The Experts below are selected from a list of 126 Experts worldwide ranked by ideXlab platform
L Polissar - One of the best experts on this subject based on the ideXlab platform.
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six and twelve month abstinence rates in inpatient alcoholics treated with Aversion Therapy compared with matched inpatients from a treatment registry
Alcoholism: Clinical and Experimental Research, 1991Co-Authors: J W Smith, P J Frawley, L PolissarAbstract:Two hundred forty-nine patients who were treated for alcoholism in an inpatient multimodal treatment program that included Aversion Therapy were matched post hoc on 17 baseline variables with patients from a national treatment outcome registry. The latter patients received inpatient treatment that emphasized individual and group counseling as the primary therapeutic elements but did not include Aversion Therapy for alcohol. Six- and 12-month abstinence rates from alcohol and all mood-altering chemicals are reported. The patients treated with Aversion Therapy for alcohol had higher alcohol abstinence rates at 6 and 12 months (p less than 0.01). The abstinence rates from all mood-altering chemicals were higher in the Aversion group at 6 months (p less than 0.05) but not at 12 months. The largest differences between treatment groups in 6-month alcohol abstinence rates were noted for males (p less than 0.001), those over 35 (p less than 0.001), daily drinkers (p less than 0.001), and those with alcohol-related work performance problems (p less than 0.05).
Donna J Drucker - One of the best experts on this subject based on the ideXlab platform.
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the penile strain gauge and Aversion Therapy measuring and fixing the sexual body
2014Co-Authors: Donna J DruckerAbstract:The early Cold War had far-reaching effects into the gendered and sexual aspects of adult life. Those effects are clearly evident in the United States and United Kingdom, in which physicians and their assistants used technology to practice Aversion Therapy on male patients who were sexually “deviant,” including homosexuals, cross-dressers, fetishists, sadists, and masochists. They designed a form of Aversion Therapy using an electroshock machine together with a penile strain gauge in order to shock those men into heterosexually normative sexual desires and behaviors. The treatment did not work, and physicians abandoned it in the light of the rise of gay rights and amid civil rights movements and professional reinterpretations of homosexuality in the late 1960s and early 1970s. This chapter first describes the setup of early voluntary sex research laboratories, which provided a framework for the setup of laboratories using involuntary subjects. It then details the theoretical framework, based on Martha Nussbaum’s conception of objectification and Michel Foucault’s ideas on the functions of institutions in policing people’s bodies and minds. It describes how Aversion Therapy (originally using drugs) and the use of electricity on human and animal bodies came together in the mid-1960s in the form of electroshock Aversion Therapy. That description includes primary-source interviews with patients, doctors, and nurses, all of whom had varying responses to the use of such Therapy. The chapter concludes with an explanation of how electroshock Aversion Therapy largely ended by the mid-1970s and how some doctors, nurses, and patients resisted it.
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erratum to the penile strain gauge and Aversion Therapy measuring and fixing the sexual body
2014Co-Authors: Donna J DruckerAbstract:In printed version, the citation ‘‘(Smith et al. 2004, p. 428)’’ cited in Chapter 2 was wrong. The correct citation is ‘‘(Dickinson 2012, p. 1349)’’ and the respective reference in list is to be read as Dickinson, T. Cook, M., Playle, J. & Hallett, C. (2012) ‘‘Queer’’ Treatments: giving a voice to former patients who received treatments for their ‘‘sexual deviations’’. Journal of Clinical Nursing, 21 (9), 1345–54.
Valentina Parma - One of the best experts on this subject based on the ideXlab platform.
