Psychosocial Profiles of Patients Admitted to Psychiatric Emergency Services: Results from the Signature Biobank Project.

OBJECTIVES: Patients admitted to psychiatric emergency services (PES) are highly heterogenous. New tools based on a transdiagnosis approach could help attending psychiatrists in their evaluation process and treatment planning. The goals of this study were to: (1) identify profiles of symptoms based on self-reported, dimensional outcomes in psychiatric patients upon their admission to PES, (2) link these profiles to developmental variables, that is, history of childhood abuse (CA) and trajectories of externalizing behaviours (EB), and (3) test whether this link between developmental variables and profiles was moderated by sex. METHODS: In total, 402 patients were randomly selected from the Signature Biobank, a database of measures collected from patients admitted to the emergency of a psychiatric hospital. A comparison group of 92 healthy participants was also recruited from the community. Symptoms of anxiety, depression, alcohol and drug abuse, impulsivity, and psychosis as well as CA and EB were assessed using self-reported questionnaires. Symptom profiles were identified using cluster analysis. Prediction of profile membership by sex, CA, and EB was tested using structural equation modelling. RESULTS: Among patients, four profiles were identified: (1) low level of symptoms on all outcomes, (2) high psychotic symptoms, (3) high anxio-depressive symptoms, and (4) elevated substance abuse and high levels of symptoms on all scales. An indirect effect of CA was found through EB trajectories: patients who experienced the most severe form of CA were more likely to develop chronic EB from childhood to adulthood, which in turn predicted membership to the most severe psychopathology profile. This indirect effect was not moderated by sex. CONCLUSION: Our results suggest that a transdiagnostic approach allows to highlight distinct clinical portraits of patients admitted to PES. Importantly, developmental factors were predictive of specific profiles. Such transdiagnostic approach is a first step towards precision medicine, which could lead to develop targeted interventions.

Sexual Attentional Bias in Young Adult Heterosexual Men: Attention Allocation Following Self-Regulation.

Being sexually aroused can lead to a stronger propensity to engage in sexual risk-taking and sexually coercive behaviors possibly by narrowing attentional focus toward immediate gratification rather than long-term consequences. The goal of this paper was to investigate the attentional processes implicated in sexual self-regulation failure and its moderating factors, namely having a stronger sensitivity to sexual cues (dual control model) or being less able to implement behavioral intentions (action control theory) following a first effortful task. A total of 82 young adult heterosexual men completed a Dot Probe task to assess their attentional bias toward sexual stimuli. Effortful control was manipulated using a Stroop task. Regardless of conditions, higher sexual excitability was predictive of a stronger attentional bias toward sexual cues, while higher inhibition due to threat of performance failure was predictive of a lower bias for such cues. In the experimental condition, action-oriented individuals were able to negate this attentional bias by staying more focused on the task, while state-oriented participants showed higher orientation toward the sexual cues and thus a higher bias. These results suggest that both higher-order processes, like intention implementation, and lower-order processes, like sexual inhibition and excitation systems, are the key to regulation failure.

Inhibitory Control in Sexually Coercive Men: Behavioral Insights Using a Stop-Signal Task With Neutral, Emotional, and Erotic Stimuli.

Response inhibition is defined as one's ability to voluntarily override an automatic or already initiated action when that action is inappropriate. Although a core mechanism of self-control, its association with sexual coercion perpetration and the impact of erotic cues on its exertion remain unknown. According to a domain-specific perspective on impulsivity, response inhibition performances should be disproportionately hindered by sexual cues in sexual coercion perpetrators. In total, 94 male college students completed a stop-signal task that included neutral, emotional, and erotic distracters. Results showed that men who reported past use of sexual coercion obtained overall poorer stop-signal task (SST) performances. Highly arousing sexual stimuli equally hindered the performances of perpetrators and non-perpetrators, whereas moderately arousing sexual and nonsexual positive stimuli did not significantly affect performances. Results do not support a domain-specific perspective on the link between response inhibition and sexual coercion, but rather suggest generally poorer inhibitory control among sexual coercion perpetrators.

The Effect of Exposure to Fear-Related Body Odorants on Anxiety and Interpersonal Trust Toward a Virtual Character.

