Volume 1, April 2012

ISSN 1927-2820 (Print) ISSN 1927-2839 (Online)

UndergraduateUniversity of Journal British Columbia’s of Psychology

Editor-in-Chief: David W. –L. Wu http://ubcujp.psych.ubc.ca

UBC’s Undergraduate Journal of Psychology University of British VolumeColumbia’s 1 Undergraduate April 2012 Journal of Psychology Volume 1 April 2012

Editor-in-Chief David W. –L. Wu Contents Editorial Board Jenn Ferris, Section Editor: Behavioural Neuroscience Editor’s Note 1 Kaitlyn M. Goldsmith, Section Editor: Clinical David W. –L. Wu Amara Sarwal, Section Editor: Cognitive Virginie Cousineau, Section Editor: Developmental Metaplasticity: A new frontier in the neural representation of memory 3 Ashley Whillans, Section Editor: Social, Personality, & Health Dano Morrison

Jade McGregor, Associate Editor: Social, Personality, & Health Psychology: A closer look at what psychologists bring to the table 15

Elizabeth Laliberte Reviewers Sophia Bobovski Bri Glazier Craniopagus: Overview and the implications of sharing a brain 21 Carly Thornton Carol Chu Jordan Squair Kurtis Stewart Adam Baimel Christina van den Brink Sepehr Nassiri Pedophilia and brain function 29 Diana Choi Taylor Davis Po Liu Katharina Block Tess Walker Thariq Badiudeen Robyn Jackowich Too much sex, a mental disorder? Examining both sides of the debate on Savannah Nijeboer Zarina Giannone hypersexual disorder 35 Xaiolei Deng Patrick Dubois Xijuan Zhang

Setareh Shayanfar Tai Khuong Startle reflex as a physiological measure of emotion regulation 45 Agnes Cywinska Yang Fei (also Statistics Consultant) Brittany C. Speed

Graduate Student Advisors The negative effect of doodling on visual recall performance 59 Patrick Piantadosi, Behavioural Neuroscience Elaine Chan Sam Rumak, Clinical Nicola C. Anderson, Cognitive Did he really earn it? An of anabolic-androgenic steroid use in sports 65 Alessandra DiGiacomo, Cognitive Dexter McMillan Loni Slade, Health Exploring religiosity’s effects on altruistic behaviour 73 Alyssa Croft, Social & Personality Lu Zhao

Faculty Advisors Communal male role models: How they influence identification with domestic Michael Souza roles and anticipation of future involvement with the family 87 Sunaina Assanand Katharina Block, 2011 Belkin Award Winning Paper

Marketing and Promotions Brendan Ghag

University of British Columbia’s Undergraduate Journal of Psychology (UBCUJP) is an annual, student-run, peer-reviewed journal. Our goal is to provide a platform for psychology undergraduates at UBC to showcase their Editor’s Note research. We believe undergraduate research papers provide a fantastic opportunity for undergraduates to experience David W.-L. Wu the peer-review process while also being a valuable resource for faculty and students to learn about the research happening next door.

Our focus is three-fold: I am honoured to present the very first volume of University of British Columbia’s Undergraduate Journal of Psychology (UBCUJP). This inaugural issue contains a year’s worth of 1) To undergraduate authors we offer a valuable and rare experience into the peer-review and publication process. dedicated work from undergraduates, graduate students, and faculty alike. It was a true delight being able to watch this journal transform from conception to reality. 2) To our editorial board and reviewers, we offer the opportunity to develop reviewing, critical thinking and managerial skills that are essential for success in graduate studies and future careers. Being involved with UBCUJP is also a great opportunity to network with faculty, graduate students and other motivated undergraduates. The response and support from students and faculty exceeded my wildest expectations. In truth, we were underprepared for the sheer amount of quality submissions we received, and 3) To graduate students and faculty, we offer the chance to engage and mentor undergraduate students. luckily the response from students wanting to help review papers was just as great. Rivalling the quality of submissions we received was the quality of reviews from our volunteer reviewers. We hope the journal itself will offer a unique peek into various developing projects around the research labs of It was astonishing to witness the transformation of each initial manuscript to the final published UBC’s psychology department. material. I want to thank all the reviewers and also the authors who chose to submit with us UBCUJP (Print ISSN: 1927-2820, Online ISSN: 1927-2839) is generously supported by the Department of for making this journal such an immense success. I also want to thank the graduate student and Psychology at the University of British Columbia, 2136 West Mall, Vancouver, B.C., Canada, V6T 1Z4, telephone: faculty advisors for taking time out of their busy schedules to be involved. 604-822-2755, fax: 604-822-6923. To my editorial team, you truly are the heart of the journal and without your hard-work UBCUJP Being an open source journal, UBCUJP applies the Creative Commons Attribution-NonCommercial-NoDerivs License to both online and in print publications. would be non-existent. A special thank-you to the people who believed in this project from the very beginning: Alan Kingstone, Ashley Whillans, and Michael Souza. With your continued Electronic Access: Visit ubcujp.psych.ubc.ca to find the online version of our journal. support, I know this journal can reach the vast potential it has. In the coming years, I hope to see UBCUJP’s reach expand to psychology undergraduates from other universities in the region. Disclaimer: The views expressed by contributing authors in this journal do not necessarily reflect those of UBCUJP or the Department of Psychology at UBC. UBCUJP cannot be held responsible for errors in, or misuse of, In this issue, we review topics ranging from metaplasticity, to whether hypersexuality disorder information contained in this journal. belongs in the new DSM-5. We also look at a diverse range of studies ranging from examining Contact: [email protected] the cognitive effects of doodling, to how religiosity influences altruism. We are also very pleased to publish the paper which received the 2011 Belkin Award for the best undergraduate psychology paper. I hope this inaugural volume of UBCUJP gives you, the reader, a glimpse of the immense degree of scholarship and psychological research from UBC undergraduates.

David W.-L. Wu Editor-in-Chief, UBCUJP

UBCUJP – April 2012 – Volume 1 1 BNS Literature Review Metaplasticity: A new frontier in the

neural representation of memory Dano Morrison1 1 Department of Psychology, University of British Columbia

Edited by: Jenn Ferris, Department of Psychology, University of British Columbia. Received for review January 10, 2012, and accepted March 2, 2012. Copyright: © 2012 Morrison. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivates License, which permits anyone to download and share the article, provided the original author(s) are cited and the works are not used for commercial purposes or altered in any way.

Abstract Synaptic plasticity, the modification of the strength of connections between neurons, is widely accepted to be essential for information storage in the brain and is thought to form the basis of learning and memory. However, in order for the richness of learning and memory to emerge from the long-term potentiation and depression of synapses, regulatory mechanisms must exist. Metaplasticity, the phenomenon of previous synaptic activity modulating the future synaptic plasticity of a neuron, might answer questions about how synaptic plasticity is regulated in order to create meaningful, coordinated changes in neural activity. There are many different proposed contributors to metaplasticity, including the NMDA and AMPA receptors, epigenetics, and neurotrophins. Although the way in which all these factors interact remains enigmatic, metaplasticity appears to play a role in learning, possibly by serving to control neuronal 'learning modes.'

Keywords: metaplasticity, plasticity, memory, learning, long-term potentiation

The seemingly simple question, “how is ability of neural connections to change by information stored in the nervous system?” strengthening or weakening, is revolutionary has proven difficult to answer in the nearly in its potential to provide a physiological five decades in which the biological basis of explanation for learning, but its mechanisms memory has been studied. Behavioural have yet to be fully understood. How the observation of learning and memory has complexity of learning and memory can arise been successful in characterizing many of from such simple changes is one the most the functional aspects of memory; short- fascinating questions in neuroscience. term memory, long-term memory, and For the purposes of this review, conditioning have all been well studied. synaptic plasticity is defined as long-term However, due to technological constraints potentiation (LTP) and the complementary and the complexity of neural systems, process of long-term depression (LTD) of knowledge of the neurobiological connections between neurons. First underpinnings behind learning and memory discovered in rat hippocampal experiments is severely lacking. Synaptic plasticity, the in 1964, LTP is the process by which high

Corresponding Author: Dano Morrison E-mail: [email protected]

BNS BNS METAPLASTICITY Literature Review Morrison Literature Review

frequency electrical stimulus delivered to a which high or low frequency stimulation vary in strength depending on a number of primarily occurs through the rapid flow of bundle of axons results in increased affects the extent with which a neuron will factors, such as the number and sensitivity ions through ion-permeable, ionotropic sensitivity or 'potentiation' of those neurons undergo LTP or LTD in the future. Between of postsynaptic neurotransmitter receptors. receptors. At glutamine-based synapses in to stimulation. Between two synapsed cells, two synapsed neurons, this could manifest These PSPs then travel to the cell body and, the hippocampus, which are known to be this means that if one neuron repeatedly as a greater frequency of stimulation much like how smaller waves in the ocean critical in learning and memory, there are stimulates another, the first neuron can required to induce LTP in a neuron that has combine to form larger waves, summate two important types of ionotropic receptors: more easily excite the second neuron. This already been potentiated. The specific into large membrane potentials which push NMDA (N-methyl-D-aspartate) and AMPA results in the strengthening of synaptic mechanisms and functions of metaplasticity the total membrane depolarization towards (α-amino-3-hydroxy-5-methyl-4- transmission between these two remain unclear, but it appears to be critical or away from the threshold at which an AP is isoxazolepropionic acid). These receptors, communicating neurons. Because this in maintaining synaptic memory traces and created (Pinel, 2007). With hundreds of though both responsive to glutamine, have potentiation was observed to last for days keeping synaptic plasticity occurring within a these incoming signals converging with several important functional differences. (up to an entire year in one study), it was tight, dynamic range. If synaptic plasticity is different strengths and frequencies, there AMPA receptors (AMPARs), will always allow believed to be the primary process through the neural representation of firing history, exists a staggering amount of computational ion flow and cause local PSPS when which memory traces were encoded in then metaplasticity is the neural history of power within each neuron. glutamate binds to them, while NMDA neural structures (Abraham, 2002). This that plasticity. Synaptic plasticity is simply the process receptors (NMDARs) possess a voltage- effect, which was first discovered by Bliss by which the sensitivity of these synaptic dependent magnesium gate and will only and Lomo in 1964, caused great excitement Synaptic Plasticity: Potentiation and connections alters according to their level of open when binding is coupled with a because it supported an important idea that Depression activity. “Those that fire together, wire significant amount of postsynaptic had been circulating—that persistent Neurons can form thousands of connections together” is a common expression depolarization (Pinel, 2007). The interplay of changes in the strength of connections with neighbouring cells between specialized describing this process in which the synapses these two of receptors is crucial for many between neurons form the basis of learning cell junctions called synapses. Neurons between neurons that often fire together neuronal functions, including synaptic and memory. transmit information through action- are strengthened, such that it becomes plasticity LTD is the reverse of LTP; wherein potentials (APs), large waves of electrical easier for the presynaptic neuron to activate During high-frequency stimulation, synapses are depressed and exhibit reduced activity that travel down the neuron's axon the postsynaptic neuron. This is glutamate binding to AMPA receptors causes sensitivity following long-term, low- and stimulate the awaiting dendrites of that accomplished by a change in synaptic a large number of ions to enter the frequency stimulation. Less extensively neuron's synaptic partners. Importantly, efficacy, defined as the amplitude of the PSP postsynaptic neuron, which initiates PSPs studied, LTD is believed to be critical in the action potentials are all-or-none responses; generated upon activation by presynaptic and opens NMDAR channels by depolarizing ability of neural systems to refine their once the threshold level of stimulation of firing. LTP strengthens PSPs and LTD the postsynaptic environment. With their circuits for efficiency. the neuron is reached, the action potential weakens them. In this way, the brain is able channels open, NMDARs are free to allow Although the brain's ability to learn, will fire with the exact same intensity, to adapt to organize its firing and adapt to the influx of calcium ions into the synapse. remember, and adapt to stimuli cannot be regardless of the magnification of the new patterns of stimulation. Calcium (Ca2+) influx leads to the explained entirely in terms of synaptic triggering stimuli. This means that the How does LTP occur? When researchers phosphorylation of regulatory protein plasticity, most memory research today is frequency, not the intensity, of action first set out the answer this question, they kinases, initiating both an early and a late- based on the assumption that plasticity is potential firing becomes the primary way hoped to pinpoint either presynaptic or phase of LTP. First, in early-phase LTP, these the foundation from which all these abilities through which out-going signal strength is postsynaptic changes as leading to changes protein kinases (e.g calcium-dependent arise. For a comprehensive review on the encoded in neural systems. in synaptic efficacy; however, it appears that protein kinase II (CaMKII)), increase the role of LTP and LTD in learning and memory The synapse is the primary junction of both presynaptic and postsynaptic changes sensitivity of existing AMPARs and recruit see Lynch (2004). information transfer. When an AP reaches are involved. Because primarily postsynaptic new receptors to the synapse (Malenka & This review will address the basic the synapse of the transmitting or changes appear to be involved in Bear, 2004). This almost immediate increase mechanisms of synaptic plasticity and presynaptic neuron, neurotransmitters are metaplasticity, only postsynaptic LTP in both AMPAR density and sensitivity leads describe metaplasticity, a recently released which stimulate much smaller mechanisms will be discussed here and to a stronger postsynaptic response to the discovered and exciting phenomenon which electrical signals of variable strength in the readers interested in presynaptic same presynaptic stimulus, effectively regulates and integrates synaptic plasticity receiving, or postsynaptic, neuron. Unlike mechanisms should consult Castillo (2012). creating a memory trace within the neuron. over time. Metaplasticity is the process in APs, these postsynaptic potentials (PSPs) can In the synapse, the generation of PSPs In what is known as late-phase LTP, a

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cascade of secondary messengers travel to desensitization and removal (Malenka & (Bienenstock, Cooper, & Munro, 1982). In lasted for upwards of thirty minutes, was the cell nucleus, initiating gene expression Bear, 2004). The selective weakening of this way, an increase in sensitivity following dependent on NMDAR activation, and and protein synthesis, facilitating increased synapses through LTD is believed to be LTP induction will not cause even more LTP seemed to represent a shift in the BCM production of AMPAR proteins and other important for the constructive use of LTP. in a cycle of positive feedback and lead to plasticity threshold since the inhibition could synaptic proteins (Lynch, 2004). Late-phase Indeed, if synapses continued to increase in excitotoxicity (cellular toxicity involving be overcome eventually by increasing the LTP often results in an increased strength, they would ultimately reach a overactivation of glutamate receptors), and intensity of stimulation. These experiments postsynaptic surface area and a greater ceiling level of synaptic efficacy which would a loss of meaningful input from the synapse. were the first to demonstrate that 'priming' number of synaptic vesicles, which further prevent the encoding of new information It A sliding threshold allows synaptic plasticity stimuli, whether it induces LTP or not, can amplifies the ability of the presynaptic is important to note that the complete to function as a synaptic 'novelty detector', cause covert changes in the synapse which neuron to excite the postsynaptic neuron picture of these mechanisms, including the with the threshold being equal to the will affect subsequent plasticity responses. (Desmond & Levy, 1988). Both early- and involvement of other supplementary average level of activity so that LTP and LTD This effect was dubbed “metaplasticity” late-phase LTP are implicated in learning and mechanisms, is much more complex than are only induced during significant bursts of because of its higher-order nature and was memory by enhancing retention of a task for described here and despite being an area of in stimulation frequency. met with much excitement because of its the first few minutes after it is learned while active research, is beyond the scope of this The BCM model was constructed based implications for a mechanism of synaptic also making arrangements for the persistent article. For further detail on LTD mechanisms, on observation and mathematical analysis of plasticity control similar to what had been retention of that learning. readers should consult Collingridge (2010). synaptic plasticity with little explanation for proposed by the BCM theory. Long-term depression, the weakening physical mechanisms. However, following Metaplasticity is often defined as “the of synaptic efficacy following prolonged low- The BCM Theory: Thresholds of the discovery of metaplasticity, it has plasticity of synaptic plasticity.” In other frequency stimulation, has not been studied Plasticity become clear that synaptic plasticity words, synaptic plasticity itself is plastic as extensively as LTP, but its basic mechanics In order to describe how metaplasticity regulation is not as simple as the BCM model (capable of change), and metaplasticity is its appear similar. During low-frequency affects the induction of synaptic plasticity, it proposes. modulation by a cell's prior history of activity. stimulation, there is a relatively low degree is appropriate to first address the BCM Metaplastic changes are subtle yet enduring, of postsynaptic depolarization and thus a theory of plasticity thresholds. During Metaplasticity: Making Plasticity Make and allow synaptic events at a single point in much smaller amount of NMDAR activation synaptic firing, increases in postsynaptic Ca2+ Sense time to regulate synaptic processing minutes, and Ca2+ influx. Interestingly, rather than cause changes in synaptic efficacy: but if Ca2+ In an early experiment on LTP, researchers hours, or even days later. For example, if a simply leading to a reduced degree of LTP, is the stimulus for both LTP and LTD, then were surprised to find that increasing the synapse has just undergone LTP, the same low levels of Ca2+ appear to have the what determines whether LTP or LTD will be permeability of NMDARs to Ca2+ stimulus delivered only minutes later will fail opposite effect entirely. While high levels of induced? Because the effect of Ca2+ is paradoxically seemed to prevent LTP to elicit the same degree of potentiation, Ca2+ phosphorylate regulatory kinases, low concentration-dependent, there seems to be induction (Coan, Irving, & Collingridge, 1989). and may even cause depression. Importantly, Ca2+ levels promote their dephosphorylation. a threshold concentration that determines This conflicted with what was known about metaplasticity can be monosynaptic, This leads to a decrease in synaptic efficacy whether potentiation, depression, or no LTP at the time; NMDAR activation leads to effective at one synapse only, or via AMPAR change in synaptic efficacy will occur. The LTP so it was expected that greater NMDAR heterosynaptic, effecting neighbouring Bienenstock-Cooper-Munro (BCM) model permeability, and thus greater Ca2+ influx, synapses as well (Abraham, 2008). best characterizes this threshold. would strengthen LTP. These researchers Functionally, metaplasticity allows The BCM model (see figure 1) describes correctly concluded that NMDAR activation neurons to integrate plasticity-relevant a relationship between postsynaptic could somehow have an inhibitory effect on signals over time, encouraging gradual and response (x-axis on figure) and change in LTP despite its central role in LTP induction, meaningful neural change. Furthermore, postsynaptic strength (Φ) with two key but were unable to specify how. Research by metaplasticity maintains plasticity within a features. First, a threshold exists (θM) above Huang et al. in 1992 clarified this effect dynamic range and prevents destructive which the synapse will be strengthened when they demonstrated that induction of feedback cycles that may lead to either (LTP), and below which it will be weakened LTP by a strong stimulus could be inhibited if excessive or insufficient activation. The (LTD). Second, this threshold is not static, a weak stimulus had been previously higher-order, 'meta', nature of this effect is Figure 1. The BCM model function depicting postsynaptic activity (X), change in postsynaptic but shifts in response to the average delivered to the same pathway (Huang, exciting not only because of its importance efficacy (Φ), and plasticity threshold (θM). frequency of presynaptic stimulation Colino, Selig, & Malenka, 1992). This effect to organized functioning of plasticity, but

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also because it suggests that neurons retain the activation of CaMKII during influencing gene expression and protein be associated with increased LTP during a trace of their own activity. metaplasticity is involved or conflicts with its translation (Simon, 2007). learning tasks. Histone acetylation is an transient phosphorylation during LTP Metabotropic glutamate receptors epigenetic process by which certain Mechanisms of Metaplasticity induction. Recent electrostatic imaging (mGluRs) appear alongside NMDA and stretches of DNA are made more accessible studies have revealed that CaMKII is an AMPA receptors in the postsynaptic to transcription proteins, leading to the NMDAR: LTP Inhibition. Much like synaptic impressively complex enzyme possessing membrane and are involved in LTP increased production of the proteins plasticity itself, metaplasticity can either two sets of six binding domains, so it is quite facilitation (Cohen & Abraham, 1996). The encoded therein. High levels of histone have potentiating or depressing effects. As possible that it may be activated at multiple activation of mGluRs has been shown to acetylation have been found in relevant described by the BCM model, a decrease in sites independently (Craddock, Tuszynski, & both facilitate the induction of LTP and brain regions during learning tasks in rats, successive LTP (a shift of the threshold θM to Hameroff, 2012). This is a fascinating area lengthen its persistence (Bortolotto, Bashir, and experimental manipulation of this the right, Figure 1) appears to be based on for further research, not only to clarify Davies, & Collingridge, 1994; Bortolotto et acetylation was shown to affect plasticity NMDA activity, and lasts from 30-90 minutes CaMKII's involvement in metaplasticity, but al., 1995). This enhancing effect can last up thresholds (Levenson et al., 2004). This not (Huang et al., 1992). There have been two also because these multiple binding domains to an hour and appears to be related to the only implicates epigenetics as yet another proposed mechanisms for how NMDAR may be another site of information storage down-regulating effect that mGluR possible mechanism of metaplasticity, but activation may lead to an increase in the in the nervous system. activation has on the After- also suggests that a learning event in one plasticity threshold. One theory was based Hyperpolarization Period (AHP): the length synapse could promote LTP to other on the observation that NMDARs themselves mGluR: LTP Facilitation. The idea that of time neurons take to return to their synapses throughout the neuron. By will occasionally become desensitized after metaplasticity facilitates LTP is exciting. resting potential after firing. A decrease in increasing the availability of proteins stimulation due to nitric oxide feedback Might there be some way our neurons can the AHP could lead to an increase in whole- involved in late-phase LTP, epigenetics could mechanisms (Sobczyk & Svoboda, 2007). It direct themselves to learn faster and more cell neuronal excitability and an increase in provide a fertile environment for LTP to was proposed that this decrease in NMDAR efficiently? postsynaptic depolarization due to back- occur and thereby enhance learning. sensitivity leads to a reduced postsynaptic Certain types of priming stimulation propagation of action potentials from the Ca2+ response and thus inhibits LTP (Murphy have indeed been shown to enhance LTP, cell body (Saar, Grossman, & Barkai, 1998). BDNF. The protein known as Brain-Derived- & Bliss, 1999). As attractive as this though the mechanisms by which this occurs Additionally, mGluR activity may also Neurotrophic-Factor (BDNF) has recently hypothesis is, metaplastic LTP inhibition has appear to be more mysterious and complex enhance LTP by trafficking AMPARs to the been suggested to be involved in been shown to occur independently of this than LTP inhibition. The lowering of the LTP synaptic membrane, preparing them for metaplasticity, although it is uncertain NMDAR-specific desensitization (Moody, threshold, decreasing the amount of involvement in subsequent plasticity events whether it can effect metaplastic changes its Carlisle, & O’Dell, 1999). Although it may be stimulation needed in order to elicit LTP (Oh, Derkach, Guire, & Soderling, 2006). own, or whether it is simply a necessary important in NMDAR function, this pathway response, appears not to be based on Despite these promising findings, the factor in LTP induction. BDNF's primary role cannot be directly mediating NMDAR- NMDARs but on an entirely different type of involvement of mGLuRs in metaplastictic in the brain is developmental: it is involved dependent metaplasticity. receptor, the metabotropic glutamine events has proven difficult to completely in the promotion of neural cell survival, The most promising explanation for receptor. describe. For instance, mGluR activation differentiation, and the establishment and NMDAR-dependent metaplasticity is the In addition to fast-acting ionotropic appears to have an inhibitory effect on LTP maintenance of newly formed synapses long-term alteration of the regulatory receptors, there also exists a different class in the dentate gyrus, and it is unknown how (Huang & Reichardt, 2001). Because of its enzyme CaMKII by previous synaptic of receptors that are slower acting, with this effect could be reconciled with their stimulatory effect on most neuronal 'priming' (Bear, 1995). Manipulation of profoundly different structure and effects. usual role in enhancing LTP (Gisabella, processes, it is not surprising that artificial CaMKII phosphorylation sites has been These receptors, known as metabotropic or Rowan, & Anwyl, 2003). introduction of BDNF can induce LTP (Ying et shown to replicate the effect of NMDAR G-protein coupled receptors, do not open al., 2002). However, research has revealed priming and increases the amount of ion channels in response to Epigenetics. In addition to synaptic receptor that BDNF may also alter the plasticity postsynaptic activity needed to induce LTP neurotransmitter binding but instead activity, there are a number of other factors threshold in conjunction with PKMζ, another without any prior high-frequency stimulation activate secondary messenger proteins on that can effect long-term modulatory critical protein for LTP induction (Sajikumar (Zhang et al., 2005). This is plausible since the inside of the postsynaptic membrane. changes on synaptic plasticity. For instance, & Korte, 2011). Furthermore, BDNF appears CaMKII is crucial in both early- and late- These secondary messengers can then effect environmentally induced changes in gene to be upregulated during certain learning phase LTP; however, it is unclear whether long-term changes within the cell, such as expression (epigenetics) have been shown to tasks (Naimark et al., 2007). BDNF's role in

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synaptic plasticity is far from being 'learning switch', providing an improved complex processes working together. References completely understood and the persistence cellular environment for learning to occur NMDAR-mediated metaplasticity inhibits Abraham, W. C., & Bear, M. F. (1996). Metaplasticity: the plasticity of synaptic plasticity. Trends in of its effect on LTP induction has yet to be (Zelcer et al., 2006). Similar learning-related future LTP through CaMKII phosphorylation Neurosciences, 19(4), 126-130. demonstrated. Metaplasticity entails a reductions in AHP have also been observed while mGluR-mediated metaplasticity doi:10.1016/S0166-2236(96)80018-X temporal component where synaptic events in reflexive eye-blink conditioning and water facilitates LTP via AHP downregulation. Abraham, W. C., Logan, B., Greenwood, J. M., & at one point in time affect later synaptic maze tasks (Lebel, Grossman, & Barkai, 2001; Histone acetylation enhances LTP by Dragunow, M. (2002). Induction and experience-dependent consolidation of stable plasticity; this property has yet to be Moyer, Thompson, & Disterhoft, 1996). increasing transcription of synaptic proteins long-term potentiation lasting months in the demonstrated with BDNF, though its Within the limited body of behavioural and BDNF may play a role in metaplasticity hippocampus. The Journal of Neuroscience, presence does appears to amplify LTP. research on metaplasticity, an important as well. Together, these processes allow 22(21), 9626–9634. Nevertheless, it does provide a promising observation has arisen which calls into neurons to maintain synaptic plasticity Abraham, W. C. (2008). Metaplasticity: tuning synapses and networks for plasticity. Nature avenue of research and serves to illustrate question the accuracy of the BCM model and within a dynamic range. There is also Reviews Neuroscience, 9(5), 387–387. just how many different factors are involved previous conceptions about synaptic mounting evidence that metaplasticity is doi:10.1038/nrn2356 in regulating synaptic plasticity. plasticity regulation. The presence of involved directly in learning processes Bear, M F. (1995). Mechanism for a sliding synaptic modification threshold. Neuron, 15(1), 1-4. multiple mechanism of metaplasticity through up-regulation of neural plasticity in Bienenstock, E. L., Cooper, L. N., & Munro, P. W. Metaplasticity and Learning (NMDARs, mGluRs), often leads to a failure task-relevant neurons and that a dynamic (1982). Theory for the development of neuron Metaplasticity is critical for maintaining of a single sliding threshold model to predict balance between mechanisms may exist in selectivity: orientation specificity and binocular synaptic plasticity within a dynamic range, or explain changes in synaptic plasticity. For order to regulate these 'learning modes'. interaction in visual cortex. The Journal of Neuroscience: The Official Journal of the but could it have a more direct role in example, when decreases in the AHP are Further research on metaplasticity could Society for Neuroscience, 2(1), 32-48. learning? Research on the link between observed, there is almost always a elaborate on this involvement in learning, Blais, B., & Cooper, L. (2008). BCM theory. metaplasticity and learning is still in its simultaneous reduction in LTP as well. This leading to new discoveries about how we Scholarpedia, 3(3), 1570. infancy, yet what has been found is exciting suggests that NMDAR-mediated LTP learn and providing knowledge to fill the doi:10.4249/scholarpedia.1570 Bortolotto, Z. A., Bashir, Z. I., Davies, C. H., & and seems to implicate metaplasticity in inhibition may occur in dynamic balance considerable gap between psychological and Collingridge, G. L. (1994). A molecular switch both the facilitation and inhibition of with mGluR sensitization and illustrates an neurobiological understanding of memory. activated by metabotropic glutamate receptors learning. For example, it is well known that important point: these processes are by no Although the stated goal of this review regulates induction of long-term potentiation. Nature, 368(6473), 740-743. stress can impair learning, and now research means exclusive. With multiple metaplastic was to dissect metaplasticity into a simple, doi:10.1038/368740a0 has demonstrated that NMDAR-related processes occurring simultaneously, it is unified, understandable phenomenon, it is Bortolotto, Z. A., Bashir, Z. I., Davies, C. H., Taira, T., metaplasticity triggered by stressful events challenging to develop a single model of clear that metaplasticity cannot be reduced Kaila, K., & Collingridge, G. L. (1995). may be the reason why (Sacchetti et al., metaplasticity that is accurate in all to a single process. NMDARs, mGluRs, Studies on the role of metabotropic glutamate receptors in long-term potentiation: some 2002). Metaplasticity may also increase situations. At this point, there is no unifying neurotrophins, epigenetics – all these methodological considerations. Journal of neural plasticity during learning periods, explanation for how these different factors are involved and inter-related in Neuroscience Methods, 59(1), 19-24. leading to more efficient learning. An mechanisms work together. They may be ways we do not yet understand, forming a Castillo, P. E. (2012). Presynaptic LTP and LTD of exciting study demonstrated that during cooperating, competing, or involved in some very complex phenomenon which is only excitatory and inhibitory synapses. Cold Spring Harbor Perspectives in Biology, 4(2). olfactory-discrimination training in mice, the complex memory encoding process we have superficially cohesive. These phenomena are doi:10.1101/cshperspect.a005728 AHP period of pyramidal neurons in the yet to discover. Explaining the interactions not neat, orderly, or amenable to a unified Christie, B. R., & Abraham, W. C. (1992). Priming of hippocampus was significantly decreased, between discrete metaplastic mechanisms is label. Instead, they constitute a complex associative long-term depression in the dentate gyrus by theta frequency synaptic activity. suggesting the presence of mGluR-mediated a critical question — how do all these pieces adaptation to endow organisms with the Neuron, 9(1), 79-84. metaplastic LTP facilitation. Importantly, this of the puzzle fit together? flexibility to adapt in a chaotic and Coan, E. J., Irving, A. J., & Collingridge, G. L. (1989). effect was present during the learning unplanned world. Low-frequency activation of the NMDA period but disappeared once the learning Conclusion receptor system can prevent the induction of LT P. Neuroscience Letters, 105(1-2), 205–210. rule had been acquired, and was even Metaplasticity, the modulation of synaptic Declaration of Conflicting Interests Cohen, A. S., & Abraham, W. C. (1996). Facilitation correlated with enhanced ability to learn a plasticity based on previous firing history, is The author declared they have no conflicts of long-term potentiation by prior activation of different task in which the same neurons critical for the emergence of learning and of interests with respect to their authorship metabotropic glutamate receptors. Journal of were involved. This suggests that mGluR- memory. Like memory itself, metaplasticity or the publication of this article. Neurophysiology, 76(2), 953-962. Collingridge, G. L., Peineau, S., Howland, J. G., & mediated metaplasticity may act as a appears to be composed of many different Wang, Y. T. (2010). Long-term depression in

