted to both adults and children. A large percentage of male pedophiles are homosexual or bisexual in orientation to children, meaning they are attracted to male children or both male and female children (Schiffer, 2008).

Many people assume that only males are pedophiles. However, case studies on pedophilia have demonstrated that female pedophilia does exist (Chow, 2002). Although this is a rare phenomenon, females who meet the DSM-IV criteria for pedophiles display similar cognitive distortions to that of males, such as irrational thoughts. Some differences, however, do exist among males and females. Females who exhibit pedophilia tend to suffer from psychiatric disorders or substance abuse problems. Also, there is a higher correlation between sexual abuses as a child with females compared to males.

What Causes Pedophilia?

The etiology of pedophilia can be attributed to both biological and environmental factors. Case studies indicate that cerebral dysfunction may be a contributing or dominant factor of pedophilia (Scott, 1984), including problems with self-control, extreme urges, and cognitive distortions. Many experts also believe that disorders for sexual preferences emerge from childhood experiences during critical periods in human development (DiChristina, 2009). In many cases, child sex abusers suffer from traumatic experiences during their childhood.

More specifically, pedophiles tend to also have been molested as children. As children, they lacked the ability to control the situation. By sexually assaulting children, pedophiles attempt to re-live the trauma they experienced and they learn how to master it. A complete role reversal gives them the upper hand and prevents them from being victimized. Overall, through the impact of cerebral dysfunction and traumatic development, the sexual urges and desires for children can become ingrained within a person’s nervous system.

Role of the Brain

There is significant evidence that indicate structural abnormalities in the brains of pedophiles (Schiffer, 2008). Abnormalities occur when the brain is developing and can be on-set through certain experiences, such as sexual abuse as a child. Abnormalities in the brains of pedophiles may result in compulsion, poor judgment, and repetitive thoughts.

These abnormalities in the brains of pedophiles are caused by early neurodevelopmental perturbations (Schiffer, 2008). The use of functional magnetic resonance imaging (fMRIs) and positron emission tomography scans (PET) has revealed that the abnormalities of pedophiles exhibit appear in the frontal and central regions of the brain. In particular, there is a decreased volume of gray brain matter in the central striatum. As a result, the nucleus accumbens, orbital frontal cortex, and the cerebellum are all affected (Schiffer, 2008).

These areas of the brain play an important role in addictive behavior. The accumbens is the central mediator of reward signaling and expectation. The striatum and orbito frontal cortex control this reward system. As a result, this contributes to the etiology of pedophilia because a reward deficiency complication disturbs the neurotransmission of dopamine involved in compulsive and addictive behaviors.

Due to the frontotemporal dysfunctions, pedophilia shares neural characteristics with psychiatric disorders that fall in the range of the obsessive-compulsive (OC) spectrum. These impulsive disorders include pathological gambling, kleptomania, and even Tourettes syndrome. While some debate this claim (Schiffer et al., 2007), there is substantial evidence for the existence of physiological and genetic overlaps. In particular, studies have shown that alterations in the frontostriatal circuitry are a major abnormality leading to obsessive-compulsive behavior. Pedophiles tend to act inappropriately and exhibit poor judgment because they lack the ability to control their impulses.

These structural alterations underlie the antisocial behaviors exhibited by someone with pedophilia. Pedophiles are burdened with repetitive thoughts and urges. Consequently, they seek to fulfill these desires through behavior that is socially unacceptable and at times, even illegal. Most pedophiles express shame and guilt after partaking in their immoral behavior because their neurological dysfunctions deal strictly with urges and not emotions (Schiffer et al., 2007).

Is There a Cure?

Pedophilia, like many types of disturbances or diseases, does not have a complete cure. The sexual urges associated with pedophilia may never permanently disappear, and a person’s sexual preference and orientation can be difficult to completely re-orient. At present, treatment primarily focuses on preventing further offenses rather than changing sexual orientation.

Yuli Grebchenko, MD, has done extensive research on pedophiles. He noted that pedophilia is a life-long disorder and stated that, “It needs lifelong treatment” (Lamberg, 2005). Recent studies have demonstrated that psychotherapy and pharmacotherapy can be combined to bring about the most effective treatment to someone suffering from pedophilia (Kersebaum, 2007).

Therapy includes discussing traumatic events, especially those from the childhood of an abuser. Therapy also seeks to help patients identify situations that may tempt them to engage in harmful behaviors toward children. During therapeutic treatment, therapists may try to correct a patient’s cognitive disorder, which may include misperceptions that the child enjoyed the abuse.

