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1
Maren, Stephen. Neural Circuits for Context Processing in Aversive Learning and Memory. Edited by Israel Liberzon and Kerry J. Ressler. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190215422.003.0005.
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The nature and properties of emotional expression depend importantly on not only the stimuli that elicit emotional responses, but also the context in which those stimuli are experienced. Deficits in context processing have been associated with a variety of cognitive-emotional disorders, including post-traumatic stress disorder (PTSD). These deficits can be localized to specific neural circuits underlying context processing in the mammalian brain. In particular, the hippocampus has been implicated through numerous animal and human studies to be involved both in normal contextual memory formation, but also in discrimination of trauma-related cues. Decreased hippocampal functioning, as is observed in PTSD, is associated with increased generalization of fear and threat responses as well as deficits in extinction of fear. Understanding context processing offers the opportunity to further understand the biology of PTSD and to target new approaches to therapeutics.
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Troisi, Alfonso. Detachment. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199393404.003.0003.
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Most of us find social encounters rewarding, especially when we encounter those with whom we are familiar and have built up a relationship. From an evolutionary point of view, this is not surprising; human beings are fundamentally social organisms, and human development and functioning occur within a social context. The origin of individual differences in the capacity to experience social reward is likely to involve a complex interplay of genetic and environmental variables, including genetic variation, early experience and current situational factors. A few individuals seem to lie at the lower extreme of this continuum, experiencing little or no positive feelings during affiliative interactions. This chapter deals with the psychological and behavioral traits that characterize these uncommon individuals and reviews the mechanisms likely to cause their emotional detachment. The chapter then discusses the importance of aversive early experience in promoting an avoidant style of adult attachment and the role of the brain opioid system and genetic polymorphisms in mediating diminished hedonic response to affiliative interactions.
3
Snyder, James, and Thomas J. Dishion. Introduction. Edited by Thomas J. Dishion and James Snyder. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199324552.013.1.
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This chapter provides an introduction to the concept of coercion in human relationships. Coercion is defined as an interpersonal strategy that results in avoidance or escape of an aversive social experience. We describe the basic topographic, functional, and contextual factors associated with coercion. The varied ways in which coercive behaviors are manifested and operate in multiple social relationships are described, along with the kinds of social contingencies and conditions that grow coercive dynamics. The origins, shaping by social environmental experiences, and longer term outcomes of coercive behaviors and relationship dynamics are discussed from a developmental perspective. Research on coercion was inspired by an interest to design effective interventions. The dialectic between applied and basic research strengthens our scientific understanding of the role of coercive relationship dynamics in developmental outcomes and provides the basis for several evidenced-based interventions that improve the lives of children and families.
4
Baldock, Emma, and David Veale. The Self as an Aesthetic Object : Body Image, Beliefs About the Self, and Shame in a Cognitive-Behavioral Model of Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0023.
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This chapter describes a cognitive-behavioral model of body dysmorphic disorder (BDD), focusing on a core concept of “processing of the self as an aesthetic object.” This concept refers to the experience of being intensely self-focused on a distorted and negative “felt sense” of how one appears to others, and of anticipating or experiencing negative evaluation and rejection because of how one looks. The model proposes that this “felt sense” is informed by intrusive imagery derived from aversive memories, which many individuals with BDD experience. Appearance may become an “idealized value” (i.e., something of primary importance in defining the self and its worth). According to the model, the negative “felt sense” of how the person looks is interpreted in terms of a threat to the self as a whole (e.g., being unacceptable or unlovable). Behavioral responses designed to minimize the threat to the self (e.g., having cosmetic surgery, checking disliked features in the mirror, and avoiding being seen by others) are postulated to instead exaggerate the sense of threat and reinforce the processing of the self as an aesthetic object. Implications for therapeutic intervention are discussed.
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Risse, Guenter B. Banished. University of Illinois Press, 2017. http://dx.doi.org/10.5406/illinois/9780252039843.003.0006.
