The American Psychiatric Association has approved changes to the Diagnostic and Statistical Manual of Mental Disorders, commonly referred to as the DSM. The fifth edition of the flagship guide to psychiatric diagnosis, due for release in May 2013 and known as the DSM-5, features several controversial revisions.

The DSM establishes criteria for the diagnosis of mental health conditions. Because changes to the manual can affect insurance coverage for certain issues and help define “normal” behavior, advocacy groups are often concerned about the effect additions and alterations will have. The latest revision is no exception.

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Children and Mental Health
Diagnosing children with mental health conditions is often dicey because of concerns about stigma and the use, or overuse, of psychiatric drugs. At a time when some groups argue that fewer children should be diagnosed with mental health issues, the DSM-5 adds new diagnostic criteria for children. Those over the age of 6 who display irritability or frequent angry outbursts now qualify for a diagnosis of disruptive mood dysregulation disorder. While some mental health professionals emphasize that this new diagnosis could make it easier to plan early intervention for children who have extreme difficulties controlling their emotions, some advocacy groups have expressed concern that such a diagnosis could stigmatize normal childhood behavior or lead to the prescribing of unnecessary drugs to young children.

Autism Spectrum Disorder
The DSM-5 eliminates Asperger’s syndrome, folding it into a broader category called autism spectrum disorder. Diagnoses of Asperger’s and autism have been steadily increasing over the past several years, and many children with less severe symptoms of autism have been diagnosed with Asperger’s. The DSM-5, however, incorporates several autism-like issues, including Asperger’s, into the diagnosis of autism spectrum disorder. Not everyone is happy with this change. Many people with Asperger’s view the issue as part of their identity and do not want it to be lumped in with other issues. The APA, however, argues that this change will make diagnosis of autism more consistent and access to treatment easier.

Grief and Depression
Previous versions of the DSM incorporated a bereavement exception into depression diagnoses. This exclusion prevented mental health professionals from diagnosing a person who was grieving the death of a loved one with depression. The DSM-5, however, permits depression diagnoses in the bereaved. Members of the APA argued that the old bereavement exception excluded grieving people who had been diagnosed with chronic depression from being diagnosed with, and receiving treatment for, depression. But some people worry that the new changes pathologize grief and turn normal grieving—which often looks a lot like depression—into a mental health diagnosis.

Other Changes
The DSM-5 adds hoarding and excoriation disorder—a diagnosis for people who compulsively pick their skin. The APA also rejected several proposed disorders, including parental alienation syndrome, hypersexual disorder, and anxious depression. While the APA emphasized that the revisions—like all changes to the DSM—are intended to clarify diagnostic criteria and improve consistency in diagnosing, mental health advocacy groups argue that many diagnostic criteria have been loosened and that the DSM-5 will increase the number of people diagnosed with mental health conditions.

Which changes to the DSM did you find most controversial? Please share your comments below.

References:

1. Asperger’s syndrome dropped from American Psychiatric Association manual. (n.d.). MedPage Today. Retrieved from http://www.medpagetoday.com/Psychiatry/DSM-5/36206
2. Gever, J. (n.d.). DSM-5 wins APA board approval. MedPage Today. Retrieved from http://www.medpagetoday.com/Psychiatry/DSM-5/36206
3. Gupta, P. (n.d.). Controversial changes to stay in DSM-5. Salon. Retrieved from http://www.salon.com/2012/12/02/controversial_changes_to_stay_in_dsm_5/
4. Spiegel, A. (2012, November 30). Weekend vote will bring controversial changes to psychiatrists’ bible. NPR. Retrieved from http://www.npr.org/blogs/health/2012/11/30/166252201/weekend-vote-will-bring-controversial-changes-to-psychiatrists-bible

Last month, we talked about how figuring out why someone is doing something is key to changing his or her behaviors. We learned that most behaviors are motivated by getting something, getting away from or stopping something, feeling good, or are simply automatic (a reflex, for example).

In order to change behaviors, we must learn about reinforcement, not merely the functions of the behaviors.

Case Example
Imagine this scene, one that is played out in countless grocery stores every day around the world. Picture, if you will, a harried mother trying to get the shopping for the house completed. She is tired and in a rush to get home. With her is her young son. In the checkout line, as Mom tries to load the groceries on the little conveyor belt, her child asks for a candy bar (located conveniently an arm’s reach away, at child eye level). Mom, being a kind and benevolent mom, says, “No, we’re going home and having dinner. You don’t need a candy bar right now.” Her son, being like most children of his age, doesn’t like this state of affairs. In response to the denial of sucrose refreshment, he starts wailing at the top of his lungs, “PLEEAAAASEE! I WANNA CANDY! I WANNA CANDY! I WANNA CANDY!”

