"Comforting, Reassuring, and Hot": A Qualitative Exploration of Engaging in Bondage, Discipline, Domination, Submission, Sadism and (Sado)masochism and Kink from the Perspective of Autistic Adults.

Background: There is a lack of research on autistic intimacy; however, a small body of research suggests that bondage, discipline, domination, submission, sadism and (sado)masochism (BDSM)/kink may be appealing to autistic people. We aimed at exploring how engagement in BDSM/kink related to autistic identity, using a phenomenological approach. Methods: We recruited six autistic adults through purposive sampling on social media. All participants took part in a one-to-one spoken interview about their engagement in BDSM/kink and how it related to their sense of identity. Results: We used interpretative phenomenological analysis to analyze the data and found three key themes. Theme 1, "Practicing safe 'sex'" highlighted how the clear communication and explicit focus on consent present in BDSM/kink facilitated a feeling of safety. Theme 2, "So many ways to touch and be touched" was focused on the sensory draw of BDSM/kink, and how it provided exciting ways to explore sensory joy (and sometimes revulsion). Theme 3, "Subverting (neuro)normativity" showed how autistic people can find pleasure in intimate practices that transgress normative expectations. Conclusion: Our findings highlighted the importance of exploring the perceptions of autistic adults in relation to their own intimate practices. Autistic intimacy is an emerging area of research, with very little focus on lived experience. Although engagement in BDSM/kink may appear niche, our findings suggest that there are aspects which are inherently appealing to autistic people. These findings can be used to destigmatize both autistic intimacy and engagement in alternative intimate practices more broadly.

Why is this an important issue?: Autistic intimacy is an under-explored area, with very little focus on the lived experiences of autistic adults and their preferences. Bondage, discipline, domination, submission, sadism and (sado)masochism (BDSM) and kink are alternative intimate practices. There are aspects of BDSM/kink that may appeal to autistic people (e.g., sensory experiences such being restrained during intimacy). However, to date, there is very little research to explore this. What was the purpose of this study?: This study aimed at exploring the experiences and motivations of autistic people who engage in BDSM/kink from their own perspectives. What did the researchers do?: We conducted online video interviews with six autistic adults. We purposefully recruited a small number of people, choosing to use a method called "interpretative phenomenological analysis" that emphasizes deep explorations of the experiences of a small number of people. This method is particularly suitable for areas where very little research exists. What were the results of the study?: We found three key themes: Theme 1, "Practicing safe 'sex'" highlighted how the clear communication and explicit focus on consent present in BDSM/kink facilitated a feeling of safety for our participants, who found uncertainty during intimacy stressful. The sense of safety fostered within these interactions also provided the participants with a space to be their authentic selves, and "switch off" from the outside world. Theme 2, "So many ways to touch and be touched" was focused on the sensory lure of BDSM/kink, and how it provided exciting ways to explore sensory joy (and sometimes revulsion) for autistic people. Theme 3, "Subverting (neuro)normativity" showed how autistic people can find pleasure in intimate practices that other people might find unusual. What do these findings add to what was already known?: To our knowledge, this is the first study to explore autistic engagement in BDSM/kink from a first-person perspective. Our findings show that some alternative ways of being intimate might attract autistic people, because they provide stability, pathways for sensory exploration, or because they are fun in ways that other people sometimes find unexpected. What are potential weaknesses in the study?: We only interviewed a small number of people, and most of them shared similar interests within BDSM/kink. In future, it would be good to find out about the interests of a larger number of autistic people. How will these findings help autistic adults now or in the future?: There is very little research exploring autistic intimacy from a validating perspective. Our findings will help to destigmatize autistic intimacy and normalize conversations about things that people might think of as "taboo.".

Sex/Gender Differences in Brain Lateralisation and Connectivity.