A growing body of literature documents how exposure to another person's fear-related body odorants can increase one's own anxiety and interfere with processing of social information, such as facial expression and impression formation. Building on these results, we aimed to 1) test the hypothesis that exposure to fear-related odorant would affect impression formation through fear contagion and 2) verify whether these effects can be observed in an ecologically valid (i.e., virtual) environment. We proposed that exposure to fear-related odorant would cause receivers to feel more anxious, which in turn would lead them to report less trust toward an unknown virtual character. This study had 2 distinct phases. First, we collected perspiration odorants from the armpits of 12 male senders (i.e., the source of the odorant) during the viewing of either fear or joy inducing film clips. In the second phase, 53 women receivers were exposed to either a fear, joy, or neutral odorant (i.e., between-subjects design) by breathing through a gauze attached to a disposable respirator mask while immersed in a virtual bar. As expected, receivers exposed to fear odorants felt significantly more stressed. Mediation analysis also revealed an indirect effect of exposure on trust through anxiety. More specifically, the more anxious the receiver felt, the less she trusted the virtual character. Our results show for the first time that the impact of exposure to fear-related body odorants on negative interpersonal impression formation is mediated by the anxiety induced in the receiver.

What Money Can't Buy: Different Patterns in Decision Making About Sex and Money Predict Past Sexual Coercion Perpetration.

Self-reported impulsivity has been found to predict the perpetration of sexual coercion in both sexual offenders and male college students. Impulsivity can be conceptualized as a generalized lack of self-control (i.e., general perspective) or as a multifaceted construct that can vary from one context to the other (i.e., domain-specific perspective). Delay discounting, the tendency to prefer sooner smaller rewards over larger delayed rewards, is a measure of impulsive decision making. Recent sexual adaptations of delay discounting tasks can be used to test domain-specific assumptions. The present study used the UPPS-P impulsivity questionnaire, a standard money discounting task, and a sexual discounting task to predict past use of sexual coercion in a sample of 98 male college students. Results indicated that higher negative urgency scores, less impulsive money discounting, and more impulsive sexual discounting all predicted sexual coercion. Consistent with previous studies, sexuality was discounted more steeply than money by both perpetrators and non-perpetrators of sexual coercion, but this difference was twice as large in perpetrators compared to non-perpetrators. Our study identified three different predictors of sexual coercion in male college students: a broad tendency to act rashly under negative emotions, a specific difficulty to postpone sexual gratification, and a pattern of optimal non-sexual decision making. Results highlight the importance of using multiple measures, including sexuality-specific measures, to get a clear portrait of the links between impulsivity and sexual coercion.

Validation of the French-Canadian Version of the Sexual Inhibition and Sexual Excitation Scales-Short Form (SIS/SES-SF): Associations With Sexual Functioning, Sociosexual Orientation, and Sexual Compulsivity.

INTRODUCTION: The Dual control model proposes that both excitatory and inhibitory processes are responsible for the human sexual response. AIM: To validate the French-Canadian translation of the Sexual Inhibition and Excitation Scales-Short Form (SIS/SES-SF) by exploring its factor structure and by investigating its capacity to retrospectively predict sexual functioning and behaviors, namely, sociosexual orientation and sexual compulsivity. METHODS: A French-Canadian translation of the SIS/SES-SF was created using forward-backward translation. A community sample of 362 men and 420 women completed an online survey. The factor structure and the measurement invariance between men and women was explored using Exploratory Structural Equation Modeling. Predictive power of the scales was tested using Multiple Linear Regression models using a corrected threshold (P< .008). MAIN OUTCOME MEASURES: Sexual functioning was assessed using the International Index of Erectile Function and the Female Sexual Function Index while sexual compulsion and sociosexual orientation were measured using the Sexual Compulsion Scale and the Revised Sociosexual Orientation Inventory, respectively. RESULTS: The original three-factor solution of the SIS/SES-SF was replicated. All three scales showed acceptable internal consistency and good temporal stability. Yet, results only supported configural measurement invariance between men and women, suggesting that their scores cannot be directly compared. Overall, for both men and women, higher sexual excitation (SES) was significantly predictive of better sexual functioning, while higher sexual inhibition due to threat of performance failure (SIS1) was a significant predictor of lower sexual functioning. Both sexual compulsivity and sociosexual orientation were significantly predicted by higher SES and lower sexual inhibition due to threat of performance consequences (SIS2). CONCLUSION: These results support the cross-cultural transferability of the SIS/SIS-SF and the Dual control model to French-Canadian men and women, higlighting the utility for clinicians to evaluate both excitatory and inhibitory factors associated with sexual dysfunction and sexual behaviors. Nolet K, Guay JP, Bergeron S. Validation of the French-Canadian Version of the Sexual Inhibition and Sexual Excitation Scales-Short Form (SIS/SES-SF): Associations With Sexual Functioning, Sociosexual Orientation, and Sexual Compulsivity. Sex Med 2021;9:100374.