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the CNS. Nature Reviews Neuroscience, 11(7), Receptor-Sensitive Form of Metaplasticity Sobczyk, A., & Svoboda, K. (2007). Activity- 459–473. doi:10.1038/nrn2867 Limits θ-Frequency Stimulation-Induced LTP dependent plasticity of the NMDA-receptor Craddock, T. J. A., Tuszynski, J. A., & Hameroff, S. in the Hippocampal CA1 Region. Learning & fractional Ca2+ current. Neuron, 53(1), 17-24. (2012). Cytoskeletal Signaling: Is Memory Memory, 6(6), 619–633. doi:10.1016/j.neuron.2006.11.016 Encoded in Microtubule Lattices by CaMKII Murphy, K. P., & Bliss, T. V. (1999). Photolytically Ying, S.-W., Futter, M., Rosenblum, K., Webber, M. J., Phosphorylation? (G. Bernroider, Ed.)PLoS released nitric oxide produces a delayed but Hunt, S. P. , Bliss, T. V. P. , & Bramham, C. R. Computational Biology, 8(3), e1002421. persistent suppression of LTP in area CA1 of (2002). Brain-derived neurotrophic factor doi:10.1371/journal.pcbi.1002421 the rat hippocampal slice. The Journal of induces long-term potentiation in intact adult Desmond, N. L., & Levy, W. B. (1988). Synaptic Physiology, 515 ( Pt 2), 453–462. hippocampus: requirement for ERK activation interface surface area increases with long-term coupled to CREB and upregulation of Arc potentiation in the hippocampal dentate gyrus. Murphy, K. P. , Williams, J. H., Bettache, N., & Bliss, synthesis. The Journal of Neuroscience: The Brain Research, 453(1-2), 308-314. T. V. (1994). Photolytic release of nitric oxide Official Journal of the Society for Neuroscience, Diamond, D. M., Fleshner, M., & Rose, G. M. (1994). modulates NMDA receptor-mediated 22(5), 1532–1540. Psychological stress repeatedly blocks transmission but does not induce long-term Zelcer, I., Cohen, H., Richter-Levin, G., Lebiosn, T., hippocampal primed burst potentiation in potentiation at hippocampal synapses. Grossberger, T., & Barkai, E. (2006). A cellular behaving rats. Behavioural Brain Research, Neuropharmacology, 33(11), 1375-1385. correlate of learning-induced metaplasticity in 62(1), 1-9. doi:10.1016/0166-4328(94)90032-9 Naimark, A., Barkai, E., Matar, M. A., Kaplan, Z., the hippocampus. Cerebral Cortex (New York, Gisabella, B., Rowan, M. J., & Anwyl, R. (2003). Kozlovsky, N., & Cohen, H. (2007). N.Y.: 1991), 16(4), 460-468. Mechanisms underlying the inhibition of long- Upregulation of neurotrophic factors doi:10.1093/cercor/bhi125 term potentiation by preconditioning selectively in frontal cortex in response to Zhang, L., Kirschstein, T., Sommersberg, B., Merkens, stimulation in the hippocampus in vitro. olfactory discrimination learning. Neural M., Manahan-Vaughan, D., Elgersma, Y., & Neuroscience, 121(2), 297–305. Plasticity, 2007, 13427. Beck, H. (2005). Hippocampal synaptic Huang, E. J., & Reichardt, L. F. (2001). Neurotrophins: doi:10.1155/2007/13427 metaplasticity requires inhibitory roles in neuronal development and function. Oh, M. C., Derkach, V. A., Guire, E. S., & Soderling, autophosphorylation of Ca2+/calmodulin- Annual review of neuroscience, 24, 677–736. T. R. (2006). Extrasynaptic membrane dependent kinase II. The Journal of doi:10.1146/annurev.neuro.24.1.677 trafficking regulated by GluR1 serine 845 Neuroscience, 25(33), 7697 -7707. Huang, Y. , Colino, A., Selig, D., & Malenka, R. phosphorylation primes AMPA receptors for doi:10.1523/JNEUROSCI.2086-05.200 (1992). The influence of prior synaptic activity long-term potentiation. Journal of Biological on the induction of long-term potentiation. Chemistry, 281(2), 752 –758. Science, 255(5045), 730 -733. doi:10.1074/jbc.M509677200 doi:10.1126/science.1346729 Pinel, J. P. J. (2007). Biopsychology Eighth Edition. Lebel, D., Grossman, Y. , & Barkai, E. (2001). Allyn and Bacon: Toronto Olfactory learning modifies predisposition for Saar, D., Grossman, Y., & Barkai, E. (1998). Reduced long-term potentiation and long-term after-hyperpolarization in rat piriform cortex depression induction in the rat piriform pyramidal neurons is associated with increased (olfactory) rtex. Cerebral Cortex, 11(6), 485– learning capability during operant conditioning. 489. doi:10.1093/cercor/11.6.485 The European Journal of Neuroscience, 10(4), Levenson, J. M., O’Riordan, K. J., Brown, K. D., 1518–1523. Trinh, M. A., Molfese, D. L., & Sweatt, J. D. Sacchetti, B., Lorenzini, C. A., Baldi, E., Bucherelli, (2004). Regulation of histone acetylation C., Roberto, M., Tassoni, G., & Brunelli, M. during memory formation in the hippocampus. (2002). Time-dependent inhibition of Journal of Biological Chemistry, 279(39), hippocampal LTP in vitro following contextual 40545 -40559. doi:10.1074/jbc.M402229200 fear conditioning in the rat. The European Lynch, M. A. (2004). Long-term potentiation and Journal of Neuroscience, 15(1), 143–150. memory. Physiological Reviews, 84(1), 87 -136. Sajikumar, S., & Korte, M. (2011). Metaplasticity doi:10.1152/physrev.00014.2003 governs compartmentalization of synaptic Malenka, R. C., & Bear, M. F. (2004). LTP and LTD: tagging and capture through brain-derived an embarrassment of riches. Neuron, 44(1), 5- neurotrophic factor (BDNF) and protein kinase 21. doi:10.1016/j.neuron.2004.09.012 Mζ (PKMζ). Proceedings of the National Martin, S. J., Grimwood, P. D., & Morris, R. G. (2000). Academy of Sciences, 108(6), 2551–2556. Synaptic plasticity and memory: an evaluation doi:10.1073/pnas.1016849108 of the hypothesis. Annual Review of Simon, P. (2007). The role of glutamate in central Neuroscience, 23, 649-711. nervous system health and disease – A review. doi:10.1146/annurev.neuro.23.1.649 The Veterinary Journal, 173(2), 278-286. Moody, T. D., Carlisle, H. J., & O’Dell, T. J. (1999). A doi:10.1016/j.tvjl.2005.11.007 Nitric Oxide-Independent and β-Adrenergic

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CLINICAL A CLOSER LOOK AT PSYCHOLOGY Commentary

Psychology: A closer look at what psychologists bring to the table Elizabeth Laliberte1 1Department of Psychology, University of British Columbia - Okanagan

Edited by: Kaitlyn Goldsmith, Department of Psychology, University of British Columbia. Received for review December 20, 2011, and accepted March 14, 2012. Copyright: © 2012 Laliberte. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivates License, which permits anyone to download and share the article, provided the original author(s) are cited and the works are not used for commercial purposes or altered in any way.

Abstract While it is clear that psychologists are an important component of the mental health field in Canada, there is often confusion as to what exactly makes the services provided by psychologists distinctive to those provided by other mental health care professionals. This paper aims to explore some of the contributing factors that make the field of clinical psychology unique and essential in the provision and treatment of mental health problems. This discussion will investigate differences between psychologists and psychiatrists, with particular emphasis on the exclusive benefits provided by clinical psychologists. Furthermore, the following discourse will outline the various advantages associated with psychotherapy and the ways in which clinical psychologists in particular utilize this tool in providing treatment and services to clients. This paper will also focus on the costs of mental health provision in the Canadian health care system and how one particular form of psychotherapy has proved to be extremely cost- effective in relation to other types of treatment. Additionally, this paper will challenge the current lack of financial coverage afforded to individuals seeking treatment from clinical psychologists in Canada and how this is problematic. Finally, this paper will identify the specific role psychologists maintain in providing preventative approaches to mental illness and the value of such approaches.

Keywords: clinical psychology, advocacy, pyschotherapy

The purpose of this discussion is to advocate allegiances in areas such as hospitals, for the profession of psychology and to universities, courtrooms, clinics, prisons, and identify the value of this profession in terms schools there is truly no other mental health of the skill sets and roles that psychologists, profession with such a degree of career specifically clinical psychologists, maintain in diversity. With a smorgasbord of career society. As the great Carl Rogers (1961) once options, the face of psychology is never said, “When I look at the world I am stagnant; ultimately this is one part of what pessimistic, but when I look at people I am makes psychologists unique, while at the optimistic”; the essence of psychology is same time contributes to the public helping people. With psychology’s vast confusion about the roles that psychologists

Corresponding Author: Elizabeth Laliberte E-mail: [email protected]

CLINICAL CLINICAL A CLOSER LOOK AT PSYCHOLOGY Commentary Laliberte Commentary

uphold in our society. The following plays a fundamental role in advocating the (2010), a “fundamental difference between stands currently, clinical psychologists in discourse will dive head first into the world importance of mental health issues. Clinical training in clinical psychology and psychiatry Canada use various forms of psychotherapy as seen by psychologists, to uncover the psychology in particular is concerned with is that psychiatric training generally rather than drugs to treat mental illness. unique and vital contributions that the field human functioning and the assessment and emphasizes psychopharmacological As stated above, clinical psychologists of psychology has to offer in the present day. treatment of mental health concerns treatment over psychological treatment”. do not depend on medication for treating Specifically, this paper will explore the (Canadian Psychological Association, n.d.). Typically, psychiatrists rely more heavily on their patients, but instead use various forms unique role that clinical psychologists Not only do clinical psychologists deal with the use of medication for the treatment of of psychotherapy. According to Nordqvist maintain in our society with a focus on what human psychological problems and their individuals suffering from mental health (2009), psychotherapy is the “treatment of they have to offer that is exceptionally solutions, but they also are an intricate part issues and generally incorporate less emotional, behavioral, personality, and different from psychiatrists, such as of health promotion in terms of physical, psychotherapy as a part of a treatment plan, psychiatric disorders based primarily on extensive training in psychotherapy. This mental, and social well-being (Canadian as compared to clinical psychologists. In verbal or nonverbal communication and paper will examine the advantages that Psychological Association, n.d.). The Canada, most registered psychologists have interventions with the patient, in contrast to psychotherapy alone can offer, and in problems and concerns treated by clinical completed a Ph.D in psychology, which treatments using chemical and physical particular, the benefits that can be derived psychologists include, but are not limited to, involves extensive coursework, research and measures”. Psychotherapy can take many from cognitive behavioral therapy (CBT). depression, learning disabilities, anxiety, practical clinical training (Canadian forms including behavioral therapy, There will also be a focus on the cost- stress, substance abuse, addiction issues, Psychological Association, n.d.). The intense cognitive therapy, group therapy, effectiveness of psychotherapy in regard to relationship problems, issues surrounding research aspect of psychology is often interpersonal therapy, and psychodynamic its ability to treat mental illness and the coping, problems related to physical or considered one of the main distinguishing therapy to name a few. One of the most cost-benefits this can have for the Canadian sexual abuse, developmental and behavioral features between psychiatry and psychology. widely used and most intensely researched health care system. Furthermore, there will issues, lifestyle management, criminal Research psychology is a branch of form of psychotherapy is Cognitive be an emphasis on the reasons why clinical behavior and crime prevention, and psychology devoted to conducting research Behavioural Therapy (CBT) (Butler, Chapman, psychology is an ideal candidate to be facilitating adherence to health studies and contributing to the growing Forman, & Beck, 2005). A core theoretical considered for Medicare coverage in Canada, interventions (Canadian Psychological body of psychological research, which is not underpinning of CBT is the belief that the comparing and contrasting the benefits Association, n.d.). With such a diversity of a characteristic feature found in many other symptoms and dysfunctional behaviors that resulting from psychiatric treatment vs. responsibilities and roles, it is easy to see training programs for mental health characterize mental illness are often psychological treatment. Finally, this how the general public can maintain professions. This inclusion of research is a cognitively mediated, suggesting that discussion will examine the significant role uncertainties about what the field of clinical large part of psychologists’ role in academia, improvement can be created by modifying psychologists play in the promotion of the psychology encompasses. Psychology in as well as a foundational part of clinical dysfunctional thoughts and beliefs (Dobson treatment and prevention of mental health general remains one of the few disciplines psychology training programs. Another & Dozois, 2001). In a meta-analysis issues. Each of these points serves to with such a wide-ranging scope of scientific important distinctive aspect of psychologists completed by Butler et al. (2005), it was illuminate one general theme: the immense concerns, which ultimately adds to its and of clinical psychologists in particular, is found that CBT is extremely effective in the overall worth of psychology. uniqueness (British Columbia Psychological that they rely on different methods of treatment of adult unipolar depression, To begin this discussion, it is imperative Association, 2009). treatment for mental illnesses than adolescent unipolar depression, generalized to understand what psychology is and its There is often public confusion psychiatrists, such as psychotherapy rather anxiety disorder, panic disorder, social importance. According to the British regarding the field of mental health than drug treatment. Though psychologists phobia, PTSD, and childhood depressive and Columbia Psychological Association (BCPA; professionals, specifically on what the are certainly able to see a role for drugs in anxiety disorders. Furthermore the meta- 2009) psychology is “the study of behavior, difference is between a psychologist and a the treatment of mental illness, analysis strongly suggested that across many including the biological, cognitive, emotional, psychiatrist. There is indeed much overlap psychologists in Canada do not currently of these disorders, the effects of CBT are social and cultural determinants of behavior, between the two professions; however they have prescription privileges to administer maintained for a considerable amount of that is, how we think, feel and behave in our are also both distinctive in their own right drugs to patients (Hunsley & Lee, 2010). time beyond the cessation of treatment social and physical environments”. In an era (Lea, 2011). In terms of education, There are currently psychologists who (Butler et al., 2005). In some cases, in which the intricacies and overlap between psychiatrists attend medical school and advocate for prescription rights in Canada, psychotherapy has been found to result in mental health and physical health are receive an M.D. degree with a specialization while other psychologists oppose the greater alleviation of symptoms compared continually being uncovered, psychology in psychiatry. As noted by Hunsley and Lee movement (Hunsley & Lee, 2010). As it to the results of drug treatment. To further

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CLINICAL CLINICAL A CLOSER LOOK AT PSYCHOLOGY Commentary Laliberte Commentary

illustrate this point, a study done by from mental illness receive treatment (2009) suggests that “psychological services prevention, which is something that should Gloaguen, Cottraux, Cucherat, and Blackburn through these avenues. This is problematic should be an integral component of the not be taken lightly. (1998) found that CBT was significantly more because, although these mental health Canadian health care system”. The BCPA This paper has outlined the successful in the treatment of depression professionals are helpful in some areas and (2009) goes further to illustrate the need for contributions and benefits stemming from than was medication. In other studies, it has receive some training in psychotherapy, they psychological intervention by highlighting psychology as a field and has attempted to been suggested that the combination of CBT are not as extensively trained in the fact that psychological intervention has illustrate the essential services that many and pharmacotherapy (medication) for psychotherapy nor do they necessarily and been estimated to cost 10%-50% less than psychologists provide. Through the unique depression can actually yield a slight consistently implement treatment with an drug treatments. The BCPA (2009) claims role maintained by clinical psychologists, the advantage over CBT administered alone emphasis on psychotherapy. It is suggested that for every $1 spent on psychology proven benefits of CBT and other forms of (Hollon, Thase, & Markowitz, 2002). On a that this leads to a heavier reliance on and services, $5 are saved on medical costs. psychotherapy, the provision of different separate note, CBT provided by clinical increased use of medication because it is Considering the plethora of potential treatment approaches rather than psychologists may also be preferable over considered the first-line, mainstay treatment societal benefits that can arise from the field pharmacotherapy, and the overall cost- medication because it is considered a less for mental health disorders. Consequently it of clinical psychology, the question is how effectiveness of psychological interventions intrusive way of treating patients compared has been suggested that this over- can Canadians afford not to have these and the role psychologists can play in health to drug administration (Associated medicalization of psychological concerns services covered? prevention and promotion, it is clear that Psychological Health Services, 2006). Indeed, greatly contributes to the rising health care Finally, the last area of psychological the field of psychology adds tremendously to the side effects of some drugs can be severe costs in Canada (Romanow & Marchildon, contributions that this paper will touch on the overall mental health and well being of and the benefits can disappear when the 2003). As Myhr and Payne (2006) point out, deals with the role of psychologists in humanity. Though there is an array of medication is no longer being taken. publicly funded CBT for mental disorders is mental health promotion and mental illness mental health professionals, such as Additionally, studies have found that scarce in Canada, regardless of its proven prevention. As Kenkel, Deleon, Mantell, and psychiatrists, social workers, and counselors pharmacotherapy has considerably larger efficacy and the health guidelines endorsing Steep (2005) state, “as health professionals, that have similar goals to psychologists, the drop-out rates than psychological its use. This is troubling, considering the psychologists have many opportunities to treatment approaches to dealing with intervention (Hunsley, 2003). And finally, plethora of studies that have demonstrated use mental health promotion and early mental health concerns are fundamentally psychotherapy is less costly than drug the positive effects that CBT can have on detection skills in the health arena”. Since different and should be recognized for their treatments in the long run (Associated relieving many mental illnesses. Additionally, many of the visits to primary health uniqueness and individual contributions. Psychological Health Services, 2006). It is from a financial perspective, psychological practitioners concern mental health, a Psychology is clearly a constantly evolving clear that, psychotherapy provided by interventions are thought to be very cost- preventative approach would be optimal for field and it is suggested that the evidence- clinical psychologists is vital in the treatment effective. A recent meta-analysis of 92 decreasing health care costs and visits based services provided by psychologists will of mental illness and psychiatric disorders research studies found that the average (Kenkel et al., 2005). This would be in the become even more valuable in the future and is effective in its own right. health care savings attributed to best interest of practitioners as well as the (Hunsley & Lee, 2010). With the prevalence The unique advantages of psychological interventions as opposed to public. Furthermore, despite overwhelming of many mental health issues and health psychotherapy are clearly evident in the drug treatments was between 20-30% evidence and education about the benefits care costs on the rise (Sheppard, 2011), it is discussion above, yet the question remains: (Chiles, Lambert, & Hatch, 2006). Of the that come from living a healthy lifestyle, likely that the services provided by why is treatment administered by studies included in this analysis, many people are disinclined to make major psychologists will continue to increase in psychiatrists, and not psychologists, covered approximately 90% of them showed a lifestyle changes. Psychologists, who are value. Furthermore, Hunsley and Lee (2010) under the Canadian health care system? In medical cost offset, that is, the reductions in extremely experienced in behavior change, suggest that the future face of clinical Canada, the direct and indirect cost of health care costs resulting from can attempt to tackle these sorts of psychology will be active in providing mental illness has been estimated to be psychological interventions were large problems in society, with outcomes that psychological services to an assortment of $14.4 billion dollars and mental illness alone enough to completely cover the costs of the could potentially benefit the overall health health problems, and not focusing as strictly accounts for more than 50% of physician psychological interventions themselves of the country’s population (Kenkel et al., on mental health. For example, the future of billing (Myhr & Payne, 2006). Because (Hunsley, 2003). Hunsley (2003) stated that 2005). The bigger picture is that clinical psychology will involve developing psychiatry and general practitioner services there has been considerable evidence of this psychologists play an important role in along with changing health care needs are covered under the Canadian health care phenomenon, as evidence in dozens of mental health promotion and mental illness aimed at facilitating Canada’s aging system, the bulk of individuals suffering research studies. Additionally, the BCPA population. Furthermore, clinical psychology

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CLINICAL CLINICAL Commentary Laliberte Literature Review

as a discipline will continue to ensure that Cognitive Therapy in Depressed Patients. treatments, psychological assessments, and Journal of Affective Disorders, 49, 59-72. doi: 10.1016/S0165-0327(97)00199-7 Craniopagus: Overview and the programs geared at prevention are Hollon, S. D., Thase, M, E., & Markowitz, J. C. evidence-based and well suited for the wide (2002). Treatment and Prevention of implications of sharing a brain range of people who are seeking these Depression. Psychological Science in the Jordan Squair1 Public Interest, 3, 39-77. doi:10.1111/1529- 1 services. Psychology is certainly a 1006.00008 School of Kinesiology, University of British Columbia multifaceted field, and the services it Hunsley, J. (2003). Cost Effectiveness and Medical provides toward improving the overall status Cost-Offset Considerations in Psychological Edited by: Amara Sarwal, Department of Psychology, University of British Columbia. Received for review January 8, quo of mental health services in Canada are Service Provisions. Canadian Psychology, 44, 2012, and accepted February 27, 2012. 61-73. doi:10.1037/h0085818 Copyright: © 2012 Squair. This is an open-access article distributed under the terms of the Creative Commons palpable and distinguishing. Hunsley, J. & Lee M. C. (2010). Introduction to Attribution-NonCommercial-NoDerivates License, which permits anyone to download and share the article, clinical psychology an evidence-based provided the original author(s) are cited and the works are not used for commercial purposes or altered in any Declaration of Conflicting Interests approach. Mississuaga, ON: John Wiley & way. The author declared they have no conflicts Sons Canada, Ltd. Kenkel, M. B., Deleon, P. H., Mantell, E. O., & Steep, of interests with respect to their authorship A. S. (2005). Divided No More: Psychology’s Abstract or the publication of this article. Role in Integrated Health Care. Canadian Craniopagus twins, who are conjoined at the head, are uncommon and often misunderstood. Psychology, 46, 189-202. While craniopagus is rare in itself, Krista and Tatiana Hogan are unique even among References doi:10.1037/h0087026 Lea, Gary. (2011). Pending Retirements Leave Room craniopagus twins: their brains are connected. In this review, I will explore the history of Associated Psychological Health Services. (2006). for New Psychologists. Retrieved from craniopagus as well as our current understanding of the malformation. Furthermore, I will Ten Reasons for Saying No to Drugs. http://www.bclocalnews.com/okanagan_similk Retrieved from discuss surgical separation techniques, classification systems, and how these have led to higher ameen/kelownacapitalnews/opinion/letters http://www.abcmedsfree.com/SayNo.htm survival rates in separated craniopagus twins. Surgical separation of craniopagus twins is /116868813.html# British Columbia Psychological Association. (2009). Linden, W., Moseley, J., & Erskine, Y. (2005). perhaps the most formidable of all neurosurgery operations, particularly in the presence of What is a Psychologist. Retrieved from Psychology as a Health-Care Profession: shared neural tissue. Krista and Tatiana fall into this daunting category. The risk of neural http://www.psychologists.bc.ca/sites/default/fil Implications for Training. Canadian es/pdfs/What_is_a_psychologist.pdf damage, coupled with circulatory complications, led Krista and Tatiana’s physicians to conclude Psychology, 46, 179-188. British Columbia Psychological Association. (2009). a separation would be too dangerous. Consequently, Krista and Tatiana are left with a doi:10.1037/h0087025 Cost-Effectiveness of Psychological Treatment. Myhr, G., & Payne, K. (2006). Cost-Effectiveness of connection that is both novel to documented research and exquisitely mysterious. They possess Retrieved from Cognitive-Behavioural Therapy for what their pediatric neurosurgeon Dr. Doug Cochrane has called a “thalamic bridge” (Dominus, http://www.psychologists.bc.ca/sites/default/fil MentalsDisorders: Implications for Public es/pdfs/Psych_ cost_ effectiveness.pdf 2011a). Krista and Tatiana’s thalamic bridge will provide significant insight into the study of Health Care Funding Policy in Canada. Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, Canadian Journal of Psychiatry, 51, 662-670. cognition and behaviour, and may even have significant implications to the philosophy of mind. A. T. (2005). The Empirical Status of Nordqvist, C. (2009). What is Psychotherapy? What Furthermore, their connection will be accompanied by major social change, as we must Cognitive-Behavioural Therapy: A Review of are the Benefits of Psychotherapy? Retrieved Meta-Analyses. Clinical Psychology Review, redefine our definition of what it means to be an individual. For us to understand how being from 26, 17-31. doi:10.1016/j.cpr.2005.07.003. part of a pair is more important than being an individual to one’s identity, we must shift our http://www.medicalnewstoday.com/articles/15 Canadian Psychological Association. (n.d.). The 6433.php perspective and eliminate our preconceived notions of individuality. Clinical Psychologists in Canada: How Can Rogers, R. C. (1961). On becoming a person. New we Help? Retrieved from Keywords: craniopagus, conjoined twins, thalamus, brain, surgical separation York, New York: Houghton Mifflin Company. http://www.cpa.ca/cpasite/userfiles/Documents Romanow, R. J., & Marchildon, G. P. (2003). /sections/clinical/brochureE.pdf Psychological Services and the Future of Chiles, J., Lambert, M., & Hatch, A. (2006). The Health Care in Canada. Canadian Psychology, Impact of Psychological Interventions on Examples of human fascination with twins high standing: they were not only great 44, 283-295. doi:10.1037/h0086954 Medical Cost Offset: A Meta-analytic Review. are evident through history. The Gemini warriors, but raised by gods. Conjoined Sheppard, M. (2011). Anxiety Disorders: A Mental Clinical Psychology: Science and Practice, 6, Illness on the Rise. Retrieved from constellation, known in Greek mythology as twins, though less recognized, also appear in 204-220. doi: 10.1093/clipsy.6.2.204 http://www.cbc.ca/news/health/story/2011/02/0 Castor and Pollux, is arguably the most well Greek and Roman mythology. Kteotos and Dobson, K. S., & Dozois, D. J. (2001). Historical and 1/f-anxiety-disorder-young-people.html Philosophical Bases of the Cognitive- known set of twins. Castor and Pollux fought Eurytos, known as the Molionides, were Behavioural Therapies. New York: Guildford great battles alongside Herkales and others joined at the hip and adversaries of Press. in what became known as the Argonauts Herkales. The Molionides destroyed Gloaguen, V., Cottraux, J., Cucherat, M., & Blackburn, I. (1998). A Meta-Analysis of the Effects of (Hard, 2004). The Greeks held these twins in Herkales’s armies and are responsible for

Corresponding Author: 20 UBCUJP – April 2012 – Volume 1 Jordan Squair E-mail: [email protected]

CLINICAL CLINICAL Literature Review Squair CRANIOPAGUS Literature Review

one of the great warrior’s rare losses in must gain an appreciation of how their them to hide Stefen and Tyler from much of fusion of two embryonic disks. Specifically, battle (Hard, 2004). Furthermore, Janus, the brains are connected, and objectively the world. It was not until June of 2011 that Spencer (2000b) states that craniopagus Roman god of beginnings and transitions, is contemplate what it means to be an they gave their first interview – at the age of twins may result from fusion of primitive depicted as having two faces. Initially Janus individual. nineteen (Hochman, 2011). Stefen, Tyler, neural folds. Nevertheless, without a may not resemble conjoined twins; Krista, Tatiana, and all other craniopagus concrete cause, prevention is not an option however, a recent interview with nineteen- Modern History of Craniopagus twins are so rare that the most recent and the focus must be on treatment. year-old brothers Stefan and Tyler Delp, Although there are cases of conjoined twins review shows a total of only 64 documented The precision of existent classification craniopagus twins facing opposite directions, dating to the 10th century (as cited in Browd cases (Stone & Goodrich, 2006). The systems and their correct application are shows just how similar Janus is to conjoined et al., 2008), it was not until 1491 that the discussed history of craniopagus extensively critical for those attempting to successfully twins (Hochman, 2011). Greek and Roman first case of craniopagus was documented shows how craniopagus twins can be seen separate craniopagus twins, since different mythology clearly glorify twins, and to this (Browd et al., 2008). Sebastian Münster’s by some as “monsters.” Therefore, junction sites present different day, twins continue to captivate us. famous work Cosmographia universalis combating ignorance through both complications (Browd et al., 2008). The first Krista and Tatiana Hogan are provides the first account of craniopagus knowledge and being mindful of existing attempt at a craniopagus classification craniopagus conjoined twins. Craniopagus twins (as cited in Walker & Browd, 2004). prejudices are vital steps in removing system was made by O’Connell (1976), who twins, a term originally coined by August While discussing Bavarian history, Münster ancient stereotypes associated with refuted the philosophy of classifying Förster to describe twins conjoined at the mentions a pair of unique twins, joined at craniopagus twins, thus providing Krista and according to the site of cephalic junction. head (as cited in Browd et al., 2008), are a the head, who lived for ten years. Münster Tatiana with the social acceptance they Instead, he stated that depth of junction was rare (i.e., 0.6 per million births; Bucholz, follows with an account attributing the deserve. the most important aspect in determining Yoon, & Shively, 1987) and misunderstood twins’ malformation to a punishment for survival after separation. O’Connell (1976) congenital disorder, representing only 6% of their mother’s mistakes (as cited in Browd et Classification Systems and Surgical proposed a differentiation between partial all conjoined twins. If born, the chances of al., 2008). Furthermore, Browd et al. (2008) Interventions and total craniopagus. Partial craniopagus, craniopagus twins surviving past infancy are discuss a chapter from “On Monsters and In addition to increasing social awareness, characterized by a small cephalic junction, quite low (Stone & Goodrich, 2006): 40% are Marvels,” a republished book, originally there must be a push to increase scientific has the possibility that each cranium is still still-born (Browd, Goodrich, & Walker, 2008) written by 16th Century French surgeon understanding of separation techniques; intact. Conversely, total craniopagus would and 33% die within twenty-four hours of Ambroise Paré. In the chapter entitled and, if separation is not an option, how to be characterized by a wide connection: two birth. Despite these harrowing odds, Krista “Monsters,” Paré depicts various types of improve quality of life for the twins. Over brains, one cranium. Additionally, O’Connell and Tatiana Hogan are already beyond their “supernatural” twinning, some of which, the past fifty years, craniopagus research (1976) discusses three different fourth birthday. They not only survived, but curiously enough, resemble craniopagus. has had two main focuses: surgical subclassifications of total parietal they are healthy and thriving. Later, Paré asserts that “[i]t is certain that separation techniques and classification craniopagus, or as he calls it, vertical While craniopagus is rare in itself, Krista most often these monstrous and marvelous systems (Browd et al., 2008; Bucholz et al., craniopagus. Type I entails the twins facing and Tatiana are unique even among creatures proceed from the judgment of 1987; O’Connell, 1976; Stone & Goodrich, the same direction; Type II entails the twins craniopagus twins: their brains are God…” (p 5). Fortunately, over time, this 2006; Walker & Browd, 2004; Winston, facing the opposite direction (inter-twin connected. Krista and Tatiana’s neural radical view towards conjoined twins began 1976). Increasing our knowledge of surgical angle ≥ 140°); and Type III entails anything in bridge will provide significant insight into the to change. separation techniques and classification between. study of cognition and behaviour, and might Chang and Eng, the original “Siamese systems is of utmost importance to advance A decade later Bucholz et al. (1987) even have significant implications to the twins,” embraced their malformation. They research on craniopagus twins; however, contested O’Connell’s (1976) system, stating philosophy of mind. Their unique neural traveled in road shows near the beginning of addressing the ongoing debate of that the difference between partial and total connection may forever change the meaning the 19th Century – eventually becoming not classification systems should precede any craniopagus described was not precise. of individuality and perception. In this only rich, but a new type of art (as cited in consideration of separation techniques. A Instead, four different classifications were review, I will explore the history of Browd et al., 2008). Nevertheless, because secondary research question, which is introduced: frontal, parietal, craniopagus as well as our current of the rarity of craniopagus twins, even now related to both areas of focus, is the temporoparietal, and occipital. These understanding of the malformation. Through many still share Paré’s view of them as tragic question of how craniopagus twins form. classifications, unlike O’Connell (1976)’s this we can begin to grasp what Krista and or punished. The Delp family’s fear of While this is unknown, Spencer (2000a) system, are dependent on the specific Tatiana’s lives will entail. From them, we people’s ignorance and discrimination led argues that conjoined twins result from location of the junction. Bucholz et al.’s