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commentary olfactory aversive conditioning during sleep reduces cigarette smoking behavior
Frontiers in Psychology, 2015Co-Authors: Nicola Cellini, Valentina ParmaAbstract:For more than half of a century, we have known that the sleeping brain is able to perceive sensory information; however, learning new associations during sleep was deemed mythical. Indeed, experiments suggested that participants could not recall material presented during EEG-monitored sleep (Simon and Emmons, 1956). Recently, Arzi et al. (2012) made an exciting discovery, which suggested a revision of the myth. They demonstrated that humans can indeed learn new associations while they are asleep and act on this knowledge both during sleep and the ensuing wake period. Arzi et al. (2012) paired non-awakening pleasant and unpleasant odors with sounds during sleep. When the association was acquired, they measured sniff responses to the sounds only. As expected, inhalations to the tones matched with pleasant odors were stronger than those paired with malodors, demonstrating that healthy young adults can acquire novel associations while sleeping and maintain them during wake. Recently, the same group built on this groundbreaking discovery by addressing a serious health concern, namely smoking cessation. Capitalizing again on the valence-dependence of the sniff response, they paired cigarette odor with aversive smells during sleep in a group of nicotine-addicts who subsequently significantly reduced the number of cigarettes smoked in the week following exposure (Arzi et al., 2014). In these studies, Arzi et al. (2012, 2014) took advantage of the distinctive, yet complementary, features of sleep and olfaction. Compelling evidence indicates that sleep may be optimized for the cortical reorganization that mediates memory consolidation (Rasch and Born, 2013), in part because of the reduced sensory input during this brain state. As sleep deepens, thalamo-cortical neurons show increased hyperpolarization that limits sensory inputs to the cortex (Steriade, 2003). However, odors might be exceptional stimuli for two reasons: first, the lack of a necessary thalamic relay offers odors privileged cortical access; and second, during slow wave sleep, functional connectivity between olfactory, limbic, and neocortical areas is enhanced (Barnes and Wilson, 2014). With this in mind, Arzi et al. (2014) transformed odors into Trojan horses, sneaking into the sleeping brain and creating associations between cigarettes and noxious smells. As a result, the idea of smoking during wake becomes, with no voluntary effort, as unsavory as it was during encoding while asleep. Although fears outside of the full awareness domain are known for being quickly acquired and swiftly forgotten (Lovibond and Shanks, 2002), the behavioral changes resulting from this sleep learning study lasted at least a week. Importantly, this surprising, long-term, positive health outcome was achieved with only one odor-induced sleep learning session and without mustering willpower or emotional resources. Tapping into non-voluntary learning processes for clinical purposes gains further plausibility considering the independent findings by Hauner et al. (2013). In this case, the authors presented during wake a visual aversive conditioning in the presence of an olfactory context. Odors previously matched with a threatening stimulus, such as an irritating electrical shock, and then presented alone during slow wave sleep, facilitate human psychophysiological and neurophysiological processes underpinning fear extinction. Very recently, this form of inhibitory learning has also been extended to auditory triggers (He et al., 2015). Thus, re-presenting learned odors while asleep is enough to recall related emotional material and may unconsciously modify the old association with the new (non-traumatic) experience during sleep. In humans, the beneficial effects of acquiring (Arzi et al., 2014) or just re-targeting emotional memories during sleep (Hauner et al., 2013; He et al., 2015) could address, in an evidence-based manner, disorders such as alcoholism, multiple chemical sensitivity, specific phobias, washing and cleaning compulsions, trauma-related, and eating disorders, for which many treatments entail highly distressing side effects. For instance, considering that conditioned Aversion Therapy for alcoholism has shown mixed results (O'tousa and Grahame, 2014), we hypothesize that the same treatment during sleep might produce more convincing outcomes toward the maintenance of sobriety. Along the same lines, intense fear reactions, such as those experienced by patients with phobias or post-traumatic stress disorder (PTSD), often prevent clinicians from using exposure Therapy tools or significantly reduce compliance and/or increase the time at which clinical improvement is achieved. Exposing patients during sleep would maintain the “exposure” component of the treatment—critical in securing improvement—and it would reduce collateral overt emotional burden, for both patient and therapist. Such tempting speculations underscore the need for more robust empirical evidence and demand that