There is now a significant body of literature concerning sex/gender differences in the human brain. This chapter will critically review and synthesise key findings from several studies that have investigated sex/gender differences in structural and functional lateralisation and connectivity. We argue that while small, relative sex/gender differences reliably exist in lateralisation and connectivity, there is considerable overlap between the sexes. Some inconsistencies exist, however, and this is likely due to considerable variability in the methodologies, tasks, measures, and sample compositions between studies. Moreover, research to date is limited in its consideration of sex/gender-related factors, such as sex hormones and gender roles, that can explain inter-and inter-individual differences in brain and behaviour better than sex/gender alone. We conclude that conceptualising the brain as 'sexually dimorphic' is incorrect, and the terms 'male brain' and 'female brain' should be avoided in the neuroscientific literature. However, this does not necessarily mean that sex/gender differences in the brain are trivial. Future research involving sex/gender should adopt a biopsychosocial approach whenever possible, to ensure that non-binary psychological, biological, and environmental/social factors related to sex/gender, and their interactions, are routinely accounted for.

Can cerebral lateralisation explain heterogeneity in language and increased non-right handedness in autism? A literature review.

BACKGROUND: Autism is characterised by phenotypic variability, particularly in the domains of language and handedness. However, the source of this heterogeneity is currently unclear. AIMS: To synthesise findings regarding the relationship between language, handedness, and cerebral lateralisation in autistic people and consider how future research should be conducted in order to progress our understanding of phenotypic variability. METHODS AND PROCEDURES: Following a literature search and selection process, 19 papers were included in this literature review. Studies using behavioural, structural, and functional measures of lateralisation are reviewed. OUTCOMES AND RESULTS: The studies reviewed provided consistent evidence of differential cerebral lateralisation in autistic people, and this appears to be related to between-group differences in language. Evidence relating this to handedness was less consistent. Many of the studies did not include heterogeneous samples, and/or did not specify the language process they investigated. CONCLUSIONS AND IMPLICATIONS: This review suggests that further research is needed to fully understand the relationship between cerebral lateralisation and phenotypic variability within autism. It is crucial that future studies in this area include heterogeneous samples, specify the language process they are investigating, and consider taking developmental trajectories into account.

Antipsychotic effects of sex hormones and atypical hemispheric asymmetries.

Functional cerebral asymmetries (FCAs) are a fundamental principle of brain organisation. While specific patterns of asymmetry are characteristic of healthy human brains, atypical or reduced FCAs have been reported for several psychotic disorders, including schizophrenia and mood disorders. However, it is unclear whether atypical FCAs reflect a predisposition to psychotic disorders or a compensatory neural strategy for the progressive structural and functional changes in the brain associated with psychosis. A separate stream of research has demonstrated the antipsychotic effects of sex hormones in clinical populations. Moreover, modern neuroscience has shown that sex hormones, particularly estrogen and progesterone, can affect FCAs due to their organising effects (e.g., during prenatal development), and also by their activating effects throughout life (e.g., in younger women during the menstrual cycle or in post-menopausal women as a consequence of hormone therapy). By combining these research streams, this narrative literature review explores the relationship between the neuromodulatory properties of estrogen, FCAs and psychotic and psychotic-like symptoms. This research is not only of theoretical interest for the understanding of FCAs and psychotic symptoms, but might also be of clinical relevance for the development of stratified treatment approaches for women and men suffering from psychosis and mood disorders.

Predictors of psychosocial outcome of bipolar disorder: data from the Stanley Foundation Bipolar Network.

BACKGROUND: Impairments in psychosocial functioning have been demonstrated in 30-60% of adults with bipolar disorder (BD). However, the majority of studies investigating the effect of comorbid mental health disorders and age at onset outcomes in BD have focused on traditional outcome measures such as mood symptoms, mortality and treatment response. Therefore, this project aimed to investigate the impact of comorbid mental health disorders and age at onset on longitudinal psychosocial outcome in participants with BD. METHOD: Mixed effects modelling was conducted using data from the Stanley Foundation Bipolar Network. Baseline factors were entered into a model, with Global Assessment of Functioning (GAF) score as the longitudinal outcome measure. Relative model fits were calculated using Akaike's Information Criterion. RESULTS: No individual comorbidities predicted lower GAF scores, however an interaction effect was demonstrated between attention deficit hyperactivity disorder (ADHD) and any anxiety disorder (t = 2.180, p = 0.030). Participants with BD I vs BD II (t = 2.023, p = 0.044) and those in the lowest vs. highest income class (t = 2.266, p = 0.024) predicted lower GAF scores. Age at onset (t = 1.672, p = 0.095) did not significantly predict GAF scores. CONCLUSIONS: This is the first study to demonstrate the negative psychosocial effects of comorbid anxiety disorders and ADHD in BD. This study adds to the growing database suggesting that comorbid mental health disorders are a significant factor hindering psychosocial recovery.