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(1987) classifications are junctions of either axial rotation” (p 1084). Conversely, Stone & system being immediately recognized as a towards their own deep venous drainage the frontal bones, parietal bones, both the Goodrich (2006) define vertical as having a significant risk; nevertheless, classification system (Browd et al., 2008). The process is parietal and temporal bones, and occipital continuous cranium. Thus, their system is failed to address their novel neural repeated until one twin’s drainage system bones, respectively. Yet, literature on recent comprised of four major classifications: total connection (Dominus, 2011a). Classification completely bypasses the shared sinus, at separation attempts does not support vertical, total angular, partial vertical, and of neural connections may prove daunting, which point the twins can be physically Bucholz et al.’s view; rather, it reinforces partial angular. as variability in the connection is extreme; separated. Bucholz et al. (1987) first showed classification according to O’Connell’s (1976) The most recent proposed classification however, understanding the nature of that this method provided the lowest system by building on it (Browd et al., 2008; scheme comes from Browd et al. (2008), neural connections may give surgeons the mortality rate and best post-operative Parameswari, Vakamudi, Raghupathy, & who stress the importance of including tool they need to remove the connection neural function. Huang et al. (2004) discuss a Siddhartha, 2010). In addition to this new important risk factors such as “connectivity without causing neurological deficits. case in which a staged separation was not classification, Bucholz et al. (1987) also between scalp, calvaria, dura mater, neural Surgical separation of craniopagus twins is a used. Serious complications arose, such as proposed a venous scale to classify the tissue, arterial and venous connections, difficult task, perhaps the most formidable extreme blood loss and shock as a result of amount of venous drainage interrupted deep venous drainage, and ventricular of all neurosurgery operations. Classification severe decrease in blood volume. These during surgery: (1) no venous drainage was anatomy, as well as atrial and venous systems will help surgeons be aware of complications can be fatal, and they posed interrupted; (2) only cortical veins were outflow” (p 5). They provide a score, common problems, but surgeons must have extreme challenges to the surgeons and divided; (3) major dural sinuses were between 10 and 28, with a higher value a plan in place and be ready to tackle a host anesthesiologists. By performing a staged encountered and ligated in the course of suggesting a more difficult separation. of obstacles once the twins are on the operation, the surgeon avoids the most separation (Bucholz et al., 1987). Venous Classification systems, coupled with operating table. common complication associated with drainage describes the extent of which a significant advancements in imaging Classification systems and imaging separating craniopagus twins: disastrous twin’s blood may be drained from their techniques, allow surgeons to better techniques aside, enhanced surgical and bleeding due to a shared venous drainage brain, collected in a sinus, or reservoir, and understand common and unique problems anesthetic techniques may be the most system (Browd et al., 2008). then sent to the heart to be re-oxygenated. when presented with craniopagus twins important factors contributing to the Although staged separation was a key If this drainage is interrupted, blood may be (Browd et al., 2008). It has been shown that decreasing mortality rates seen in separated breakthrough in the surgical separation of prevented from leaving the brain, resulting a surgeon's awareness of shared venous craniopagus twins (Browd et al., 2008; craniopagus twins, carefully planned in swelling which ultimately leads to neural drainage is imperative for a successful Bucholz et al., 1987; Girshin et al., 2006). anesthetic management is crucial if the damage. This venous drainage classification separation of craniopagus twins (Bucholz et Browd et al. (2008) indicate the importance twins are to survive. Girshin et al. (2006) system, important to subclassify different al., 1987), and Winston (1987) proposed that of classifying surgical risk factors in order to discuss the substantial benefits of using a cases of craniopagus, has the strongest a classification system be developed based determine mortality and the extent of staged separation and the challenges it correlation with survival and outcome of the on the “deepest shared anatomical surgery required. They then point to poses to anesthesiologists. Namely, separated twins. Classification of these structure” (p 769). Despite huge advances in enhancing surgical techniques, stating that craniopagus twins must be put under and systems has proven essential in separation classification there are still significant areas in the presence of a shared venous sinus, a woken back up multiple times – each time attempts, as the presence of a shared missing. For example, there has yet to be a staged separation is of great importance. In with significant risk of complication. This is venous system is now known to be the single discussion of neural connections aside from this series of surgeries – often six to eight – particularly troublesome since craniopagus largest risk factor for fatalities (Browd et al., their presence being correlated to higher the surgeon’s goal is to remove one of the twins often have other pulmonary and 2008). incidence of neurological deficits following twins from the shared sinus. This is done by cardiac complications (Girshin et al., 2006). Recently, Stone and Goodrich (2006) separation (Bucholz et al., 1987). slowly cutting bridging veins from the twin Additionally, if a shared circulatory system is added to O’Connell’s (1976) system by Furthermore, Browd et al. (2008) are the that will be removed from the sinus; the present, medicine provided to one twin will further subclassifying total and partial first to document a classification system that surgeon must not rush this process. Cutting affect the other twin while under anesthesia craniopagus into vertical and angular. More takes complicated neural, vascular, and too many bridging veins in one surgery may (Parameswari et al., 2010). These problems specifically, they define total craniopagus as ventricular anatomy into account. However, result in fatal bleeding (Browd et al., 2008). are significant but can be partially addressed the twins sharing a significant venous sinus there is still more research needed to After each surgery, the venous system of the by a strong pre-operative plan, the use of and partial as an absence of a shared venous understand how to classify shared neural twin being removed will show increased two separate anesthesia teams, and strong sinus. They define angular as “an inter-twin tissue. The current classification systems led blood pressure, resulting in angiogenesis, communication (Browd et al., 2008). longitudinal angle below 140°, regardless of to Krista and Tatiana’s shared circulatory which is the formation of a new path

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Another major complication may arise thalamic bridge to the other girl’s thalamus three aspects are all, in part, mediated by embody the expression “seeing the world in surgery that is often missed by current (Dominus, 2011a). Krista and Tatiana share nuclei in the thalamus such as the thalamic through someone else’s eyes.” The imaging techniques, and is not currently sensory information. To share every sensory reticular nucleus, thought to preserve emotional repercussions of this ability are, at addressed in existent classification systems modality passing through the thalamus attention by gating information (Blumenfeld, this time, a mystery; however, through (Browd et al., 2008): shared neural tissue. allows them to not only feel what each feels 2010). Accordingly, it could be that as Krista observation, Krista and Tatiana’s Shared neural tissue significantly decreases but even see out of each other’s eyes. A fine and Tatiana age, it will become apparent relationship may serve as an example of how the chances of optimal neural function after example of this emerges in an interview of that their levels of consciousness, which may empathy is expressed in its truest form. They separation (Bucholz et al., 1987). Oddly, this the girls and their mother (Dominus, 2011b). affect spiritual understanding, self- will feel each other’s pain and may struggle risk factor has rarely been discussed in the Their mother covers Krista’s eyes and holds actualization, and perception, stay very to differentiate their own sensations from literature. The enormous complexity of a a plush pony in front of Tatiana. She then similar. As the thalamus is crucial in their sister’s sensations. Krista and Tatiana neural connection is daunting; however, asks Krista what she is holding and Krista consciousness and sensory information will struggle to find individual identity – as current research must begin to approach replies, “pony.” In the New York Times processing, damage to it would be we know it. Their version of individual this issue and how it may be addressed in article, “Could Conjoined Twins Share a detrimental to Krista and Tatiana. This risk of identity will, perhaps, be as half of a pair. separation attempts. As craniopagus cases Mind?” Susan Dominus (2011a) describes an damage, coupled with circulatory They are described as using the word “I” to are rare in humans, this research may need unpublished study performed by Dr. complications, led their physicians to refer to the other twin; however, they are to begin with animal models. In the case of Cochrane when the girls were just two- conclude a separation would be too aware they are two separate people Krista and Tatiana Hogan, separation posed years-old. While recording dangerous. Consequently, Krista and (Dominus, 2011a). Krista and Tatiana’s too many risks. Not only do they share electroencephalography, or brain waves, Tatiana are left with a connection that is conception of “I” may be different from cerebral circulation (possibly a shared from both girls, Dr. Cochrane covered both novel to documented research and everyone else’s. venous sinus) but also a complex neural Krista’s eyes and flashed a light in front of exquisitely mysterious. The twins’ inability to differentiate connection, a bridge on which information Tatiana. Increased electrical activity from between the personal and their sister may can go from one girl to the other. both girls’ brain’s visual areas was recorded. Continued Observation and Social be one behavioural consequence of their The test also worked when the girls switched Issues neural bridge; in that, their inability to The Thalamic Bridge roles (Dominus, 2011a). Surface Krista and Tatiana’s thalamic bridge seems distinguish between their own sensations Krista and Tatiana possess what their electroencephalography is imprecise in its to connect one or more of their sensory and those of their sister may confuse their pediatric neurosurgeon Dr. Doug Cochrane ability to localize where activity is happening modalities. It might also connect their levels sense of identity. Continued observation of has called a “thalamic bridge” (Dominus, but the fact that there is increased activity in of consciousness and perceptions of the Krista and Tatiana may result in the finding 2011a). To appreciate the significance of both recordings is incredible. world. Scientific exploration of this of other behavioural consequences caused this, a current understanding of the role of Krista and Tatiana’s ability to share connection holds the potential to change by their thalamic bridge, which could further the thalamus is essential. Blumenfeld (2010) sensory information is extraordinary; modern society’s view of individualism. our understanding of the thalamus and introduces the thalamus as “an important however, the thalamus does more than Specifically, by observing Krista and Tatiana individuality. Furthermore, the sharing of relay centre” (p 35). Pinel (2011) adds that simply act as a relay centre. As stated by as they age, their unique concept of identity identity, levels of consciousness, and “the most well understood thalamic nuclei Pinel (2011), sensory relay nuclei are only a will become more apparent. Due to their perhaps thoughts, has implications for our are the sensory relay nuclei – nuclei that portion of the nuclei in the thalamus and connection, Krista and Tatiana will spend understanding of the philosophy of mind. If receive signals from sensory receptors, describe merely one of its functions. their entire life, as a pair, being extremely Krista and Tatiana share these complex process them, and then transmit them to Although the exact mechanisms are still different from most people. Thus, as a pair, notions of identity and thought – commonly the appropriate areas of sensory cortex” (p unclear, the reciprocal connections from the they paradoxically exemplify individualism. associated with “the mind” as opposed to 66). Dr. Cochrane describes the way in which thalamus to cerebral cortex are heavily However, these girls face a challenge in “the body” – it implies the mind may be Krista and Tatiana are unique: when sensory involved in moderating consciousness. individuality that has never been addressed. shared through a physical bridge. The mind information travels to their thalamus it Blumenfeld (2010) poses a theoretical Although Krista and Tatiana have separate may not be separate from the body, but branches into two routes. Krista and system, “the consciousness system,” that brains and personalities, they may share a housed within it. Although the notion that Tatiana’s thalami receive neural inputs, and regulates level of consciousness. He common perception of their surroundings, the mind and brain are one is not new, Krista process and relay them to the appropriate discusses three aspects of this system: which makes them rare even amongst and Tatiana’s case may further strengthen brain area. The inputs also cross the alertness, attention, and awareness. These craniopagus twins. Consequently, they our understanding of how and where the

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mind is housed in the brain. Despite the Girshin, M., Broderick, C., Patel, D., CHacko, S., endless scientific advances Krista and Reddy, S., Staffenberg, D., & Wasnick, J. Pedophilia and brain function (2006). Anesthetic management of staged 1 Tatiana may provide, one must remember: separation of craniopagus conjoined twins. Po Liu they are individual girls, but, more Pediatric Anesthesia, 16, 347-351. 1Department of Psychology, University of British Columbia importantly, an individual pair of girls. For us doi:10.1111/j.1460-9592.2005.01712.x Hochman, G. (2011). A rare pair: Nineteen-year-old Edited by: Kaitlyn Goldsmith, Department of Psychology, University of British Columbia. Received for review to understand how being part of a pair is conjoined twins from South Jersey, who thrive more important than being an individual to January 2, 2012, and accepted March 11, 2012. as brothers and best friends, give their first-ever Copyright: © 2012 Liu. This is an open-access article distributed under the terms of the Creative Commons interview. Philadelphia Inquirer. one’s identity, we must shift our perspective Attribution-NonCommercial-NoDerivates License, which permits anyone to download and share the article, Hard, R. (2004). The routledge handbook of Greek and eliminate our preconceived notions of provided the original author(s) are cited and the works are not used for commercial purposes or altered in any mythology: Based on H.J. Rose’s handbook of individuality. Also, it is crucial that Greek mythology. New York, NY: Routledge. way. researchers be aware of the ethical Huang, W.Q., Fang, J.Y., Xiao, L.C., Jiang, X.P., Xia, complications coupled with pursuing J.H., Feng, X., & Jiang, N. (2004). Anesthetic Abstract research on the girls. Apart from possible management for separation of craniopagus Pedophilia is defined as a sexual deviation in which an adult is sexually attracted to a twins. Acta Anaesthesiologica Scandinavica, developmental consequences, it may 48, 919-921. doi:10.1111/j.1399- prepubescent child. With relatively high prevalence rates and growing public concern over this enhance the social stigma they already face. 6576.2004.00444.x issue, there has been a need to empirically investigate the neuropsychological basis of Additionally, the question of their voluntary Koppes, L. L. & Pickren, W. (2006). Historical pedophilic behaviour. This literature review examines the resulting research, starting with perspectives in industrial and organizational research identifying the differences displayed in pedophilic individuals in IQ scores as compared consent must also be taken into account. psychology. Mahwah, NJ: Erlbaum Krista and Tatiana will face challenges arising O’Connell, J.E. (1976). Craniopagus twins: surgical to the general population. The developmental onset of pedophilia may also be linked to from the possession of an ability no one in anatomy and embryology and their abnormal brain morphology: neurological structures in both the frontal/dysexecutive the world can fully understand. They implications. Journal of Neurology, hypothesis and the temporal/limbic hypothesis have been proposed to be associated with Neurosurgery & Psychiatry, 39, 1-22. simultaneously epitomize individuality as a doi:10.1136/jnnp.39.1.1 pedophilia. Morphological differences between pedophilic individuals and non-pedophilic pair while facing individual struggles never Paré, A. (1982). On Monsters and Marvels. Chicago, individuals have been further substantiated by the link between left-handedness and a before seen. IL: University of Chicago Press. diagnosis of pedophilia. Developmental reports of childhood head injury further support this Parameswari, A., Vakamudi, M., Raghupathy, V., & claim, as pedophiles are more likely to have experienced head trauma at an early age. Finally, Siddhartha, R. (2010). Anaesthetic Declaration of Conflicting Interests management of total craniopagus twins for modern brain imaging studies have enabled researchers to discover that those individuals The author declared they have no conflicts magnetic resonance imaging and cerebral diagnosed with pedophilia display altered brain activity when presented with sexual stimuli in of interests with respect to their authorship angiography. British Journal of Anaesthesia, comparison with those not diagnosed. It must be emphasized that all of the findings may 105, 368-370. doi:10.1093/bja/aeq165 contain an innate bias due to the social denigration that is attached to research conducted on or the publication of this article. Pinel, J.P.J. (2011). Biopsychology (8th ed.). Boston, MA: Allyn & Bacon. known pedophiles. References Spencer, R. (2000a). Theoretical and analytical Blumenfeld, H. (2010). Neuroanatomy through embryology of conjoined twins. Part I: Keywords: pedophilia, brain function, neurobiology, neurology clinical cases (2nd ed.). Sunderland, MA: Embryogenesis. Clinical Anatomy, 13, 36-53 Sinauer Associates, Inc. Spencer, R. (2000b). Theorectical and analytical embryology of conjoined twins. Part II: Browd, S.R., Goodrich, J.T., & Walker, M.L. (2008). Pedophilia is considered a psychiatric deviant sexual behaviour, as evidenced by Craniopagus twins. Journal of Neurosurgery, 1, Adjustments to union. Clinical Anatomy, 13, 1-20. doi:10.3171/PED-08/01/001 97-120. disorder, which is characterized by the popular reality television program To Bucholz, R.D., Yoon, K.W., & Shively, R.E. (1987). Stone, J.L. & Goodrich, J.T. (2006). The craniopagus statistically abnormal sexual urges and Catch a Predator, perpetuating a growing Temporoparietal craniopagus: Case report and malformation: classification and implications behaviours in adults directed towards societal-level concern. The sexual review of literature. Journal of Neurosurgery, for surgical separation. Brain, 129, 1084-1095. 66, 72-79. doi:10.3171/jns.1987.66.1.0072 doi:10.1093/brain/awl065 prepubescent children (American Psychiatric exploitation of children has been Dominus, S. (2011a). Could conjoined twins share a Walker, M. & Browd, S.R. (2004). Craniopagus twins: Association, 1994). Typically, this sexual documented in various cultures around the mind? The New York Times. embryology, classification, surgical anatomy, desire for prepubescent children surpasses world (Bauserman, 1997; Ford & Beach, Dominus, S. (2011b, May 25). Could conjoined twins and separation. Child’s Nervous System, 20, the individual’s sexual desire for physically 1951), which has motivated the creation of share a mind? [Video File]. Retrieved from 554-566. doi:10.1007/s00381-004-0991-6 http://video.nytimes.com/video/2011/05/13/ma Winston K.R. (1987). Craniopagi: Anatomical mature adults and exists predominately in international sex offender legislation gazine/100000000814707/two-united-as- characteristics and classification. Neurosurgery, men (Freund, 1981). The media has (Newman et al., 2011). In the USA, the one.html 21, 769-781. heightened the public’s awareness of prevalence of child molestation is at an

Corresponding Author: 28 UBCUJP – April 2012 – Volume 1 Po Liu E-mail: [email protected]

CLINICAL CLINICAL Literature Review Liu PEDOPHILIA AND BRAIN FUNCTION Literature Review

estimated 100,000 to 200,000 cases every it seems that the average IQ scores of child offenders who have been caught, adults and therefore become attracted to year (Gorey & Leslie, 1997), underscoring pedophilic individuals are lower in accused, or convicted. This is a clear children (Marshall et al., 2000). the need to understand the underpinnings comparison to various control groups, and limitation to the research conducted in the of this disorder, including the that their intelligence scores decrease along area. Head Preference and Head Injuries neurobiological aspects of this condition. with the age of their victims. Using other Another line of research investigating hand This review will examine scientific evidence neurological assessments, Schiffer and Hypothesis on the Development of preference (handedness) has provided supporting hypotheses in the literature that Volaufen (2011) found that child molesters Pedophilia evidence relating brain dysfunction to brain function differs between pedophiles showed executive dysfunction concerning There are two main hypotheses concerning pedophilia. Bogaert (2001) demonstrated and non-pedophiles. response inhibition. Such research provides the development of pedophilia and sexual that pedophiles have a higher incidence of convincing evidence that child sex offenders offending: the frontal/dysexecutive left-handedness and these results remained Early Work – IQ may have decreased cognitive hypothesis and the temporal/limbic significant after IQ and age were controlled It has been hypothesized that brain neuropsychological functioning. hypothesis (Blanchard et al., 2006). The for (Cantor et al., 2001). While it may be the dysfunction contributes to sexual th While these observations provide useful frontal/dysexecutive hypothesis predicts case that pedophiles with lower IQ are more criminology since the 19 century (Krafft- evidence, there is an alternate that neurological deviations occur in the likely to be caught by the law, this argument Ebing, 1886/1965). Early studies into interpretation of the apparent relationship prefrontal cortex (which may be responsible does not hold true in the case of left-handed cognitive functioning assessed the general between intelligence and child molesting: for planning, decision making, and pedophiles. Therefore, the correlation intelligence or Intelligence Quotient (IQ) of less intelligent pedophiles may be more conforming to social norms), producing an between left-handedness and pedophilia sexual offenders (Frank, 1931), and these likely to be apprehended, and low inability to inhibit sexual urges (Yang & Raine, indicates a unique characteristic of the assessment techniques were subsequently socioeconomic status due to relatively low 2009). The temporal/limbic hypothesis disorder and handedness may suggest adopted into the common battery of tests intelligence may render these offenders suggests that pedophilia may be related to neurological differences as well. It has been administered to pedophiles by many unable to afford the most effective legal abnormalities within structures in the well documented that disrupted perinatal researchers in the field. Subsequent representation. Perhaps the less intelligent temporal lobe, which has been associated neurodevelopment increases the likelihood research found that child sexual offenders pedophiles are more likely to be convicted with hypersexuality. Hypersexuality is the of becoming left-handed (Coren & Halpern, score lower in intelligence than age- and due to the influence of these other variables. tendency to seek out sexual activity with 1991). For example, individuals who have socioeconomically-matched individuals Unfortunately, researchers only have access both appropriate and inappropriate partners experienced insults to neurodevelopment (Langevin et al., 1985). Furthermore, when to known (accused or convicted) child or objects at appropriate or inappropriate such as birth stress (Williams, Buss, &, compared to convicted offenders of non- molesters. Because of legal implications and times. This pattern of behaviour is one of Eskenazi, 1992), ultrasound (Kieler et al., sexual crimes, child sexual offenders moral condemnation, pedophiles have little many of the behavioural manifestations of 2001), neurotoxins (Biro & Stukovsky, 1995), continue to score lower on measures of or no incentive to reveal their sexual Kluver-Bucy syndrome in which individuals and prematurity (Marlow, Roberts, & Cooke, intelligence (Hambridge, 1994). In further attraction to children for the purposes of have damaged or ineffective temporal lobes 1989) have higher rates of left-handedness support of this pattern of lowered research studies. Not surprisingly, even (Baird et al., 2002). Kluver-Bucy syndrome is than controls. Therefore, disruptions in intelligence test scoring, research suggests those individuals who have documented a behavioural disorder caused by bilateral perinatal development of the brain may be that child sex offenders have lower sexual histories suggesting symptoms of the temporal lobe malfunction, and the disease related to the diagnosis of pedophilia. intelligence test scores than sex offenders disorder will often outright deny sexual is characterized by both cognitive and sexual Because of the possible differences in who target adults (Blanchard et al., 1999). interest in children (Brown, Gray, & disturbances including visual agnosia (the the neurological development of pedophiles Results from a large meta-analysis done by Snowden, 2009). In addition, since sexual inability to associate meaning with visual compared to controls, researchers have Cantor et al. (2005) indicated that there is a offences against children committed by stimuli), oral tendencies (examining objects studied whether childhood injuries to the specific relation between IQ and the age of women are estimated to constitute only 0.4% or surroundings with the mouth), reduced head have associations with pedophilic the child victims targeted by sex offenders: - 4% of all convicted sexual offenders sexual inhibition, and increased sex drive tendencies. Indeed, an association seems to the average IQs of males who molested (Maletzky, 1993), research studies tend to (Ozawa et al., 1997). Damage to the exist. For example, Blanchard et al. (2002) children age 13 or younger were lower than focus on male subjects and the results may temporal lobe is also responsible for speech found that accidents in childhood leading to the IQs of men who molested children not be applicable to females for this reason. and language deficits, which may explain unconsciousness were associated with between age 13 and 17. Based on the Thus, the pool of possible research why pedophiles have difficulty relating to pedophilia, lower IQ, and lower levels of extensive research done in this area to date, participants may be limited to male sexual education. Later studies provided further

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evidence that pedophiles reported more children, structures corresponding to areas References Burns, J. M., Swerdlow, R. H. (2003). Right head injuries before the age of 13 than non- of the brain involved in sexual arousal and American Psychiatric Association. (1994). The orbitofrontal tumor with pedophilia symptom Diagnostic and Statistical Manual of Mental and constructional apraxia sign. Archival pedophilic controls (Blanchard et al., 2003). behaviour (the thalamus, globus pallidus, Disorders, fourth edition (DSM-IV). Neurology, 60(3), 437-440. One possible interpretation of these results and striatum) were significantly more highly Washington DC: APA Press. Carlson, N. R. (2010). Foundations of Behavioural th is that brain damage after birth increases the activated in pedophiles compared to Baird , A. D., Wilson , S. J. , Bladin , P. F., Saling , M. Neuroscience. (8 ed.). New York: Princeton Hall. probability that a male will develop controls. M., & Reutens, D.C.(2002). Hypersexuality after temporal lobe resection. Epilepsy & Cantor, J. M., Blanchard, R., Robichaud, L. K., & pedophilia, falling in line with the While only a few studies are Behaviour, 3(2), 173–181. Christensen, B. K. (2005). Quantitative observation that pedophilic populations summarized here, the differential brain Bauserman, R. (1997). Man-boy sexual relationships reanalysis of aggregate data on IQ in sexual have a higher incidence of left-handedness. activation patterns described in the in a cross-cultural perspective. In J. Geraci offenders. Psychological Bulletin. Cantor, J. M., Christensen, B. K., Klassen, P. E., aforementioned studies lend strong support (Ed.), Dares to speak: Historical and contemporary perspectives on boy-love (pp. Dickey, R., & Blanchard, R. (2001, July). Brain Imaging Studies for the suggestion that pedophiles show 120-137). Norfolk, England: Gay Men’s Press. Neuropsychological functioning in pedophiles. More recent studies using modern imaging differences in brain function in response to Biro, V. & Stukovsky, R. (1995). Handedness as In R. Blanchard (Chair), Diagnosis, prognosis, techniques such as positron emission erotic and sexual stimuli compared to manifested in school children from a region and etiology of pedophilia. Symposium conducted at the meeting of the International tomography (PET) and functional magnetic polluted by neurotoxins. Studia Psychologica, controls. 37, 81-87. Academy of Sex Research, Bromont, Quebec. resonance imaging (fMRI) allow for the Blanchard, R. (1989). The concept of autogynephilia Coren, S., & Halpern, D. (1991). Left-handedness: A depiction of neural activity within individuals. Conclusion and the typology of male gender dysphoria. marker for decreased survival fitness. Psychological Bulletin, 109, 90-106. These technologies are useful in identifying The cross-cultural and widespread Journal of Nervous and Mental Disease, 177, 616-623. Ferretti, A., Caulo, M., Del Gratta, C., Di Matteo R., specific areas of the brain and their prevalence of pedophilia have necessitated Blanchard, R., Cantor, J.M., & Robichaud, L. K. Merla, A., Montorsi, F., Pizzella, V, Pompa, P., differential responses to identical stimuli. academic efforts to understand the (2006). Biological factors in the development Rigatti, P., Rossini, P. M., Salonia, A., Tartaro, For example, studies in this area may be able neurobiological underpinnings of brain of sexual deviance and aggression in males. In A., & Romani, G. L. (2005). Dynamics of male sexual arousal: distinct components of brain to identify differing patterns of activity in structure, function, and development in H.E. Barbaree & W.L. Marshall (Eds.), The juvenile sex offender (pp. 77-104). New York: activation revealed by fMRI. Neuroimage, pedophiles compared to non-pedophiles. relation to altered sexual tendencies. While The Guilford Press. 26(4), 1086-1096. Using fMRI, Walter et al. (2007) found traditional methods in the form of IQ tests, Blanchard, R., Christensen, B. K., Strong, S. M., Ford, C. S. & Beach, F. A. (1951). Patterns of sexual abnormal brain activity in the hypothalamus, retrospective head injury studies, and hand Cantor, J. M., Kuban, M. E., Klassen, P., behaviour. New York: Harper & Row. Frank, B. (1931). Mental level as factor in crime. periaqueductal gray, and dorsolateral Dickey, R., & Blak, T. (2002). Retrospective preference statistics have suggested self-reports of childhood accidents causing Journal of Juvenile Research, 15, 192-197. prefrontal cortex (DLPFC) in response to neurological differences in pedophilic unconsciousness in phallometrically diagnosed Freund, K, & Watson, R. J. (1981). Assessment of adult visual-erotic stimulation in individuals, modern studies using advanced pedophiles. Archives of Sexual Behaviour, 31, pedophilia. In M. Cook & K. Howells (Eds.), Adult sexual interest in children (pp. 139-179). heterosexual pedophiles. Walter et al. (2007) imaging technologies have provided a 511-526. Blanchard, R., Kuban, M. E., Klassen, P., Dickey, R., London: Academic Press. suggested that because these regions are glimpse into the complexity of this Christensen, B. K., Cantor, J. M., & Blak, T. Gorey , K.M. & Leslie, D. R.(1997). The prevalence involved in the emotional components of psychiatric disorder, which may be (2003). Self-reported head injuries before and of child sexual abuse: Integrative review sexual arousal (Ferretti et al., 2005), influenced by the interplay of multiple after the age of 13 in pedophilic and non adjustment for potential response and measurement biases. Child Abuse & Neglect, dysfunction within these areas may be neurological structures. The studies pedophilic men referred for clinical assessment. Archives of Sexual Behaviour, 32, 573-581. 21 (4), 391–398. involved in the lack of sexual interest discussed in this paper have pointed to the Blanchard, R., Watson, M. S., Choy, A., Dickey, R., Kieler, H, Cnattingius, S., Haglund, B., Palmgren, J., towards adults. Through case study reduced neurocognitive abilities and Klassen, P., Kuban, M., & Ferren, D. J. (1999). & Axelsson, O. (2001). Sinistrality – a side- investigations and brain anatomy studies, abnormalities in brain function among Pedophiles: Mental retardation, maternal age, effect of prenatal sonography: A comparative study of young men. Epidemiology, 12, 618- morphological changes in the prefrontal and sexual orientation. Archives of Sexual pedophiles; however, more research is Behaviour, 28, 111-127. 623. cortex, ventral striatum (reward center), and needed to gain a complete understanding of Bogaert, A. F. (2001). Handedness, criminality, and Krafft-Ebing, R. von. (1965). Psychopathia sexualis: regions of the temporal lobes have also been the mechanisms underlying pedophilia. sexual offending. Neuropsychologia, 39, 465- A medico-forensic study (H. E. Wedeck, Trans.). New York: Putnam. (Original work found (Mendez et al., 2000; Burns & 469. Brown, A. S., Gray, N. S., Snowden, R. J. (2009). published 1886) Swerdlow, 2003; Schiffer et al., 2007). These Declaration of Conflicting Interests Implicit measurement of sexual associations in Hambridge, J. A. (1994). Pedophiles’ ratings of adult studies provide support for the The author declared they have no conflicts child sex abusers: role of victim type and and child photographs using a semantic temporal/limbic hypothesis. Furthermore, of interests with respect to their authorship denial. Sexual Abuse: A Journal of Research differential. Journal of Forensic Sciences, 39, 456-461. Schiffer et al. (2008) found that when or the publication of this article. and Treatment, 21(2), 166-180.

presented with erotic stimuli featuring

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Langevin, R., Hucker, S. J., Handy, L., Purins, J. E., Schiffer, B., Paul, T., Gizewski, E., Forsting, M., Russon, A. E., & Hook, H. J. (1985). Erotic Leygraf, N., Schedlowski, M., & Kruger, preference and aggression in pedophilia: A T.H.C. (2008). Functional brain correlates of Too much sex, a mental disorder? comparison of heterosexual, homosexual, and heterosexual paedophilia. NeuroImage, 41(1), bisexual types. In R. Langevin (Ed.), Erotic 80-91. Examining both sides of the debate on preference, gender identity, and aggression in Schiffer, B., Peschel, T., Paul, T., Gizewski, E., men: New research studies. (pp. 137-159). Forsting, M., Leygraf, N., Schedlowski, M., & Hillsdale, NJ: Erlbaum. Krueger, T. H. (2007). Structural brain hypersexual disorder Maletzky, B. M. (1993). Factors associated with abnormalities in the frontostriatal system and Xijuan Zhang1 success and failure in the behavioural and cerebellum in pedophilia. Journal of Psychiatry 1Department of Psychology, University of British Columbia cognitive treatment of sexual offenders. Annual Research, 41(9), 753-762.