many important basic questions regarding mechanisms are addressed before clinical implementation. For example, potential unpredicted side effects of such a treatment are not known. Indeed, the re-targeting process of fear memories provide opposite outcomes across species. In humans, cueing memories during SWS (Hauner et al., 2013; He et al., 2015) extinguish fear responses, whereas in rodents fear memories are enhanced (Rolls et al., 2013; Barnes and Wilson, 2014). As argued by Diekelmann and Born (2015), although it is more likely that these differential effects depend on the methodological differences of this set of studies rather than on species-specific mechanisms, further research is warranted in order to clarify this issue. It is also unknown whether aversive conditioning during sleep specifically modifies the hypothesized behavior(s) alone (e.g., smoking) or some downstream effects on ancillary undesired outcomes (e.g., increased food cravings). Furthermore, would the minimal awareness of olfactory experiences and the lack of clear olfactory counterparts for many mental representations (Stevenson, 2009) represent stumbling blocks for the translation beyond the laboratory? Also, the temporal dimension of the outcomes needs to be defined. Evidence from aversive olfactory learning during wake suggests that perceptual salience effects following one-time exposure are present a week following conditioning, but disappear 8 weeks later, therefore suggesting that this type of learning has specific time constraints (Ahs et al., 2013). As a consequence, longitudinal studies following up volunteers for more than a week post-sleep learning (ideally 6–12 months for clinical purposes) are warranted to assess the trajectories over time of both the learned association and the behavioral outcomes. Another critical issue entails whether it is necessary and sufficient that volunteers express a desire for change in their behavior for sleep learning to occur. Indeed, all participants in Arzi et al. (2014) study, who demonstrated a reduction in number of smoked cigarettes following sleep learning, had expressed their willingness to quit smoking. Since motivational factors seem to enable sleep-related memory consolidation (Rasch and Born, 2013), the outcome for populations whose volition is either not strongly exercised (e.g., young children, dementia patients) or needs to be challenged (e.g., PTSD patients) cannot be predicted at present. Finally, even if the current and hypothesized research and clinical procedures cannot be compared to Watson fear conditioning of the helpless Little Albert (Watson and Rayner, 1920), ethical considerations of learning in states of unconsciousness should be carefully considered. In summary, the study by Arzi et al. (2014) demonstrated that relatively durable, positive health outcomes can be achieved via odor-based associative learning during sleep without any conscious effort by the participants. Their results hold far-reaching implications not only for future neuroscientific investigations within the fields of sleep, olfaction, emotion, and memory, but also for the clinical domain. We hope that these promising data will inspire researchers to elaborate on the possibilities of this implicit learning mechanism, bearing in mind the unresolved ethical and methodological issues.
Davison, Katherine Maeve - One of the best experts on this subject based on the ideXlab platform.
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Sex, Psychiatry and the Cold War: A Transnational History of Homosexual Aversion Therapy, 1948-1981
2020Co-Authors: Davison, Katherine MaeveAbstract:© 2020 Katherine Maeve DavisonAversion Therapy was a method of ‘treatment’ for sexual ‘deviation’ adopted by some psychiatrists and psychologists in the decades following the Second World War. There were several variations of the procedure, but most involved subjecting a patient to nausea or electric shocks while showing them erotically stimulating images in order to de- and re-condition their sexual behaviours. Aversion Therapy enjoyed two short but intense waves of clinical experimentation, first in Czechoslovakia (1950-1962), and then in the British world, including Australia (1962-1975). The Sydney psychiatrist Dr Neil McConaghy, a self-declared ‘Marxist’ and himself bisexual, was directly inspired by the Czechoslovakian experiment led by Dr Kurt Freund and promoted the practice in Australia. McConaghy, Freund and some other practitioners of Aversion Therapy believed themselves to be sympathetic to sexual minorities, rejected the idea that sexual orientation could be changed and supported decriminalisation. How was this possible? The explanation is to be found in the specific context of its emergence: the geopolitical polarisation of the Cold War and a parallel theoretical polarisation within psychological medicine. A behaviourist paradigm based on the ideas of Russian physiologist Ivan Pavlov gained popularity in contradistinction to Freudian psychoanalytic theories favoured in the United States, and from 1949 was the unofficial doctrine of the Eastern Bloc. As homosexuality became a crucial area for expert research by intelligence and security