The three standard pharmacotherapy treatments for pedophilia are selective serotonin reuptake inhibitors (SSRI), luteinizing hormone-releasing hormone (LHRH), and leuprolide acetate (LA) (Briken, 2003). These pharmacotherapy treatments target certain hormones and chemicals in the body, but have varying side effects. SSRIs are effective in less severe cases and patients often experience only sexual side effects (Kraus, 2007). In more serious cases, LA can reduce testosterone to extremely low levels along with pedophilic urges. While LA treatment is somewhat dangerous, it has been found to be very effective (Schober, 2005). The newest treatment drug, LHRH, reduces neural responsiveness to visual sexual stimuli and has very little side effects (Briken, 2003).

Today’s World

Most people are in denial that pedophilia exists in their community or home. Pedophiles, however, will go to great lengths to continue their compulsive behavior. They will volunteer in church youth groups, coach youth athletic teams, and find other ways to associate with potential victims. Many times, they place themselves in positions where they can easily meet children.

The Internet has become a common hunting ground to prey on children. Today more and more kids are using Facebook accounts. While Facebook acts as a social network to help link people together, the ability to create a profile displaying one’s personal information may indirectly be helping pedophiles find their next victim. Pedophiles can then befriend children and manipulate, trap, and lure their victims into a false sense of trust. Some pedophiles may pretend they are someone else, such as a classmate. Others develop friendship with children and then arrange meeting times and places so they can act upon and fulfill their sexual desires (Deirmenjian, 2009).

The Catholic Church frowns upon certain sexual behavior. Yet, priests were recently discovered to have engaged in sexual behavior with children. A great deal of hypocrisy surrounds the sex abuse scandal in the Catholic Church. Over the course of the past two decades, the Church has struggled with confronting sex crimes committed by Catholic priests and religious orders against children. In many cases, the clergy suffered from pedophilia. These priests sexually abused minors, primarily male altar servers, and exerted power over these boys.

The children who fell victim to the clergy were easily accessible, vulnerable, and unthreatening. These priests who engaged in sexual behavior with youth should be held responsible for their actions. The Church should come forward and acknowledge this type of inappropriate behavior. They should take the proper steps to correct this type behavior and have their pedophilic priests seek treatment for their disorder.

Conclusion

Pedophilia is a complex disorder with many underlying factors. These range from dysfunctions in the development of the brain to particular traumatic experiences, such as sexual abuse or rape as a child. Despite no cure for pedophilia, measures can be taken to help people with this disorder control their urges and behavior. Society needs to be more aware of this disorder and its prevalence in everyday life. So while not all people who engage with children are pedophiles, the prominence of pedophiles across many facets of life is much greater than we think.

Works Cited

Briken, P. “Pharmacotherapy of Paraphilias with Long-Acting Agonists of Luteinizing Hormone-Releasing Hormone.” Journal of Clinical Psychiatry 64.8 (2003): 890-7.

Chow, Eva W. C. “Clinical Characteristics and Treatment Response to SSRI in a Female Pedophile.” Archives of Sexual Behavior 31.2 (2002): 211-5.

Deirmenjian, JM. “Pedophilia on the Internet.” Journal of Forensic Sciences, 47.5 (2002): 1090-1092.

DiChristina, Mariette. “Abnormal Attraction.” Scientific American Mind, 20.3 (2009): 76-81.

Kersebaum, Sabine. “Correcting Pedophilia.” Scientific American Mind 18.1 (2007): 62-.

Kraus, C. “Selective Serotonine Reuptake Inhibitors (SSRI) in the Treatment of Paraphilia – A Retrospective Study.” Fortschritte Der Neurologie Psychiatrie 75.6 (2007): 351-6.

Lamberg, Lynne. “Researchers Seek Roots of Pedophilia.” JAMA, the Journal of the American Medical Association, 294.5 (2005): 546.

Schiffer, Boris. “Reduced Neuronal Responsiveness to Visual Sexual Stimuli in a Pedophile Treated with a Long-Acting LH-RH Agonist.” 6.3 (2009): 892-4.

Schiffer, Boris. “Brain Response to Visual Sexual Stimuli in Homosexual Pedophiles.” Journal of Psychiatry and Neuroscience 33.1 (2008): 23.

Schiffer, Boris et al. “Structural Brain Abnormalities in the Frontostriatal System and Cerebellum in Pedophilia.” Journal of psychiatric research 41.9 (2007): 753-62.

Scott, Monte, James Cole, Stephen McKay, Kenneth Liggett, and Charles Golden. “Neuropsychological Performance of Sexual Assaulters and Pedophiles.” Journal of Forensic Sciences, 29.4 (1984): 1114.