Other store patrons stare at the impending debacle. Mom feels embarrassed and more than a little ticked off. She still has to get the groceries home, get them unpacked, and make dinner. Dealing with a tantrum is the last thing she wants to do. At first she tries to calmly explain to her child that dinner will be soon, but the child screams louder. Then she commands him to cease his tantrum. That works about as well as can be expected (not at all). Finally, Mom gives in and buys her little angel the candy bar, at which point he immediately ceases his caterwauling.

Can you name all the reinforcement that occurred in the above example? What do you think will happen next time Mom brings her son to the grocery store?

What Is Reinforcement?
The technical definition of reinforcement is anything that occurs after a behavior that increases the chances of that behavior occurring again. Simply put, when your child does something (a behavior) and you do something immediately afterward, if your child repeats the behavior, whatever you did was a reinforcer.

This idea is key to behavior change. We want to provide rich and powerful reinforcement for the behaviors we wish to see (start behaviors) and avoid reinforcement for the behaviors we do not wish to see (stop behaviors). This interaction is at the heart of everything we wish to accomplish.

Important points:

• Reinforcement occurs only if you see the behavior again. You might feel you are rewarding your child, but if the reward does not result in increased frequency, intensity, or other improvement in the behavior, then the reward is not reinforcing.
• Reinforcement can be anything. It doesn’t have to be pleasant, either. For example, a person who likes fighting might enjoy when he is in a fight and find getting hit or yelled at reinforcing.
• Reinforcement always increases behaviors. Anything that decreases the chances of seeing a behavior is called a punisher.

The bottom line? Reward your kids when they do what you want them to do and they will do those things more. If you simultaneously remove the rewards from the behaviors you want to see less of, you will see less of those behaviors.

Isn’t this just bribery, you may ask? Nope. There are some key differences between bribery and reinforcement. Bribery is typically something (often money) given to someone in advance of behavior. It is generally given to get a person to do something unethical or illegal. Reinforcement always occurs after a behavior, and we are not using it to get our children to do anything unethical or illegal (hopefully!).

You might also ask: Why should I be rewarding my kid for doing what he is supposed to do? Shouldn’t he just do it? In a perfect world, yes, your child would do what he or she is supposed to do. However, in the real world, children are compelled by the “drive-your-parents-nuts accord” to not always follow directions. If we, as parents, want to keep our sanity, it behooves us to use all the tools at our disposal to encourage and reward our children, and ultimately to teach them what to do and when to do it.

Types of Reinforcement

• Positive: This is the most common type. It is something that is added to the situation (money, candy, praise). Basically, if you give your child something because he did something good, that’s positive reinforcement. In the case example, the mother positively reinforced her child’s checkout-line tantrum behavior by buying him the candy.
• Negative: This not punishment. (That decreases behaviors.) It is the removal of something. In the case example, the child negatively reinforced his mother’s candy-buying behavior by ceasing his tantrum when she gave in and bought it.

Classes of Reinforcers

• Primary: These are typically those things that all people need—food, air, companionship, etc.—and are often tied to basic survival. These are good because almost everybody will respond to them. However, they suffer from the “too-much-of-a-good-thing” effect, also known as satiety. When you’ve had enough of something, it loses its reinforcing qualities.
• Secondary: These are learned reinforcers. Typically paired in some way with primary reinforcement, these can be anything. Money is perhaps one of the most prevalent secondary reinforcers in the world. It always amazes me what people will do for colored bits of paper.

Putting This Information to Use

Follow these simple steps:

1. Ask yourself: Is this a start behavior or a stop behavior? (Do you want to see this more or less?)
2. Ask yourself: What is the function of the behavior?
3. For stop behaviors, the answer to question No. 3 will tell you what you need to decrease or eliminate from the situation to make the behavior go away. Do that.
4. For start behaviors, the answer to question No. 3 will tell you what you need to do to get the person to do the behavior more (or better).

As with all things simple, there is a lot more to look at, but it ultimately comes down to these four points. (We will discuss more about reinforcement and how to set it up and deliver it in future articles.)

What’s the Best Reinforcer?
The best reinforcer is the one that works in a given situation. However, my preference is praise. I will cover praise in more detail in a future article, but here is why I like it as a reinforcer: Just about everybody responds to praise. The more you praise someone, the more he or she likes you. The more he or she likes you, the more he or she will respond to you. Praise is free. It takes up no space. People rarely get tired of it. It pairs well with every other kind of reinforcer (thus making the praise and the other reinforcer more effective). In your experiments with reinforcement, try adding a little praise to your efforts and see how it enhances things.

I hope this information helps make your day-to-day challenges less challenging. Please comment below, ask questions, or make suggestions. Let me know about creative ways you have found to reinforce your children (or anyone else, for that matter). Hang in there, parents!

To me, “vulnerable” is wonderful word. It means openness, freedom, and the opportunity to love and be loved. But for others, it is what they are trying to get away from: They feel that they are too vulnerable. In actuality, the opposite is true. They feel unsafe because they are too defended, too guarded. True vulnerability comes only with acceptance of self. And with that, fear drops away.