Sexual Research, 6, 241-258. Schiffer, B., & Volaufen, C. (2011). Executive Marlow, M., Roberts, B. L., & Cooke, R. W. I. (1989). Dysfunctions in Pedophilic and Nonpedophilic Edited by: Kaitlyn Goldsmith, Department of Psychology, University of British Columbia. Received for review Laterality and prematurity. Archives of Disease Child Molesters. Journal of Sexual Medicine, January 3, 2012, and accepted March 14, 2012. in Childhood, 64, 1713-1716. 8(7), 1975-1984. doi: 10.1111/j.1743- Copyright: © 2012 Zhang. This is an open-access article distributed under the terms of the Creative Commons Marshall , W.L. , Seerran , G.S. , & Cortoni , F.A. 6109.2010.02140.x. Attribution-NonCommercial-NoDerivates License, which permits anyone to download and share the article, (2000). Childhood attachments, sexual abuse, Walter, M., Witzel, J., Wiebking, C., Gubka, U., Rote, provided the original author(s) are cited and the works are not used for commercial purposes or altered in any and their relationship to adult coping in child M., Schiltz, K., Bermphol, F., Tempelmann, C., way. molesters . Sexual Abuse: A Journal of Bogerts, B., Heinze, H. H., & Northoff, G. Research and Treatment, 12, 17–26. (2007). Pedophilia is linked to reduced Abstract Mendez, M. F., Chow, T., Ringman, J., Twitchell, G., activation in hypothalamus and lateral & Hinkin, C. H. (2000). Pedophilia and prefrontal cortex during visual erotic In recent decades, the concept of pathological, excessive sexual behaviour has been a source of temporal lobe disturbances. Journal of stimulation. Biological Psychiatry, 62, 698-701. ongoing controversy. This controversy is centered on defining the characteristics of excessive Neuropsychiatry in Clinical Neuroscience, 12, Williams, C., S., Buss, K. A., & Eskenazi, B. (1992). sexual behaviours and the extent to which these behaviours should be considered pathological. 71-76. Infant resuscitation is associated with an This debate was intensified after Kafta (2010)’s proposed the inclusion of hypersexual disorder Nahas, Z., Teneback, C.C., Kozel, A., Speer, A.M., increased risk of left-handedness. American DeBrux, C., Molloy, M., Stallings, L., Spicer, Journal of Epidemiology, 136, 277-286. in the DSM-5. According to Kafta’s proposal, for a person to be diagnosed with the disorder, he K.M., Arana, G., Bohning, D.E., Risch, C., Yang Y. & Raine A. (2009). Prefrontal structural and or she must have recurrent and intense sexual fantasies, urges, and behaviours which are not George, M.S. (2001). Brain effects of TMS functional brain imaging findings in antisocial, due to direct physiological effect of a drug-related substance and which cause significant delivered over prefrontal cortex in depressed violent, and psychopathic individuals: a meta- adults. Journal Neuropsychiatry Clinical analysis. Psychiatry Res, 174(2): 81-88. doi: personal distress or impairment (American Psychiatric Association, 2010). This literature review Neuroscience, 13, 459-470. 10.1016/j.pscychresns.2009.03.012. is intended to examine whether or not hypersexual disorder should be included in the DSM-5 Newman, W. J., Hold, B. W., Rabun, J. S., Phillips, G., based on current research literature in the field. Arguments for and against its inclusion in the & Scott, C. L. (2011). Child sex tourism: DSM are reviewed. In sum, there is still a lack of consensus on the specific criteria for diagnosis, Extending the borders of sexual offender legislation. International Journal of Law and the theoretical approach to the disorder, and on how to measure hypersexual sexual behaviour; Psychiatry, 34(2), 116-121. thus it is still too premature to include hypersexual disorder in the DSM. Ozawa, H., Sasaki, M., Sugai, K., Hashimoto, T., Matsuda, H., Takashima, S., Uno, A., & Keywords: hypersexuality, sexual addiction, sexual compulsive disorder, sexual disorder, DSM-5 Okawa T. (1997). Single-Photo emission CT and MR findings in Kluver-Bucy Syndrome after Reye Syndrome. American Journal of Neuroradiology, 18(3), 540-542. Excessive sexual behaviours have long been (1983) suggested that sexual addiction stems Salloway, S., Malloy P., & Cummings J. L. (1997). discussed and described in Western from an inability to effectively control one’s The Neuropsychiatry of Limbic and medicine. As early as the 1940s, terms such sexual desires or behaviour. Over the recent Subcortical Disorders. American Psychiatric Pub., p. 125. ISBN 0880489421. as nymphomania and Don Juan Syndrome decades, the concept of pathological, Schiffer, B., Krugeger, T. H., Paul, T., DeGreiff, A., were used to describe excessive sexual excessive sexual behaviour has been an Forsting, M., Leygraf, N., Schedlowski, M., & desire or behaviours (Rinehart & McCabe, ongoing source of controversy. This Gizewski, E. (2008). Brain response to visual 1997). In 1983, Carnes proposed the concept controversy is centered on defining the sexual stimuli in homosexual pedophiles. Journal of Psychiatry Neuroscience, 33, 23-33. of sexual addiction as a diagnosable and characteristics of excessive sexual treatable mental disorder in his behaviours and the extent to which these controversial book, Out of the Shadows: behaviours should be considered Understanding Sexual Addiction. Carnes pathological. New labels for excessive sexual

Corresponding Author: 34 UBCUJP – April 2012 – Volume 1 Xijuan Zhang E-mail: [email protected]

CLINICAL CLINICAL BOTH SIDES OF THE DEBATE ON HYPERSEXUALITY DISORDER Literature Review Zhang Literature Review

behaviours, such as “compulsive sexual clinical help for their “out of control” sexual Bogart, Cecil, & Abramson, 2002). In his ventral striatum, which is also associated behaviour” (Coleman, 1990), “hypersexual desire and behaviour. The adverse research paper, Kafta (1997) expressed a with other addictive pathological disorders disorder” (Kafta, 2010) and “paraphilia- consequences associated with this condition genuine concern for the men in his clinical such as alcohol addiction and pathological related disorders” (Kafka, 1997), have since include significant marital dysfunction sample, citing that the majority were gambling. Stein’s hypothesis is derived from been introduced. (Muench et al., 2007), a higher risk of married men with a mean age of thirty-six, the addiction model that has been proposed This debate was intensified after Kafta sexually transmitted infections (Langstrom & and masturbated more times per week on to explain the etiology of hypersexual (2010) proposed the inclusion of Hanson, 2006; McBride, Reece & Sanders, average than single men in their early disorder (Carnes, 1984). According to the hypersexual disorder in the fifth edition of 2008), unwanted pregnancies (Henshaw, twenties. Carnes’ (1984) addiction model, people who the Diagnostic and Statistical Manual of 1998; McBride el al., 2008) and work and/or Several empirical studies based on non- experience excessive sexual fantasies and Mental Disorders (DSM-5). In his proposal, educational role impairment (Cooper, clinical samples also found that a small behaviours often fail to control or reduce hypersexual disorder is conceptualized as a Golden, & Kent-Ferraro, 2002). Many health proportion of men’s and women’s sexual the frequency of their sexual activities and sexual desire disorder with an impulsivity clinics offer treatments such as 12-step experiences were characterized by excessive continue to engage in such activities despite component. For a person to be diagnosed group support, individual psychotherapy and sexual desire and behaviour. For example, a plethora of adverse consequences, such as with this disorder, he or she must have pharmacotherapy for these individuals Kinsey, Pomeroy and Martin’s (1948) famous the potential increased risk of contracting recurrent and intense sexual fantasies, urges, (American Psychiatric Association, 2010). study employing a large non-clinical sample STIs and/or the instigation of marital and and behaviours which are not due to the Currently, these people are diagnosed using of 5,300 American participants reported that relationship dysfunction. This behaviour direct physiological effects of a drug-related the rather unsatisfying label, “Sexual only 8% of American men had weekly pattern is similar to that seen in drug substance and which cause significant Disorder Not Otherwise Specified” under orgasm frequencies totalling seven or more. addiction. Another analogue to drug or personal distress or impairment in social, DSM-IV-TR. An increase in clarity in the A subsequent investigation of high school alcohol addiction is that these individuals occupational or other important areas of diagnostic criteria for such conditions could and college men also found that only about may also experience withdrawal symptoms functioning (American Psychiatric provide a starting point for testing and 3% to 5% of American men masturbated on such as depression, anxiety and guilt. The Association, 2010). Examples of the sexual refining the proposed diagnostic criteria. It a daily basis, suggesting that they were popular 12-step recovery program for “sex fantasies, urges and behaviours specified in could also facilitate and stimulate more experiencing at least seven orgasms per addicts” is built upon this theoretical the proposal include masturbation, cybersex, research in this area and consequently week (Atwood & Gagnon, 1987). In contrast approach. Wines’ (1997) study including 53 telephone sex, viewing pornography, and enhance the quality of treatments. to these relatively high frequencies of participants who identified themselves as visiting strip clubs, and they are said to have Secondly, this group of people that are masturbation and orgasm, a 2010 research sex addicts offered empirical support for the the potential to become excessive (American seeking clinical help for their out-of-control study indicated that the average male addiction model. More than 94% of the Psychiatric Association, 2010). According to sexual behaviours can be distinguished from undergraduate student only masturbates participants in this investigation reported U.S. News and World Report (2010), if the non-clinical samples by their increased three times per week (Pinkerton et al., 2002). failed attempts to stop or reduce their proposal is passed by the DSM-5 Working expressions of normative sexual desire Based on this empirical evidence, Kafta sexual desire or behaviours and 98% Groups, hypersexual disorder may appear in (Kafta, 2010). Over the past decade, Kafka (2010) proposed that hypersexuality could reported three or more withdrawal the DSM by 2012. In this review, I will focus has conducted numerous studies examining be operationalized as a weekly average of symptoms, such as depression, insomnia and on the controversy surrounding hypersexual clinical samples of men with paraphilia- seven or more orgasms over a period of at fatigue. disorder by examining arguments for and related disorder, which is another term for least six months. Other researchers such as Coleman against the inclusion of hypersexual disorder hypersexual disorder used in the research Many researchers argue that (1990) suggest that hypersexuality is in the DSM-5. literature (e.g., Kafta, 1997; Kafta & Hennen, hypersexual disorder stems from genuine associated with compulsivity. Unlike the There are three main arguments for the 2003). He consistently found that this group psychological and behavioural dysfunction addiction model that focuses on the failure inclusion of hypersexual disorder in DSM. of men was characterized by having seven or that can cause functional impairment and to control one’s sexual behaviour, the First, as stated by the DSM-5 Work Group, more orgasms per week (Kafta, 1997; Kafta personal distress, and thus should be compulsivity model of hypersexual many mental health professionals have & Hennen, 2003). This frequency of orgasms considered a mental disorder. For example, behaviour emphasizes the intrusive sexual expressed the clinical need for such a is two or three times greater than those Stein (2008) stated that hypersexual fantasies and irresistible urges associated diagnosis (American Psychiatric Association, observed in studies investigating average disorder is caused by a dysfunction of the with hypersexual disorder. According to this 2010). There seems to be a distinct group of male undergraduate participants’ sexual neural circuits of the reward system in the model, some individuals have compulsive men and women who have been seeking behaviour and experiences (Pinkerton, brain, particularly the amygdala and the urges to engage in repetitive sexual

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behaviour in order to reduce anxiety and findings. They interviewed 25 participants behaviour, Kafta has removed this based on self-report measures from small other dysphoric effects such as shame and who reported sexually compulsive behaviour controversial criterion from his most recent clinical samples without valid comparison depression (Coleman, 1990). Based on this and found that 88% of the participants also proposal for hypersexual disorder (Kafta, groups. For example, most of Kafta’s model, Kalichman and Rompa (1995) met diagnostic criteria for an Axis I disorder, 2010). Without empirical support for research studies on paraphilia-related developed the Sexual Compulsivity Scale the most common disorders being anxiety criteria to identify hypersexual disorder, it disorders were based on clinical samples (SCS). Several studies have demonstrated and mood disorders. becomes a challenge for clinicians to make who sought help for their hypersexuality (e.g. the reliability and validity of SCS (Dodge et However, Kafta (2010) argues that accurate diagnoses and to include Kafta, 1997; Kafta & Hennen, 2003). These al., 2004; McBride et al., 2008). Higher because not all people exhibiting hypersexual behaviour as a disorder in the clinical samples may vary systematically scores on the SCS are correlated with an hypersexual behaviour meet the criteria for DSM-5. from those who did not seek treatment for increase in frequency of masturbation and a co-existing mood or anxiety disorder, Many researchers have also questioned excessive sexual behaviours. In Winters et an increased number of risky sexual hypersexual disorder may reflect a distinct the utility of pathologizing individuals’ al.’s (2010) study comparing a treatment behaviours, such as engaging in sexual underlying psychopathology. Based on the pursuit of sexual behaviours to enhance sample with a non-treatment sample, it was behaviour with large number of partners or high co-morbidity rate and the current mood or as a strategy aimed to reduce stress found that men who sought treatment for the constant failure to use condoms when theoretical approaches to hypersexuality, (Moser, 2010; Winters, 2010). Many people their excessive sexual behaviours were more engaging in casual sexual intercourse (Dodge Kafta (2010) concludes in his proposal that engage in other rewarding activities, such as likely to belong to an organized religion and et al., 2004; McBride et al., 2008). This hypersexual disorder is a genuine hobbies and work, to alleviate negative to feel that that religion was essential to scale’s high reliability and validity indicate psychopathology, which is associated with a mood or to relieve stress, even if it may their lives. This difference could impact the that sexual compulsivity may indeed be a loss of control over sexual behaviour and the impair other aspects of their lives such as results of studies in this area, as previous valid psychological construct. maladaptive use of sexual behaviour in their marital relationship. Additionally, studies have found that increased religiosity Based on the addiction and response to negative emotions or other life Kafta’s interpretation of the high co- is correlated with negative sexual attitudes compulsivity models of hypersexuality, stressors. morbidity rate of hypersexuality with other (De Visser et al, 2007). Therefore, it may be hypersexual disorder shares common In contrast, opponents have put forth DSM disorders has also been criticized. Both especially distressing for individuals high in etiologies with alcohol addiction and four major arguments against the inclusion Moser (2010) and Winters (2010) have religiosity to have high sexual desire and this obsessive-compulsive disorders, which are of the hypersexual disorder in the DSM. First, questioned the directionality of the may make them more likely to seek highly co-morbid with other mood disorders many researchers have questioned the correlation between hypersexual behaviours treatment. and developmental disorders (disorders that validity of the diagnostic criteria proposed and other mental disorders. They argue that In addition, the majority of studies in hinder children’s motor or cognitive by Kafta (2010). Some researchers have this high co-morbidity simply reflects the this area rely on retrospective reports of development). Therefore, it is reasonable to raised doubt about the validity of Kafta’s fact that hypersexuality may be a symptom symptoms. For example, Wines’ (1997) study suspect a high co-morbidity rate between operationalization of hypersexual behaviour of other disorders. Some people may use (cited in Kafta’s proposal) was a hypersexual disorder and other psychiatric as a weekly average of seven or more sexual fantasies and behaviours to alleviate retrospective study based on participants disorders, such as depression, general orgasms (Kingston & Firestone, 2008; the negative emotions that stem from their who identified themselves as sex addicts and anxiety disorder and attention deficit Winters, 2010). Recent data has failed to underlying mood and anxiety disorders who participated in the Twelve-Step hyperactive disorder. Indeed, many research support Kafta’s proposal that a weekly (Winters, 2010). Therefore, if the underlying Alcoholics Anonymous-type program. Kaplan studies have found that excessive or average of at least seven orgasms will only disorder(s) are treated, the maladaptive and Krueger (2010) have noted the compulsive sexual behaviour is often co- capture a small proportion of the population sexual fantasies and behaviours should also limitations of these retrospective designs, morbid with many other disorders in Axis I of that could potentially be diagnosed with be ameliorated (Winters, 2010). In short, including inaccurate and exaggerated the DSM such as those mentioned above. hypersexual disorder. For example, Winters, opponents argue that there is insufficient reports of the frequency and severity of For example, Black et al. (1997) interviewed Christoff and Gorzalka (2010) conducted a data in support of the diagnostic criteria symptoms. It is possible that the men 36 participants who exhibited compulsive study using a large community-based proposed by Kafta (2010). seeking treatment are highly motivated to sexual behaviour. The researchers reported convenience sample and found that 44% of The second major argument against the change their sexual behaviours; thus they that 37% of the sample had a history of men and 22% of women reported a total inclusion of the hypersexual disorder in the are more likely to over-estimate the severity major depression and 42% had a history of weekly orgasm count of seven or more. DSM points to a myriad of methodological of their symptoms before treatment. phobia disorder. In a recent study, Raymond, Because of lack of support for the Kafta’s flaws in hypersexuality research. The Coleman and Miner (2003) reported similar original operationalization of hypersexual majority of research studies in this area are

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The third main argument against the Another theoretical approach has been level and wide variety of sexual activities are argument, I feel that there is not enough inclusion of hypersexual disorder in the DSM introduced to overcome the limitations of considered be normal; other cultures hold empirical evidence to show that hypersexual centers on the lack of consensus around the previous models, namely, the dual control “sex-negative” scripts in which low sexual disorder represents a genuine psychological theoretical approach behind the disorder model (Bancroft & Vukadinovic, 2004). This activities are deemed to be more or behavioural dysfunction, thus it is still too and the lack of solid empirical evidence for model suggests that sexual arousal is appropriate. In criticizing the concept of premature to include it in the DSM. each proposed theoretical approach. The determined by a balance between the sexual sexual compulsivity, Levine and Troiden Although DSM-5 Work Group argues that addiction model and the sexual compulsivity activation system and the sexual inhibition (1988) contrast a “sex-positive” Mangaia the inclusion of the disorder in the DSM model mentioned in Kafta’s (2010) proposal system in the brain (Bancroft & Vukadinovic, culture and a “sex-negative” Irish culture: stimulates research, this argument in itself remain controversial. The aforementioned 2004). According to this model, people with cannot be grounds for its inclusion methodological flaw present in retrospective a particularly high propensity for excitation Among the sex-positive people of (American Psychiatric Association, 2010). data has made Wines’ (1997) findings very or low propensity for inhibition are more Mangaia, casual sex with different The lack of a diagnostic label has not difficult to interpret and thus limits their likely to engage in problematic or excessive partners, and frequent intercourse with hindered research in this area, as evidenced ability to lend solid support for the addiction sexual behaviour. This new approach has multiple orgasms are perceived as by the large number of research studies model. Upon reviewing the literature on the received increasing research interest and has sexually normal….[In contrast], the sex- done on this topic in recent decades. addiction model, Kafta (2010) also been tested against other models. If this negative Irish…. consider abstinence and Proponents also argue that hypersexual concluded in his proposal that there is a lack model receives sufficient empirical evidence monogamy as normative and typically disorder is a genuine mental disorder and of empirical evidence for a specific in the future, it would become necessary to report low levels of sexual desire and individuals afflicted with this disorder can be withdrawal state and tolerance symptoms in incorporate it into the diagnostic criteria for low frequency of sexual intercourse identified by meeting the criterion of having hypersexual disorder, which are parallel with hypersexual disorder. (p.351-352). a weekly average of at least seven orgasms those in other addiction disorders. Thus, In order to fulfill the DSM’s criteria for a (e.g. Kinsey et al., 1948; Kafta, 2010). further studies are needed to support the mental disorder, hypersexual disorder must Moser (2001) suggests that in However, the lack of consensus on the utility of this model. manifest as a genuine psychological or pathologizing mental disorders, innate specific criteria of the diagnosis, the Although the sexual compulsivity model behaviour dysfunction (American Psychiatric therapist and cultural biases should be theoretical approach of the disorder, and has received more support than the Association, 2009). Therefore, it is important avoided. However, as shown by the the measurement of hypersexuality addiction model, several studies have failed for researchers in this area to arrive at some examples above, hypersexuality is by no demonstrate that there is still insufficient to support this model. For example, consensus on the explanation of hypersexual means free of cultural biases. Many evidence to support hypersexual disorder as Quadland’s (1985) study, comparing results disorder (Winters, 2010). Until such researchers caution that the pathologizing of a genuine psychological disorder. from participants seeking help for their consensus has been reached, it may be hypersexuality may cause clinicians with Furthermore, many of the research studies compulsive sexual behaviour to those of premature to include this disorder in the conservative or negative attitudes towards supporting the models for the disorder have matched controls seeking clinical help for DSM-5. sex to impose a pathological label on normal foundational limitations in methodology, non-sexual problems, found no group The fourth argument against the sexual behaviour (Kaplan & Krueger, 2010; such as small sample sizes, the use of clinical differences in mood or anxiety disorders. In inclusion of the hypersexual disorder in the Moser, 2001). Halpern (2011) also addresses samples, and retrospective designs. These his comprehensive review of 30 patients DSM is focused on criticisms concerning the the possible legal consequences of misusing methodological limitations severely who volunteered themselves for clinical concept of “hypersexuality” itself. Gagnon the concept of hypersexuality. If hypersexual compromise the analysis and generalizability interventions for excessive sexual behaviour, and Simon (1973) introduced the term disorder is included in the DSM without solid of research findings. Levine (2010) concluded that half of the “sexual scripts” to refer to a set of social empirical evidence supporting the validity of Considering opponents’ concern about sample was inadequately described using norms and values that govern the sexual such a disorder, arrestees charged with the possible misuse of the concept of addiction and compulsivity models. In the behaviour of a specific cultural group. violations of laws prohibiting child hypersexuality, a more solid research majority of cases, participants sought Different cultures vary widely in their sexual pornography or with other sex offences may foundation needs to be established in order treatment because their spouses criticized scripts and this may account for the large be able to claim that they were afflicted with to suggest that hypersexuality is a genuine them as being “sex addicts”, reflecting a variations in what cultures regard as hypersexual disorder, and be absolved of psychological or behavioural dysfunction. sexual desire incompatibility between normative sexual expression (Levine & their charges or be allowed more lenient This needs to be established before it can be partners, not a sexual disorder (Levine, Troiden, 1988). For example, some cultures sentencing (Halpern, 2011). included in the DSM. Further research 2010). hold “sex-positive” scripts, in which high Having considered both sides of the should continue to test long-standing and

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current theoretical models as they apply to Carnes, P. (1983). Out of the shadows: Understanding Kaplan, M.S., & Krueger, R. B. (2010). Diagnosis, Quadland, M. C. (1985). Compulsive sexual behavior: hypersexual disorder, and should use more sexual addiction. Minneapolis, MN: CompCare assessment, and treatment of hypersexuality. Definition of a problem and an approach to Publishers. Journal of Sex Research, 47, 181-198. treatment. Journal of Sex and Marital Therapy, community-based samples and employ a Coleman, E. (1990). The obsessive-compulsive model doi:10.1080/00224491003592863. 11, 121-132. doi:10.1080/00926238508406078. variety of methodologies. Specifically, more for describing compulsive sexual behavior. Kingston, D. A., & Firestone, P (2008). Problematic Raymond, N. C., Coleman, E., & Miner, M. H. (2003). rigorous research is needed to establish the American Journal of Preventive Psychiatry & hypersexuality: A review of conceptualization Psychiatric comorbidity and Neurology, 2, 9-14. and diagnosis. Sexual Addiction & compulsive/impulsive traits in compulsive links between human neurobiology and Cooper, A., Golden, G. H. & Kent-Ferraro, J. (2002). Compulsivity, 15, 284-310. sexual behavior. Comprehensive Psychiatry, 44, different models of hypersexual disorder in Online sexual behaviors in the workplace: How doi:10.1080/10720160802289249. 370-380. doi:10.1016/S0010-440X(03)00110-X. order to rule out models that are less valid. can human resource departments and employee Kinsey, A.C., Pomeroy, W.B., & Martin. C.E. (1948). Rinehart, N. J., & McCabe, M. P. (1997). To address opponents’ criticism that assistance programs respond effectively? Sexual behavior in the human male. Hypersexuality: Psychopathology or normal Sexual Addiction & Compulsivity, 9, 149-165. Philadelphia:W.B. Saunders Company. variant of sexuality? Sexual and Marital hypersexuality is a value laden and culturally doi:10.1080/10720160290062293. Kotz, D. (2010). Sex addiction or simple cheating? Therapy, 12(1), 45-60. biased disorder, more cross-cultural De Visser, R. O., Smith, A. M. A., Richters, J., & How to tell the difference. Retrieved from U.S. doi:10.1080/02674659708408201. research is also needed to examine both Rissel, C. E. (2007). Association between News and World Report website: Stein, D. (2008). Classifying hypersexual disorder: normative and excessive sexual behaviours religiosity and sexuality in a representative http://health.usnews.com/health-news/family- compulsive, impulsive and addictive models. sample of Australian adults. Archives of Sexual health/sexual-and-reproductive- Psychiatric Clinics of North America, 31(4), in different cultural contexts. As with many Behaviour, 36, 33-46. doi:10.1007/s10508-006- health/articles/2010/01/27/sex-addiction-or- 587-591. doi:10.1016/j.psc.2008.06.007. studies examining complex human social 9056-0. simple-cheating-how-to-tell-the- Wines, D. (1997). Exploring the applicability of behaviours, research on hypersexuality Dodge, B., Reece, M., Cole, S. L., & Sandfort, T.M. difference?PageNr=2 criteria for substance dependence to sexual (2004). Sexual compulsivity among Langstrom, N., & Hanson, R. H. (2006). High rates of addiction. Sexual Addiction & Compulsivity, 4, should not be limited to convenience heterosexual college students. The Journal of sexual behavior in the general population: 195-220. doi:10.1080/10720169708404228. samples of North American undergraduate Sex Research, 41(4), 343-350. correlates and predictors. Archives of Sexual Winters, J., Christoff, K., & Gorzalka, B. B. (2009). students and should include adult doi:10.1080/00224490409552241. Behaviour, 35, 37-52. doi:10.1007/s10508-006- Dysregulated sexuality and high sexual desire: participants of all ages from a wide variety of Gagnon, J. H., & Simon, W. (1973). Sexual conduct: 8993-y. Distinct constructs? Archives of Sexual The social sources of human sexuality. Chicago: Levine, M. P., & Troiden, R. R. (1988). The myth of Behaviour, 39, 1029-1043. cultural and religious backgrounds. Aldine. sexual compulsivity. Journal of Sex Research, doi:10.1007/s10508-009-9591-6. Halpern, A. L. (2011). The proposed diagnosis of 25, 347-363. doi:10.1080/00224498809551467. Winters, J. (2010). Hypersexual disorder: A more Declaration of Conflicting Interests hypersexual disorder for inclusion in DSM-5: Levine, S. B. (2010). What is sexual addiction? cautious approach. Archives of Sexual The author declared they have no conflicts Unnecessary and harmful. Archives of Sexual Journal of Sex & Marital Therapy, 36, 261-275. Behaviour, 39, 594-596. doi:10.1007/s10508- Behaviour. doi:10.1007/s10508-011-9727-3. doi:10.1080/00926231003719681. 010-9607-2. of interests with respect to their authorship Henshaw, S. K. (1998). Unintended pregnancy in the McBride, K. R., Reece, M., & Sanders, S. A. (2008). or the publication of this article. United States. Family Planning Perspectives, Using the Sexual Compulsivity Scale to predict 30, 24-29. doi:10.2307/2991522. outcomes of sexual behavior in young adults. References Kafta, M. P. (1997). Hypersexual desire in males: An Sexual Addiction & Compulsivity, 15, 97-115. operational definition and clinical implications doi:10.1080/10720160802035816. American Psychiatric Association. (2009). Diagnostic for men with paraphilias and paraphilia-related Moser, C. (2001). Paraphilia: A critique of a confused and statistical manual of mental disorder (4th disorders. Archives of Sexual Behavior, 26, concept. In P. Kleinplatz (Ed.), New directions ed., text revision). Washington, DC: Author. 505-526. doi:10.1023/A:1024507922470. in sex therapy: Innovations and alternatives (pp. American Psychiatric Association. (2010). Kafta, M.P. (2010). Hypersexual disorder: A proposed 91-108). Philadelphia: Routledge. Hypersexual disorder. Retrieved from diagnosis for DSM-V. Archives of Sexual Moser, C. (2010). Hypersexual disorder: Just more http://www.dsm5.org/ProposedRevisions/Pages Behaviour, 39, 377-400. doi:10.1007/s10508- muddled thinking. Archives of Sexual /proposedrevision.aspx?rid=415# 009-9574-7. Behaviour. doi: 10.1007/s10508-010-9690-4. Atwood, J. D., & Gagnon, J. (1987). Masturbatory Kafta, M. P., & Hennen, J. (2003). Hypersexual desire Muench, F., Morgenstern, J., Hollander, E., Irwin, T. behavior in college youth. Journal of Sex in males: Are males with paraphilias different W., O’Leary, A., Parson, J. T., Wainberg, M. L., Education and Therapy, 13, 35-42. from males with paraphilia-related disorders? & Lai, B. (2007). The consequences of Bancroft, J., & Vukadinovic, Z. (2004). Sexual Sexual Abuse: A Journal of Research and compulsive sexual behavior: The preliminary addiction, sexual compulsivity, sexual Treatment, 15, 307-321. reliability and validity of the Compulsive impulsivity, or what? Toward a theoretical doi:10.1023/A:1025000227956. Sexual Behavior Consequences Scale. Sexual model. Journal of Sex Research, 41(3), 225-234. Kalichman, S. C., & Rompa, D. (1995). Sexual Addiction & Compulsivity, 14, 207-220. doi:10.1080/00224490409552230. sensation seeking and sexual compulsivity doi:10.1080/10720160701480493. Black, D. W., Kehrberg, L. L. D., Flumerfelt, D. L., & scales: reliability, validity and HIP risk Pinkerton, S. D., Bogart, L. M., Cecil, H., & Schlosser, S. S. (1997). Characteristics of 36 behavior. Journal of Personality Assessment, Abramson, P. R. (2002). Factors associated subjects reporting compulsive sexual behavior. 65, 586-601. with masturbation in a collegiate sample. 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CLINICAL Research Report Startle reflex as a physiological measure of emotion regulation Brittany C. Speed1 1Department of Psychology, University of British Columbia

Edited by: Virginie Cousineau, Department of Psychology, University of British Columbia. Received for review January 5, 2012, and accepted February 10, 2012. Copyright: © 2012 Speed. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivates License, which permits anyone to download and share the article, provided the original author(s) are cited and the works are not used for commercial purposes or altered in any way.

Abstract In the present study, the startle blink reflex is used as a measure of emotion regulation to affective picture stimuli. Based on the biphasic theory of emotion, it is hypothesized that the startle response will be largest in magnitude in the presence of negative emotional stimuli (Vrana, Spence, & Lang, 1988). It is also hypothesized that when attempting to decrease emotion, participants will show smaller blink magnitudes to negative images, and larger blink magnitudes when attempting to decrease emotion to positive images due to the aversive nature of the startle reflex. The present study highlights the difficulty of finding emotion regulation to positive images with the startle blink paradigm. Participants were 6 female undergraduate students who viewed negative, positive and neutral affective picture stimuli, and attempted to either maintain or suppress their emotional responses to the images. Emotion modulation of the startle response was recorded before regulation instruction onset. Significant differences were found in blink magnitude for emotion modulation between positive and negative images, but neutral images were not significantly different from either. For negative images, blink magnitudes during emotion suppression were significantly smaller than when maintaining emotion. No significant regulation differences were found for the positive images. Keywords: psychophysiology, emotion regulation, emotion modulation, startle blink

Emotion regulation can be thought of as depression (Davidson, 2000; Jackson, Larson, consciously or unconsciously altering one's & Davidson, 2000), and eating disorders behavioural, cognitive, and/or physiological (Clyne, Latner, Gleaves, & Blampied, 2010; emotional response tendencies towards a Harrison, Sullivan, Tchanturia, & Treasure, goal (Gross, 1998). The ability to regulate 2010; Whiteside, Chen, Neighbors, Hunter, emotions is important for both mental and Lo, & Larimer, 2007). Understanding possible physical well-being, and social interaction mechanisms associated with emotion (Kim & Hamann, 2007). Dysfunction in regulation difficulties are essential to emotion regulatory abilities has been addressing these problems in clinical thought to play a role in many forms of populations. Although emotion regulation psychopathology, such as anxiety, deficits are a core feature of many forms of

Corresponding Author: Brittany C. Speed E-mail: [email protected]

CLINICAL CLINICAL PHYSIOLOGICAL EMOTION REGULATION Research Report Speed Research Report

psychopathology, physiological evidence of or smaller in magnitude, due to a mismatch In concordance with previous research, included positive emotion regulation have these emotion regulatory deficits is severely between the reflex and the emotional Eippert et al. (2007) and Ray et al. (2010) hypothesized that arousal, and not valence, lacking. A large body of research that has context (Lang et al., 1990; Vrana et al., 1988). found larger blink magnitudes for the influences the startle response (Dillon & La been used to correlate psychopathology and Indeed, research has shown that the startle negative images from the enhance condition Bar, 2005; Driscoll et al., 2008). Dillon & La emotion regulation has been self-report, blink reflex is an effective measure of compared to maintain and suppress Bar (2005) compared regulation to positive, (Aldao & Nolen-Hoeksema, 2010; Whiteside emotion modulation, with the startle reflex conditions. However, both studies failed to neutral, and negative stimuli and found that et al., 2007) and the ability of individuals to being potentiated in the presence of find significant startle blink differences for the enhance cue during positive and accurately assess their own emotion negative emotions, attenuated in the the suppress condition compared to the negative picture presentation elicited larger regulatory abilities has not been confirmed. presence of positive emotions, and maintain condition. One possible reason for blink magnitudes than the maintain and Little research exists that overtly examines moderate in size when there is a lack of this finding is that the timing of the probes suppress cues, this finding runs counter to emotion regulation and its possible deficits emotion (Bradley, Cuthbert, & Lang, 1991; may have been too early to accurately what would be expected from the aversive in an experimental setting using Vrana et al., 1988). An increase in startle detect suppression, occurring 2 s after the matching hypothesis, where enhancing psychophysiological measures of emotion magnitude from positive, neutral, to regulation cue compared to the common 3 s positive emotion should elicit the smallest regulation. negative emotional contexts has been found delay (Eippert et al., 2007). In further blink magnitudes (Bradley et al., 1993; Lang The startle blink paradigm is an when emotions are elicited using visual support of this argument, fMRI results et al., 1990; Vrana et al., 1988). The authors advantageous physiological tool as it has the stimuli (Bradley et al., 1991; Vrana et al., showed suppressed amygdala activity during contended that this finding suggests that the ability to differentiate between positive and 1988), olfactory stimuli (Miltner, Matjak, the suppress condition compared to the startle blink response is arousal dependent, negative emotional states. This paradigm Braun, Diekmann, & Brody, 1994), narrative maintain and enhance conditions, but the meaning that the level of arousal will alter involves administering a loud blast of white stimuli, such as remembering events (Cook, suppressed activation occurred after the the startle magnitude, regardless of noise, which acts to startle the participant Hawk, Davis, & Stevenson, 1991), and threat startle probe measured regulation. Another emotional valence. Therefore, increasing causing their eyes to twitch reflexively. This of shock paradigms (Greenwald, Bradley, possible explanation for both studies failing arousal will always result in larger startle startle reflex is measured using Cuthbert, & Lang, 1998; Lissek et al., 2007). to detect significant regulation of the startle responses, whether the emotion is positive electromyographic (EMG) sensors placed on Research showing that the startle blink response for the suppress compared to the or negative in valence (Dillon & La Bar, 2005). the obicularis oculi muscle below the left eye. response is an effective measure of emotion maintain cue is that both focused only on However, significant differences in blink The startle reflex triggers the defensive regulation to affective stimuli is less reappraisal as an emotion regulation magnitude for positive compared to neutral aversive response of the biphasic appetitive- conclusive. The conditions common to technique, as opposed to subjects choosing stimuli was not found, even though the aversive dimension of emotion; this emotion regulation research are: “maintain”, their own regulation strategies. Perhaps positive images were rated as significantly automatic response is enhanced when the which instructs participants to focus on their cognitive reappraisal, a cognitive strategy more arousing then the neutral images. emotional context matches the reflex (Vrana emotional response to the stimuli without that involves re-evaluating the meaning of Therefore these findings are not sufficient to et al., 1988). Funayama, Grillon, Davis, & changing it, “suppress”, which involves an emotional stimulus (Gross, 1998), is not conclude that the startle response is solely Phelps (2001) found that the startle decreasing emotional response, and the most effective negative emotion impacted by arousal, clearly valence plays response is mediated by the right medial “enhance”, which involves increasing suppression strategy for all individuals. some role. Also, unlike Jackson et al. (2000) temporal lobe, specifically the amygdala, emotional response to a stimuli (Eippert et For all of the emotion regulation studies and others (Lee et al., 2009; Lissek et al., which plays a key role in aversive or negative al., 2007; Jackson et al., 2000; Lissek et al., mentioned thus far, positive picture stimuli 2007) no significant difference was found emotional states, supporting the theory that 2007; Ray, McRae, Ochsner, & Gross, 2010). was not included. Jackson et al. (2000) between suppress and maintain conditions. the startle response is an aversive reflex. Jackson et al. (2000) found both emotion contends that the failure to include positive Possible explanations for these contradictory Therefore, the startle response is expected modulation and subsequent regulation to images was due to a difficultly finding findings may be that Dillon & La Bar (2005) to be potentiated, or larger in magnitude, negative pictures compared to neutral. attenuation of the startle response to did not utilize a within-groups design, which when it occurs in the presence of aversive Replication studies by Lissek et al. (2007), positive emotion compared to neutral during is common to these studies, because of large emotional states (Lang, Bradley, & Cuthbert, which included a threat of shock paradigm, a pilot study. Difficulty finding the expected individual differences in blink magnitudes, 1990; Vrana et al., 1988). Along the same and Lee, Shackman, Jackson, & Davidson modulation to positive affective stimuli combined with the problems associated with reasoning, one would expect that in the (2009) had similar findings of modulation compared to neutral stimuli is not using a small sample size. presence of appetitive or positive emotional and regulation to aversive contexts uncommon (Dillon & La Bar, 2005; Driscoll, Driscoll et al. (2008) also looked at the states the startle reflex would be attenuated, compared to neutral. Tranel, & Anderson, 2008). Studies that have regulation of positive and negative emotion,