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This chapter demonstrates how scenes of severe human hardship illustrate and authenticate the San Francisco pesthouse experience. While legislation, politics, aversive emotions, and medical theories determined the location of an isolation facility, ostracized patients' lives shaped the institution's character and dismal reputation. The trauma of total isolation compounded the stigma of disfigurement from disease. Life as a pariah detained in a discredited and feared prison-like institution offered occasional and welcome fodder for the print media, always a catalyst for revealing and often molding emotional landscapes. Although a religious context remained hidden, all segregations seemed per se penitential, a just destiny for people who had become dangerous to others.
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Barlow, David H., Todd J. Farchione, Shannon Sauer-Zavala, Heather Murray Latin, Kristen K. Ellard, Jacqueline R. Bullis, Kate H. Bentley, Hannah T. Boettcher, and Clair Cassiello-Robbins. Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Oxford University Press, 2017. http://dx.doi.org/10.1093/med-psych/9780190685973.001.0001.
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The Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide is a treatment programv applicable to all anxiety and unipolar depressive disorders and potentially other disorders with strong emotional components (e.g., eating disorders, borderline personality disorder). The UP for the Transdiagnostic Treatment of Emotional Disorders addresses neuroticism by targeting the aversive, avoidant reactions to emotions that, while providing relief in the short term, increase the likelihood of future negative emotions and maintains disorder symptoms. The strategies included in this treatment are largely based on common principles found in existing empirically supported psychological treatments—namely, fostering mindful emotion awareness, reevaluating automatic cognitive appraisals, changing action tendencies associated with the disordered emotions, and utilizing emotion exposure procedures. The focus of these core skills has been adjusted to specifically address core negative responses to emotional experiences.
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Corcoran, Andrew W., and Jakob Hohwy. Allostasis, interoception, and the free energy principle: Feeling our way forward. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198811930.003.0015.
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Interoceptive processing is commonly understood in terms of the monitoring and representation of the body’s current physiological (i.e. homeostatic) status, with aversive sensory experiences encoding some impending threat to tissue viability. However, claims that homeostasis fails to fully account for the sophisticated regulatory dynamics observed in complex organisms have led some theorists to incorporate predictive (i.e. allostatic) regulatory mechanisms within broader accounts of interoceptive processing. Critically, these frameworks invoke diverse—and potentially mutually inconsistent—interpretations of the role allostasis plays in the scheme of biological regulation. This chapter argues in favor of a moderate, reconciliatory position in which homeostasis and allostasis are conceived as equally vital (but functionally distinct) modes of physiological control. It explores the implications of this interpretation for free energy-based accounts of interoceptive inference, advocating a similarly complementary (and hierarchical) view of homeostatic and allostatic processing.
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Barney, Ronald O. Joseph Smith and the Conspicuous Scarcity of Early Mormon Documentation. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190274375.003.0013.
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In “Joseph Smith and the Conspicuous Absence of Early Mormon Documentation,” Ronald O. Barney considers three aspects of Joseph Smith’s distinctive leadership style. First, contrary to what one might expect, Smith largely kept to himself the sacred experiences that bore on his divine authority as a religious leader. Second, he refrained from inserting himself into the public sphere by literary means, even among his own people, when it was his prerogative to do so. Third, Smith appears to have had an aversion, or at least little to no interest, in having his numerous sermons captured and distributed. When taken together, these considerations suggest clues to his personality that complicate the view, taken by some, of Smith as a person preoccupied with chronicling his own experiences in order to bolster his credibility as an authentic religious personality.
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Pittelkow, Mark R., Charles L. Loprinzi, and Thomas P. Pittelkow. Pruritus and sweating in palliative medicine. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0112.
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Itching (pruritus) and sweating (perspiration, diaphoresis) are physiological functions of the skin that normally serve human existence well. Itching is the sensory input arising from the skin and mucous membranes that alerts man to potentially harmful insults from physical, chemical, and biological sources. The reflex of scratching is closely linked to the perception of itch, and in most situations functions effectively as an aversive motor response to relieve the sensation and protect the skin. Similarly, sweating is a well-developed and finely coordinated sudomotor response designed to regulate body temperature and prevent hyperthermia. However, both pruritus and sweating have the potential to function aberrantly and develop into pathological conditions that create significant suffering and morbidity. This chapter provides a practical overview of the normal function and pathophysiology of pruritus and sweating, and offer a variety of therapeutic options and general comforting measures for patients experiencing these maladies.