Sex differences and menstrual cycle effects in cognitive and sensory resting state networks.

It has not yet been established if resting state (RS) connectivity reflects stable characteristics of the brain, or if it is modulated by the psychological and/or physiological state of the participant. Based on research demonstrating sex hormonal effects in task-related brain activity, the present study aimed to investigate corresponding differences in RS networks. RS functional Magnetic Resonance Imaging (RS fMRI) was conducted in women during three different menstrual cycle phases, while men underwent three repeated RS fMRI testing sessions. Independent component analysis was used to identify the default mode network (DMN) and an auditory RS network. For the DMN, RS connectivity was stable across testing sessions in men, but varied across the menstrual cycle in women. For the auditory network (AN), retest reliable sex difference was found. Although RS activity in the DMN has been interpreted as trait characteristic of functional brain organization, these findings suggest that RS activity in networks involving frontal areas might be less stable than in sensory-based networks and can dynamically fluctuate. This also implies that some of the previously reported effects of sex hormones on task-related activity might to some extent be mediated by cycle-related fluctuations in RS activity, especially when frontal areas are involved.

Estradiol-related variations in top-down and bottom-up processes of cerebral lateralization.

OBJECTIVE: Natural fluctuations of sex hormones have been shown to modulate cerebral lateralization in dichotic listening tasks. Two recent studies presented contradictory notions regarding the mechanism of this effect. Specifically, whereas Hjelmervik et al. (2012) suggested that estradiol affects lateralization by enhancing top-down processes, such as cognitive control, Hodgetts, Weis, and Hausmann, (2015) suggested that the effect was attributable to estradiol-related variations in bottom-up aspects of lateralization. METHOD: The present study used 2 well-established left- and right-lateralized dichotic listening tasks (Grimshaw, Kwasny, Covell, & John, 2003; Grimshaw, Séguin, & Godfrey, 2009; Hugdahl, 1995, 2003), with forced-attention conditions to differentiate between these 2 ideas. Fifty-two naturally cycling women underwent both tasks, during either the menstrual, follicular, or luteal cycle phase. Saliva estradiol and progesterone levels were determined by luminescence immunoassays. RESULTS: The results showed that sex hormones did not affect language lateralization, which may be attributable to the larger degree of lateralization yielded by the task, compared with that shown by Hodgetts et al. (2015). In the emotional prosody task, high levels of estradiol were marginally associated with a reduction in cognitive control, whereas the language task yielded no cycle effects for either top-down or bottom-up processes. CONCLUSIONS: In sum, the current study revealed weak support for the idea that estradiol affects top-down control of lateralization, as measured with dichotic listening tasks. Given that the task employed in the present study seemed less cognitively demanding than that used previously, it is suggested that estradiol-related inter- and intraindividual variations in lateralization are small when task demands are low. (PsycINFO Database Record

The impact and measurement of social dysfunction in late-life depression: an evaluation of current methods with a focus on wearable technology.

OBJECTIVE: Depression is known to negatively impact social functioning, with patients commonly reporting difficulties maintaining social relationships. Moreover, a large body of evidence suggests poor social functioning is not only present in depression but that social functioning is an important factor in illness course and outcome. In addition, good social relationships can play a protective role against the onset of depressive symptoms, particularly in late-life depression. However, the majority of research in this area has employed self-report measures of social function. This approach is problematic, as due to their reliance on memory, such measures are prone to error from the neurocognitive impairments of depression, as well as mood-congruent biases. METHOD: Narrative review based on searches of the Web of Science and PubMed database(s) from the start of the databases, until the end of 2015. RESULTS: The present review provides an overview of the literature on social functioning in (late-life) depression and discusses the potential for new technologies to improve the measurement of social function in depressed older adults. In particular, the use of wearable technology to collect direct, objective measures of social activity, such as physical activity and speech, is considered. CONCLUSION: In order to develop a greater understanding of social functioning in late-life depression, future research should include the development and validation of more direct, objective measures in conjunction with subjective self-report measures. Copyright © 2016 John Wiley & Sons, Ltd.