organisations, technologies of detection and diagnosis turned to behaviourism through emotional observation, visual surveillance, psychometric testing and physiological measurement. In a therapeutic context, the Pavlovian framework was taken up in Western countries by practitioners who sought a more empirical and scientific – and therefore ‘humane’ – approach to clinical practice. Patients, however, did not view the procedure as ‘humane’. Nor did activists in the new social movements for gay and women’s liberation and in 1972 in Australia Neil McConaghy became their number one target. This thesis draws on intelligence documents, medical and psychiatric literature, gay print and radio media, oral history interviews, and a newly discovered archival collection: Neil McConaghy’s personal papers. My research charts shifting understandings of sexual orientation from endocrinological and psychoanalytic theories that were dominant in the first half of the twentieth century, to more emotional and behavioural theories in the post-war period. This shift was accompanied by the development of new technologies of detection and treatment which tied in with post-war modernity’s promotion of scientific and materially efficient machines and methods. My contention is that the influence of Pavlovian ideas in post-war therapeutic approaches to homosexuality can only be understood as part of the transnational Cold War circulation of sexological knowledge. By focusing on the movement of this knowledge from East to West, I hope to contribute to the project of ‘decentering Western sexualities’ (Mizlielinska & Kulpa, 2011) and to emerging scholarship charting the global histories of sexology
Katherine Maeve Davison - One of the best experts on this subject based on the ideXlab platform.
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sex psychiatry and the cold war a transnational history of homosexual Aversion Therapy 1948 1981
2020Co-Authors: Katherine Maeve DavisonAbstract:Aversion Therapy was a method of ‘treatment’ for sexual ‘deviation’ adopted by some psychiatrists and psychologists in the decades following the Second World War. There were several variations of the procedure, but most involved subjecting a patient to nausea or electric shocks while showing them erotically stimulating images in order to de- and re-condition their sexual behaviours. Aversion Therapy enjoyed two short but intense waves of clinical experimentation, first in Czechoslovakia (1950-1962), and then in the British world, including Australia (1962-1975). The Sydney psychiatrist Dr Neil McConaghy, a self-declared ‘Marxist’ and himself bisexual, was directly inspired by the Czechoslovakian experiment led by Dr Kurt Freund and promoted the practice in Australia. McConaghy, Freund and some other practitioners of Aversion Therapy believed themselves to be sympathetic to sexual minorities, rejected the idea that sexual orientation could be changed and supported decriminalisation. How was this possible? The explanation is to be found in the specific context of its emergence: the geopolitical polarisation of the Cold War and a parallel theoretical polarisation within psychological medicine. A behaviourist paradigm based on the ideas of Russian physiologist Ivan Pavlov gained popularity in contradistinction to Freudian psychoanalytic theories favoured in the United States, and from 1949 was the unofficial doctrine of the Eastern Bloc. As homosexuality became a crucial area for expert research by intelligence and security organisations, technologies of detection and diagnosis turned to behaviourism through emotional observation, visual surveillance, psychometric testing and physiological measurement. In a therapeutic context, the Pavlovian framework was taken up in Western countries by practitioners who sought a more empirical and scientific – and therefore ‘humane’ – approach to clinical practice. Patients, however, did not view the procedure as ‘humane’. Nor did activists in the new social movements for gay and women’s liberation and in 1972 in Australia Neil McConaghy became their number one target. This thesis draws on intelligence documents, medical and psychiatric literature, gay print and radio media, oral history interviews, and a newly discovered archival collection: Neil McConaghy’s personal papers. My research charts shifting understandings of sexual orientation from endocrinological and psychoanalytic theories that were dominant in the first half of the twentieth century, to more emotional and behavioural theories in the post-war period. This shift was accompanied by the development of new technologies of detection and treatment which tied in with post-war modernity’s promotion of scientific and materially efficient machines and methods. My contention is that the influence of Pavlovian ideas in post-war therapeutic approaches to homosexuality can only be understood as part of the transnational Cold War circulation of sexological knowledge. By focusing on the movement of this knowledge from East to West, I hope to contribute to the project of ‘decentering Western sexualities’ (Mizlielinska & Kulpa, 2011) and to emerging scholarship charting the global histories of sexology.