10
Sakauye, Kenneth, and James E. Nininger. Trauma in Late Life. Edited by Frederick J. Stoddard, David M. Benedek, Mohammed R. Milad, and Robert J. Ursano. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457136.003.0009.
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This chapter focuses on the prevalence of trauma exposure and posttraumatic problems in the elderly and reviews information on resilience and suggested treatment approaches. While posttraumatic stress disorder in the elderly has been studied, less is known about other common trauma- and stressor-related disorders including adjustment disorder, acute stress disorder, and traumatic grief. The Diagnostic and Statistical Manual of Mental Disorders (fifth edition) defines trauma as “exposure or actual or threatened death, serious injury, or sexual violence.” It must be directly experienced, witnessed, or occur to a family member or friend, or it could be a repeated or extreme exposure to aversive details of a traumatic event. No event is always traumatic, and, conversely, even a seemingly mild negative event can be traumatic to some individuals. Two presumed variables are (a) appraisal of the situation (whether a person feels in control) and (b) individual biological differences in responsiveness.
11
Auyoung, Elaine. George Eliot’s Promise of More. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190845476.003.0005.
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This chapter recovers the aesthetic significance of a reader’s mediated relation to the objects and experiences represented in realist fiction. When George Eliot’s intrusive narrators in Adam Bede, The Mill on the Floss, and Middlemarch cue readers to form impressions that are as distinct as possible, they expose the indeterminacy that persists in the most concrete passages of literary description, alerting us to the limits of how much we can ever know about a fictional world. By drawing on the aesthetics of indeterminacy advanced by Edmund Burke, this chapter reveals that Eliot’s commitment to narratives of disillusionment exists in tension with a surprisingly Romantic aversion to finitude, and that literary realism enchants ordinary things by freeing them from the solidity and determinacy they possess in everyday life.
12
Dunn, David Hastings. The Iraq Syndrome Revisited. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190851163.003.0012.
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Commencing from an observation by Freedman that Donald Rumsfeld’s legacy as US Secretary for Defense was comparable with that of Robert McNamara, and that where the latter begat the ‘Vietnam syndrome’ , the former would leave behind the ‘Iraq syndrome’. Analysis of discourse under President Obama reveals that the effects of Iraq are more profound than Freedman indicated. In the Obama era the use of force itself was ever more in doubt. In limiting US commitment to fighting for core interests and formal allies, the Obama administration broke with the main post-war tradition of US foreign policy. This made the use or threat of force more difficult, as the appetite for risk was blunted by its experience in Iraq. Obama’s position was unhelpful in embracing the implications of the limitations of American power. US ‘risk aversion’ risked failing both the US and the world.
13
Kearney, Christopher A., and Anne Marie Albano. When Children Refuse School. Oxford University Press, 2018. http://dx.doi.org/10.1093/med-psych/9780190604059.001.0001.
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Problematic school absenteeism is the primary focus of When Children Refuse School: A Cognitive-Behavioral Therapy Approach, Therapist Guide. Youths who complete high school are more likely to experience greater success at social, academic, occupational, and economic aspects of functioning than youths who do not. Youths with problematic school absenteeism are at risk for lower academic performance and achievement, lower reading and mathematics test scores, fewer literacy skills, internalizing and externalizing behavior problems, grade retention, involvement with the juvenile justice system, and dropout. The treatment program presented here is designed for youths with primary and acute school refusal behavior. The program is based on a functional model of school refusal behavior that classifies youths on the basis of what reinforces absenteeism. For children who refuse school to avoid school-based stimuli that provoke negative affectivity, the treatment uses child-based psychoeducation, somatic control exercises, gradual reintroduction (exposure) to the regular classroom setting, and self-reinforcement. For children who refuse school to escape aversive social and/or evaluative situations, the treatment uses child-based psychoeducation, somatic control exercises, cognitive restructuring, gradual reintroduction (exposure) to the regular classroom setting, and self-reinforcement. For youths who refuse school to pursue attention from significant others, parent-based treatment includes modifying parent commands, establishing regular daily routines, developing rewards, reducing excessive reassurance-seeking behavior, and engaging in forced school attendance. For youths who refuse school to pursue tangible rewards outside of school, family-based treatment includes contingency contracts, communication skills, escorting the child to school and from class to class, and peer refusal skills.
