David H. Barlow

Measurement of sexual arousal in male homosexuals: Effects of instructions and stimulus modality

Erections were measured in 20 male homosexual subjects under three instructional conditions and within three stimulus modalities. The three conditions were arousal (e.g., imagine yourself involved and get aroused), suppression (e.g., imagine yourself involved but suppress erection responses), and rearousal (e.g., imagine yourself involved and get aroused). The three stimulus modalities studied were video tapes, slides or pictures, and audio tapes of homosexual cues. The results show that video tape generates the highest level of arousal, audio tape the lowest level of arousal, and slides an intermediate level. Both video tape and slides show substantial voluntary suppression effects. During suppression, video tape continues to elicit relatively high levels of arousal in contrast to slides and audio tapes, which are equally low.

The transfer gap in systematic desensitization: An analogue study ☆

Abstract The effect of systematic desensitization upon snake fearful subjects was compared in two conditions. In the first, relaxation was paired with imagined scenes of the snake, and in the second with a real snake. The second group improved more in a behavioral approach test and evidenced less anxiety as measured by GSR than the first group. The results point to an inefficiency of the imaginative process, and the possibility that behavioral change is enhanced by contact with the feared object.

Increasing heterosexual responsiveness in the treatment of sexual deviation: A review of the clinical and experimental evidence

Despite wide agreement that avoidance of heterosexuality is a major component in the genesis and maintenance of sexual deviation, the development of therapeutic procedures to increase heterosexual responsiveness has been largely neglected in favor of aversion therapy to suppress deviant responsiveness. Therapeutic procedures that have been employed to increase heterosexual responsiveness include: aversion relief techniques in which relief from an aversive stimulus is paired with heterosexual stimuli; “Systematic Desensitization procedures” in which heterosexual avoidance is desensitized either in imagination or in the real situation; social retraining where heterosexual skills are directly encouraged and taught; or pairing techniques in which sexual arousal is elicited and associated with heterosexual stimuli. Clinical and experimental evidence for the effectiveness of these procedures, as well as some newly developed techniques which cannot be classified in the above categories, is evaluated and the relationship of these procedures to aversion therapy in the treatment of sexual deviation is discussed.

An experimental analysis of classical conditioning as a method of increasing heterosexual arousal in homosexuals

Classical conditioning of sexual response to female stimuli, using slidesand films with homosexual content as UCS, was examined in three homosexuals using single subject experimental designs. Critical variables in the classical conditioning procedure were systematically introduced and removed while objective and subjective measures of homo- and heterosexual behavior were recorded. In two subjects, classical conditioning was isolated as an effective procedure for increasing heterosexual arousal, although in one of these subjects, alteration of the temporal relationship between the CS and UCS was first necessary. In a third subject, classical conditioning was not effective. Implications for further clinical application are discussed.