By becoming vulnerable to life, we discover its meaning. Not the meaning of life in an objective sense, but rather its meaning and purpose for each one of us, as individual souls. Whether that is the truth of a given moment, or an expanded sense of purpose and destiny in our professional or personal lives, we can discover it only if we learn to listen to our own hearts in an unguarded and open way.

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Our Own Vulnerability

To be happy and content in life, we must give in and learn to listen to ourselves deeply. We must accept our vulnerabilities, open ourselves to them, and embrace them! Why? Because only then do we feel the safety net that is always there; that mysterious presence that is beauty, love, kindness, and truth. When we don’t move into the mystery of vulnerability, it is like we are clinging to a tightrope after having fallen off, peering into the dark, afraid that there is no net. We find the net by letting go, by falling into the unknown.

This surrender does not have to be, as many think, a large display of emotion, because it is at its heart something internal, something private. Our closest, longest, and most intimate relationship is the one we have with ourselves. So while we might first experience vulnerability with someone else, it is at its heart something we must do with ourselves, by ourselves. It is not enough to be accepted by someone else: We must accept ourselves.

Allowing Others to Be Vulnerable

By becoming vulnerable to yourself, you move toward being vulnerable in your relationships and, just as importantly, being able to accept the vulnerability of those you love. This can be some of the hardest work we do: allowing the people we depend on to have their own vulnerabilities, their own weaknesses, their own struggles.

When vulnerability is not allowed in a relationship, it separates people, no matter how much they love each other. A person may love someone, but he or she may also want that person to be something he or she is not, or to just plain stop having the pain or struggle that he or she does. This dynamic can create a vicious cycle of resentment and frustration in one person, and a sense of confinement, judgment, and claustrophobia in the other.

Practice

Maybe this sounds simple to you, or perhaps complicated and confusing. It all begins with whatever moment you are in. And it takes baby steps. If you are interested in exploring more, note the time and do this five-step practice for the next five minutes:

1. Take three deep breaths. In through the nose, out through the mouth. Soften your shoulders, your forehead, your eyes.
2. Become vulnerable to everything happening in this moment. All the feelings, all the thoughts. Accept and allow everything. Soften toward every part of yourself. Breathe.
3. Soften all resistance to what is here. Feel the energy of your body, emotions, and mind. Feel whatever pain you may be having. Don’t label or think about it, just sense it fully. Don’t push anything away. Breathe.
4. Allow the waterfall that is the experience of each passing moment to wash over you. Just for this moment, accept fully and forgive yourself for all the failings and faults, all the regrets and mistakes that are marching through your mind. Let go of the fight and allow yourself to be just as you are right now. Breathe.
5. Now return to the top and continue the practice. Close your eyes as you are able, repeating the steps and continuing to soften and breathe.

According to Diane Falzone, author of a recent column, the “deployment sex pact” is a long-standing military arrangement. Essentially, the pact gives permission for partners to engage in sexual relations with someone other than their spouses during long periods of deployment. There are no hard and fast rules; each couple makes guidelines that are acceptable to them. Falzone, however, believes such agreements may cause more pain than pleasure.

When Falzone first wrote about it, she had readers who were for it and others who vehemently opposed it. Some wrote that vows were vows and deployment doesn’t change that. Others stated that permission to have sex satisfies natural, biological urges without putting the relationship at risk. Falzone begs to differ, even though she believes every couple has the right to determine the limits of their own relationship. “But it’s my belief that if you cannot be faithful for the 10-18 months of a given deployment, perhaps you should reconsider the fundamentals of what makes a relationship,” she said.

Having guidelines and regulations in the military is one thing, but extending them to infidelity within the marriage is another entirely. And what about discipline? Doesn’t the military teach discipline, restraint, and sacrifice? If a soldier can adhere to those tenets in the field, can’t he or she uphold those same character traits within his or her marriage?

Relationships are founded on trust and honesty. Even if partners believe they might be OK with the idea of a sex pact initially, they may find themselves becoming secretly jealous of their spouses. A deployed partner might develop romantic feelings for someone else and not be willing to divulge that information to his or her spouse. The military marriage and potentially other relationships could be at risk, and there are additional threats such as sexually transmitted disease and unintended pregnancy. Falzone believes finding love is hard enough. She suggests that when you do find that special someone, don’t commit to conditional infidelity—commit to being faithful.

Reference:
Falzone, Diane. Should military marriages include a “deployment sex pact”? (n.d.): n. pag. Fox News. 26 Nov. 2012. Web. 26 Nov. 2012. http://www.foxnews.com/opinion/2012/11/26/military-marriages-and-deployment-sex-pact/

“Owning up to the ‘good-bye’ that is built into our finite human existing makes possible the saying of an authentic ‘Hello!’ ” —Robert D. Stolorow

For most people, death is something that will happen to us someday. Not today. Not tomorrow. But sometime in the future, distant enough that we need not concern ourselves at the moment. In other words, we ignore it and forget about it. Yet in doing so, we forget who we are. Death is not just something that happens at the end of life. It is a part of us throughout, whether we confront it or not. In facing death, traumatic as it may be, we cannot help but change, grow, and clarify what it is that we love and care about most. The preciousness of time comes to the fore.

