A treatment-oriented typology of self-identified hypersexuality referrals.

Men and women have been seeking professional assistance to help control hypersexual urges and behaviors since the nineteenth century. Despite that the literature emphasizes that cases of hypersexuality are highly diverse with regard to clinical presentation and comorbid features, the major models for understanding and treating hypersexuality employ a "one size fits all" approach. That is, rather than identify which problematic behaviors might respond best to which interventions, existing approaches presume or assert without evidence that all cases of hypersexuality (however termed or defined) represent the same underlying problem and merit the same approach to intervention. The present article instead provides a typology of hypersexuality referrals that links individual clinical profiles or symptom clusters to individual treatment suggestions. Case vignettes are provided to illustrate the most common profiles of hypersexuality referral that presented to a large, hospital-based sexual behaviors clinic, including: (1) Paraphilic Hypersexuality, (2) Avoidant Masturbation, (3) Chronic Adultery, (4) Sexual Guilt, (5) the Designated Patient, and (6) better accounted for as a symptom of another condition.

Cortisol reactivity and regulation associated with shame responding in early childhood.

The purpose of this study was to characterize cortisol response and regulation associated with shame responding in early childhood and to examine how general the relation between shame and cortisol is. It was predicted that children responding to task failure with shame would show a larger and more prolonged cortisol response than other children. Participants were 214 children (124 boys, 90 girls) ranging from 3.7 to 4.5 years of age (M = 4.14 years, SD = 0.24). Shame responding was assessed from children's emotion-expressive behavior in response to failing 6 performance tasks, 2 preceding (initial) and 4 following (subsequent) assessment of hypothalamic-pituitary-adrenal axis activation. Cortisol response and regulation associated with failure were assessed from saliva sampled before and 15, 20, 25, 30, and 40 min following the first of the 2 initial failures. For boys and for some girls, high initial shame was associated with greater cortisol reactivity and slower regulation of the cortisol response. For boys, high initial shame and relatively slow regulation of the associated cortisol response predicted subsequent shame responding occurring after recovery of the cortisol response. For girls, high initial shame, but not cortisol response, predicted subsequent shame responding.

From facial cue to dinner for two: the neural substrates of personal choice.

The current experiment examined the neural substrates of response selection, comparing conditions that required participants to make criterion-free selections from sets of same-sex faces (i.e., inconsequential decision) to choosing a dinner date from opposite-sex faces (i.e., consequential decision). In each of these tasks, either a single face (i.e., no choice) or two or three faces (i.e., free choice) appeared for selection. The results revealed that regions of dorsal premotor cortex (PMd) and parietal cortex bilaterally, as well as an area along the medial surface of the superior frontal gyrus, were activated by both consequential and inconsequential decisions, thereby providing evidence for a common selection network. Consequential decisions were further indexed by activation of the insula/ventrolateral prefrontal cortex (BA 47) and the paracingulate gyrus (BA 32). The implications of these findings for current accounts of response selection and social-cognitive functioning are considered.