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and found that during the enhance condition, al., 2009; Lissek et al, 2007), while others hypothesis is that the startle response will Stimuli regardless of valence, there were larger employ different methodologies or have show potentiation during the suppress All images were selected from the IAPS blink magnitudes than during the suppress very few participants (Dillon & La Bar, 2005; positive condition compared to the maintain based on normative female arousal and condition. The authors concluded that these Driscoll et al., 2009). positive condition. These hypotheses are valence ratings. Pictures were selected to findings suggest that arousal is the main The purpose of this study is to replicate based on the concept that the startle create three discrete picture types: negative factor that controls the startle response. and extend the findings of previous research response is a defensive response to threat, (low valence, high arousal), positive (high However, across regulation conditions the on emotion regulation using the startle blink activating the aversive domain of the valence, high arousal), and neutral (medium startle response for negative images was paradigm (Jackson et al., 2000), with the appetitive-aversive dimension of emotion valence, low arousal). Thirty-two of each significantly larger than for positive images, inclusion of positive affective stimuli. To (Vrana et al., 1988). Therefore, when a picture type (positive, negative and neutral) even though both were matched on arousal. overcome the limitations of previous negative emotional state is suppressed, the were included in the picture set, 16 per Being matched on arousal and maintaining research a balanced design will be used, magnitude of the startle reflex will be block. The overall normative female ratings differences in startle blink magnitude matching the frequency of picture type and decreased, and when a positive emotional for valence were negative M = 2.16, SD = suggests that the startle response is also regulation cues. Probe and trial times that state is suppressed the startle reflex will 0.61, positive M = 7.56, SD = 0.61, and influenced by valence. It should also be are consistent with previous research of increase in magnitude. neutral M = 5.0, SD = 0.23. Paired t-tests noted that Driscoll et al. (2008) used a small emotion modulation and regulation will also revealed significant differences for valence sample size in their analysis, and be used (Eippert et al., 2007; Jackson et al., Method between negative and positive images t(62) consequently their findings should be 2000). = -35.16, p< 0.001, negative and neutral interpreted with caution. Emotion modulation is of high Participants images t(62) = -24.5, p< 0.001, and positive Clearly, previous research utilizing importance in this study as it is an All procedures were approved by the and neutral images t(62) = -22.06, p< 0.001. physiological measures to assess emotion established finding in startle paradigm University of British Columbia Behavioural The overall female normative arousal ratings regulation yields inconsistent and confusing research (Bradley et al., 1991; Sanchez- Research Ethics Board, and all participants were negative M = 6.47, SD = 0.74, positive findings, and the exact relationship between Navarro et al., 2008; Vrana et al., 1988); provided informed consent before M = 6.02, SD = 0.76, and neutral M = 2.94, the startle response and positive emotional failing to obtain the expected linear participation. Participants were eight female SD = 0.5. Paired t-tests revealed significant cues is not agreed upon or well understood. relationship of valence may suggest undergraduate students from the University differences for arousal between negative Possible reasons for a failure to find startle problems in the paradigm that limit the of British Columbia. This study included only and neutral images t(62) = 22.51, p< 0.001, response differences between neutral and ability to interpret the emotion regulation females as it was part of a pilot test for a positive and neutral images t(62) = -19.12, positive stimuli may be due to a difficulty findings. Subjective ratings of valence and larger study involving emotion regulation p< 0.001, and positive and negative images eliciting positive emotion in a lab setting arousal to the images will also be measured and disordered eating behaviours. As t(62) = 2.42, p< 0.05. However, follow-up t- (Jackson et al., 2000), and subjective in conjunction with normative ratings in disordered eating is much more common tests between negative and positive images differences in interpreting stimuli as positive. order to assure that arousal between among females, males were excluded. Three for all probed conditions revealed no Research shows that arousal also influences positive and negative images are matched, participants were recruited through the significant differences in arousal between the startle response (Dillon & La Bar, 2005; and therefore not responsible for University’s Human Subject Pool for 1.5 the positive and negative conditions. Each Driscoll et al., 2008; Lang et al., 1990). To differences in regulation. course credits; the remaining five block was organized in quasi-random order, effectively measure emotional valence, In this study the independent variable is participants were volunteers from the ensuring that the pictures were arousal must be balanced for positive and the combined picture types and regulation University’s Clinical and Cognitive counterbalanced for regulation instruction, negative stimuli; however, some research cues, which result in 6 distinct conditions. Neuroscience Lab. Participants ranged in age order of presentation, and time of startle studies fail to take into account the The dependent variable is the blink from 20 to 23 years (M = 22, SD = 1.06), and probe. No more than three picture types participant’s subjective ratings of arousal or magnitude elicited by the startle paradigm. all participants had a minimum of 10 years (same valence, regulation cue, or probe time) valence to the stimuli (Larson et al., 2000; Based on this information two main of English fluency. Two participants were occurred in a row. Lee et al., 2009). Problems with current hypotheses were generated. The first excluded from analysis due to a failure to emotion regulation research using the hypothesis is that the startle response will stay awake and alert during picture Procedure startle blink paradigm are that a majority of show attenuation during the suppress presentation. Each participant came in for a testing session the research fails to include positive negative condition compared to the that lasted approximately 1.5 hrs. Details affective stimuli (Jackson et al., 2000; Lee et maintain negative condition. The second were then provided about the nature of the

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task, and each participant provided decrease the predictability of the probes. and not by thinking of something unrelated there was a visible artifact in the segment, informed consent. EMG sensors were then There were 6 conditions in total, combining to the picture or by trying to produce a or if the magnitude was greater than 3 applied to the obicularis oculi muscle of the each picture type and regulation cue, which different emotion. A similar example is standard deviations above the subject’s left eye. EMG sensors at the obicularis oculi each occurred 8 times during the course of provided for a positive picture in the individual mean amplitude. Trials with no site are used to measure the size of the the experiment. No probe was presented for maintain regulation instruction. All discernable startle response were given a startle response, as this muscle is an 24 of the trials. After the task was completed participants are also given a 9 trial, 3 of each magnitude of zero and included in the important component of the startle reflex. the EEG and EMG sensors were removed picture type, practice session and question analysis (Larson et al., 2005). Startle Electroencephalographic (EEG) sensors were and the participants filled out an image period before the actual experiment begins responses were standardized using within also applied at this time as part of another rating for each picture on arousal and to ensure that they understood the subject z-score conversions to normalize study; the EEG data will not be included in valence using the Self Assessment Manikin regulation instructions. data, and to reduce the influence of the analysis. (SAM) valence and arousal scales, with 9 between subjects variability unrelated to After receiving both visual and verbal rating high (arousal or valence) and 1 rating EMG data collection and analysis psychological processes (Blumenthal, instructions and engaging in a practice low, this is the same scale that was used to To measure the startle reflex two Ag-AgCl 4 Cuthbert, Filion, Hackley, Lipp, & Van Boxtel, session, participants viewed digitized colour measure the normative ratings of the IAPS mm electrodes were placed on the obicularis 2005). images from the International Affective (Bradley & Lang, 1994). Pictures were oculi muscle below the left eyelid. The Test-retest reliability of the emotion Picture Set (IAPS; Lang et al., 1999). Each presented in the same order that they had ground electrode was placed at the AFz site. modulated startle response may not be picture was presented for 8 s. A total of 96 originally appeared and picture-viewing time Preparation of the sensors involved briskly stable over time; a study by Larson et al. pictures were presented in 2 blocks of 48 was recorded to assess interest. Participants brushing the skin with medical gauze, (2000) found low reliability at a second pictures each. At 4 s post-stimulus onset the were also asked to fill-out a strategy cleaning the area with rubbing alcohol, assessment. However, replication of this regulation cue, either a white equal sign or a questionnaire in which they described the gently exfoliating with saline gel, and study that includes subjective ratings of red minus sign, appeared on the screen strategies they used to regulate their brushing the skin once more with gauze. arousal and valence to stimuli are needed to briefly. A white equal sign instructed emotions for each picture type (decrease EMG sensors were filled with Quickgel. help understand why the reliability of the participants to maintain their emotional and maintain for positive, negative and Impedance levels of the electrodes below 20 emotion modulated startle appears to be response to the picture. A red minus sign neutral images). After the strategy kΩ were accepted (Larson et al., 2000). EMG low. A study by Lee et al. (2009) found low instructed participants to decrease the questionnaire was complete all participants data was obtained with a Brain Products Inc, test-retest reliability of the emotion intensity of the emotion they were were debriefed on the nature of the study. QuickAmp 72 System. Brain Vision Recorder regulated startle response, with decreased experiencing in response to the picture. Both was used to record the data and Brain Vision sensitivity to regulation, compared to a regulation instructions were presented for Emotion regulation instructions Analyzer was used to process and score the corrugator measure. The startle paradigm all picture types (positive, negative, and Participants were left free to decide on how startle responses. Data was sampled at 1000 measures emotion over a span of neutral) an equal number of times to to regulate their emotions effectively. No Hz. Signals were digitally filtered offline with milliseconds, which may account for its maintain consistency across trials. After 8 s a strategies were provided on how to regulate high and low pass frequency filters at 30 Hz variability across assessments, whereas black screen replaced the picture for 5 s. The emotions. However, to separate emotion and 500 Hz (48 dB/octave roll-off) with a 60 corrugator activity is measured over a larger word “RELAX” then appeared on the screen regulation from inattention, participants Hz Notch filter. Startle EMG was rectified span of time and is therefore likely to be for 5 s, at this time participants were were instructed to focus on the picture, and and smoothed with a 20 ms moving window more consistent. To be confident in the instructed to stop decreasing or maintaining told not to produce thoughts or images that average. The data was baseline corrected, ability of the startle paradigm to measure their emotional response to the previous were unrelated to the picture or emotion subtracting the average value of the 50 ms emotion modulation and regulation over picture and to get ready for the next picture. they were experiencing. For example, in the baseline period (before the probe onset) time more research needs to be done testing During picture presentation an acoustic sample trial participants are shown a picture from all time points in the segment. The reliability, and the factors that may influence startle probe (a 95 dB, 50 ms burst of white of a striking snake. Participants are then told peak startle magnitude was determined it. noise generated by the Audacity 1.3 Beta that if they are presented with a red minus within a window of time extending from the Unicode Software) was presented to both sign and are required to decrease their time of probe onset to 120 ms. Trials were ears at either 3 s (probe A) or 7 s (probe B) emotion, fear is the example given, they excluded if the blink began prior to 15 ms after picture onset. Inter-trial probes were should accomplish this by decreasing the following the probe, if there was excess presented 4 times during the trial to intensity of the fear they are experiencing, noise in the baseline period (>10 µV), if

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0.3 subjective ratings of valence and arousal for meaning that differences in blink magnitude 0.8 Negative

0.2 the images matched the normative ratings. between the regulation conditions showed a Positive 0.6

0.1 trend, but were not substantial enough to Neutral scores) -

Emotion Modulation show significant differences. The interaction scores) 0.4 0 - A one-way repeated measures ANOVA was between valence and regulation was non- -0.1 conducted to examine the predicted significant, F(2,8)=2.74, ns. Therefore, blink 0.2 -0.2 emotion modulation effects on the startle magnitudes were not significantly affected 0 Blink Magnitude (z Magnitude Blink -0.3 response to probe A, which was presented 3 by the relationship between picture type Blink Magnitude (z Magnitude Blink -0.4 s after picture onset, before the regulation and regulation cue. The linear contrast for -0.2 Negative Neutral Positive Valence cue. The effect of valence was non- valence was significant with -0.4 Figure 1. Differences in blink magnitude by affective significant, F(2,8) = 3.05, ns, startle blink negative>positive>neutral, F(1,4) = -8.69, p< Maintain Suppress picture type. Measured 3 s after picture onset. magnitudes for each picture type were not 0.05. Concretely, a consistent linear trend Regulation Cue significantly different. The hypothesized was found for blink magnitudes and picture Figure 2. Changes in blink magnitude relative to the

linear trend of negative>neutral>positive type at both probe times, before and after affective picture type and regulation cue condition. Measured 7 s after picture onset. Results was examined using a linear trend contrast the regulation cue, highlighting the stability

on valence and revealed a significant linear of this effect. Paired t-tests were conducted Image Ratings successfully, and that the pictures were trend, F(1,4) = 8.39, p< 0.05, blink to test the hypothesized regulation effects A one-way repeated measures ANOVA was eliciting the expected response, we expected magnitudes did follow the expected pattern for the negative and positive images (see conducted to evaluate the participant’s to replicate the findings of other emotion of largest in magnitude to negative images Figure 2). A significant difference was found subjective ratings of picture valence. A modulation research (Bradley et al., 1991; and smallest in magnitude to positive images, between negative maintain and negative significant effect for valence was revealed, Sanchez-Navarro, Martinez-Selva, Torrente, supporting the argument that the startle decrease, t(4) = 5.01, p< 0.05, with blink F(2,10) = 52.28, p< 0.001. Follow-up paired t- & Roman, 2008; Vrana et al., 1988). The response is an aversive reflex. Follow-up magnitudes being significantly smaller in the tests revealed a significant difference of startle magnitude was significantly larger for paired t-tests revealed a significant decrease condition than the maintain valence between negative and positive, t(5) negative compared to positive images. difference between negative and positive, condition. The difference between positive = -7.41, p = 0.001, neutral and negative, t(5) However, responses to the neutral images t(4) = 2.90, p< 0.05 while the difference maintain and positive decrease were non- = 8.48, p< 0.001, and neutral and positive, were not significantly different from either between negative and neutral, t(4) = 0.83, ns significant, t(4) = 1.06, ns. Blink magnitudes t(5) = -5.42, p< 0.05. Therefore, participants the positive or negative images. Failing to and neutral and positive, t(4) = 1.48, ns were were not significantly different in size rated each picture type as significantly find differences in response magnitude for non-significant (see Figure 1). Therefore, between the decrease and maintain different from each other on emotional neutral and positive images has been a blink magnitudes to negative pictures were conditions. As expected there was no valence. A one-way repeated measures problem in other emotion regulation studies significantly larger than to positive pictures. significant difference in blink magnitudes ANOVA was conducted to evaluate the (Dillon & La Bar, 2005; Driscoll et al., 2008). However, no significant differences in blink between neutral maintain and neutral participant’s subjective ratings of arousal. A This finding may indicate that the positive magnitudes were found between neutral suppress conditions. Therefore, significant significant effect for arousal was revealed, images were not interpreted as positively as and positive or neutral and negative images. differences in blink magnitude were found F(2,10) = 34.37, p< 0.001. Follow-up paired t- expected by the participants. only during regulation to the negative tests revealed a significant difference for The lack of significant differences Emotion Regulation images. arousal between neutral and negative t(5) = between negative pictures to neutral A 3 (image valence) x 2 (regulation condition) -9.44, p< 0.001, and neutral-positive t(5) = - pictures could be due to a lack of repeated measures ANOVA was conducted 6.08, p< .005, while the difference between Discussion habituation to the startle probe at the for the startle response to probe B, negative and positive, t(5) = 2.14, ns were beginning of the paradigm. The first probed presented at 7 s following picture onset. This The initial emotional response to the non-significant. In other words, participants images in both trials were neutral, and revealed a significant main effect for valence, pictures, before any regulation cues were rated the positive and negative pictures as responses to these images were typically F(2,8) = 7.08, p< 0.05, blink magnitudes were given, as measured by probe A, was an high in emotional arousal, while the neutral much larger than for the rest of the neutral significantly different across picture types. A important characteristic of this study. To images were rated as low in emotional pictures in the task. Therefore, a few large main effect for regulation approached help assess that the paradigm was working arousal. Accordingly, the participant’s startle responses in the neutral condition significance, F(1,4) = 5.08, p = 0.087,

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could be responsible for driving the mean up. Current research has not found the An important limitation of this study, and drinking, gambling, and self-injury Leaving out the first trial in the paradigm has expected emotion regulated startle response and others, that have attempted to measure (Klonsky, 2008). As most research regarding been used in previous research as it has to positive images (Dillon & La Bar, 2005; positive and negative emotion regulated emotion regulation is self-report it is critical been found to be larger than all other Driscoll et al., 2008). Jackson et al. (2000) startle is the small size of the sample (Dillon to address if these emotion regulation responses, and may be useful in future has proposed that this may be due to a & La Bar, 2005; Driscoll et al., 2008). The deficits are also present at the physiological research to avoid habituation effects (Larson difficulty in eliciting positive emotion in a magnitude of the emotion modulated and level, in order to better develop and assess et al., 2000). Another possible reason laboratory setting. Genuine positive emotion regulated startle varies widely across treatment strategies that improve emotion significant differences were not found for may be harder to elicit in participants than individuals (Lang et al., 1990), therefore, a regulation cognitively, behaviourally, and positive and negative images to neutral is negative emotion, as the participants are larger sample size is needed before making physically. However, due to inconsistencies because of the small sample size in this sitting in a dark room, unaware of what they any strong conclusions about the results. in the research and insufficient data to study. Due to the small sample size, the will see next, with loud noises occasionally The small sample size reported in this and support the expected hypotheses, more power to detect smaller significant startling them. Also, to ensure that arousal is other research may play a large role in the research needs to be done using the startle differences was low. matched in both negative and positive failure to gather significant or consistent paradigm on positive and negative emotion Emotion regulation to the picture images, erotic images are often used findings of emotion regulation to positive regulation, with large sample sizes, to stimuli was also measured by the startle because other positive images are often stimuli. properly understand the mechanisms at response. The first hypothesis stated that in rated low on arousal. Although the startle This study only used female work that influence the startle response the suppress negative condition the startle response is supposed to be smallest when undergraduate subjects, as have others before it can be used to provide reliable response would be attenuated compared to viewing erotic images (Lang et al., 1990), it is (Eippert et al., 2007; Ray et al., 2010), which information about clinical samples. the maintain negative condition. This possible that individuals may vary on their limits the generalizability of the results. Future studies on the emotion hypothesis was supported, during the responses to the erotic images in the lab Females were used exclusively in this study regulated startle response should utilize a suppress negative condition the startle setting, depending on their comfort level. as they were participants in part of a larger larger sample size, balanced paradigms for response was significantly smaller than Another explanation for the failure to study involving behaviours most common to picture valence, and matched subjective and during the maintain negative condition. The find the expected regulation to positive women. Although previous research that has normative arousal for positive and negative startle blink paradigm successfully measured images comes from Dillon and La Bar (2005) included both sexes has found no significant stimuli in order to successfully extend upon voluntary changes in emotional response to who suggested that the emotion regulated differences of gender (Jackson et al., 2000) it current knowledge on the nature of the a regulation cue for the negative images. startle response is arousal-dependent. would be beneficial to include both sexes in startle response to emotion regulation. It The second hypothesis stated that for the Therefore, stimuli that are arousing, a study of the emotion regulated startle may also be beneficial to look for more positive images, startle blink magnitude regardless of valence, should show an response with positive and negative stimuli, effective ways to elicit positive emotion in would be potentiated during the suppress attenuated startle response when to be able to further generalize the findings the lab setting, beyond the IAPS picture set. positive condition compared to the maintain suppressed compared to maintained, in and to test for any possible differences in Moreover, fear conditioning has been shown positive condition. As others have found, opposition to the aversive matching emotion regulation between gender. How to modulate the startle response in the lab this hypothesis was not confirmed; the hypothesis. However, both the positive and these results relate to other populations, for (Greenwald et al., 2007; Lissek et al., 2007); startle response was smaller during the negative stimuli in the task were matched on example, non-educated individuals, older perhaps associating a stimulus with a suppress condition than the maintain arousal for normative and subjective ratings, adults or clinical populations is unclear. It positive experience or reward could also be condition for positive images, however, this but positive images failed to show any would be beneficial if these findings could be used to modulate the startle response, difference was not significant (Dillon & La significant differences between the suppress replicated with more varied samples. eliciting a more genuine positive emotion in Bar, 2005; Driscoll et al., 2008). In this study and maintain conditions, while the negative In the introduction it was suggested the lab. In conclusion, the startle blink the startle blink paradigm was not a images did show significant differences that the emotion regulated startle response paradigm is a promising physiological sensitive measure of emotion regulation to between condition. Therefore, arousal does could potentially be a useful measure of measure of emotion regulation, however positive affective stimuli. No significant not appear to fully explain why positive emotion regulation abilities/deficits in more research needs to be conducted with differences were expected for startle blink emotion regulation has not followed the clinical samples. Emotion dysregulation, or larger samples before it can be used to magnitudes between the suppress neutral pattern expected by the biphasic (appetitive- the inability to regulate one’s emotions in a assess dysregulation in clinical populations. and the maintain neutral conditions, and aversive) theory of emotion. healthy or adaptive way has been linked to indeed no differences were found. destructive behaviours such as binge eating

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Declaration of Conflicting Interests threat-related stimuli. Human Brain Mapping, Lissek, S., Orme, K., Mcdowell, D. J., Johnson, L. L., The author declared they have no conflicts 28, 409-423. Luckenbaugh, D. A., Baas, J. M., Cornwell, B. Funayama, E. S., Grillon, C., Davis, M., & Phelps, E. R., & Grillon, C. (2007). Emotion regulation of of interests with respect to their authorship A. (2001). Double dissociation in the affective potentiated startle across affective picture and or the publication of this article. modulation of startle in humans: Effects of threat-of-shock paradigms. Biological unilateral temporal lobectomy. Journal of Psychology, 76, 124-133. Cognitive Neuroscience, 13(6), 721-729. Miltner, W., Matjak, M., Braun, C., Diekmann, H., & References Gross, J. J. (1998). The emerging field of emotion Brody, S. (1994). Emotional qualities of odors Aldao, A., & Nolen-Hoeksema, S. (2010). Specificity regulation: An integrative review. Review of and their influence on the startle reflex in of cognitive emotion regulation strategies: A General Psychology, 2(3), 271-299. humans. Psychophysiology, 31, 107-110. transdiagnostic examination. Behaviour Greenwald, M. K., Bradley, M. M., Cuthbert, B. N., & Ray, R. D., McRae, K., Ochsner, K. N., & Gross, J. J. Research and Therapy, 48(10), 974-983. doi: Lang, P. J. (2007). Startle potentiation: Shock (2010). Cognitive reappraisal of negative 10.1016/j.brat.2010.06.002 sensitization, aversive learning, and affective affect: Converging evidence from EMG and Blumenthal, T. D., Cuthbert, B. N., Filion, D. L., picture modulation. Behavioural Neuroscience, self-report. Emotion, 10(4), 587-592. doi: Hackley, S., Lipp, O. V., & Van Boxtel, A. 112(5), 1069-1079. doi: 10.1037/0735- 10.1037/a0019015 (2005). Committee report: Guidelines for 7044.112.5.1069 Sanchez-Navarro, J. P., Martinez-Selva, J. M., human startle eyeblink electromyogtaphic Harrison, A., Sullivan, S., Tchanturia, K., & Treasure, Torrente, G., & Roman, F. (2008). studies. Psychophysiology, 42(1), 1-15. doi: J. (2010). Emotional functioning in eating Psychophysiological, behavioral, and cognitive 10.1111/j.1469-8986.2005.00271.x disorders: Attentional bias, emotion recognition indices of the emotional response: A factor- Bradley, M. M., Cuthbert, B. N., & Lang, P. J. (1991). and emotion regulation. Psychological analytic study. The Spanish Journal of Startle and emotion: Lateral acoustic Medicine, 40, 1887-1897. Psychology, 11(1), 6-25. probes and the bilateral blink. Jackson, D. C., Malmstadt, J. R., Larson, C. L., & Vrana, S. R., Spence, E. L., & Lang, P. J. (1988). The Psychophysiology, 28(3), 285-295. doi: Davidson, R. J. (2000). Suppression and Startle Probe Response: A New Measure of 10.1111/j.1469-8986.1991.tb02196.x enhancement of emotional responses to Emotion? Journal of Abnormal Psychology, Bradley, M. M., & Lang, P. J. (1994). Measuring unpleasant pictures. Psychophysiology, 37, 97(4), 487-491. emotion: The self-assessment manikin and the 515-522. doi:10.1017/S0048577200990401 Whiteside, U., Chen, E., Neighbors, C., Hunter, D., Lo, semantic differential. Journal of Therapy and Kim, S. J., & Hamann, S. (2007). Neural correlates of T., & Larimer, M. (2007). Difficulties Experimental Psychiatry, 25, 49-59. positive and negative emotion regulation. regulating emotions: Do binge eaters have Clyne, C., Latner, J. D., Gleaves, D. H., & Blampied, Journal of Cognitive Neuroscience, 19(5), 776- fewer strategies to modulate and tolerate N. M. (2010). Treatment of emotional 798. doi: 10.1162/jocn.2007.19.5.776 dysregulation in full syndrome and negative affect? Eating Behaviours, 8, 162-169. Klonsky, E. D. (2008). The functions of deliberate subthreshold binge eating disorder. Eating self-injury. A review of the evidence. Clinical Disorders, 18, 408-242. Psychology Review, 27, 226-239. Cook, E. W., Hawk, L. W., Davis, T. L., & Stevenson, Lang, P. J., Bradley, M. M., & Cuthbert, B. N. (1990). V. E. (1991). Affective individual differences Emotion, attention, and the startle reflex. and startle reflex modulation. Journal of Psychological Review, 97(3), 377-395. doi: Abnormal Psychology, 100, 5-13. 10.1037/0033-295X.97.3.377 Davidson, R. J. (2000). Affective style, Lang, P. J., Bradley, M. M., & Cuthbert, B. N. (1999). psychopathology, and resilience: Brain International affective picture system mechanisms and plasticity. American (IAPS): Technical manual and affective ratings. Psychologist, 55(11), 1196-1214. doi: NIMH Centre for the Study of Emotion and 10.1037/0003-066X.55.11.1196 Attention. Driscoll, D., Tranel, D., & Anderson, S. W. (2008). Larson, C. L., Ruffalo, D., Nietert, J. Y., & Davidson, The effects of voluntary regulation of positive R. J. (2005). Stability of emotion-modulated and negative emotion on psychophysiological startle during short and long picture responsiveness. International Journal of presentation. Psychophysiology, 42, 604-610. Psychophysiology, doi: doi: 10.1111/j.1469-8986.2005.00345.x 10.1016/j.ijpsycho.2008.03.012. Larson, C. L., Ruffalo, D., Nietert, J. Y., & Davidson, Dillon, D. G., & La Bar, K. S. (2005). Startle R. J. (2000). Temporal stability of the emotion- modulation during conscious emotion modulated startle response. Psychophysiology, regulation is arousal-dependent. Behavioural 37, 92-101. doi: 10.1017/S0048577200981344 Neuroscience, 119(4), 1118-1124. Lee, H., Shackman, A. J., Jackson, D. C., & Davidson, Eippert, F., Veit, R., Weiskopf, N., Erb, M., R. J. (2009). Test-retest reliability of voluntary Birbaumer, N., & Anders, S. (2007). emotion regulation. Psychophysiology, 46, 874- Regulation of emotional responses elicited by 879.

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The negative effect of doodling on visual recall task performance Elaine Chan1 1Department of Psychology, University of British Columbia

Edited by: Amara Sarwal, Department of Psychology, University of British Columbia. Received for review January 9, 2012, and accepted March 4, 2012. Copyright: © 2012 Chan. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivates License, which permits anyone to download and share the article, provided the original author(s) are cited and the works are not used for commercial purposes or altered in any way.

Abstract Doodling consists of drawings that are often made to pass the time while an individual’s primary attention is elsewhere. Therefore, it is often seen as a sign of lack of attention. Studies have shown that doodling can actually be beneficial to recall performance on auditory tasks since it does not require many executive resources and may serve to stop mind wandering without affecting attention on the main task (Andrade, 2009). To date, there have been no studies investigating whether recall performance is affected when the primary task requires the same modality as doodling; the present study aimed to determine whether doodling would affect performance on a visual recall task. Participants (N = 14) were randomly assigned to either ‘doodling’ or ‘non-doodling’ conditions. Both groups observed a collection of images that they were then instructed to recall from a second list presented directly afterwards, with the ‘doodling’ group instructed to doodle while observing the first set of images. As hypothesized, the mean number of recalled images by the doodlers was found to be significantly lower than that of the non-doodlers. This was likely due to the fact that doodlers’ visual processing resources were divided between the two tasks. An implication of this finding is that multitasking in activities which require the same primary modality as that of the main task can have a negative effect on the amount of information processed and retained.