Music-induced changes in functional cerebral asymmetries.

After decades of research, it remains unclear whether emotion lateralization occurs because one hemisphere is dominant for processing the emotional content of the stimuli, or whether emotional stimuli activate lateralised networks associated with the subjective emotional experience. By using emotion-induction procedures, we investigated the effect of listening to happy and sad music on three well-established lateralization tasks. In a prestudy, Mozart's piano sonata (K. 448) and Beethoven's Moonlight Sonata were rated as the most happy and sad excerpts, respectively. Participants listened to either one emotional excerpt, or sat in silence before completing an emotional chimeric faces task (Experiment 1), visual line bisection task (Experiment 2) and a dichotic listening task (Experiment 3 and 4). Listening to happy music resulted in a reduced right hemispheric bias in facial emotion recognition (Experiment 1) and visuospatial attention (Experiment 2) and increased left hemispheric bias in language lateralization (Experiments 3 and 4). Although Experiments 1-3 revealed an increased positive emotional state after listening to happy music, mediation analyses revealed that the effect on hemispheric asymmetries was not mediated by music-induced emotional changes. The direct effect of music listening on lateralization was investigated in Experiment 4 in which tempo of the happy excerpt was manipulated by controlling for other acoustic features. However, the results of Experiment 4 made it rather unlikely that tempo is the critical cue accounting for the effects. We conclude that listening to music can affect functional cerebral asymmetries in well-established emotional and cognitive laterality tasks, independent of music-induced changes in the emotion state.

High estradiol levels improve false memory rates and meta-memory in highly schizotypal women.

Overconfidence in false memories is often found in patients with schizophrenia and healthy participants with high levels of schizotypy, indicating an impairment of meta-cognition within the memory domain. In general, cognitive control is suggested to be modulated by natural fluctuations in oestrogen. However, whether oestrogen exerts beneficial effects on meta-memory has not yet been investigated. The present study sought to provide evidence that high levels of schizotypy are associated with increased false memory rates and overconfidence in false memories, and that these processes may be modulated by natural differences in estradiol levels. Using the Deese-Roediger-McDermott paradigm, it was found that highly schizotypal participants with high estradiol produced significantly fewer false memories than those with low estradiol. No such difference was found within the low schizotypy participants. Highly schizotypal participants with high estradiol were also less confident in their false memories than those with low estradiol; low schizotypy participants with high estradiol were more confident. However, these differences only approached significance. These findings suggest that the beneficial effect of estradiol on memory and meta-memory observed in healthy participants is specific to highly schizotypal individuals and might be related to individual differences in baseline dopaminergic activity.

Sex hormones affect language lateralisation but not cognitive control in normally cycling women.

This article is part of a Special Issue "Estradiol and Cognition". Natural fluctuations of sex hormones during the menstrual cycle have been shown to modulate language lateralisation. Using the dichotic listening (DL) paradigm, a well-established measurement of language lateralisation, several studies revealed that the left hemispheric language dominance was stronger when levels of estradiol were high. A recent study (Hjelmervik et al., 2012) showed, however, that high levels of follicular estradiol increased lateralisation only in a condition that required participants to cognitively control (top-down) the stimulus-driven (bottom-up) response. This finding suggested that sex hormones modulate lateralisation only if cognitive control demands are high. The present study investigated language lateralisation in 73 normally cycling women under three attention conditions that differed in cognitive control demands. Saliva estradiol and progesterone levels were determined by luminescence immunoassays. Women were allocated to a high or low estradiol group. The results showed a reduced language lateralisation when estradiol and progesterone levels were high. The effect was independent of the attention condition indicating that estradiol marginally affected cognitive control. The findings might suggest that high levels of estradiol especially reduce the stimulus-driven (bottom-up) aspect of lateralisation rather than top-down cognitive control.