It’s true that people understand death in different ways. Does the soul continue on or does it die with the body? Is there life after death, or does it end with this one? Whatever one’s beliefs about the hereafter, death is the end of life as we know it. When a loved one dies, he or she departs from us in a way that is undeniable. We are forced to notice their importance to us, as well as everything we value. In romantic relationships, as often depicted in romantic comedies, each partner’s love becomes inestimable often only after it has been tested with the threat of loss.

Confronting death as an ever-present reality means mourning the loss of all we hold dear. It is no mystery that death is not a favored topic for cocktail conversation. It’s often depressing and lacks a joy and levity that is so much a part of life. When a loved one dies, we often say that he or she “passed on,” avoiding the harsh word of death, attempting to soften the painful reality for the sake of our loved ones. Few people choose to spend their lives isolating themselves with thoughts of death. It is isolating because it forces us to depart from ordinary social values.

David Fincher’s film Fight Club (1999) is a dark and violent satire that exposes the superficialities of commercial life and hints at the meaninglessness of life altogether. And yet the film holds great potential to discover meaning. The antihero Tyler Durden recruits a large number of young men into his “fight club,” and insists they shun the values associated with ordinary social life, particularly advertising. “You’re not your job,” he preaches. “You’re not how much money you have in the bank. You’re not the car you drive. You’re not the contents of your wallet.” Durden pulls these young men away from their ordinary day-to-day living into a profound confrontation with themselves. He prescribes to his followers that they let “what truly doesn’t matter slide.” Fincher’s film hints at the sort of existential confrontation I’m trying to describe. Durden insists to his pupils, “You have to know, not fear, that someday you are going to die.”

It would be a mistake, however, to conflate the commentary on death in Fincher’s fight club with my own. Fincher’s Durden develops a following, a cult of sorts. He removes people from the social conformity of ordinary life only to foster a new conformity to the cult of fight club. Confrontation with death, whether through the loss of a loved one, escaping the threat of physical harm, or simply philosophical contemplation, is always traumatic. It leaves one disoriented, forcing us to abandon the thoughts and beliefs that root us in everyday life. Fincher’s fight club finds its way toward destruction and a certain kind of meaninglessness, where there’s little, if any, light at the end of a dark tunnel. The commentary on death in Fight Club treats life recklessly, not carefully. In coming to terms with death, life needs to be respected in order to preserve the opportunity for growth. It is then that from darkness may come great illumination.

Most women might like to believe that men fight to win their affections. However, the aggression men display toward one another often has little or nothing to do with the woman in question. According to a recent study led by Sarah E. Ainsworth of the Department of Psychology at Florida State University, men are more inclined to engage in violence to exhibit social dominance. Research has theorized that the desire for procreation motivates men to use certain behaviors to attract women. Less is known about the factors that prompt men to behave aggressively when they are faced with competition for a woman. Violence is a serious problem within intimate relationships. In social settings, violence can occur not just between two partners, but between two adversaries. Understanding why men become aggressive toward one another when they are in pursuit of a woman could help researchers design interventions and prevention strategies that target the root of the aggression.

In her study, Ainsworth enlisted male and female participants and conducted an experiment in which the men competed against other men or other women in a mating objective, and were instructed to deliver aggressive noise blasts in order to win. Another experiment gave the men an opportunity to assert dominance and control over their male rivals through nonviolent means. Ainsworth found that the men displayed more aggression—louder noise blasts—to the male adversaries than the female adversaries. In fact, when pitted against a female, the men did not show any signs of aggression. Similarly, when the men were given a method of asserting dominance over their male rivals without aggression, they chose the nonaggressive approach.

Ainsworth believes these results are clinically significant. Although the men in this study varied in age, she believes these findings demonstrate one of the causes of violence, particularly in younger men more vulnerable to impulsive behavior. “In tying male violence to its more ultimate motivational roots, the current research provides a basis for understanding—and reducing—many seemingly irrational acts of violence,” Ainsworth said. Having insight into these causes can help with the formation of treatments for violent behavior and can help men develop the skills necessary to seek out alternate methods of achieving a sense of social dominance over rivals without the use of aggressive tactics.

Reference:
Ainsworth, Sarah E., and Jon K. Maner. Sex begets violence: Mating motives, social dominance, and physical aggression in men. Journal of Personality and Social Psychology 103.5 (2012): 819-29. Print.