Schober, Justine M. “{L}Euprolide Acetate Suppresses Pedophilic Urges and Arousability.” Archives of Sexual Behavior 34.6 (2005): 691-705. Web.

Still Upset, But Can't Remember Why? New Research Explains

From a new study by Feinstein, et al.: 

Can the experience of an emotion persist once the memory for what induced the emotion has been forgotten? We capitalized on a rare opportunity to study this question directly using a select group of patients with severe amnesia following circumscribed bilateral damage to the hippocampus. The amnesic patients underwent a sadness induction procedure (using affectively-laden film clips) to ascertain whether their experience of sadness would persist beyond their memory for the sadness-inducing films. The experiment showed that the patients continued to experience elevated levels of sadness well beyond the point in time at which they had lost factual memory for the film clips. A second experiment using a happiness induction procedure yielded similar results, suggesting that both positive and negative emotional experiences can persist independent of explicit memory for the inducing event. These findings provide direct evidence that a feeling of emotion can endure beyond the conscious recollection for the events that initially triggered the emotion.

Source: Feinstein, J. S., Duff, C. M., & Tranel, D. (2010). Sustained experience of emotion after loss of memory in patients with amnesia. Proceedings of the National Council of Sciences of the United States of America, 107(17). 7674-7679. Retrieved May 3, 2010, from http://www.pnas.org/content/107/17/7674.abstract.

Losing a Parent to Suicide Increases Child's Own Risk of Suicide

Medical News Today

Losing a parent to suicide makes children more likely to die by suicide themselves and increases their risk of developing a range of major psychiatric disorders, according to a study led by Johns Hopkins Children's Center that is believed to be the largest one to date on the subject. 

A report on the findings will appear in the May issue of theJournal of the American Academy of Child & Adolescent Psychiatry.

How and when the parent died strongly influenced their child's risk, the researchers report. And because the findings show that parental suicide affects children and teens more profoundly than young adults, it is likely that environmental and developmental factors, as well as genetic ones, are at work in next-generation risk, the scientists say.

"Losing a parent to suicide at an early age emerges as a catalyst for suicide and psychiatric disorders," says lead investigator Holly C. Wilcox, Ph.D., a psychiatric epidemiologist at Hopkins Children's. "However, it's likely that developmental, environmental and genetic factors all come together, most likely simultaneously, to increase risk."

The good news, the researchers say, is that though children in this group are at increased risk, most do not die by suicide, and non-genetic risk factors can be modified. And there may be a critical window for intervention in the aftermath of a parent's suicide during which pediatricians could carefully monitor and refer children for psychiatric evaluation and, if needed, care.

Family support is also critical, the investigators say.

"Children are surprisingly resilient," Wilcox says. "A loving, supporting environment and careful attention to any emerging psychiatric symptoms can offset even such major stressor as a parent's suicide."

In the United States, each year, between 7,000 and 12,000 children lose a parent to suicide, the researchers estimate.

The current study looked at the entire Swedish population over 30 years, making it the largest one to date to analyze the effects of untimely and/or sudden parental death on childhood development.

U.S. and Swedish investigators compared suicides, psychiatric hospitalizations and violent crime convictions over 30 years in more than 500,000 Swedish children, teens and young adults (under the age of 25) who lost a parent to suicide, illness or an accident, on one hand, and in nearly four million children, teens and young adults with living parents, on the other.

Those who lost a parent to suicide as children or teens were three times more likely to commit suicide than children and teenagers with living parents. However there was no difference in suicide risk when the researchers compared those 18 years and older. Young adults who lost a parent to suicide did not have a higher risk when compared to those with living parents. Children under the age of 13 whose parent died suddenly in an accident were twice as likely to die by suicide as those whose parents were alive but the difference disappeared in the older groups. Children under 13 who lost a parent to illness did not have an increased risk for suicide when compared to same-age children with living parents.

In addition, those who lost parents to suicide were nearly twice as likely to be hospitalized for  depression as those with living parents. And those who lost parents to accidents or illness had 30 and 40 percent higher risk, respectively, for hospitalization.

Losing a parent, regardless of cause, increased a child's risk of committing a violent crime, the researchers found.

The researchers did not count suspected suicides, nor did they include children with psychiatric or developmental disorders who were treated before the parent's death or as outpatients, meaning the effects of parental suicide may be even more profound than the study suggests.