Keywords: doodling, modality, visual processing, recall, multitasking

A doodle is a drawing that is made while a performance by maintaining concentration is person’s primary attention is elsewhere. It currently being questioned. can consist of cartoons, landscapes, While doodling has long been geometric shapes and/or lettering. Doodling associated with a lack of attention on the is often done to pass the time when one is task at hand, such as an ongoing lecture, bored or while daydreaming. An example of some studies have shown that doodling doodling can be seen in schools on students' actually improves recall performance. In lecture notes. Whether doodling impairs one such study, forty participants listened to performance by detracting resources from a monotonous mock telephone message the primary task or whether it can improve containing the names of people coming to a

Corresponding Author: Elaine Chan E-mail: [email protected]

COGNITION COGNITION EFFECT OF DOODLING ON VISUAL RECALL Research Report Chan Research Report

party. The researchers randomly assigned demand the use of both of these pathways, Materials The experiment was conducted half of the group to a doodling condition in information may not be processed to the Microsoft Office PowerPoint 2007 was used between-groups, and each participant was which they shaded printed shapes while same degree as when there is solely one to present the two slideshows of images for individually tested. The independent listening to the message. Unexpectedly, the visual task because the capacity of the visual the visual recall task. The two lists of images variable was doodling, and the dependent doodling group performed better on the task system is limited (e.g., Broadbent, 1958; and the order they were presented in are variable was the number of images correctly and recalled 29% more information on a Kastner & Ungerleider, 2000). shown in Supplementary Table 1. The identified in List 2 as being from List 1. surprise memory test than the non-doodling To the author’s knowledge, no previous images were found on the internet. The Participants were scored on correctly group (Andrade, 2009). studies have investigated the effects of slideshows of images were all presented in indicating whether or not each image in List Unlike many dual task situations, doodling on recall on a primary task which colour on the full screen setting of a 15.4” 2 was present in List 1 for a total maximum doodling while working may be beneficial requires the use of the same primary Toshiba laptop. For the duration of the score of 20 (i.e., participants were given a because it is thought to improve attention to modality, such as the recall of objects. study, each participant was seated at a table point for correctly identifying when an the primary task by reducing mind Therefore, as doodling and viewing objects with the laptop directly in front of them, image in List 2 was or was not presented in wandering such as daydreaming, which both require visual processing, this study will with sufficient table space on which to use List 1). requires more executive functioning than investigate whether or not doodling affects the paper and pen provided. doodling (Andrade, 2009). A simple task recall on a visual task. Participants will be Results such as doodling requires very few executive randomly assigned to the ‘doodling’ and Procedure resources and may be sufficient to stop ‘non-doodling’ conditions and instructed to At the beginning of the experimental task, A between-groups, independent samples t- daydreaming without affecting attention memorize a slideshow of images, with those half of the participants were randomly test was conducted to test for a difference in and processing of information – therefore in the ‘doodling’ condition instructed to assigned to the ‘doodling’ condition based the average number of images recalled in performance – on the main task (Andrade, doodle. They will then be presented with a on the order in which they took part in the the visual task between the ‘doodling’ group 2009). Another study proposed that second slideshow and asked to identify the study. All participants were instructed to and the ‘non-doodling’ group. As shown in doodling is beneficial for attention to a images that were in the first slideshow. view the first slideshow (List 1) and to try to Figure 1, the mean number of recalled primary task by being a way for students to Since doodling will compete for the visual memorize all of the images that would be images by the doodlers (M = 15.86, SD = address their need to be active when they processing resources necessary for the presented. Participants in the ‘doodling’ 1.07) was significantly lower than that of the are forced to be inactive in a confined space primary recall task, it is hypothesized that condition were given the additional non-doodlers (M = 19.29, SD = 1.11), t (12) = such as a classroom setting. By acting as an doodlers will do worse than non-doodlers on instruction to draw flowers (an arbitrary, 5.88, p< .001. outlet for this tension, doodling allows the the visual recall task by recalling fewer relatively simple image) on the piece of student to focus on the class lecture (Aellig, images than the non-doodlers. paper provided at the same time as they Cassady, Francis, & Toops, 2009). were viewing the slideshow. They were told However, doodling may only be Method that they could look at their doodling as they beneficial in dual task situations where the wished, and not to stop drawing until the two tasks do not compete for the same Participants slideshow was over. Directly afterwards, all information processing resources. After Fourteen undergraduate students from the participants were told to view the second being viewed, images must travel from the University of British Columbia participated in slideshow (List 2) and, as they watched, to eyes through the optic nerve to the lateral this study. There were ten females and four indicate on the paper provided which images geniculate nucleus of the thalamus. From males, with an average age of 19.79 years in List 2 also appeared in List 1. There were there, this signal is sent to the visual cortex, (SD = 1.19). Participants were enrolled in twenty images in each slideshow, and ten of where it is further processed. For example, the PSYC 260 course and recruited as the original twenty images from List 1 were the ventral stream of the visual association volunteers.1 in List 2 along with ten new images (Table 1). Figure 1. Mean number of images recalled ± standard cortex, or the “what” stream, plays a role in However, participants were not told how error of participants (n=14) in the ‘doodling’ and ‘non-doodling’ conditions. Non-doodlers (M = 19.29, recognition and identification of visual many of the images from List 1 would be in SE = 0.42) had a significantly higher mean number of stimuli. The dorsal stream, or the “where” List 2. Each image in both slideshows was images recalled in the visual task than doodlers

stream, helps to guide visual attention. 1 presented once and shown for three (M = 15.86, SE = 0.40). As this experiment was conducted as part of a When a person engages in tasks that course project, ethics approval was not needed. seconds.

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Discussion filtered through a limited processing channel would also make the task of doodling more secondary task that uses minimal executive that can become overloaded (Broadbent, “mindless” and allow more cognitive resources and does not compete for visual As hypothesized, there was a significantly 1971). When this happens, some of the resources to be devoted to the primary resources, such as listening to music without higher mean number of images recalled by incoming information is filtered out, while recall task. Furthermore, participants were lyrics, would be beneficial for performance the non-doodlers than by the doodlers, other information is selected for further allowed to look at their doodling as they on a visual recall task. To further specify which suggests that doodling negatively processing (Broadbent, 1971). If this is wished and the viewing time of each findings, future studies using larger sample affects performance on the visual recall task. indeed the case, some of the information participant to the slideshow images was sizes could also investigate whether sex This is likely a result of the fact that as both from the visual recall task could have been therefore inconsistent and uncontrolled. differences play a role in the effect of a doodling and the main visual recall task filtered out and not processed by the brain More precise instructions in future studies secondary task on main recall task required visual processing by the brain, into short term or working memory as a would help to minimize confounds. performance (i.e., doodling on audio recall performance on the recall of images was result of engaging in doodling. It is assumed However, in the interest of standardizing the task performance) as it has been shown that impaired. In a similar fashion, Andrade that performance on a recall task, measured experiment, a limitation to the implications there may be sex differences in the ability to (2009) noted that tests of memory or in terms of accuracy in recall, reflects the of the findings exists in how participants’ multitask (Ren, Zhou, & Fu, 2009). attention often use a second task to depth of processing of the monitored doodling is unnatural since they are not Continued research on the effects of a selectively block a particular mental process, material (Andrade, 2009). allowed to draw as they please; doodling is secondary task on a primary recall task will and if that process happened to be A potential confound for this typically done at one’s own discretion. allow students and professionals alike to important for the main cognitive task, it experiment arises in how participants were Important implications of this study adopt work habits that can help to maximize would result in performance being impaired told prior to the task that they would be focus around methods of aiding attention information processing and recall, thus due to this competition for cognitive tested on recall. As a result of this, and memory. In previous research, such as increasing time efficiency and productivity in resources. As well, all doodlers were participants had incentive to focus on the that of Andrade (2009), auditory tasks were their everyday lives. observed to glance at their doodles from images and devote their attention to the chosen to be the main cognitive tasks in time to time throughout the slideshow, task, thereby resisting from any mind order for doodling to compete minimally for Declaration of Conflicting Interests which detracted from the time that could wandering, such as daydreaming, that may modality-specific resources, and resulted in The author declared they have no conflicts have been spent looking at and memorizing occur in a natural setting. Another potential doodling being found to improve recall. The of interests with respect to their authorship the pictures. Therefore, it is possible that confound lies in how the images in the findings of the present study further develop or the publication of this article. doodlers viewed the images for a shorter slideshows were not strictly neutral and this idea by showing that doodling does not duration of time than non-doodlers. could have generated some emotion or remain beneficial for performance on a References A further explanation for these results memory in the participants, which could primary task when it competes for the same Aellig, A., Cassady, S., Francis, C., & Toops, D. (2009). Do attention span and doodling relate could be that the ‘doodling’ condition have affected recall. In the future, the cognitive resources. Therefore, it could be to ability to learn content from an educational evoked the effects of multitasking on images could be selected from a list of pre- generalized that in order to improve video? Epistimi, 4, 21-24. performance since doodlers had to doodle at determined neutral images. information processing and memory, one Andrade, J. (2009). What does doodling do? Applied the same time as memorizing the images in In the present study, although all should not multitask in activities which Cognitive Psychology, 24, 100-106. Broadbent, D.E. (1958). Perception and the slideshow that was presented. participants assigned to the ‘doodling’ group require the same primary modality as that of communication. London: Pergamon. Multitasking requires attention to be divided were instructed to draw pictures of flowers the task. This has practical applications for Broadbent, D.E. (1971). Decision and stress. London: between simultaneously occurring tasks, and as a way of standardizing doodling, every real-life activities, such as studying, and for Academic Press. after much research (e.g., Broadbent, 1971; Hembrooke, H. & Gay, G. (2003). The laptop and the participant had their own interpretation of behaviour in class lectures and during lecture: The effects of multitasking in learning Hembrooke & Gay, 2003), it has been shown these instructions, and hence, all the meetings in the workplace. It is plausible environments. Journal of Computing in Higher almost without exception that performance doodled images of flowers were different. In that multitasking could be beneficial if the Education, 15, 46-64. on one or both tasks suffers as a direct result order to better standardize the doodling secondary task serves to reduce mind- Kastner, S. & Ungerleider, L.G. (2000). Mechanisms of visual attention in the human cortex. Annual of having to perform two tasks condition, a sample image of a flower could wandering while not detracting from the Review of Neuroscience, 23, 315-341. simultaneously (Hembrooke & Gay, 2003). be given to participants to copy or the cognitive resources necessary for the Ren, D., Zhou, H., & Fu, X. (2009). A deeper look at This effect may be explained by Broadbent’s doodling task should be even more primary task (Smallwood, O’Connor, gender difference in multitasking: Gender- theory of selective attention which proposed simplified (i.e., participants instructed to Sudbery, & Obonsawin, 2007). A future specific mechanism of cognitive control. 2009 Fifth International Conference on Natural that after sensory processing, information is draw a simple shape such as a square). This study could explore whether an auditory Computation, 13-17.

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COGNITION Health Research Report Chan Literature Review

Smallwood, J., O’Connor, R.C., Sudbery, M.V., & Obonsawin, M. (2007). Mind-wandering and dysphoria. Cognition and Emotion, 21, 816– Did he really earn it? An examination 842. of anabolic-androgenic steroid use in

Supplementary Material sports Dexter McMillan1 Table 1. Images presented in List 1 and List 2. 1 Order of images List 1 List 2 Department of Psychology, University of British Columbia

Edited by: Jade McGregor, Department of Psychology, University of British Columbia. Received for review January 1 Tropical island City (List 1) 3, 2012, and accepted March 6, 2012. Copyright: © 2012 McMillan. This is an open-access article distributed under the terms of the Creative Commons 2 City Beach Attribution-NonCommercial-NoDerivates License, which permits anyone to download and share the article, provided the original author(s) are cited and the works are not used for commercial purposes or altered in any 3 Pink flower Pink flower (List 1) way.

4 Airplane Piles of wood (List 1) Abstract 5 Wooden loom Colourful water droplet Performance-enhancing drug scandals have tarnished the reputation of many professional athletes in a wide variety of sports, from baseball to swimming to cycling. This paper will 6 Tree trunk Oak tree in sunset examine the literature in order to determine the effects of anabolic-androgenic steroids (AAS) 7 Kite Snail (List 1) on performance and both physical as well as psychological health; the prevalence in both professional and amateur sports; how steroids are used; how they produce their intended 8 Fighter jet Purple flower effects; and a brief history of doping in sport and relevant organizations created to deal with doping in sport. The literature will be reviewed and used to conclude that anabolic-androgenic 9 Purple flower petal Rocks steroid use should not be allowed a place in the professional sporting environment. Analysis of 10 Snail Kite (List 1) this question proves to be increasingly relevant as more players are indicted for illegal use of performance-enhancing drugs, and as the ethics of “cheating” by using PEDs are cited as a 11 Bed Pile of marbles reason to keep great athletes from the Hall of Fame.

12 Brick wall Butterfly Keywords: anabolic steroids, sports, performance-enhancing drugs, doping

13 Various slate patterns Tree trunk (List 1) Roger Clemens played for a total of four plagued baseball and many of its players at 14 Water droplet Snow-covered landscape teams over his 23-year career as a pitcher; the end of the 20th century, and even today 15 Palm tree in sunset Bookcase (List 1) accruing 4,672 strikeouts and 354 wins and anabolic steroids are one of the most making him arguably the most dominant commonly abused PEDs in many sports. 16 Piles of wood Purple flower petal (List 1) pitcher the game of baseball has ever seen Considering the difficulty of banning these (Fantasy Sports Ventures, 2011). At the end substances, more and more authorities are 17 Multicoloured swirl Toy wagon of his hall-of-fame-worthy career, Clemens considering allowing anabolic-androgenic 18 Wagon Fighter jet (List 1) was indicted in the Mitchell Report, a 400+ steroid use in sport. This paper will now page report highlighting the rampant use of discuss the reasons why athletes abuse PEDs, 19 Pile of beads Window performance-enhancing drugs (PED) in the what exactly an anabolic-androgenic steroid game of baseball, which cast his illustrious is, its effects and side effects, an historical 20 Bookcase Multicoloured swirl (List 1) record in the nasty light of anabolic- account of drug abuse in sport and the androgenic steroid (AAS) use. Abuse of AAS prevalence of doping today, and conclude

Corresponding Author: 64 UBCUJP – April 2012 – Volume 1 Dexter McMillan E-mail: [email protected]

Health Health ANABOLIC-ANDGROGENIC STEROID USE IN SPORTS Literature Review McMillan Literature Review

with the reasons why anabolic steroids do chiefly responsible for muscle development, influences seem to play a disproportionately and the effects of HGH in the sporting not have a place in the sporting environment. and are consumed to mimic its effects in the large role in how “‘roid rage” is expressed. It environment are a hotly contested issue and Colloquially, anabolic-androgenic body. They accelerate muscle growth, often is well documented that hormones alter our are far from conclusive (see USA Today, steroids are known as “anabolic steroids” or to unhealthy extremes. This commonly perceptions of social cues and others’ 2009). Many advocate for controlled use of even just “steroids”, and their use is often occurs in conjunction with weight training to intentions, and as a result it is not simply this substance to speed up recovery from referred to as “doping”. PEDs are used for speed up tissue repair after damage caused high levels of androgens that cause injury, although its potential for abuse still various purposes and for different reasons by a workout (National Institute of Drug increased aggression, but rather the needs to be explored (for more information depending on the sport. Baseball players Abuse, 2011). AAS is often prescribed for environment in which they are in effect on HGH and sport, see Saugy, Robinson, use AAS to hit balls farther and to throw therapeutic purposes, and is often used to (Lumia & McGinnis, 2010). This is important Saudan, Baume, Avois, & Mangin, 2006). balls faster in order to gain a competitive treat HIV-related muscle wasting and to consider in the aggressive environment of Historically, substance use and abuse in advantage over other players, whereas a hypogonadal men; however, use without a sports, and compounds the problems of sport goes back as far as the first Olympic bodybuilder might use them for the simple prescription is against the law and is injury and aggression during games when Games in Athens, when athletes would use reason of being able to lift heavier weights. recognized as cheating in most competitive AAS drugs are abused. Additionally, it is alcohol, bull’s blood and mushrooms to Although this paper is concerned with AAS sporting events (Evans, 2004; National important when considering the place that enhance athletic ability (Kamber, 2011). use in sports, AAS abuse is problematic even Institute of Drug Abuse, 2011). Men with PEDs have in the sporting environment at Even in these times, use of substances such outside of the sports environment. Some testosterone blood plasma levels that are the end of this paper. as these was banned, even though it would researchers assert that although the media below the normal range of 300 to 1000 ng/dl In addition to these relatively short- not become a major concern until anabolic focuses on AAS abuse in sports, the great are those who would typically be treated term side effects of steroid use, steroid use substances were produced in large majority of users are not athletes at all, but with anabolic steroids (Evans, 2004). by younger athletes has developmental quantities after World War II (Kamber, 2011). rather individuals desiring to become more Side effects of steroid abuse include consequences, leading to stunted growth, an As far back as the 1960s, athletes in muscular and more attractive (Kanayama, extreme acne, increases in low-density increased tendency towards aggression and Germany were facing governmental Hudson, & Pope, 2008). lipoprotein (LDL, or “bad” cholesterol), altered serotonin levels in the brain pressure into taking extremely high doses of The World Anti-Doping Agency (WADA) which leads to elevated blood pressure and (National Institute of Drug Abuse, 2011; anabolic steroids (Savulescu, Foddy, & outlaws a number of substances in the related heart problems, and shrinking of the Lumia & McGinnis, 2010). Additionally, Clayton, 2004). A doping scandal at the sporting environment, most notably testes in males along with a decreased cardial problems associated with use of 1988 Seoul Olympics produced the 1990 stimulants and hormones. Stimulants are sperm count and possibly even infertility these drugs often continue to persist well Dubin Report, investigating steroid and often used in cycling, and have led to several (National Institute of Drug Abuse, 2011; into adulthood (Kanayama, Hudson, & Pope, other PED use in Canadian sports (Kamber, deaths in the sport (Catlin, Fitch, & Grace, Sculthorpe, Baker, & Davies, 2003). 2008). Furthermore, long-term health 2011). Anabolic steroid use by baseball Ljungqvist, 2008). Strychnine, ephedrine, Additionally, injuries associated with rapid consequences such as renal disorders and players in North America during the 1990s amphetamines and methylphenidate are muscle gain and slow bone growth are often prolonged changes in brain chemistry and early 2000s was revealed by the Mitchell several examples of stimulants that have reported, such as muscle tears and bone leading to psychiatric disorders are Report, an investigation of the practice of historically been abused in sport (for a more fractures (see Stannard & Bucknell, 1993). associated with extrended use of AAS doping in the MLB (Major League of complete list of banned stimulants and their In fact, after reviewing the relevant (Deshmukh, Petroczi, Barker, Szekely, Baseball). This report drew considerable effects, see Deventer, Roels, Delbeke, & Van literature on steroid use and infertility, de Hussain, & Naughton, 2010; Kailanto, media attention to the problem of doping in Eenoo, 2011). Steroids are the most abused Souza and Hallak (2010) strongly Kankaapaa, & Seppala, 2011). baseball, and indeed sports in general. class of substances that are outlawed by the recommend that AAS use be avoided based It is worth noting that although AAS Unfortunately, this scandal tarnished the WADA. Synthetic testosterone, a type of on the fact that the negative effects on abuse is highly dangerous, there are other reputation of several legendary players like steriod, is detected in the blood through an fertility are so severe. Lumia and McGinnis PEDs that may have a legitimate place in Clemens. After this scandal, more reports immunoassay (or urine test), which is (2010) found similar effects of testosterone sport. Some types of PEDs, such as Human on doping practices emerged in other administered to every athlete on a regular on rats, along with an increase in aggressive Growth Hormone (HGH), are often used to countries, and eventually another major basis as a requirement to play professional behaviour as well. It is well known that use speed up recovery after a sports injury. scandal of PED abuse in the 1998 Tour de sports (Catlin, Fitch, & Ljungqvist, 2008). of AAS is also associated with mood swings, Although HGH is not the focus of this article, France triggered the International Olympic Anabolic-androgenic steroids are a often referred to as “’roid rage.” It is it should be noted that the WADA still Committee (IOC) to form the WADA, one of synthesized type of testosterone, a hormone interesting to note that environmental outlaws HGH in most sporting environments, the first international-level anti-doping

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agencies. The formation of the WADA made steroid abuse, such as urine switching or the either wins or their spot on the team is using competitor for their athletic prowess fighting PED abuse in sport an international use of diuretics. It should be noted, PEDs, it becomes a perceived necessity to knowing that they did not earn it through initiative for the first time, and was a huge however, that diuretics are also on the list of abuse substances as well. A survey hard work. step towards promoting fairness in the WADA banned substances, in part for this conducted by Dr. Bob Goldman highlights Research conducted by Stirin et al. sports environment. The WADA still exists very reason (Cadwallader, de la Torre, Tieri, the power of competition in relation to (2012) underscores the psychological effects today, and is still fighting against the use of & Botre, 2010). doping behavior. In this survey, respondents of a few athletes doping versus standardized PEDs in sport. Why is it so important that doping in were asked if they would take a substance doping. Their experiment examined how How effective is the fight against doping sport be eradicated? This is a question that that would cause them to remain unbeaten perceived disadvantage in a competitive in the sports environment? Gradidge, many athletes and spectators ask in an effort for five years, but would subsequently be situation effects performance, and revealed Coopoo and Constantinou (2011) found the to understand just how PED use in sport is the cause of their death. Over 50% of evidence that a perceived advantage (for prevalence of AAS use among high school damaging. Firstly, AAS use is physiologically respondents said they would take the instance, by taking steroids) in itself can give athletes to be 4%, most of them citing that damaging. As discussed earlier, the high substance (Bird & Wagner, 1997). The a performance enhancement, while a they used it because they felt it gave them a levels of anabolic steroids that are often intense effects of competition on drug abuse perceived disadvantage decreases performance advantage. Sports at the high used by those abusing the substance becomes an especially important point to performance. Therefore, it seems that if all school level can be a stressful and highly (oftentimes 10 to 100 times higher than that consider when this paper discusses the athletes are taking steroids these effects competitive environment. Many students which would be used for therapeutic effect that a perceived disadvantage can might disappear. In fact, it is possible that as depend on sporting scholarships to finance purposes) cause many adverse side effects, have on a player (Stirin, Ganzach, Pazy and performance becomes attributed to a highly post-secondary education, creating immense most notably increased aggression and Eden, 2012). The powerfully compelling externalized source (the drug), the pressure to excel in students who are decreased fertility along with many cosmetic psychology behind competition probably widespread use of these drugs may operate already under plenty of stress. In turn, this changes (National Institute of Drug Abuse, fueled the baseball PED scandal of the late to wash out any natural ability differences stress can foster a desire to use anabolic 2011). Secondly, the issue of fair play in 20th century even further, and continues to that each athlete might perceive (i.e., they steroids, and use of AAS creates problems in sport is important to consider, as those who make implementing successful anti-doping would assume that because each competitor normal developmental processes (See Lumia “cheat” by taking PEDs without putting in as measure difficult. is on the same drug, they will perform & McGinnis, 2010 for complete information much work as those who are “clean” is It has long been suggested that AAS use roughly the same), which might diminish on developmental problems associated with considered by most to be unfair. In relation should simply be given a place in sport. incentives to prepare for competition. This anabolic steroid use and puberty). Lorang et to this, Solberg and Ringer (2011) note that Anti-doping measures cost national anti- research suggests that when AAS use is al. (2011) revealed a smaller proportion of that baseball culture is a unique case in that doping agencies millions of dollars each year, standardized among all players, there are high school students in the United States the culture promotes unfairness. Cheating is and some believe them to be a waste of diminishing returns on performance for (1.4%) used anabolic steroids, but more accepted in baseball than in other resources (World Anti-Doping Agency, 2006). identical risks to health. nevertheless found that some athletes sports, made evident by the fact that The argument for legalizing any PED stems Some researchers believe that PED use practiced doping at a young age. stealing signs, corking bats, and throwing from eliminating these costs, and from the should be standardized across specific sports, Additionally, between 1 and 3 million people “spitballs,” have historically been part of the fact that if they were legal, everyone would or at least monitored in a different way. In in the United States are thought to have game. It may be this attitude that use them and there would no longer by any one article, Savulescu, Foddy and Clayton misused AAS at some point in their life contributed to the steroid abuse scandal of unfair advantage. However, looking at the (2004) explain why legalizing most hormonal (Sjoqvist, Garle, & Rane, 2008; de Souza & the 1990’s, and the higher proportion of damaging effects that long-term use of AAS PEDs and instead monitoring the hormone Hallak, 2010). These numbers are certainly baseball players that abuse AAS compared has on the athlete, it is ethically difficult to levels in the body would level the playing striking, and highlight the fact that doping is to other sports (Solberg & Ringer, 2011). give substances like AAS a place in sport, field, save time and money on detection, indeed an issue. Unfortunately, it is difficult This attitude continues to pose problems for especially when the high levels of aggression and still ensure a safe, competitive to determine the prevalence of doping in the those trying to eradicate abuse of AAS in that are already present in competitive environment for all athletes. Levels of both current professional sports environment, as baseball. sporting environments are considered. Even natural and synthetic hormones in the body athletes who are still active in the sport and From a psychological point of view, AAS though much time and money could be (for example, HGH) could be measured and using AAS are doing so illegally and thus will use has compounding effects within a sport. saved by not having to test for the presence as long as they do not breach a certain not disclose such information. Athletes may For instance, when it is learned by one of anabolic steroids, it is hard to imagine threshold the athlete will be allowed to try many methods to avoid detection of their athlete that another player competing for children growing up and idolizing a compete. This allows for athletes to use

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therapeutic hormones while still competing, as well as investigating how often athletes Grace, F., Sculthorpe, N., Baker, J., & Davies, B. Solberg, J., & Ringer, R. (2011). Performance- or to correct for natural deficiencies in these turn to other, legal competitive advantages (2003). Blood pressure and rate pressure enhancing drug use in baseball: The impact of product response in males using high-dose culture. Ethics and Behavior , 21 (2), 91-102. hormones that would otherwise make like psychological skills training. Awareness anabolic androgenic steroids (AAS). Journal of Stirin, K., Ganzach, Y., Pazy, A., & Eden, D. (2012). performing at a competitive level impossible. of these skills could deter athletes from Science and Medicine in Sport , 6 (3), 307-312. The effect of perceived advantage and Although the authors raise some very good abusing PEDs. Anabolic-androgenic steroid Gradidge, P., Coopoo, Y., & Constantinou, D. (2011). disadvantage on performance: The role of Prevalence of performance-enhancing external efficacy. Applied Psychology, 61 (1), points, it is still important to note that they use in sports today pulls dominant records substance use by Johannesburg male 81-96. do not recommend that anabolic steroids held by legends like Roger Clemens into adolescents involved in competitive high World Anti-Doping Agency. (2006). Costs of Anti- specifically become legalized, as anabolic question, and makes us ask ourselves: “Did school sports. Archives of Exercise in Health Doping: Report of the WADA Working Group steroids are in themselves harmful, whereas he really earn it?” and Disease , 2 (2), 114-119. on Anti-Doping Costs. The Hague, The Kailanto, S., Kankaapaa, A., & Seppala, T. (2011). Netherlands: The Working Group. many PEDs (like HGH) are not (Savulescu et Subchronic steroid administration induces long al., 2004). Declaration of Conflicting Interests lasting changes in neurochemical and Competitive sport has been plagued The author declared they have no conflicts behavioral response to cocaine in rats. Steroids, since its origin by a history of drug abuse in of interests with respect to their authorship 76, 1310-1316. Kamber, M. (2011). Development of the role of order to obtain an unfair advantage. or the publication of this article. National Anti-Doping Organisations in the Anabolic-androgenic steroid use is perhaps fight against doping: From past to future. the most problematic, and historically it has References Forensic Science International , 213, 3-9. Kanayama, G., Hudson, J. L., & Pope, H. G. (2008). been a huge problem in the world of Bird, E. J., & Wagner, G. (1997). Sport as a Common Property Resource. Journal of Conflict Long-term psychiatric and medical professional baseball, where a “cheating Resolution , 41, 749-766. consequences of anabolic-androgenic steroid positive” atmosphere and the need for Cadwallader, A. B., de la Torre, X., Tieri, A., & Botre, abuse: A looming public health concern? Drug larger muscles create a great incentive to F. (2010). The abuse of diuretics as and Alcohol Dependence , 98, 1-12. Lorang, M., Callahan, B., Cummins, K. M., Achar, S., abuse the drug. Although some argue that performance-enhancing and masking agents in sport doping: pharmacology, toxicology and & Brown, S. A. (2011). Anabolic androgenic AAS use in sport should be legalized to save analysis. British Journal of Pharmacology , steroid use in teens: Prevalence, demographics money and remove the problem of fair play, 161, 1-16. and perception of effects. Journal of Child and this conclusion would be ignorant of the Catlin, D. H., Fitch, K. D., & Ljungqvist, A. (2008). Adolescent Substance Abuse , 20, 358-369. Medicine and science in the fight against Lumia, R. A., & McGinnis, M. Y. (2010). Impact of damaging effects that anabolic-androgenic doping in sport. Journal of Internal Medicine , anabolic androgenic steroids on adolescent steroids have on the body and of the 264, 114. males. Physiology and Behaviour , 100, 199- psychological effects surrounding de Souza, G., & Hallak, J. (2010). Anabolic steroids 204. National Institute of Drug Abuse. (2011, October). competitive advantage and drug abuse. and male infertility: a comprehensive review. British Journal of Urology , 108, 1860-1865. NIDA for teens: Facts on drugs - anabolic Additionally, sport has a responsibility to set Deshmukh, N., Petroczi, A., Barker, J., Szekely, A. D., steroids. Retrieved November 26, 2011, from an example for those spectators who draw Hussain, I., & Naughton, D. P. (2010). NIDA for teens: The science behind drug abuse: inspiration from their favourite pitcher or Potentially harmful advantage to athletes: a http://teens.drugabuse.gov/facts/facts_ster1.php Perez, A. J.. (2009, April 2). Baseball finances quarterback. Sport needs to send the putative connection between UGT2B17 gene deletion polymorphism and renal disorders research on HGH. USA Today. Retrieved from message that hard work and determination - with prolonged use of anabolic androgenic http://www.usatoday.com/sports/baseball/2009 and not a drug - are the most important steroids. Substance Abuse Treatment, -02-03-hgh-study_N.htm. tools for success. Although some Prevention, and Policy , 5 (7), 1-7. Saugy, M., Robinson, N., Saudan, C., Baume, N., Deventer, K., Roels, K., Delbeke, F. T., & Van Eenoo, Avois, L., & Mangin, P. (2006). Human growth performance-enhancing drugs may be P. (2011). Prevalence of legal and illegal hormone doping in sport. British Journal of legalized in the near future, the effects, stimulating agents in sports. Anal Bioanal Sports Medicine , 40 (Suppl I), i35-i39. history, and prevalence of anabolic steroids Chem , 401, 421-432. Savulescu, J., Foddy, B., & Clayton, M. (2004). Why we should allow performance enhancing drugs reviewed in this article clearly suggest that Evans, N. A. (2004). Current Concepts in Anabolic- Androgenic Steroids. The American Journal of in sport. British Journal of Sports Medicine , the standardized use of AAS should still be Sports Medicine , 32 (2), 534-542. 38, 666-670. vehemently protested. New detection Fantasy Sports Ventures. (2011). Roger Clemens Sjoqvist, F., Garle, M., & Rane, A. (2008). Use of techniques are constantly in development to Statistics and History. Retrieved November 26, doping agents, particularly anabolic steroids, in sports and society. Lancet , 371, 1872-1882. try and stop AAS use, and future research 2011, from Baseball-reference.com: http://www.baseball- should focus on new technology in this area reference.com/players/c/clemero02.shtml

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Social Research Report

Exploring religiosity’s effects on altruistic behaviour Lu Zhao1 1Department of Psychology, University of British Columbia

Edited by: Ashley Whillans, Department of Psychology, University of British Columbia. Received for review November 1, 2011, and accepted March 4, 2012. Copyright: © 2012 Zhao. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivates License, which permits anyone to download and share the article, provided the original author(s) are cited and the works are not used for commercial purposes or altered in any way.

Abstract Previous research has found that a person’s altruism is related to religiosity. This study attempted to tease apart whether this finding is due to religion itself or other factors related to religiosity. This study asked participants to donate money towards a friend and charity using a cold pressor task. This task involved asking participants to put their hand in ice cold water, once for the friend and once for the charity. The longer a participant could hold their hand in the water, the more money they earned for the recipient. Because the task was painful, it was an altruistic act for participants to hold their hand in the water. We then used the Moral Foundations Questionnaire (Graham, Haidt, & Nosek, 2009) to study the four different moral foundations people use to make moral judgements. The study found that the relationship between religiosity and altruism was actually related to the moral foundation of concern about purity and highly correlated with religiosity. Furthermore, the relationship between purity/sanctity and altruism was mediated by in-group/loyalty and authority/respect. Therefore, this study suggests that it is not religiosity that influences altruistic behaviour, but rather the moral foundations that religious people score highly on.