The contribution of therapeutic instruction to covert sensitization

Abstract R ecent controlled studies demonstrate that aversion therapies can be effective treatments for certain behaviour disorders such as alcoholism (Ashem and Donner, 1968) and sexual deviation (Feldman and MacCulloch, 1971). However, the mechanism of action in the various forms of aversion therapy has not been determined. As one form of aversion therapy, covert sensitization employs descriptions of noxious scenes as aversive stimuli. An earlier study (Barlow, Leitenberg and Agras, 1969) suggested that pairing descriptions of noxious scenes with scenes of the undesired behavior was the critical procedure in covert sensitization. There, a single case design was used with two sexual deviates. Sexually arousing scenes were paired with descriptions of nausea and vomiting during the first phase, while in a second phase the same sexually arousing scenes were presented alone, and finally, pairing was reinstated. Put another way, these phases represent acquisition, extinction and re-acquisition respectively. During the pairing of scenes in the first phase, deviant arousal declined, rose again when the pairing of scenes was removed, and dropped in the final phase when pairing was reinstated. This appeared to demonstrate the effectiveness of pairing in the procedure. It is possible, however, that therapeutic instructions and the resulting expectancy of improvement present in both covert sensitization phases, were responsible for the effectiveness of the treatment, since the patient may have viewed the middle extinction phase as non- therapeutic. To test this notion, the procedure of the first experiment was changed somewhat. Four homosexual Ss were told that the acquisition procedure (covert sensitization) with pairing would temporarily worsen their sexual deviation and that the extinction procedure (no pairing) was therapeutic. The experiment began with the no pairing procedure with therapeutic instructions to create the desired expectancies at the outset and to test for an initial placebo effect. In addition, an objective measure of sexual arousal, penile circumference change, was recorded. If pairing is the necessary and sufficient procedure in covert sensitization, then deviant sexual arousal should decrease during covert sensitization despite instructions to the contrary and, conversely, no improvement should occur during the no pairing, placebo phase.Recent controlled studies demonstrate that aversion therapies can be effective treatments for certain behaviour disorders such as alcoholism (Ashem and Donner, 1968) and sexual deviation (Feldman and MacCulloch, 1971). However, the mechanism of action in the various forms of aversion therapy has not been determined. As one form of aversion therapy, covert sensitization employs descriptions of noxious scenes as aversive stimuli. An earlier study (Barlow, Leitenberg and Agras, 1969) suggested that pairing descriptions of noxious scenes with scenes of the undesired behavior was the critical procedure in covert sensitization. There, a single case design was used with two sexual deviates. Sexually arousing scenes were paired with descriptions of nausea and vomiting during the first phase, while in a second phase the same sexually arousing scenes were presented alone, and finally, pairing was reinstated. Put another way, these phases represent acquisition, extinction and re-acquisition respectively. During the pairing of scenes in the first phase, deviant arousal declined, rose again when the pairing of scenes was removed, and dropped in the final phase when pairing was reinstated. This appeared to demonstrate the effectiveness of pairing in the procedure. It is possible, however, that therapeutic instructions and the resulting expectancy of improvement present in both covert sensitization phases, were responsible for the effectiveness of the treatment, since the patient may have viewed the middle extinction phase as non- therapeutic. To test this notion, the procedure of the first experiment was changed somewhat. Four homosexual Ss were told that the acquisition procedure (covert sensitization) with pairing would temporarily worsen their sexual deviation and that the extinction procedure (no pairing) was therapeutic. The experiment began with the no pairing procedure with therapeutic instructions to create the desired expectancies at the outset and to test for an initial placebo effect. In addition, an objective measure of sexual arousal, penile circumference change, was recorded. If pairing is the necessary and sufficient procedure in covert sensitization, then deviant sexual arousal should decrease during covert sensitization despite instructions to the contrary and, conversely, no improvement should occur during the no pairing, placebo phase.

Measurement and modification of spasmodic torticollis: An experimental analysis

The use of a horizontal grid placed over a videotape television monitor proved to be a precise method of defining and measuring incidence of torticollis. Effects of instructions and negative feedback in modifying percentage of spasmodic torticollis were also examined in an experimental single case design. Application of negative feedback resulted in a significant decrease in percentage of torticollis per ten minute session. Instructions, however, did not diminish percentage of torticollis, but appeared to result in greater variability of performance.