Co-investigators on the study included S. Janet Kuramoto, M.H.S., of Hopkins; Paul Lichtenstein, Ph.D., Niklas Långström, M.D. Ph.D., and Bo Runeson, M.D. Ph.D, of the Karolinska Institutet in Sweden; and David Brent, M.D., of the University of Pittsburgh.

The research was funded by the National Alliance for Research on Schizophrenia and Depression (NARSAD), by the National Institute on Drug Abuse and by the Swedish Research Council. 

Hospitalization Helps Borderline Symptoms

Long-term symptom remission is common among patients after they've been hospitalized because of borderline personality disorder, says a new study.

The disorder is characterized by chronic unhappiness, frequent changes in mood, irrational thoughts, impulsivity and unstable interpersonal relationships.

The study included 290 patients who were evaluated every two years after their release from the hospital. After 10 years of follow-up, 86 percent of the patients had sustained remission of symptoms.

While achieving concurrent symptom remission and good psychosocial functioning seems difficult for many borderline personality disorder patients, this recovery is relatively stable once it's attained, said Mary Zanarini and colleagues at McLean Hospital in Massachusetts.

The researchers suggested that treatment for borderline personality disorder should include a rehabilitative component that focuses on social and work skills.

"Improving interpersonal relationships and job performance is a large part of the goal for many patients and their families. A rehabilitation approach might also have the practical effect of reducing the percentage of patients who receive Social Security disability benefits, and, equally important, it could help alleviate some of their feelings of low self-worth," Zanarini stated in a news release from the American Psychiatric Association.

The study was published online April 15 in the American Journal of Psychiatry.

Source: Robert Preidt, MedicineNet

Bullying Bystanders Suffer More Than Victims

Peter Brown
Students who witness bullying of their peers may suffer more psychologically than the victim or the bullies.

Read The Original Research Paper (PDF)

2002 students ages 12 to 16 were surveyed at public schools in England. The survey asked them whether they’d committed, witnessed, or been the victim of several types of bullying behavior (e.g., kicking, name-calling, threatening, etc.) and whether they had experienced psychological stress symptoms such as anxiety, depression, or hostility.

Why bystanders suffer more than victims of bullying

As reported in the article, previous research shows that children who witness bullying feel guilty, presumably for not doing anything to help the victim.

In addition, they may have felt more stressed by vacillating between doing what they thought they should do (i.e., help the victim) on the one hand, and being afraid of being victimized themselves, on the other.  Being in this type of “approach/avoidance” conflict has been shown in numerous studies to create high levels of stress.

The combination of guilt and fear among witnesses that they will experience the same thing may be another reason why they are more affected by bullying than the actual victims.
Uncertainty, especially combined with feelings of fear or guilt, contributes to stress. Stress leads to depression, anxiety, and other mental disorders.

Sitting down and discussing feelings of fear and guilt with your child may help to minimize the destructive force and ultimate impact of those emotions on mental health.  Practical“survival” tips about how to avoid, distract, or other means of handling bullies would help, too, giving kids options if they are cornered by or are a witness to bullies in action.
Read The Original Research Paper (PDF)

Source: Psychological Association (2009, December 15). Witnesses to bullying may face more mental health risks than bullies and victims. ScienceDaily

Bullying and Depression Linked Even for the Bullly

AP
The word "bully" may conjure up images of a 9-year-old punk shaking down a 7-year-old for lunch money. But teenagers experience bullying, too, and research shows it can be a red flag for depression and suicidal behavior.

That is true whether teens are doing the bullying or are its victims.

"If you are vulnerable and being bullied, it can be the straw that breaks the camel's back," said Madelyn S. Gold, a professor of psychiatry and public health at Columbia University and the New York State Psychiatric Institute who has studied bullying. Read more...

Resetting Your Sleep Clock with Chronotherapy

New York Times. 
People sleep best when the internal clock is in sync with the workday rest/activity cycle. When there is a mismatch, the likely results are insomnia, depressed mood and daytime fatigue.

An unbalanced circadian rhythm can be returned to equilibrium through the application of light to a sleeper’s retina near the end of a person’s “internal night.” Internal night? Yes — it may be night outside, but if your circadian clock is not prepared for sleep, internal night may not start until late and last well into morning. Biologically, it coincides with the secretion of melatonin by the brain’s pineal gland. It is difficult to know where your internal night lies if you artificially force sleep earlier, for example with sleeping pills. You can estimate internal night with a quick chronotype questionnaire that helps determine when light exposure will be most effective for syncing your circadian rhythm with external reality.