The Adoption of New Treatment Modalities by Health Professionals and the Relative Weight of Empirical Evidence in Favor of Virtual Reality Exposure Versus Mindfulness in the Treatment of Anxiety Disorders.

Anxiety disorders are among the most prevalent mental disorders, and cognitive-behavioral therapy (CBT) with exposure exercises is considered as the gold-standard psychological intervention. New psychotherapeutic modalities have emerged in the last decade and, among them, mindfulness has been rapidly adopted by therapists. The adoption rate is slower for the use of virtual reality (VR) to conduct exposure. The goal of the present position paper is to contrast, for the treatment of anxiety disorders, the weight of empirical evidences supporting the use of exposure in VR with the use of mindfulness-based therapy (MBT). Based on the most recent meta-analyses, we found that CBT with exposure conducted in VR was more thoroughly researched and supported than MBT, receiving validation from roughly twice as many studies with high control (i.e., randomized, active controls with clinical samples). However, this conclusion is nuanced by reviewing gaps in the literature for both therapies. Potential factors influencing clinicians' choice of treatment and suggestions for future research directions are proposed.

How Ego Depletion Affects Sexual Self-Regulation: Is It More Than Resource Depletion?

Rational thinking and decision making are impacted when in a state of sexual arousal. The inability to self-regulate arousal can be linked to numerous problems, like sexual risk taking, infidelity, and sexual coercion. Studies have shown that most men are able to exert voluntary control over their sexual excitation with various levels of success. Both situational and dispositional factors can influence self-regulation achievement. The goal of this research was to investigate how ego depletion, a state of low self-control capacity, interacts with personality traits-propensities for sexual excitation and inhibition-and cognitive absorption, to cause sexual self-regulation failure. The sexual responses of 36 heterosexual males were assessed using penile plethysmography. They were asked to control their sexual arousal in two conditions, with and without ego depletion. Results suggest that ego depletion has opposite effects based on the trait sexual inhibition, as individuals moderately inhibited showed an increase in performance while highly inhibited ones showed a decrease. These results challenge the limited resource model of self-regulation and point to the importance of considering how people adapt to acute and high challenging conditions.

Sexual self-regulation and cognitive absorption as factors of sexual response toward virtual characters.

The eye movements and penile responses of 20 male participants were recorded while they were immersed with virtual sexual stimuli. These participants were divided into two groups according to their capacity to focus their attention in immersion (high and low focus). In order to understand sexual self-regulation better, we subjected participants to three experimental conditions: (a) immersion with a preferred sexual stimulus, without sexual inhibition; (b) immersion with a preferred sexual stimulus, with sexual inhibition; and (c) immersion with a neutral stimulus. A significant difference was observed between the effects of each condition on erectile response and scanpath. The groups differed on self-regulation of their erectile responses and on their scanpath patterns. High focus participants had more difficulties than low focus participants with inhibiting their sexual responses and displayed less scattered eye movement trajectories over the critical areas of the virtual sexual stimuli. Results are interpreted in terms of sexual self-regulation and cognitive absorption in virtual immersion. In addition, the use of validated virtual sexual stimuli is presented as a methodological improvement over static and moving pictures, since it paves the way for the study of the role of social interaction in an ecologically valid and well-controlled way.