You entered therapy feeling broken, lonely, anxious, dissatisfied with your relationships and your career. Now you feel whole and healthy; your relationships have improved, and you’ve made some professional changes that have led to a more fulfilling career. You feel good about yourself. Life isn’t perfect, but you have come to accept these imperfections, and you feel equipped to handle life’s challenges when they come your way. Congratulations! The time, effort, and willingness to openly and honestly explore the most complex and painful areas of yourself and your life have paid off. Therapy worked. Now what? You have a standing weekly appointment with your therapist, and you have probably developed a strong therapeutic alliance with him or her. But lately you have noticed that you don’t feel a need to go to therapy and you struggle to find ways to fill the hour. These are some strong indicators that you are ready to leave therapy.

For most people, therapy is not forever. Very few people have reason to be in therapy for life. In fact, many of the people who make therapy a way of life are therapists. They have a personal and professional responsibility to maintain high levels of self-awareness. They must take precautions to ensure that their issues are not getting in the way of helping their clients, and that they are not letting their clients’ issues prevent them from living their own lives. Weekly therapy sessions can create the time, space, and support for therapists to do just that.

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Certainly, there are some people who are not therapists who also come to view therapy as a way of life. These people are often deeply dedicated to self-growth, and therapy may provide the support they need as they pursue constantly evolving personal goals. However, the vast majority of people who come to therapy do so with the intent of getting help with something specific. Whether it is something as broad as wanting to feel better or something as narrow as making a decision about a career move, people usually bring a specific goal to therapy. For some, these goals can be achieved in a few short months, while for others, it can take years. But ultimately there is a resolution and they feel ready to end therapy. The question then is how to do it.

One of the things people find most useful about therapy is that there is nothing you can’t talk about in a session—including your relationship with your therapist. In fact, a growing body of research indicates that much of the positive change produced by therapy comes as a result of the therapeutic relationship. For example, if your relationships improved while you were in therapy, it is likely, in part, because you learned new ways of being in relationships by actively participating in your therapeutic relationship. So take the well-honed skill set that you developed in therapy and open a discussion with your therapist about ending the therapeutic relationship.

This will likely come as no surprise to your therapist. He or she knows what you came in to work on and knows that you have achieved your goal. Plus, this is a natural part of the process—all therapists in training learn about how to help clients work through this final stage, called termination. This is a prime opportunity to review the goals that brought you to therapy and to reflect on the growth that allowed you to accomplish them. This part of therapy is kind of like a graduation ceremony—it is an opportunity to step back, look at how far you have come, and revel in your success. And, as with graduations, it is an opportunity to ponder and plan for what comes next. Part of termination involves reinforcing the coping skills that evolve during therapy and reminding clients to continue to draw upon them in the future. Another important part of this process is to identify indicators that may signal the need to return to therapy in the future.

Finally, working through the process of termination with your therapist will allow you the opportunity to process the ending of a powerful and unique relationship. While this is a deeply genuine relationship, it is also one that exists within strictly prescribed boundaries—within the therapist’s office during appointment times. Of course, there may have been phone calls and additional meetings scheduled during times of crisis, but there isn’t a healthy way to continue the relationship you have formed with your therapist outside of therapy. Feelings of grief, loss, and anxiety about ending the therapeutic relationship often come up, and termination is designed to address these feelings. Like all aspects of therapy, this can be a difficult process, but seeing it through can be invaluable in helping you continue to develop and implement the kind of sophisticated relational skills that enable you to have deeper, more meaningful, and authentic relationships.

Women have many roles. They are sisters, friends, daughters, mothers, and wives. And most women are employed in some capacity, with or without pay. Whether they work at home—raising children and running the house—or they enter the workforce as an employee, most women work. For young women, the transition from student to worker can be challenging. Equally difficult can be the reentry into the workforce for women who return to a job after having stayed home to raise children. How a woman approaches these transitions can affect not only her success in this pursuit, but also her self-esteem and well-being.

David Weiss of the Department of Psychology at the University of Zurich in Switzerland looked at two specific factors in women’s work-related aspirations. First, he looked at how openness influenced the experience. Second, he gauged how women’s gender ideology affected outcome. Weiss conducted a study that followed 61 young women as they left high school and began careers. He then looked at more than 800 women’s transitions from school or parenthood to work. Weiss found that the women who were lower in openness embraced traditional female gender roles, while those with more openness embraced nontraditional gender roles.

Those women who were more open demonstrated high levels of self-efficacy and well-being. Women who were less open fared poorly when they tried to step out into nontraditional female roles. “Taken together, the present research suggests that endorsing an ideology that provides strong behavioral guidelines can help women low in openness to master the challenges of a developmental transition,” Weiss said. He added that for women who approach career choices with an open mind, working within the confines of traditional gender expectations can have negative effects on self-esteem, well-being, and overall work-related success.

Reference:
Weiss, David, Alexandra M. Freund, and Bettina S. Wiese. Mastering developmental transitions in young and middle adulthood: The interplay of openness to experience and traditional gender ideology on women’s self-efficacy and subjective well-being. Developmental Psychology 48.6 (2012): 1774-784. Print.