In American psychiatry, chronotherapeutics is a new kid on the block, viewed by some as a counter-intuitive departure from conventional medication. By contrast, in Europe, where it is already well established, it is seen as compatible with medication and a means for expediting improvement with fewer residual symptoms. Residual symptoms are harbingers of relapse. To protect our patients, we should be pulling out all the stops.

Hallucinogens for Depression Work Like Magic

(New York Times) “All of a sudden, everything familiar started evaporating. Imagine you fall off a boat out in the open ocean, and you turn around, and the boat is gone. And then the water’s gone. And then you’re gone.” 


That's how Clark Martin, a clinical psychologist himself, with lifelong, seemingly intractable depression described the experience of taking psilocybin, the psychoactive ingredient better known as the "magic" in magic mushrooms, as research subject in a study at Johns Hopkins. 


To  those familiar with mindfulness, a practice imported from Eastern meditation to Western psychology with great, empirically documented success, this could be described as mindfulness squared. Or more like mindfulness cubed. Where mindfulness involves slowly training patients to learn to fully experience their present with full acceptance,  


“Under the influences of hallucinogens,” writes a UCLA researcher working on psilocybin experiments, “individuals transcend their primary identification with their bodies and experience ego-free states before the time of their actual physical demise, and return with a new perspective and profound acceptance of the life constant: change.”


As Dr. Martin describes, "It was a whole personality shift for me. I wasn’t any longer attached to my performance and trying to control things. I could see that the really good things in life will happen if you just show up and share your natural enthusiasms with people. You have a feeling of attunement with other people.”

1UP, indeed!

Being Mindful of the Brain

The brain is a monstrous, beautiful mess. Its billions of nerve cells - called neurons - lie in a tangled web that displays cognitive powers far exceeding any of the silicon machines we have built to mimic it. -William F. Allman, Apprentices of Wonder. Inside the Neural Network Revolution

Shaped a little like a loaf of French country bread, our brain is a crowded chemistry lab, bustling with nonstop neural conversations.
Imagine the brain, that shiny mound of being, that mouse-gray parliament of cells, that dream factory, that petit tyrant inside a ball of bone, that huddle of neurons calling all the plays, that little everywhere, that fickle pleasuredome, that wrinkled wardrobe of selves stuffed into the skull like too many clothes into a gym bag. -Diane Ackerman, An Alchemy of Mind: The Marvel and Mystery of the Brain

A NUMBER OF YEARS AGO I had the interesting experience of teaching a class on Shaar HaBechina (Gate of Investigation) of the Chovos HaLevavos (Duties of the Heart) while taking a course in neuroanatomy. That section of the famous mussar, or ethical, work deals with a person's imperative of recognizing and examining the wonders of the world around him or her in order to build faith in and appreciation for G-d.


I had always been a sucker for a beautiful sunset or an awesome mountain view, but hard science had always seemed to me kind of dry. This time, though, I was amazed. Here was, essentially, a little mound of goo with chemicals and electricity running through it, but with such intricacy and efficiency that it was basically running the show. (Obviously, I speak of the physical components of the human being that by G-d's design are the only aspects of our existence that are subject to scientific inquiry.) The deeper I looked, the more astounded I became. For even the smallest function to work as it should, countless other processes have to work in total concert with it. Together, these purely physical networks are capable of processing sensation, imagining, thinking, stimulating emotion, and even (within limits) understanding the Divine. At one point that semester, I even pounced upon a poor neurosurgeon that I met at a Shabbos meal and pumped him with eager questions for over an hour, in an effort to grab a little of the wonder that he, no doubt encountered in his work. 


WHY THE AUTOBIOGRAPHICAL CHATTER, you ask? Because today marks the start of Brain Awareness Week, a project of the Dana Foundation, a brain research organization, and the Society for Neuroscience to raise awareness of advances in brain research. Not a bad excuse for engaging in a bit of "mib'sari echezeh E-lokah," "from my own flesh I will witness the Divine." To that end, I will be posting over the course of this week some links that make the workings and development of the brain come alive in an accessible and interesting way.


To start, I offer this 3D tour of the brain from the companion site for PBS's The Secret Life of the Brain series (requires Adobe Shockwave plugin).
Also check out their episode pages, such as this one, which shows you life from the perspective of a baby's brain. 
 

Reducing Parental Depression's Impact on Children

Parental depression increases children's risk for emotional, social, and cognitive difficulties. But, as the L.A. Times reports, new research indicates that parents can significantly reduce those effects by providing children with plenty of attention, helping children develop positive coping skills and a sense of self-efficacy, and teaching them not to blame themselves for the parents' depression.