Keywords: religiosity, altruism, moral foundations, beliefs

A person walking on any street in Canada Social Distance and Altruism will inevitably see panhandlers, who she will Altruism is defined as the willingness to help then try to brush past. This same person another at a cost to oneself. There are many may willingly give money to one of her factors that affect one’s altruistic level friends. Why would she refuse to donate including social distance, which is one of the money to someone who probably most ubiquitous influences on altruism. desperately needs money, but would gladly Regardless of a person’s level of religiosity, give the donation to a friend, who is people will be more willing to help someone probably a lot less desperate? Because the who is socially closer to them than someone friend has a much closer social distance with who is more socially distant. The relationship her than the panhandler and social distance between social distance and altruism is can affect altruistic action. known as the altruism curve, which states

Corresponding Author: Lu Zhao E-mail: [email protected]

Social Social RELIGIOSITY’S EFFECTS ON ALTRUISTIC BEHAVIOUR Research Report Zhao Research Report

that there is an inverse correlation with religious and non-religious people remain behaviour within the group increases group. This loyalty can be observed in areas altruism and social distance (Rachlin & Jones, even after controlling for possible, (Norenzaya & Shariff, 2008; Berg, Dickhaut, such as scoring higher on nationalism 2008). Therefore, according to this curve, alternative factors such as marriage status, & McCabe, 1995). This type of altruism is (Eislinga, Felling, & Peters, 1990). The flip both religious and non-religious people will age, and income. On the surface then, it known as “parochial altruism” (Choi & side of this is that when faced with groups be more willing to perform an altruistic act seems that the idea that religious belief Bowles, 2007). Yet, it also has a dark side: that are different from them, religious for their friends than for charities, even promotes altruistic behaviour is correct; increased parochial altruism is correlated people tend to be discriminatory. Previous though objectively speaking; the charity may however, there is a small complication in this with discriminatory and unhelpful behaviour studies done by Allport and Ross (1967) have need the help more. interpretation. towards out-group members (Hunsberger & found religion to be positively correlated Jackson, 2005). with most or all types of prejudice. This Religiosity and Altruism Studies that found religiosity sometimes leads religious people to be less altruistic Historical Background. One of the major positively affect altruism. Other research Moral Foundations Theory and Religiosity towards out-group members. Studies have factors that influence the altruism slope is has found a positive correlation between The research above has shown that found that when faced with people who are religiosity, the level of religious belief that a religiosity and social desirability – the religiosity has a complicated relationship different from them, such as people who are person possesses. All major religious texts tendency for people to project an overly with altruism. One factor that affects homosexual, religious people were much explicitly encourage altruism, therefore, the favourable self-image in evaluative contexts religiosity’s effects on altruism is who is less willing to help (Pichon & Saroglou, 2009). stronger a person’s religious belief, the more (Trimble, 1997). Religiosity predicts greater being helped. Another factor is the moral This difference in attitudes towards in-group the person should be altruistic (Batson, altruism when reputation-related egoistical foundations that people use to make moral and out-group members can be summed up Schoenrade, & Ventis, 1993). In fact, Pichon, motivation has been activated in the judgements. These foundations can be in studies that show that religious people Boccato, and Saroglou's study (2007) shows believer and in within-group situations defined using the Moral Foundations Theory highly value benevolence, a pro-social trait that the link between religion and altruism is (Batson et al., 1989). This egoistical created by Graham, Haidt, and Nosek (2009). in relation to interpersonal interactions, so firmly entrenched in people's belief motivation relates back to the positive According to the theory, there are five universalism, which includes a broader system that even when individuals are correlation between religiosity and social functions of these moral foundations: openness to all people, is not so highly primed with a positive concept of religion, desirability discussed earlier. If performing harm/care, fairness/reciprocity, in- endorsed by religious people (Schwartz & they become more altruistic. In the last or appearing to perform the altruistic group/loyalty, authority/respect, and Huismans, 1995). Therefore, people who couple of decades, psychology has begun to behaviour would promote a good self-image purity/sanctity. Religious people are more score higher on the in-group/loyalty score test whether the belief in the positive effects in the eyes' of the participant or observers, likely to use three of these foundations, should be more altruistic towards their of religion is warranted (e.g. Ahmed, 2009; than religiosity predicts a greater level of known as the “bonding foundations”: in- friends than charity. Batson et al. 1989). Does scientific research altruism. This means that it is possible that group/loyalty, authority/respect, and agree with this idea that religious belief religiosity does not predict greater altruistic purity/sanctity. In-group/loyalty and "Give help to the needy." This in-group bias promotes altruism? Results have been behaviour, just greater reported altruistic authority/respect have been found in other is complicated by the fact that religious decidedly mixed (e.g., Ahmed, 2009; Pichon behaviour, which may or may not be a true literature to influence altruistic behaviour, people also tend to score higher on the et al., 2007). reflection of the believer's behaviour. while purity/sanctity has been found to authority/respect scale. Authority/respect is Together, these studies suggest that it is the influence in-group/loyalty and defined by Haidt and his colleagues (2009) as Studies that found a correlation between desire to appear altruistic that explains the authority/respect. concerns related to social order and religiosity and altruism. relationship between religiosity and altruism, hierarchical relationships such as obedience Studies using self-report measures, have not an actual desire to be altruistic. “Help your friends.” In-group/loyalty is and respect as moral imperatives. Therefore, found a weak positive link between However, it is not always about defined as concerns related to obligations of someone who scores higher on this scale, all religiosity and altruism (e.g., Piazza & Glock, appearances, as religiosity does predict group membership such as self-sacrifice for other things being equal, may more strongly 1979). Researchers have also found a reliable, altruistic behaviour in within-group contexts. the group and preference towards the group, believe that that obedience to authority is a positive link between religious service Religious people behave more altruistically in other words, in-group bias (Haidt, Graham, moral imperative. Religious people tend to attendance and frequent praying and to in-group members than non-religious & Joseph, 2009). Religious people tend to score higher on this scale. One of the altruistic behaviour such as charitable people. One reason is that religious belief score higher on in-group bias. This leads reasons they score higher is that religion donations and volunteerism (Brooks, 2003). enhances within-group interpersonal trust. them to be more helpful towards in-group socializes people to conform to rules and the These differences in altruism between With greater trust, the chances of altruistic members and possess stronger loyalty to the orders of authorities (Donahue & Benson,

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1995). Thus, they are more likely to obey the purity/sanctity scale, who tend to be exchange for half a credit that they could items. The new scale lost a small amount of those they consider authorities, such as religious people because they tend to use then apply to their grade in a psychology reliability (Cronbach's alpha) compared to religious commandments, which encourage more purity metaphors (Beck, 2006), should course. the original 30 item RWA scale, (.86 vs. .72). charitable behaviour (Batson et al., 1993). score higher on in-group/loyalty and However, the new scale still reliably This would suggest that religious people authority/respect. Independent Variables measured all the items that the original RWA should be more altruistic towards charities Moral foundations questionnaire (MFQ). scale measured: conventionalism, than non-religious people. However, Hypothesis Created by Graham and colleagues (2009), authoritarian aggression, and authoritarian previous research on political stances, Hypothesis #1. Based on the literature cited the MFQ had 32 statements divided into two submission. Seven items on the scale were conservatives versus liberals, found that above, we predict that religiosity will predict sections and was designed to measure five reverse-scored. Items included "our country individuals who score high on conservativism, a greater difference in donations towards scales: harm/care, fairness/reciprocity, in- needs a powerful leader, in order to destroy which is highly correlated with religiosity friends compared to charity. Specifically, we group/loyalty, authority/respect, and the radical and immoral currents prevailing (Jonathan, 2008) also score higher on the predict that the more religious someone is, purity/sanctity. Each scale measured a in society today" and counter-balanced authority/respect scale, and are less the more they will donate to friends, as possible purpose for moral judgment. The items such as "our country needs free altruistic overall (e.g., Carey & Paulhus, opposed to charity. five foundations were correlated with thinkers, who will have the courage to stand 2010). Therefore, non-religious people different explicit and implicit political up against traditional ways, even if this should be more likely donate to people than Hypothesis #2. Furthermore, we predict that ideology = .16 to .52, p < .001). In- upsets many people" (1 = Strongly disagrees, religious people. the relationship between religiosity and group/loyalty, authority/respect, and 6 = Strongly agree). Larger overall scores altruism will be mediated by the three purity/sanctity were positively correlated indicated more conservative and less liberal "They tell me that they're disgusting." In- bonding moral foundations: in-group/loyalty, with conservatism ( = .17 to .34, p < .001). orientations, whereas smaller scores group/loyalty and authority/respect are authority/respect, and purity/sanctity. We The Cronbach's alphas for these foundations indicate more liberal and less conservative influenced by the purity/sanctity foundation. predict that the relationship between are .71 (in-group), .64 (authority), and .76 orientations. Purity/sanctity relates to concerns about the religiosity and altruism is actually the (purity). purity of the body and spirit. In relation to relationship between religiosity and The first section of the MFQ asked, Ten item personal inventory (TIPI). A ten- religious doctrine, this would express itself in purity/sancity, which is mediated by in- "When you decide whether something is item scale created by Gosling, Rentfew, and areas such as concern for chastity, group/loyalty and authority/respect. right or wrong, to what extent are the Swann Jr. (2003) was used to measure the temperance, control of one's desires (Haidt following considerations relevant to your Big Five personality dimensions (i.e., et al., 2009). A person who behaves or Hypothesis #3. Finally, we predict that the thinking?" and listed 16 statements to which extraversion, agreeableness, possesses a trait that is not considered effects of in-group/loyalty and participants indicated their relevance on a conscientiousness, emotional stability, and "pure" evokes disgust from others. This type authority/respect on altruism will be six-point scale. Statements included openness to expression). The TIPI asked of disgust is called sociomoral disgust (Beck, opposite of each other, whereby in-group "whether or onto someone suffered participants to rate their agreement to 2006) and it is in response to the person loyalty will lead to more altruism and emotionally" and "whether or not someone statements about their own personality on a who possesses the undesirable action or authority/respect will lead to less altruistic acted unfairly" (1 = Not at all relevant, 6 = five-point scale. Half of the statements were trait. Which behaviours and traits are behaviours. Extremely relevant). The second section reverse-scored. Statements included "I see considered undesirable are defined by asked participants to indicate their myself as: extraverted, enthusiastic" and "I cultural factors, such as religious authorities Method agreement on a six-point scale to 16 see myself as: dependable, self-disciplined" (Beck, 2006). The people who invoke this statements. Items included "compassion for (1 = Strongly disagree, 5 = Strongly agree). type of disgust are generally categorized as Participants those who are suffering is the most crucial This scale was highly correlated with the members of an out-group, and, in turn, not The 39, participants (77% females; East virtue" and "it is better to do good than to original Big-Five Inventory (r = .65 to .87, p worthy of charitable help (Nussbaum, 2001). Asian 54%, 13% European, 8% South Asian, do bad" (1 = Strongly disagree, 6 = Strongly < .01). The Cronbach's alphas ranged Consequently, those who are considered not and 26% “other”) were all undergraduate agree). from .45 to .73. pure, as defined by authorities, are students at the University of British considered to be less worthy of help Columbia who were taking at least one Right wing Authoritarian scale (RWA scale). Belief in a just world (BJW). Created by because they become more distant out- psychology course. Among the participants, We then used the five-point RWA scale that Lerner (1980), the BJW contains 15 items group members. People who score higher on 64% were religious. They participated in was shortened by Zakrisson (2005) to 15- which test belief in a just world. Scoring

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highly on the BJW indicates that people they earned a total of $20. The amount Table 1. Regression of religiosity, RWA total score, and politics on time difference

believe that those who have unfortunate increased by $5 per minute. The money was B Std. β t p event happen to them deserved it, thus, high split between the conditions depending on Error scores identify individuals who participate in the difference between the times in the two Constant -51.236 81.655 -.627 .534 victim blaming. Participants were asked how conditions. For every 60 seconds difference, Religiosity 32.064 15.602 .403 2.055 .047 much they agreed with each item on a five- the longer lasting condition earned $5 more. RWA Total -.876 34.305 -.005 -.026 .980 point scale. Items included "I feel that a For example, if a person held on for one Politics -5.820 15.925 -.060 -.365 .717 person's efforts are noticed and rewarded" minute in the charity condition and three and "I feel that the world treats people and a half minutes for the friend condition, fairly" (1 = Strongly disagree, 5 = Strongly then they earned $20 in total with $5 to electronic gift certificate for Therefore, religiosity was correlated with agree). charity and $15 to the friend. Canadahelps.com that was emailed to them how much time participants were willing to at the end of the day. keep their hand in the cold pressor for the Demographics. On the last page of the Procedure two recipients. questionnaire package, we asked Participants were placed in front of a Results participants to indicate their age, years they computer where they entered a unique Hypothesis #2: The relationship between We first calculated altruism preferences for have spoken English, gender, number of identification code. The computer randomly religiosity and altruism is mediated by the the friend condition by finding the time family members, primary ethnic heritage, determined if they started with the three bonding moral foundations. difference between the friend and charity. political orientation, and level of religious personality questionnaires or the cold We did a regression with religiosity, time Then we did a regression with political belief. Both the political orientation and pressor task. During the personality difference, and the Moral Foundations stance, Right Wing Authoritarianism (RWA) religiosity questions were on a five-point questionnaires component, participants Questionnaire to see if any of the moral score, and religiosity with the time scale. The political orientation ranged from 1 filled out the questionnaires listed above, foundations had a significant relationship difference between the friend and charity = very liberal to 5 = very conservative and including demographics, on the computer with religiosity and time difference in cold pressor task as the dependent variable. religiosity ranged from 1 = not at all religious and went on to the cold pressor task. When keeping the hand in the cold pressor task for We used political stance, RWA score, and to 5 = very religious. the participant got to the cold pressor task, friend vs. charity. We found that in- religiosity because previous research has the research assistant explained to the group/loyalty had a significant relationship found a relationship between them (e.g., Dependent Variable participants that they would earn money for Graham, Haidt, & Nosek, 2008). We wished Level of altruism. The level of altruism was their friend and charity. The research to confirm that religiosity was driving the measured by the amount of money assistant showed participants the relationship between these three factors participants earned for their friend and Canadahelps.com website to convince 200 and altruism. The regression found only charity. They earned the money with the participants that the charities were real and religion to be significant, = .40, p = .047 cold pressor task. The cold “pressor” was a that they were really earning money for (see Table 1). 180 cooler filled with water, which was cooled by charity. The computer randomly decided

ice packs. Participants were asked to put whether the participants earned money for Hypothesis #1: Religiosity will predict a 160

their hands in the cold pressor twice, once the friend or for charity first. If it was the Time greater difference in donations towards for friend using one hand and once for friend condition, participants were asked to friends compared to charity charity using the other hand. The longer write the name of a close friend, who was 140 they kept their hand in the water, the more not a relative or significant other, onto a We did a repeated measures ANOVA and money they earned. The total amount they white envelope. Participants then performed controlled for the order of the tasks, cold pressor or questionnaire first and friend or earned was dependent on how long they the cold pressor task, once for the friend and 120 held their hand in the water on either round. once for charity. At the end of the study, the charity first. The ANOVA looked at the Not Religious Religious If the longest they held their hand in the amount of money they earned for the friend religiosity, friend time, and charity time. Religiosity There was a significant relationship between water was under a minute, then the total was placed in the envelope for them to give Figure 1. Interaction between religiosity and time amount they earned was $10, and if they to their friend. The money they earned for religiosity and time according to Wilk's spent on friend and charity. Lambda, F = 14.10, p = .001 (see Figure 1). longest was at the maximum of five minutes, charity was given to them in the form of an

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factors are separated, it becomes clear that between religiosity and time difference, both do affect the relationship between = .61, p = .027. Also, authority/respect had a religiosity and altruism. significant relationship between religiosity and time difference, = -.64, p = .039. Hypothesis #3: The effects of in- Mediation analysis was performed to test group/loyalty and authority/respect on whether in-group/loyal ty and altruism will be opposite of each other authority/respect mediated the relationship Simple effects for both in-group/loyalty and between religiosity and time difference. authority/respect were calculated to see They were not significant. For their effects on the time for friends and Figure 2. Mediation between purity/sanctity and time difference. authority/respect, b = -11.11, z = -1.43, p charities. None of the correlations were = .15, bootstrapping CI.95[-32.12,-.29], or for significant; however, most show a significant in-group/loyalty, b = 18.10, z = 1.83,p = .067, trend. Friend times were not affected by in- functions of moral judgment that religious increase the people's concerns about the bootstrapping CI.95[.90, 61.32]. group/loyalty, p = .89, and decreased as people share. Religious people score highly morality of purity (Beck, 2006). It should be But, religiosity was strongly correlated authority/respect increased, r = -.21, p = .24. on purity/sanctity, which this study found to pointed out that the relationships between with purity, r = .50, p = .002. Therefore, Charity times decreased as in-group/ loyalty correlate with altruism. Higher scores on this purity with in-group/loyalty and mediation was again performed to test increased, r = -.22, p = .20, and as purity/sancity scale signify that individuals authority/respect were found using whether in-group/loyalty and authority/respect increased, r = -.21, p = .23. put more moral weight on the purity of a mediation, consequently, they can only be authority/respect mediated the relationship The length of time participants kept person or group. seen as correlations, not causations. between purity and time difference. It did, their hand in the cold pressor for a friend As Beck (2006) suggests this could be Both in-group/loyalty and for the authority/respect path, b = -33.81, z was not affected by how high participants due to many religions using purity authority/respect effected how much time = -2.03, p = .042, bootstrapping CI.95[-87.44, - scored on the in-group/loyalty scale. metaphors. Or, it could be that people who was spent on friends and charity in the cold 4.62], and for in-group/loyalty, b = 34.24, z = However, there was a negative correlation are more easily disgusted are more pressor task. In-group/loyalty stretched out 2.31,p = .021, bootstrapping CI.95[4.09, between the time and authority/respect. conservative (Inbar, Pizarro, & Bloom, 2009), the distance between friends and charity as 104.43] (see Figure 2).This suggests that the The higher participants scored on the which would predict that they would also be it did not affect friend time and decreased factor that was driving the correlation authority/respect scale, the less time they more religious. Purity/sanctity was positively charity time. However, there was no between religiosity and altruism was kept their hand in the water. The length of correlated with in-group/loyalty and correlation between stronger in-group bias purity/sanctity. time participants kept their hand in the cold authority/respect. Therefore, people who and more altruistic behaviour towards This relationship was mediated by in- pressor for charity was correlated with both put more moral weight on purity, also have friends. In-group bias was correlated with group/loyalty and authority/respect. In- factors. As participant scores for both scales greater in-group bias due to the fact that behaving less altruistically towards charities, group/loyalty mediated a positive increased, the time they kept their hand in they view their own group as being pure and which are considered out-groups. The correlation between purity/sanctity and the water decreased. out-group members as being impure. reason in-group bias does not increase altruism and authority/respect mediated a Widening the gap between in-group and altruism towards friends is probably negative correlation. This explains why the Discussion out-group members, out-group members explained by the effects of authority/respect. original test to see if they mediated the become not just strangers, but disgusting Authority/respect decreased the time spent We discovered a very interesting relationship religiosity and altruism were not strangers. Seeing strangers as disgusting on friends and charity because it caused the relationship between levels of religious significant. These opposing effects are about tends to cause people to view others as less altruism slope to become steeper. Hence, belief and altruistic behaviour. These the size and opposite of each other, human and less worthy of help. Also, people even if the social distance between the findings suggest that it is not religious belief therefore, they cancel and when looking at who are highly concerned with purity will helper and helped was the same for a that influences altruism, but rather the their effects together, so it appears that they look to authorities, including religious religious and non-religious helper, the have no effect. However, when the two authorities, to tell them what is pure and helped would gain less altruistic behaviour what is not. Religious authorities, since they from the religious helper than the non- use a lot of purity metaphors, probably also religious helper. This agrees with previous

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research done by Carey and Paulhus (2010) people's altruistic behaviour towards out- help secular moral authorities influence a tolerance might have confounded the time that conservatism, which is correlated with group members is influenced by who their more universal altruism in society and avoid differences between friend and charity. In obedience to authority, and decreased authorities tell them is worthy of help. the negative consequences of religious future studies, pain tolerance should be pre- altruism. As indicated by the results, people Considering that this study has provided driven altruism. tested to ensure that all participants have who score higher on in-group/loyalty and evidence that religiosity does not promote similar levels of tolerance. Furthermore, the authority/respect provide less help towards altruism and may in fact create prejudice Limitations maximum time for the task should be charities than toward friends. and division between groups, nations might There are several limitations to the study. increased or the water made colder to wish to be careful when encouraging religion The main limitation is that there was only eliminate ceiling effects. Implications in case it has negative, rather than positive one question relating to religiosity that There are several important implications of effects. We would also like to clearly state participants completed, which did not allow Future Directions this study. Importantly, this study suggests that we are not suggesting that religion is a for much differentiation of religious belief. As stated above, future studies should try to that it is not religiosity itself that influences negative influence or that it should be Also, there were very few participants, 21 of tease apart various aspects of religious belief altruism, but rather the moral functions of discouraged. We would only like to point out whom were East Asians and all who were to isolate which aspects are relevant to moral judgments related to religion. that research, including our study, suggests undergraduates. As religious belief does which type of moral functioning. Also, Therefore, if society wishes to encourage that some people might benefit from change with age (Kenrick, in press) and studies may want to compare other groups more altruistic behaviour in group contexts, religious based altruism, but most are interacts with ethnicity (Chatters, Taylor, that share the same moral foundations, such it would probably not be most helpful to victims of it. Bullard, & Jackson, 2009), our results are less as minority ethnic groups, and see if they encourage different moral functions of The effect of religious salience also generalizable to the general population. Also, share similar altruism patterns as religious moral judgment. Also, these findings suggest suggests that should society wish to use the operational definition for altruism in this people. Previous studies have shown that that if a charity is looking for donations from religious belief to increase altruism, it needs study was one-time donation behaviour. minority ethnic groups who score highly on a religious person or group, it should to ensure that religion is always salient. Thus, the relationships found in this study in-group/loyalty and authority/respect show emphasize the similarities between the When it is, studies have found that the might not generalize to other types of similar altruism patterns for donations (e.g., charity and people they are close to. religious people are more helpful than non- altruistic behaviour. For example, studies Amponsah-Afuwape, Myers, & Newman, Considering the moral foundations that religious people (e.g., Sosis & Ruffle, 2003). have found that sustained altruistic 2002), but l am not aware of any studies that are driving the relationship between However, an alternative explanation could behaviour, such as volunteering, has a directly compare minority ethnic groups and religiosity and altruism, people might be be that it is not the religious salience, but greater positive relationship with religion religious groups to study how similar the tempted to suggest that society should the public ritual participation which than spontaneous altruistic behaviour, such groups are. Also, it would be interesting to encourage religious belief because it encourages altruistic behaviour (Norenzaya as donation (Benson et al., 1980). tease apart the differences among the encourages altruism. However, religious & Shariff, 2008). Given the uncertainty of Furthermore, this study evaluated the different groups of non-religious people. Are driven altruism does have costs. Religious what is driving the increased altruism, donation behaviour using the cold pressor atheists different from agonistics and people are more altruistic toward in-group religious salience or public ritual task where ethics bound the participants spiritual people? Some studies have members because of in-group bias than non- participation, more research in this area from keeping their hand in the water for suggested atheists follow similar altruistic religious people, but in-group bias is linked should be conducted. more than five minutes. We found ceiling patterns as spiritual people (e.g., Dillon, with parochial altruism (Choi & Bowles, Our study found that it was the moral effects among some participants, suggesting Wink, & Fay, 2003). These future studies 2007). This means that believers are less foundations, not religiosity itself, that that we might have found more variance if could build and expand the intriguing results helpful and more discriminatory towards influenced altruistic behaviour. In large, we had permitted participants to participate found in the current study. outgroup members (e.g., Hunsberger & modem secular societies, such as Canada, it in the task for longer than five minutes. Jackson, 2005). This might not have been a is possible for secular moral authorities to There were also participants who kept their Declaration of Conflicting Interests problem in earlier societies, which were replace religious influence on altruism hand in the water for a very short time (less The author declared they have no conflicts more homogeneous, but it does pose a big because secular authorities can promote the than 30 seconds). The difference in time for of interests with respect to their authorship problem in modern societies such as Canada, same moral foundations as religiosity those who experienced the ceiling effect and or the publication of this article. where most people in society will be out- (Norenzaya & Shariff, 2008). Future research for those who could barely keep their hand group members to the believer, non in- should aim to understand what types of in the water suggests that there might be an group members. Furthermore, religious moral judgments predict greater altruism to individual difference in pain tolerance. Pain

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References Eislinga, R., Felling, A., & Peters, J. (1990). Religious Randolph-Seng, B., & Nielsen, M.E. (2007). Honesty: Sosis, R., & Ruffle, B. (2003). Religious ritual and Ahrned, A.M. (2009). Are religious people more belief, Church involvement, and ethnocentrism One effect of primed religious representations. cooperation: Testing for a relationship on prosocial? A quasi-experimental study with in the Netherlands. Journal for the Scientific The International Journal for the Psychology of Israeli religious and secular Kibbutzim. Current Madrasah pupils in a rural community in India. Study of Religion, 29(1), 54-75. Religion, 17(4), 303-315. Anthropology, 44(5), 713-722. Journal for the Scientific Study of Religion, Gosling, S.D, Rentfrow, P.J., & Swarm Jr., W.B. Rachlin, H., & Jones, B.A. (2008). Social discounting Trimble, D.E. (1997). The religious orientation scale: 48(2), 368-374. (2003). A very brief measure of the big-five and delay discounting. Journal of Behavioural Review ad meta-analysis of social desirability Allport, G., & Ross, J. M. (1967). Personal religious personality domain. Journal of Research in Decision Making, 21, 29-43. efforts. Education and Psychological orientation and prejudice. Journal of Personality, 37, 504-528. Schwartz, S. H., & Huismans, S. (1995). Value Measurement, 57(6), 970-986. Personality and Social Psychology, 5, 432-443. Graham, J., Haidt, J., & Nosek, B.A. (2009). Liberals priorities and religiosity in four Western Zakrisson.L (2005). Construction of a short version of Amponsah-Afuwape, S.A., Myers, L.B., & Newman, and conservatives rely on different sets of religions. Social Psychology Quarterly, 58(2), the right-wing authoritarianism (RWA) scale. S.P. (2002). Cognitive predictors of ethnic moral foundations. Journal of Personality and 88-107. Personality and Individual Differences, 39, minorities' blood donation intention. Social Psychology, 96(5), 1029-1046. 863-872. 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Social 2011 Belkin Award Winning Paper Research Report Communal Male Role Models: How they influence identification with domestic roles and anticipation of future involvement with the family Katharina Block1 1Department of Psychology, University of British Columbia

Edited by: Ashley Whillans, Department of Psychology, University of British Columbia. Received for review Janurary 8, 2012, and accepted March 7, 2012. Copyright: © 2012 Block. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivates License, which permits anyone to download and share the article, provided the original author(s) are cited and the works are not used for commercial purposes or altered in any way.

Abstract The division between work and family is still gendered in our society. While today’s women heavily participate in the workforce, men have not begun to participate in household tasks and child care to the same extent, leading to continuing gender imbalances. This seems to have an influence on individuals’ self-concepts, their association with work and family, and how they predict their future work-family balance. Furthermore, previous research has shown the influence of career-oriented female role models but has neglected the possible influence of male role models. In this study we investigated whether exposing female and male participants to three different conditions of male exemplars, differing on their work-family balance in lifestyle, from family orientation over a balanced lifestyle to extreme career orientation, would influence their implicit associations with work and family as well as their predictions of their future life. Consistent with our predictions, a preliminary data analysis focusing on female participants showed different anticipations of their future work-family balance when exposed to family oriented male models rather than balanced or career- oriented males.

Keywords: modelling, gender roles, male, division of labour

Gender-typing of activities is very salient in women’s rights movement and the entry of our society, with children as young as three women into the workforce have paved the years of age showing knowledge of which way for the different gender norms we activities are stereotypically masculine and experience today. Although young women which activities are stereotypically more today are increasingly more career oriented feminine (Boston & Levy, 1991). Since the and obtain a larger percentage of 1970s we have experienced considerable undergraduate degrees than men (Statistics changes in gender norms and gender Canada, 2008), expectations for men and equality in North America and Europe. The women’s life course continue to differ.

Corresponding Author: Katharina Block E-mail: [email protected]

Social Social COMMUNAL MALE ROLE MODELS Research Report Block Research Report

Remainders of archaic gender they manage the division of labour, comes does not necessarily mean they will do less masculine traits, a concept termed hierarchies can still be seen in today’s from the fields of the sociology, gender or housework. Instead women often take on a “androgyny” (Bem, 1974; Spence, Helmreich society. For example, female leaders are still family studies, and concentrates on “second shift,” being responsible for the & Stapp, 1974, Spence 1983, Lubinski, perceived as role-incongruent, meaning not describing phenomena. The research from majority of the housework in addition to Tellegen & Butcher, 1983). typically feminine (Eagly & Karau, 2002), and these fields shows that traditional their paid job (Hochschild, 1989). This, however, does not mean that less than 7% of males are househusbands conceptions of husbands being the bread- This research exemplifies the one-sided Western society has arrived at a point where (Smith, 2007). Although society has come a winners and women taking care of the trend towards more egalitarian attitudes men and women equally display and long way, there is still the need to work household are still relevant (Blair and Lichter, and actions. We have witnessed a associate themselves with communal and towards equality between men and women. 1991). Women and men’s attitudes are in considerable amount of change in women’s agentic characteristics. In line with the True gender equality could enable each line with these stereotypes, with women attitudes and lives but men have failed to finding that men are still less likely to individual to make choices and realize their holding more favourable attitudes towards show changes to the same extent. Men are associate themselves with domestic matters, potential independent of any gender specific housework than men do (Blair and Lichter, still shown to be less family oriented than which are closely connected to femininity expectations. Research in psychology can 1991). These attitudes also seem to be women in how they situate themselves in (Diekman & Brown, 2010), research has give us important insight into which reflected by the actual division of labour in relation to career and family. These failed to find a strong change in men’s methods could be used to achieve more families, with women doing more childcare differences have been demonstrated when femininity and masculinity scores over past equal thinking and actions in individuals. In and housework (Blair and Lichter, 1991). It is young males and females are asked to decades. In a recent examination of gender this study we are interested in the influence worth noting that men’s attitudes are more imagine their “possible selves,” a concept typing, Spence and Buckner (2000) found of counter-stereotypical primes on important in determining how the couple introduced by Markus and Nurius (1986). An that women have developed a stronger participants’ adherence to traditional gender actually handles the division of household important gender distinction in these identification with agentic traits but men roles. work (Poortman & Van der Lippe, 2009). This forecasts has been found by Diekman and have stayed relatively constant in their Generally, men still tend to associate finding suggests that it is extremely Brown (2010), where young men predicted identification with agentic and communal themselves with traditional gender roles and important to find ways to change men’s themselves to be less involved with family in traits –meaning that they do not identify norms (Spence & Buckner, 2000). Changing associations with the domestic sphere in the distant future than young women did. strongly with communal traits. This men’s adherence to these traditional gender order to promote gender equality. This This gender difference is also evident on illustrates the one-sided male maintenance roles, which prevent them from taking part makes the possibility of a simple a conceptual level. Conceptualizations of and retention of traditional gender roles. We in nurturing and family activities, can be intervention, such as exposure to role femininity and masculinity are still closely think that this lopsided advancement creates seen as a benefit to women as well as men. models, especially interesting for shaping connected to agentic (i.e., expressive) and a mismatch between women wanting to Compliance to traditional gender roles might male attitudes. communal (i.e., instrumental) traits, with participate in the working world and men actually deprive males from experiencing We have already noted the persistent women stereotyped as more communal and who are not willing to be more involved in alternative roles, such as being a stay-at- underlying conservative attitudes toward men as more agentic (Lippa & Conelly, 1990). family life. As long as more egalitarian home dad, which could be rewarding. the division of labour within marriages. Interestingly, some researchers have argued attitudes fail to exist for men, gender Researchers have indeed suggested that These attitudes and their consequences in favour of renaming these traits equality cannot be achieved – so ultimately fatherhood and fathering activities are have a markedly negative effect on women. “Dominance and Nurturance” (eg. Spence, we are interested in what could create a beneficial for males’ well-being (Dykstra & One study showed that having a husband 1983) which clarifies the role segregation change in this imbalance. Keizer, 2009). In this current line of research, who works long hours made wives more that underlies these dimensions. Since One reason for the rigidity of men’s we are investigating whether men and likely to quit their jobs, especially when women are connected to nurturance it may roles may be that masculinity is still seen as women predict that their own life will take a children were present, but this effect wasn’t seem evident that this accounts for their more positive and desirable in our society. less counter-stereotypical path and whether seen the other way around, when the wife traditional adherence to household and Masculinity is connected with competence, they will change their own association with worked long hours (Chaa, 2010). Women family matters, in contrast to the dominant whereas femininity is perceived to be linked family and career when primed with male have also been shown to have less leisure male, who is concerned with work and to warmth and expressiveness (Broverman, exemplars that display an alternative, family- time today compared to 1975, which is not achievement. Fortunately, masculinity and 1972). A man who engages in feminine, oriented lifestyle. the case for men (Mattingly & Sayer, 2006). femininity are now conceptualized as a two- nurturing activities may then be seen as Most research on how men and women This supports the notion that the increasing dimensional model, meaning that men and showing weakness. This idea is best relate to family and career matters and how participation of women in the work force women can possess both feminine and reflected by the idea of “precarious