Adults and children with attention-deficit hyperactivity disorder (ADHD) often exhibit patterns of behavior that are different from individuals without ADHD. They tend to be more impulsive, have less focused attention, and take more risks. Tests that measure inhibitory control and attention can require subjects to respond rapidly to risk/reward scenarios. Other assessment tools used to gauge symptoms of inattention in ADHD prompt subjects to answer questions that are posed one after the other. All of these methods explore levels of cognitive functioning, processing speed, and working memory. But in a recent study, Walter Roberts of the Department of Psychology at the University of Kentucky posed a different question.

Roberts theorized that perhaps the impulsivity and inattention associated with ADHD were not merely the result of impaired cognitive ability, but inability to multitask due to decreased response capacity. To test this theory, Roberts conducted a study comparing 33 individuals without ADHD to 38 with ADHD in two separate tasks. The first task was designed to demonstrate response-selection ability, while the second test measured working memory. Together, the two tasks captured how well the participants responded under increased processing burdens. Roberts found that as the cognitive load became greater, the performance of both groups decreased. In the first task, the decline was more evident in the participants with ADHD, which suggests that these individuals have deficits in response-selection resources.

When Roberts assessed each group on the working-memory task, however, he found virtually no difference in their performance with respect to accuracy, but the ADHD group did take longer to respond. This could reveal a task-switching impairment in those with ADHD. Also, as the time between memory tasks decreased, the performance decreased for the ADHD group. These results show that although multitasking is one mechanism that appears to be negatively affected in people with ADHD, overall memory capacity is not. “This limited processing capacity may have implications for understanding cognitive dysfunction in adults with ADHD,” Roberts said. For example, maintaining employment requires constant cognitive task-switching, making it potentially more difficult for people with ADHD than for those without. Comprehending oral and written material in classroom settings could also deplete processing capacity and result in academic challenges for children with ADHD. Roberts hopes the results of his study will open the door for further exploration into the factors that could contribute to cognitive and behavioral impairments in those with ADHD.

Reference:
Roberts, Walter, Richard Milich, and Mark T. Filmore. Constraints on information processing capacity in adults with ADHD. Neuropsychology 26.6 (2012): 695-703. Print.

In an increasingly connected world, most people have an account on at least one social networking platform, and many people use social networking as their primary means of communication with friends and family. Most of us are aware that social networking poses some dicey questions in romantic relationships—whether to “friend” exes, whether to share private conversations with partners, what constitutes flirting, how much information about a relationship is acceptable to share online, and so on—but social networking is primarily an avenue for connecting with nonromantic friends.

Is social networking changing friendship as we know it? Research hints that the answer is yes.

Reduced Investment

Facebook provides bountiful opportunities for “friending”—a term we owe to social networking—and many people have hundreds or even thousands of online friends. Historically, people have had 150 to 200 people in their circle of acquaintances, on average, and only a few close friends. But Facebook, for example, allows people to “friend” others without making much investment. This could change the way people approach friendship. Where friendship previously required time, effort, and a lot of conversation, it now seemingly requires only a click of a button. This has the potential to broaden the number of people a person may consider his or her friends, while significantly reducing the number who fit the more traditional traits associated with close friendship.

Changed Boundaries

Although some social networking sites offer options that allow people to limit the viewers on certain posts, people tend to post things to everyone on their friends list. This serves to alter the boundaries of traditional acquaintance relationships. Your boss might read about your difficult pregnancy, and an old college professor might hear about your difficulties in your marriage. Conversely, when people use only social networks to communicate with their close friends, they limit the intimacy and detail of their conversations because—despite the compromised boundaries brought about by social networking—there are still some things that most people won’t post online, even if they’d share these things with close friends.

Social networks also make it much easier to share controversial opinions with friends and acquaintances. Many of us have friends with whom we would never discuss politics or religion. But the endless political jockeying on Facebook and Twitter makes it much more likely that people will engage with their political foes. Depending on how these conversations are handled, they can increase conflict or even destroy friendships, or they can promote understanding and mutual respect.

Reaching Out

Starting a new friendship can be challenging, particularly for adults who are no longer in school or who don’t have a large pool of co-workers. For shy people and those seeking new friends, social networking provides an easy way to make the first overture of friendship. By simply clicking the “add friend” button, people can convey that they’re interested in getting to know someone, reducing a traditional barrier to friendship.

Changing Face Time

In-person communication with friends has always been an important part of friendship. Social networking might reduce the frequency of face-to-face contact. One study found that 10% of social networking friends ranked as “close” had never actually met in person. Social networking also changes how people spend face time with friends; they may spend time together perusing others’ social network profiles or discussing what they’ve seen online rather than catching up on one another’s lives.