14
Roy, Michael J., Albert Rizzo, JoAnn Difede, and Barbara O. Rothbaum. Virtual Reality Exposure Therapy for PTSD. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190205959.003.0013.
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Expert treatment guidelines and consensus statements identified imaginal exposure therapy as a first-line treatment for posttraumatic stress disorder (PTSD) more than a decade ago. Subsequently, an Institute of Medicine report concluded that cognitive–behavioral therapy with exposure therapy is the only therapy with sufficient evidence to recommend it for PTSD. Imaginal exposure has been the most widely used exposure approach. It requires patients to recall and narrate their traumatic experience repeatedly, in progressively greater detail, both to facilitate the therapeutic processing of related emotions and to decondition the learning cycle of the disorder via a habituation–extinction process. Prolonged exposure, one of the best-evidenced forms of exposure therapy, incorporates psychoeducation, controlled breathing techniques, in vivo exposure, prolonged imaginal exposure to traumatic memories, and processing of traumatic material, typically for 9 to 12 therapy sessions of about 90 minutes each. However, avoidance of reminders of the trauma is a defining feature of PTSD, so it is not surprising that many patients are unwilling or unable to visualize effectively and recount traumatic events repeatedly. Some studies of imaginal exposure have reported 30% to 50% dropout rates before completion of treatment. Adding to the challenge, some patients have an aversion to “traditional” psychotherapy as well as to pharmacotherapy, and may find alternative approaches more appealing. Younger individuals in particular may be attracted to virtual reality-based therapies.
15
Giladi, Rotem. Jews, Sovereignty, and International Law. Oxford University Press, 2021. http://dx.doi.org/10.1093/oso/9780198857396.001.0001.
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Jews, Sovereignty, and International Law explores Israel’s engagement with international law during the early years of statehood, and the role of ideology in shaping how Ministry of Foreign Affairs legal advisers approached international law at the age of Jewish sovereignty. Drawing on archival sources, the book reveals the patent ambivalence of these jurist-diplomats—Jacob Robinson and Shabtai Rosenne—towards three international law reform projects: the right of petition in the draft Human Rights Covenant; the 1948 Genocide Convention; and the 1951 Refugee Convention. In all cases, Rosenne and Robinson approached international law with disinterest, aversion, and hostility while, nonetheless, investing much time and toil in these post-war reforms. They were ambivalent towards international law precisely because of, not despite, the ‘Jewish aspect’ of the right of petition and the human rights project, the Genocide Convention, and the Refugee Convention. The book demonstrates that, rather than the Middle East conflict, Rosenne and Robinson’s ambivalence towards international law was driven by ideological sensibilities predating Israel’s establishment. Their ambivalence expressed the terms on which pre-state Zionism approached international law: inherent ambivalence confirmed by political experience and fuelled by contestation with competing visions of Jewish emancipation. They approached international law through the prism of the creed of Jewish nationalism, testing it against the yardstick of Zionism’s interpretation of the modern Jewish condition and its prescriptions for resolving the Jewish Question. Jews, Sovereignty, and International Law reconstructs the terms of national Jewish engagements with international law to challenge prevalent assumptions on the cosmopolitan outlook of Jewish scholars and practitioners of international law, offer new vantage points on modern Jewish history, and critique orthodox interpretations of the Jewish aspect of Israel’s foreign policy.