Biofeedback and reinforcement to increase heterosexual arousal in homosexuals

Abstract Relatively few procedures exist for developing heterosexual arousal in the treatment of sexual deviation (Barlow, 1973) although several recent studies suggest this is a necessary component of treatment (Feldman and MacCulloch, 1971; Bancroft, 1970; Barlow, 1974). In recent years, biofeedback techniques have been applied to many types of disorders (Blanchard and Young, 1974). Basic to biofeedback technology is the notion that providing a person with feedback (or immediate information) of a bioelectric response enables him to learn (gain) self-control of that response. These responses traditionally have been considered involuntary and include heart rate (Scott et al. , 1973a). blood pressure (Benson et al. , 1971), stomach acid pH (Welgan. 1972), and electroencephalographic activity (Sterman, 1972), In the present experiments, biofeedback and its attendant technology was applied to the problem of generating heterosexual arousal in homosexual males. Frequently, in biofeedback research, reinforcement has been used in addition to feedback in attempting to teach self-control of a response. In fact, an alternate way of conceptualizing and describing the biofeedback research is in terms of operant conditioning (e.g., Weiss and Engel, 1971: Scott et al. , 1973b). In one sense, however, feedback and reinforcement are inextricably confounded: the delivery or non-delivery of a reinforcer provides the S with information about the rightness or wrongness of his response and hence, binary feedback about it. Likewise, if feedback or knowledge of whether the response has reached a criterion level or not is effective in leading to a change in the response, then feedback functions as a reinforcer. Reinforcement, however, may be viewed as providing both information about the response (feedback) plus an incentive to change it in the desired direction in addition to any incentive provided by successful performance of a task. Thus, if one provides S s with a separate, functionally defined reinforcer in such a way that no additional information about the response is conveyed, it becomes possible to detect additive effects of reinforcement over feedback effects. Such was the second purpose of this study. Several recent analogue experiments with volunteers have reported success in modifying erections through feedback and/or reinforcement. Price (1973) found that heterosexual volunteers who received analogue visual feedback as well as binary feedback, provided by a colored light once the needle had passed a pre-set criterion, showed a shorter latency to peak erection and maintained criterion erection longer than a control group receiving no feedback. Both groups were listening to erotic audio tapes. Rosen (1973) demonstrated significant suppression of tumescence in a group of heterosexual volunteers provided with response contingent signal lights. A group receiving non-contingent feedback did not show this effect. In a technical paper, Laws and Pawlowski (1973) have suggested audio feedback of tumescence as a treatment for deficits in sexual arousal. In the clinic, Harbison, Quinn and McAllister (1970), in an uncontrolled case study, reported increasing heterosexual responsiveness in homosexuals through reinforcement of erection. In one of their homosexual patients they were able, over a long series of trials, to increase erection to a heterosexual stimulus (female slide) through rewarding progressively larger responses with sips of iced lime after the patient was water deprived. In addition to the reinforcement, this S was given feedback, of sorts, in that a light was flashed for each successful trial. A second homosexual patient was similarly rewarded for maintaining progressively longer and clearer fantasies of heterosexual behavior. Since other treatments were also applied and no experimental analysis was performed, it is not possible to evaluate the effectiveness of the procedure. In the present experiment the separate effects of feedback and reinforcement to increase heterosexual arousal in homosexuals was experimentally evaluated using single case experimental design methodology (Barlow and Hersen, 1973). Since each experiment was somewhat different in design and purpose, each will be described separately.

Measurement and Modification of Incestuous Behavior: A Case Study:

Treatment of a 52-yr.-old male complaining of repeated incestuous behavior with his daughter is described. Objective and subjective measures of incestuous interest were devised along with ratings of normal father-daughter interaction. Covert sensitization, employing noxious scenes based on subjectively reported aversive aspects of the incestuous behavior, eliminated incestuous interest but did not de-value appropriate interaction.

An experimental analysis of exposure to "explicit" heterosexual stimuli as an effective variable in changing arousal patterns of homosexuals.

Abstract The effect of exposure to explicit heterosexual stimuli on heterosexual arousal was experimentally analyzed in four homosexuals in a series of single case experimental designs. Each subject was sequentially exposed to films of female or male sexual content under positive therapeutic instructions. Penile response to female slides in separate measurement sessions increased during exposure to the female film, decreased during exposure to the male film, and increased once again when the female film was reinstated. The increase in penile response to female stimuli was paralleled in many instances by changes in masturbatory fantasy, reports of arousal and heterosexual behavior outside the laboratory. Increasing heterosexual arousal had little effect on homosexual responsivity. Results are discussed in terms of exposure facilitating extinction of avoidance responses toward females and providing new sexual fantasy content.

Plasma testosterone levels and male homosexuality: a failure to replicate.

The plasma testosterone values for 15 male homosexuals of Kinsey rating 5 or 6 were compared to the values reported by Kolodny et al.(1971), who had found male homosexuals to have lower testosterone values than heterosexuals. The values for our 15 male homosexuals were found to be significantly higher than those reported by Kolodny et al.In fact, the mean values for the current sample did not differ from the mean value reported by Kolodny et al.for heterosexual (Kinsey rating 0 or 1) controls. The present findings thus fail to confirm the relation between degree of homosexuality and plasma testosterone level.