References:

1. Novotney, A. (n.d.). R U friends 4 real? American Psychological Association. Retrieved from http://www.apa.org/monitor/2012/02/friends.aspx
2. Is social networking changing the face of friendship? (2007, September 14). ScienceDaily. Retrieved from http://www.sciencedaily.com/releases/2007/09/070912161147.htm

We all know the feeling, but few of us want to talk about it. Shame often runs our lives and undermines our relationships, but we often keep it hidden. We’re ashamed of being ashamed. I felt it today when my wife reminded me of something I had said to her that was unkind. I pride myself on being a sensitive, caring man, and when she pointed out this shortcoming, I could feel the shame rise up in me. I felt myself getting warm. My first thought was, “I didn’t do it.” My first words were, “I never said it.” I felt confused and off balance. I wanted to run away and hide. I wanted to disappear.

I was awash in my shame, but I tried to cover my discomfort. Shame is such a wretched feeling, most of us try and deny we are feeling it, hoping that if we don’t look at it, shame will magically disappear. But shame is stubborn. The more we deny it, the more it sticks to us like glue.

Recent research shows that shame is conceptualized as a multidimensional construct, manifesting in various physical and emotional ways. Shame manifests physically in a wide variety of forms. “The person may hide their eyes; lower their gaze; blush; bite their lips or tongue; present a forced smile; or fidget,” psychotherapist Marc Miller said. Other responses may include irritability, annoyance, defensiveness, exaggeration, or denial. Research indicates that the strongest correlates of shame across studies include individual differences in nonacceptance of negative emotions and expressive suppression. Because the effect of shame often interferes with our ability to think clearly, we may experience confusion, being at a loss for words, or a blank mind.

“Man is the only animal that blushes,” Mark Twain once said. “Or needs to.” He reminds us how central shame is to the human experience.

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When couples come to me for counseling, they rarely mention shame as a cause for their difficulty. Yet I’ve found that shame is a major factor of relationship problems. Research shows that shame can have a severe negative impact on intimate relationships, leading to negative shame loops between partners. We know that couples often fight about money and sex. He gets angry when she spends money on things he thinks are not important. Underneath his anger we often find feelings of inadequacy. Beneath her spending patterns may be feelings of loneliness and unworthiness.

Key Insight: Nathanael Schlect, Licensed Associate Counselor “Shame often operates alongside other vulnerabilities such as fear, grief, or insecurity rather than existing in isolation.”

One partner wants more sex, and the other feels tired or withdrawn. One gets angry. The other feels hurt. Shame is rarely discussed, but is always present. One may feel like a lousy lover. The other may feel unattractive.

Recent umbrella reviews show that a relative majority of studies conceptualize shame as a multidimensional construct, representing what Helen B. Lewis, a pioneer in recognizing the importance of shame to psychotherapy, argued was an entire family of emotions. This family includes humiliation, embarrassment, feelings of low self-esteem, belittlement, and stigmatization. Shame is often experienced as a critical inner voice that judges us as “damaged goods,” inadequate, inferior, or worthless.

Shame in Men and Women

I’ve found the things that trigger shame differ in men and women. Research confirms that gender stereotypes maintain that women experience more guilt and shame than men, with meta-analyses showing small but significant gender differences (d = -0.29 for shame). Women often feel shame when they are unable to do all the things they think they should do. They must be a good mother, a sexy wife, a successful breadwinner, a caring friend, a good sister, and more. Studies show that women avoid the shame they may have if others observe that they overestimated themselves, while men do not seem to be similarly shame averse, possibly due to different societal expectations where men are expected to be overconfident.

The list is smaller for men. Shame usually manifests when we don’t feel strong. Dr. Brené Brown, an expert on shame, says, “While women are faced with a web of many layered, competing, and conflicting expectations, there seems to be one major expectation for men—do NOT appear weak.”

I’ve also found that men and women often react to shame differently. Research indicates larger gender gaps in shame with trait versus state scales, and gender differences in shame about domains such as the body, sex, and food tend to be larger than other domains. While individual responses to shame vary widely and are not strictly gender-bound, often women often blame themselves when they feel ashamed. They look embarrassed. They turn inward. Men often blame others when they feel ashamed. They often look angry. They may explode outward.

Key Insight: Nathanael Schlect, Licensed Associate Counselor “While patterns can differ across socialization, people of any gender may turn shame inward or outward depending on personality, history, and context.”

In fact, male violence is often an attempt to ward off shame. Recent research shows masculinity threats lead to emotions including shame, guilt, and a reduction in empathy, and these masculinity threats predict harmful behaviors such as men’s aggression, sexual violence, anxiety, shame, self-harm, and homophobic attitudes. Dr. James Gilligan has spent more than 30 years researching anger and violence in men. His research traces the role that shame plays in the etiology of murder and shows how feelings of shame cause violent and vengeful behavior. He says, “I have yet to see a serious act of violence that was not provoked by the experience of feeling shamed and humiliated, disrespected and ridiculed, and that did not represent the attempt to prevent or undo this ‘loss of face.’ ” Respect is important to all of us, but for men it is essential. Recent research on masculinity and violence shows that when men were targets of partner violence, many described feelings of weakness and shame, reflecting assumptions that men should be dominant and not victimized. Feeling disrespected or “dissed” can cause a man to strike out in rage.