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manhood” which describes the finding that There is a large body of evidence giving association of women with these fields after these profiles could model a counter- manhood, in contrast to womanhood, is a support to all of these pathways, many of exposure to female experts or after being stereotypical but positive version of males less stable concept. Research shows that which emphasize the role of models in taught by female math professors (Stout, and therefore be successful in changing there is an underlying belief that manhood, gender development. These findings help Dasgupta, Hunsinger & McManus, 2011). attitudes about what lifestyles are but not womanhood, is a trait that can be explain why the male gender role appears to The value of role model primes also appropriate for males as well as females. lost and is therefore something that has to be more rigid. Research indicates that connects to findings that suggest that Hence, our prediction is that male students be proven. It is partly because of this various role models encourage males not to decisions about the division of labour are will be faster to associate themselves with instability of manhood that men still feel show feminine characteristics. These role often made on an implicit level, but serve to family related words when primed with threatened when they are associated with models come from a variety of sources, perpetuate gender roles (Wiesman et al, profiles of family-oriented men than femininity or activities deemed feminine including characters within children’s books, 2008). This may mean that attitudes about participants who are primed with traditional, (Vandello et al, 2008). actors, teachers or their own parents what is appropriate for each gender are so career oriented males. Male participants in The importance of role models is (Diekman & Murnen, 2004; Coltrane and deeply internalized that they influence this condition should also predict more emphasized by a number of social learning Adams, 1997; Raag & Rackliff, 1998; Lamb cognition without awareness. This suggests involvement in the family compared to male theories that attempt to explain how we Easterbrooks, & Holden, 1980). All of these that participants may not consciously participants in the other conditions. acquire gender stereotypical knowledge, findings suggest that boys may be under recognize the influence a counter Because of the findings related to attitudes and behaviours (e.g., Bandura, special pressure to conform to the models of stereotypical male role model can have on precarious manhood, which require males to Ross & Ross, 1961). Different models in the masculinity and provides an explanation as their thoughts and behavior. Overall, the constantly “prove their maleness,” we social learning perspective are used to to why gender-incongruent males may elicit previous findings connected to modelling expect that some men may have a threat- explain how society teaches individuals to more negative reactions in participants than and gender roles leads us to believe that role like reaction when confronted with behave according to a gender standard. For gender incongruent females. models may be a promising way to change examples of communally oriented men and example, social cognitive theory describes As I will describe here, there has been a traditional gender role adherence. A notable may rate them as less favourable and less how children first learn behaviours through vast amount of research into women’s issues point, however, is that previous like themselves than career oriented men. observing models in their environment in gender equality. This work has examined investigations concentrated on how women This presumably serves to distance their self (Bandura, Ross & Ross, 1961; Perry & Bussey, how exposure to successful female role benefit from female role models. The male from the counter stereotypical males. 1979). Male and female children learn to models can usher women to adopt more side of this issue has, unfortunately, been Women, in contrast, would likely not show behave differently because they learn agentic traits and roles and promote women largely ignored. We, on the other hand, an adverse reaction to examples of behaviour appropriate for their gender from to move into the workforce. One study want to utilize these past research findings communal men and may even rate them models in their environment. Moreover, showed that exposing female participants to to see how communal male role models can more favourable than men who have little socialization theory (operant conditioning), exemplars of successful women in a lab influence not only men, but also women. association with family. We believe that it is applied to the learning of gendered setting leads them more easily associate vital to search for ways that might be able to behaviour, holds that men and women differ females with leadership attributes on an IAT, Hypothesis 1 curtail men’s strong adherence to masculine because they are reinforced by peers and marking less stereotypical cognitions In this study, we wanted to assess how gender-typing, and past research has shown superiors when they display gender- (Dasgupta & Asgari 2004). Another study heterosexual male and female students that role models may be an extremely congruent behaviour and punished when showed that young college women were were influenced by reading about family- valuable tool for attempting to do so. they display gender incongruent behaviours more likely to believe that they would have a oriented males (condition 1) , males with an (Fagot, 1977). Furthermore, social role successful career when they had a higher equal balance between work and family Hypothesis 2 theory maintains that females and males amount and better quality of contact with (condition 2) or males with a clear career For women, we envision a different picture. develop different characteristics because of female professors (Asgari, Dasgupta & oriented lifestyle (condition 3). We expect We believe that being primed with family the diverging social roles they are assigned Gilbert Cote, 2010). Most recently, a series effects on the way students implicitly oriented men might free up women to to (e.g., domestic roles vs. career roles). of studies focusing on the fields of Science, associate themselves with work and family pursue career opportunities. Hence, we These roles require distinct attributes that Technology, Engineering and Mathematics on a Go-No-Go Association Task of implicit predict that women will show the opposite the individual develops to fit into the role (STEM) has shown that women in these associations (GNAT; Nosek & Banaji, 2001), pattern of men when primed with the (Eagly & Diekman, 2000). fields exhibit stronger implicit association of as well as on how students imagine a day in family-fathers. Specifically, we predict that self with STEM subjects as well as higher the life of their future self. We think that women will be more likely to associate

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themselves with career words (implicitly) Procedure task, participants completed the Go/No-Go fit into one of two categories presented on and to indicate high work involvement when Upon entering the lab, participants read and Association Test (GNAT; Nosek & Banaji, top of the screen. We used four (Self, Other; primed with male profiles that are family signed a standard consent form discussing 2001) designed to measure their implicit Career, Family) different categories to gauge oriented or keep a work-family balance the general study procedures, participant’s associations between themselves and career participants’ implicit associations between compared to the career focused primes. The rights and contact information. Next, or family. During the final portion of the career and family. Target stimuli included strong evidence for social learning participants were given the cover story that study, we invited participants to compose a either pictures (see Supplementary Figure 2 perspectives of gender differences makes us we were investigating people’s life future life narrative for themselves in which for example pictures) related to family or confident that our manipulation of role narratives and the activities they typically we asked them to thoroughly imagine and career or words representing self (e.g., me, models differing in career vs. family engage in. We told them that we were pilot visualize their future-life 15 years from now. mine, my) or other (e.g., they, them, theirs). orientation should have an effect on testing some sample narratives to obtain This task was divided into two parts: Participants completed four separate pairing participant’s implicit association with career baseline information needed for an predicting demographic information and blocks (self-career, self-family, other-career and family, as well as influence how they upcoming study. Next, we explained that reconstructing a typical day in their future and other family) of categorizations with 96 picture themselves in the distant future and they would do a computer-sorting task to lives. randomly ordered trials each. The categories how they predict work-family balance to give us a baseline measure of how fast “Self” or “Other” were each paired with turn out in their own lives. people are generally able to sort stimuli. Measures either “Family” or “Career” in a Finally, they were told that after evaluating Profile Ratings. After reading each of the counterbalanced order between participants. Method the sample narratives, that they would be individual profiles we asked participants to The stimuli were presented with a 500-ms given the chance to compose their own, make ratings of how they perceived the response window and an inter-stimulus Participants future-life narrative. person they just read about. First interval of 150-ms (as in Park et al., 2010). Participants were 81 UBC students (28 males Our independent variable was a role participants rated the exemplar on the 16 Categorizations were made by either and 53 women) who participated for either model prime with three conditions (career, item Personal Attributes Questionnaire (PAQ; pressing the spacebar if the item did not fit course credit or monetary compensation. balance and family). Participants were Spence, Helmreich & Stapp, 1974), which in to one of the two target categories (“Go”) Fifty nine percent of our participants were randomly assigned to one of these assesses masculine traits (e.g. independent) or not acting (“No-Go”) if the item did not fit East Asian, 22 % Caucasian, 12 % Hispanic, 3% conditions and asked to read the profiles of and feminine traits (e.g. kind) on a five-point into either category. We then measured the south Asian and 2% Southeast Asian. We are five men (the exemplars) and rate them. The scale. To determine whether or not speed and the accuracy that participants still in the process of collecting data and five profiles (see Supplementary Material) participants were aware of our primary made these categorizations. The GNAT task because our current number of male included the same pictures, education, manipulation, we asked them to rate each works off the assumption that participants participants lacks the power to detect any profession, and number of children in all role model’s family-career balance on a scale will be slower or make more errors when the meaningful differences between conditions, three conditions, but differed in the amount of 1 to 7, with 1 indicating family orientation, two categories presented together this paper will concentrate on reporting the of career-family balance expressed in the 4 indicating balance and 7 indicating career contradict their own implicit associations results of the female participants. After biographical statements. In the career orientation (α = .84). Furthermore, (Park, Smith & Corell, 2010). In principle, excluding participants that indicated condition the men worked full time and participants were asked to indicate how someone who, for example, has a strong homosexuality in the post-study made minimal reference to their family lives, physically attractive (α = .83), how attractive association of self to career should then be questionnaire (n = 9) and participants with in the balance condition the men had a as a possible mate (α = .88), how similar to better able to categorize stimuli when the evident language barriers (n =1) we were left thriving career but flexible schedules which themselves (α = .86) and how representative categories self and career are presented with a sample of 70 participants (48 women allowed them to spend more time with their (α = .74) they perceived the exemplar. These together than when the categories self and and 23 men). Following the exclusions our families, and in the family condition the men ratings were made on a scale of 1 to 7, with family are presented together. The female data consisted of 17 women in the were extremely family oriented, taking time 1 indicating “not at all” and 7 indicating dependent variable for the GNAT (d-prime) career condition, 16 women in the balance off of work to be there for their family and “very much”. is calculated for each block (i.e. associative condition and 15 women in the family raise small children. pairing) by subtracting a participant’s condition. After reading each profile, participants Implicit Measures. The GNAT (Nosek & probability of showing false alarm responses were asked to make ratings of each of the Banaji, 2001) we used was modelled after (pressing the space bar if the stimuli does

exemplars, presumably to help us pilot test Park, Smith and Corell (2010). In this task, not fit) from their probability of getting a

stimuli for another project. Following this participants had to decide whether stimuli correct hit (pressing the spacebar when the

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stimuli does fit in one of the categories). In focusing on how much time participants Notably, however, we can see that the suggests that participants felt, on average, turn, a more negative value indicates more anticipated working, taking part in personal ratings for family and career condition were that the males trying to keep a work-family error and, therefore, a weaker association activities or family activities, or other not at the far end of the family-career balance were most representative of the between the two concepts. activities such as commuting. Time spent on spectrum. males they encountered in everyday life. family activities was furthermore split up Although participants rated the males Future Self Predictions. The measure of into time spent with kids, doing housework, Profile Ratings differently on several dimensions, e.g., not future self-predictions consisted of two parts. being with the whole family or spending First, we tested how female participants perceiving them as equally masculine and First, participants filled out a questionnaire exclusive time with a spouse. rated the profiles of the role-model primes feminine in the three conditions, these that asked them to predict the demographic they saw at the beginning of the experiment. differences were not reflected in how characteristics of their future life. These Results As predicted, there was a significant effect of physically attractive participants perceived questions were largely associated with condition on perceived masculinity of the the exemplars, as we found no difference anticipated career-family balance such as Analytic Strategy exemplars, F(2, 45) = 11.15, p < .001. between conditions (p = .31). Instead, we martial status, occupation, number of To analyze our data we used one-way Pairwise comparisons showed that found that participants responded children and time spent with family. A Analyses of Variance (ANOVAs) to test the masculinity ratings for the career condition differently to the exemplars as possible number of questions pertained to the significance of the effects of condition (M = 32.41) were significantly higher than mates, F(2, 45) = 3.63, p = .04. Pairwise likelihood of certain life events and lifestyle (Family, Balance and Career) on our primary ratings for the family condition (M = 26.51) comparisons indicated that female in the future. Questions included the dependent variables. Subsequently, we used and the balance condition (M =26.90; p participants who were exposed to the career likelihood of having a spouse, having the Fisher’s Least Significant Difference (LSD) < .001), whereas masculinity ratings in the oriented males (M = 4.31) judged them to be children, being the primary economic to examine pairwise comparisons between balance and family condition were extremely significantly less attractive potential mates provider and being the primary caregiver for the different conditions. Because we are not similar to each other (p = .77, ns). than the male exemplars in the family (M = their family. We also asked participants how yet done collecting data for this study and Furthermore, there was a significant 5.31), p = .02, and the balance condition (M satisfied and successful they anticipated to we are aiming for a larger sample size, effect of condition on perceived femininity, F = 5.29), p =.03. be in terms of their family, career and especially for males, but female participants (2, 45) = 5.59, p = .001. Pairwise comparison overall life. These questions were answered as well, I will present some promising trends revealed that femininity ratings in the career Implicit Associations on a scale of 1 to 7, with 1 indicating “not at in the data in addition to significant results. condition (M = 25.14) were significantly When we conducted the same one-way all” and seven indicating “very much”. Furthermore, as stated above, the extremely lower than femininity ratings in the family ANOVA on participants’ implicit associations Additionally, participants had to predict limited power due to the low number of (M = 29.14), p = .01 and balance condition of self vs. other and family vs. career, the which activities would take up what male participants has led us to concentrate (M = 31.88), p <.001. We see here that males only effect of condition we observed was a percentage of time in their day as well as on reporting female participants’ data in this in the career condition were perceived as marginal effect on self and family their spouse’s day. paper. less feminine compared to the other two associations, F(2, 45) = 2.41, p = .10. A follow To aid participants in predicting a day in conditions. up pairwise comparison analyses showed their future life we used a modified version Manipulation Check Interestingly, participants reported no that women in the family condition were of the day reconstruction method A one way ANOVA run on our manipulation significant differences between conditions in actually significantly faster at associating self (Kahneman, Krueger, Schkade, Schwarz & check (F(2,67) = 104.54, p < .001) and a perceived similarity of the exemplars to with family stimuli (M = - 0.02) compared to Stone, 2004). This method provided subsequent pairwise comparison indicated themselves (p = .50). There was, however, women in the balance condition (M = - 0. participants with a framework that divided that participants yielded significantly an effect of condition on average 186), p = .03. Recall that a mean d-prime their day in three large blocks (waking to different ratings for Family (M = 3.13), representativeness of the exemplars, F(2, 45) value closer to zero indicated faster noon; noon to 6 pm; and 6pm to bedtime) Balance (M = 4.07) and Career (M = 5.23) = 4.58, p = .02. Participants perceived the association of the two concepts than a value with a number of sub-episodes. For each condition (all p’s < .001). These significant exemplars in the balance condition (M = further away from zero. These results may sub-episode participants were asked to mean differences indicate that participants, 4.31) to be significantly more representative suggest that it took women longer to provide a topical name and then a more as expected, perceived our family-oriented than the family oriented exemplars (M = associate themselves with family when they detailed description of what they did durin exemplars as family oriented, our balanced 3.64), p < .01 and marginally more were exposed to the balanced male role this period of time. The predictions exemplars as balanced and our career- representative than the exemplars from the models than when exposed to the career participants made were coded by two coders oriented exemplars as career oriented. career condition (M = 3.91), p = .09. This oriented role models.

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Future Life Predictions examples of career oriented men as role theory that predicts that females and reported in the career condition as opposed Next, we examined whether participants’ opposed to being opposed to more family males are perceived feminine when they are to the balance condition. predictions of future demographic oriented male exemplars. assigned female roles and as masculine Furthermore, the finding that females characteristics differed between conditions. The only difference between conditions when they are assigned male typical roles had higher anticipated time spent in the In line with our predictions, we found a that appeared in the predictions of a typical ( Eagly, Wood & Diekman, 2000). This also career condition connects to the idea that significant effect of condition on how likely future day was in how many hours on supports the notion of precarious manhood, women perceive family oriented males as female participants expect that they will be average female participants anticipated as we saw that females assigned males more more attractive potential mates than the the primary economic caregiver 15 years in spending at work. As the overall ANOVA masculine quality when they proved career oriented males, which may suggest the future, F (2,45) = 4.86, p = .01, see Figure yielded non-significant results, p = .21, themselves through living traditionally that there is, today, a general desire among 1. Pairwise comparisons showed that there pairwise comparisons showed that females masculine career-oriented lifestyles females to have a successful career. This is was a significant difference in likelihood that may anticipate having more time when they (Vandello et al, 2008). Participants easily explained by the higher status our female participants will be the breadwinner were confronted with career males (M = furthermore perceived the role models from society reserves for work outside the home between the Balanced (M = 2.81) and the 7.59 hours) than when they were confronted the balance condition as the most (e.g., Furgeson, 1991). A tendency to discard Family (M = 4.47) condition, p < .001. with the exemplars in the balance (M = 6.54), representative of the average male males who are not willing to participate in Furthermore there was a near marginal p = .09, and the family condition (M = 6.45), population, while they indicated preferring family duties from the pool of potential difference between the Balance and the p = .06. the family-oriented males as potential mates. mates may also explain why females Career condition (M = 3.65), p = .11 as well 5 The finding that was most supportive of confronted with career oriented males do as between the Career and the Family our predictions was the finding that not anticipate a significantly lower condition, p = .12. This data suggests that 4 exposing female participants to male role probability of the being the breadwinner.

females might be more likely to want to 3 models had an effect on how they viewed Females that read about career oriented engage in a career when confronted with their future life related to family and career. males may actually have had a defiance-like the family-oriented males as opposed to the 2 Interestingly, females reported a reaction and dissociate from these males as career-oriented males. Women exposed to Mean Ratings significantly higher likelihood of being the models of potential partners. This may the balanced condition, however, showed 1 primary economic provider when they were explain why these women actually show the lower career anticipation than women 0 confronted with family oriented males as desire for more career involvement. Overall, exposed to the other two conditions. Career Balanced Family opposed to males that were trying to keep a our data would suggest that young female Moreover, although the initial ANOVA Condition work-family balance. This finding is in line university students already show a p was not significant ( = .20), the data Figure 1. Female participants’ reported likelihood of with our prediction that females should be significant affinity towards focusing on indicated that females in the balance being the primary economic provider. more likely to anticipate a thriving work-life career matters. This is amplified by being condition predict a marginally lower mean when they come in contact with family exposed to the possibility of a house- percentage of their spouse’s time spent with Discussion oriented male models. It is however, husband but not necessarily reversed by family matters (M = 22.36 %) compared to somewhat surprising that there was no being exposed to career-focused men – as females in the family condition (M = Although preliminary, these data suggest significant difference between female these men are perceived as unattractive 28.87 %), p < .10. This means that females in that our manipulation had the hypothesized participants’ anticipated career involvement partners. the balance condition actually predict lower effect with participants perceiving the in the career condition and the other The finding that females presented with spousal family involvement. exemplars’ career-family balance in the conditions. In fact, women in the balance the exemplars of men who strive for a work- In addition, despite a none-significant different conditions as we had planned. condition appeared to predict the lowest family tradeoff anticipate lower probability overall ANOVA (p = .21) we observed a Secondly, women’s perceptions of the likelihood of becoming the primary of being the breadwinner of their future- marginal difference between career (M = exemplars seemed to be shaped by the economic provider for their family. This family than females in the other condition is 6.29) and balance (M = 5.81) condition of exemplars’ orientation towards career or somewhat unexpected reaction of women somewhat counterintuitive. One speculation participants anticipation of satisfaction with family. In particular, masculinity and was also reflected by the marginally higher to explain women’s unexpected reaction to their job in the future, p = .09. This suggests femininity ratings, which showed higher anticipated time spent with career and being presented with the balanced that women may anticipate more job masculinity and lower femininity in the satisfaction with career that females exemplars might be that these exemplars satisfaction when they are exposed to career condition, are consistent with social may have represented a realistic tradeoff for

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women, which may have lead them to through a simple lab procedure. It is example, we could explore how parents’ Blair, Samson Lee & Lichter, Daniel T. (1991). actually anticipate shared duties, which questionable, however, whether the brief gender stereotypical beliefs affect their Measuring the division of household labor: Gender segregation of housework among would require them to still be involved with exposure to profiles in a sterile laboratory children’s gender related cognition, American couples. Journal of Family Issues, their families. These balanced males may setting can substitute for real world contacts. especially on an implicit level. In connection 12, 91-113. very well be seen as the embodiment of If anything, one would expect the effects of to the data I presented in this paper, it Blake, J. (2009). Psychological distress, masculinity ideology, and self-threat: A model of men's modern conceptualizations of equal real-life role models to be stronger on the would be intriguing to see would be whether attitudes toward help seeking. Dissertation partnership. The exemplars might have, basis of authenticity and length of contact. family-oriented or even stay-at home fathers Abstracts International, 70, Retrieved from therefore, made a compromise between In addition, although our sample contains a influence their daughters to be more eager PsycINFO database. career and family, and seem like an considerable percentage of Caucasians and to have a career and associate themselves Boston, M., & Levy, G. (1991). Changes and differences in preschoolers' understanding of attractive and realistic option. In such a East Asian participants, the population is still with more with work. gender scripts. Cognitive Development, 6(4), partnership, none of the partners would limited to undergraduate students at a 417-432. doi:10.1016/0885-2014(91)90047-H. actually be the primary breadwinner, which North American university and therefore Acknowledgements Brown, E. & Diekman, A. (2010).What Will I Be? Exploring Gender Differences in Near is reflected by our participants’ answers. cannot adequately address cultural I want to thank my fellow RA Jennifer and Distant Possible Selves . Sex Roles, Moreover, our data show marginal variability in the influence of gender role McDermid, who put a great deal of work Broverman, I. (1972). Sex-role stereotypes: A current effects that point to lower anticipated job modeling. into this project, and my supervisors who appraisal. Journal of Social Issues, 28(2), 59- satisfaction and lower anticipated The most important next step in this have helped and inspired me many times. 78. Retrieved from PsycINFO database Byron, K. (2005). A meta-analytic review of work- percentage of the spousal day spent with research would be the continuation of data family conflict and its antecedents. Journal of family for females in the balance condition. collection on this project in order to obtain Declaration of Conflicting Interests Vocational Behavior, 67(2), 169-198. This could suggest that our participants fear greater power to make statistically The author declared they have no conflicts doi:10.1016/j.jvb.2004.08.009 higher work-family strain and stressful significant conclusion about the effects of of interests with respect to their authorship Chaa, Y. (2010). Reinforcing separate spheres: The effect of spousal overwork on men's and experiences resulting from the vision of a our role model prime on females and males. or the publication of this article. women's employment in dual-earner dual-earner couple. Females might be As participant’s reactions to the balance households. American Sociological Review, especially aware of the notion of the condition seem somewhat unexpected, References 75(2), 303-329. “second shift” (Hochschild, 1989). Research establishing a fourth condition could be a Asgari, S., Dasgupta, N., & Cote, N. (2010). When Coltrane, S., & Adams, M. (1997). Work–family does contact with successful ingroup members imagery and gender stereotypes: Television and shows that working mothers as well as way to gain a better control measure. Such change self-stereotypes? A longitudinal study the reproduction of difference. Journal of fathers are at risk of feeling strain from this condition would likely consist of giving comparing the effect of quantity vs. quality of Vocational Behavior, 50(2), 323-347. situation (Bakker, Demerouti & Dollard, participants a short reading about a non- contact with successful individuals. Social doi:10.1006/jvbe.1996.1575. Psychology, 41(3), 203-211. doi:10.1027/1864- Dasgupta, N., & Asgari, S. (2004). Seeing is believing: 2008). In fact, trying to be highly involved relevant topic instead of the role-model 9335/a000028. Exposure to counterstereotypic women leaders with both work and family can create prime, to find out what people’s associations Bakker, A. B., Demerouti, E., & Dollard, M. F. (2008). and its effect on the malleability of automatic interference of work with family life and vice and future life predictions look like at How job demands affect partners' experience of gender stereotyping. Journal of Experimental versa (Byron, 2005). This is especially true baseline. exhaustion: Integrating work-family conflict Social Psychology, 40(5), 642-658. and crossover theory. Journal of Applied doi:10.1016/j.jesp.2004.02.003. for employed mothers of young children, As our research shows some promising Psychology, 93(4), 901-911. doi:10.1037/0021- Diekman, A., & Murnen, S. (2004). Learning to be who can experience guilt with regard to their trends pertaining to the influence male 9010.93.4.901 little women and little men: The inequitable employment (Elvin-Novak, 1999). Our models can have on females’ future life Bandura, A., Ross, D., & Ross, S. (1961). gender equality of nonsexist children's participants’ unexpected response to the expectations, we believe that these findings Transmission of aggression through imitation literature. Sex Roles, 50(5-6), 373-385. of aggressive models. The Journal of Abnormal Dribe, M., Stanfors, M. (2009). Does Parenthood balance condition could then represent a should be further pursued. Research could and Social Psychology, 63(3), 575-582. Strengthen a Traditional Household Division of concern about the hardships of combining explore the impact of family-oriented male doi:10.1037/h0045925. Labor? Evidence From Sweden. Journal of work and family duties in their future. models on males and female in other Bem, S. (1974). The measurement of psychological Marriage and Family, 71 (1), 33-45. androgyny. Journal of Consulting and Clinical Dykstra, P. A., & Keizer, R. (2009). The wellbeing of Although these findings are intriguing, settings. As our data suggest that work or Psychology, 42(2), 155-162. childless men and fathers in mid-life. Ageing & there are some limitations of this study that family-orientation of male role models have doi:10.1037/h0036215. Society, 29(8), 1227-1242. should be noted. Specifically concerns about an effect on females anticipation of a Bem, S. (1981). Gender schema theory: A cognitive doi:10.1017/S0144686X08008374 external validity and cross-cultural validity breadwinner role in their future, it might be account of sex typing. Psychological Review, Eagly, A., Wood, W., & Diekman, A. (2000). Social 88(4), 354-364. doi:10.1037/0033- role theory of sex differences and similarities: are applicable. Our study aims to interesting to see whether such role model 295X.88.4.354. A current appraisal. The developmental social approximate the effect of role models effect are present in non-lab settings. For psychology of gender (pp. 123-174). Mahwah,

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NJ US: Lawrence Erlbaum Associates Park, B., Smith, J., & Correll, J. (2010). The Supplementary Material Publishers. Retrieved from PsycINFO database. persistence of implicit behavioral associations Eagly, A., & Karau, S. (2002). Role congruity theory for moms and dads. Journal of Experimental of prejudice toward female leaders. Social Psychology, 46(5), 809-815. Psychological Review, 109(3), 573-598. doi:10.1016/j.jesp.2010.04.009 doi:10.1037/0033-295X.109.3.573. Perry, D., & Bussey, K. (1979). The social learning Eisler, R., & Skidmore, J. (1987). Masculine gender theory of sex differences: Imitation is alive and role stress: Scale development and component well. Journal of Personality and Social factors in the appraisal of stressful situations. Psychology, 37(10), 1699-1712. Behavior Modification, 11(2), 123-136. doi:10.1037/0022-3514.37.10.1699. doi:10.1177/01454455870112001. Poortman, A., Van der Lippe, T., (2009). Attitudes Elvin-Nowak, Y. (1999). The meaning of guilt: A Toward Housework and Child Care and the phenomenological description of employed Gendered Division of Labor. Journal of mothers' experiences of guilt. Scandinavian Marriage and Family, 71(3), 526-541. Journal of Psychology, 40(1), 73-83. Raag, T., & Rackliff, C. (1998). Preschoolers' doi:10.1111/1467-9450.00100 awareness of social expectations of gender: Fagot, B. (1977). Consequences of moderate cross- Relationships to toy choices. Sex Roles, 38(9- gender behavior in preschool children. Child 10), 685-700. doi:10.1023/A:1018890728636. Development, 48(3), 902-907. Spence, J. T., Helmreich, R., & Stapp, J. (1974). The Figure 1. Profile picture for profile 1. doi:10.2307/1128339. Personal Attributes Questionnaire: A measure Ferguson, E. (1991). The Child-care Crisis: Realities of sex role stereotypes and masculinity- Profile 1 – Career condition of Women's Caring, Women's Caring: Feminist femininity. JSA. Catalog of Selected Christopher Berry went to The University of Alberta and received a Bachelor's of Science degree in Perspectives on Social Welfare, C. Baines, P. Documents in Psychology, 1974, 4, 127. (Ms. Chemical Engineering. He started out in engineering design at Dow Chemical, a large chemical company Evans, & S. Neysmith (eds.),Toronto: No. 617). McLelland & Stewart. Spence, J. (1983). Comment on Lubinski, Tellegen, where he designed equipment and processes that were used to make chemicals such as plastics and Hochschild, A., (1989) The second shift: Working and Butcher's 'Masculinity, femininity, and chlorine. In his work he focused on creating a better and more biodegradable form of packaging for food parents and the revolution at home. New York: androgyny viewed and assessed as distinct products. Christopher has found this very fulfilling, and despite the amount he has to put into his Viking. concepts.'. Journal of Personality and Social research, Chris knows he is making a valuable contribution to the environment. He never loses interest Kahneman, D., Krueger, A. B., Schkade, D. A., Psychology, 44(2), 440-446. doi:10.1037/0022- in what he is doing, as he feels that all of his hard work will eventually pay off. It is this persistence that Schwarz, N., & Stone, A. A. (2004). A survey 3514.44.2.440. makes him such a good chemical engineer. Chris is also married and has a young son. method for characterizing daily life experience: Spence, J., & Buckner, C. (2000). Instrumental and The day reconstruction method. Science, 306, expressive traits, trait stereotypes, and sexist 1776-1780. attitudes. Psychology of Women Quarterly, Profile 1- Balance condition Lamb, M., Easterbrooks, M., & Holden, G. (1980). 24(1), 44-62. doi:10.1111/j.1471- Christopher Berry went to The University of Alberta and received a Bachelor's of Science degree in Reinforcement and punishment among 6402.2000.tb01021.x. preschoolers: Characteristics, effects, and Stout, J. G., Dasgupta, N., Hunsinger, M., & Chemical Engineering. Chris works as an engineer at Dow Chemical, a large chemical company where he correlates. Child Development, 51(4), 1230- McManus, M. A. (2011). STEMing the tide: designs equipment and processes that are used to make chemicals such as plastics and chlorine. In 1236. doi:10.2307/1129565. Using ingroup experts to inoculate women's addition to his success at work Chris maintains a healthy home life and enjoys spending his time off Lippa, R., & Connelly, S. (1990). Gender self-concept in science, technology, diagnosticity: A new Bayesian approach to engineering, and mathematics (STEM). work with his son and wife. Chris says: “since my son Nathan was born, I try to stick to a regular gender-related individual differences. Journal Journal of Personality and Social Psychology, schedule and go home early to spend time with my family.” Although Chris loves being an Engineer and of Personality and Social Psychology, 59(5), 100(2), 255-270. doi:10.1037/a0021385 is happy at his workplace he is equally eager to spend time with his family. 1051-1065. doi:10.1037/0022-3514.59.5.1051. Statistics Canada, CANSIM, table 477-0014. Lubinski, D., Tellegen, A., & Butcher, J. (1983). Vandello, J., Bosson, J., Cohen, D., Burnaford, R., & Masculinity, femininity, and androgyny viewed Weaver, J. (2008). Precarious manhood. Profile 1 – Family condition and assessed as distinct concepts. Journal of Journal of Personality and Social Psychology, Christopher Berry went to The University of Alberta and received a Bachelor's of Science degree in Personality and Social Psychology, 44(2), 428- 95(6), 1325-1339. doi:10.1037/a0012453. Chemical Engineering. He started out in engineering design at Dow Chemical, a large chemical company 439. doi:10.1037/0022-3514.44.2.428. Wiesmann, S., Boeije, H., Van Doorne-Huiskes, A., Markus, H., & Nurius, P. (1986). Possible selves. Den Dulk, L. (2008) Not worth mentioning': where he designed equipment and processes that were used to make chemicals such as plastics and American Psychologist1986; 41:954-69.1987- The implicit and explicit nature of decision- chlorine. He was very successful within his field, and well liked by his colleagues. However, Chris’s 01154-00110.1037/0003-066X.41.9.954. making about the division of paid and domestic priorities changed when his first son, Nathan, was born. Since then, he has decided to take paternity 10.1037/0003-066X.41.9.954 . work Community. Work & Family, 11(4), 341- leave to care for Nathan, while his wife goes back to work to advance her career and support their Nosek, B. A., & Banaji, M. R. (2001). The Go/No-go 363. family. Chris really loves taking care of his son and he is planning to return to work once Nathan is ready Association Task. Social Cognition, 19(6), to attend kindergarten. 625-666. doi:10.1521/soco.19.6.625.20886

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A. B.

Figure 2. A. Example of a family-related stimulus. B. Example of a work-related stimulus.

102 UBCUJP – April 2012 – Volume 1

University of Undergraduate Journal of Psychology British Columbia’s 1 Editor’s Note David W. –L. Wu

3 Metaplasticity: A new frontier in the neural representation of memory Dano Morrison

15 Psychology: A closer look at what psychologists bring to the table Elizabeth Laliberte

21 Craniopagus: Overview and the implications of sharing a brain Jordan Squair

29 Pedophilia and brain function Po Liu

35 Too much sex, a mental disorder? Examining both sides of the debate on hypersexual disorder Xijuan Zhang

45 Startle reflex as a physiological measure of emotion regulation Brittany C. Speed

59 The negative effect of doodling on visual recall performance Elaine Chan

65 Did he really earn it? An of anabolic-androgenic steroid use in sports Dexter McMillan

73 Exploring religiosity’s effects on altruistic behaviour Lu Zhao

87 Communal male role models: How they influence identification with domestic roles and anticipation of future involvement with the family Katharina Block, 2011 Belkin Award Winning Paper