Self-Disclosure and Empathy

The most difficult thing in the world to do when we are feeling down on ourselves is to admit how we feel. Yet self-disclosure is what we need to do to stop the cycle of shame and blame that so many of us get caught up with. Recent research on intimacy shows that self-disclosure, a fundamental component of intimacy, occurs only when vulnerability is met with acceptance rather than rejection. However, shame disrupts this process by inhibiting vulnerability and promoting defensive strategies. It’s harder than hell to say to my wife, “You’re right, what I said was unkind. I’m sorry.” But that’s the key to washing the shame away.

Attachment research shows that shame loops within couple relationships may not only be triggered by negative cues, such as criticism from a partner, but can also innocently be triggered by a partner seeking connection or even offering comfort. It feels counterintuitive. We’re afraid that if we admit our faults, we’ll feel even more ashamed. But the opposite is true. The more we’re able to say, “Yes, I messed up,” or, “Yes, I made a mistake,” or, “Yes, I’m sorry for what I said,” the better we feel about ourselves.

We all know the good feeling we get when we can own our mistakes and be forgiven. But that takes empathy on the part of our partner. Our partner has to be able to feel with us, not blame us or put us down. Recent clinical trials of Emotionally Focused Couple Therapy show significant improvements in intimacy and reductions in shame when couples learn to address these dynamics. For men, it often means admitting our weakness. And for women, it means accepting that we can still be strong, adequate men, even when we are weak.

Men need also to practice empathy with the women in our lives. We have to understand the things we do that shame them, the subtle ways we may put them down. And we all need to be more empathic with ourselves. We don’t have to be successful at everything, all the time. We don’t have to be strong all the time and hide our weakness. We can learn to love and accept the wonderful, flawed, human beings we all are.

References:

1. Mirzazade, Z., Molazade, J., & Hadianfard, H. (2025). The effect of emotionally focused couple therapy (EFCT) on shame and intimacy in couples: a randomized controlled trial (RCT). BMC Psychology, 13, 1111. https://doi.org/10.1186/s40359-025-03415-3
2. Frediani, M. J., et al. (2024). Seeking connection can trigger shame loops in couples: An attachment-based understanding. Family Process, 63(1), 34-47. https://doi.org/10.1111/famp.12888
3. Vescio, T. K., et al. (2025). Masculinity threats sequentially arouse public discomfort, anger, and positive attitudes toward sexual violence. Personality and Social Psychology Bulletin, 51(1), 3-20. https://doi.org/10.1177/01461672231179431
4. Stanaland, A., Gaither, S., & Gassman-Pines, A. (2023). When is masculinity “fragile”? An expectancy-discrepancy-threat model of masculine identity. Personality and Social Psychology Review, 27(4), 285-315. https://doi.org/10.1177/10888683221141176
5. Swerdlow, B. A., Sandel, D. B., & Johnson, S. L. (2023). Shame on me for needing you. Emotion, 23(3), 737-752. https://doi.org/10.1037/emo0001109
6. O’Donnell, S., et al. (2024). Masculinity and violence interconnectedness: Defining and reconciling the gender paradox among men with cumulative lifetime violence histories. SAGE Open, 14(3), 21582440241266998. https://doi.org/10.1177/21582440241266998
7. Else-Quest, N. M., Higgins, A., Allison, C., & Morton, L. C. (2012). Gender differences in self-conscious emotional experience: A meta-analysis. Psychological Bulletin, 138(5), 947-981. https://doi.org/10.1037/a0027930
8. DeSantis, A. J., Eshelman, L. R., & Messman, T. L. (2025). Emotional dysregulation, anger, and masculinity in men who have experienced lifetime sexual violence. Journal of Interpersonal Violence, 40(21-22), 5199-5222. https://doi.org/10.1177/08862605241301790
9. Deshmukh, A., Mehta, R., & Acar, Z. (2024). Perceived criticism and intimacy avoidance in couples: The mediating role of shame. Research and Practice in Couple Therapy, 2(1), 1-10. https://doi.org/10.61838/rpct.2.1.1
10. Bardi, L., et al. (2024). Conceptualization and assessment of shame experience and regulation: An umbrella review of synthesis studies. Clinical Psychology Review, 113, 102436. https://doi.org/10.1016/j.cpr.2024.102436

Since the beginning of recorded history, people have been forecasting the end of the world. In biblical times, many people believed that Jesus would return in a few short years, and religions throughout the world have cautioned people to repent and prepare for the end of days for as long as there have been religions.

In modern times, with science gaining popular acceptance and doomsday scenarios falling outside the mainstream, such beliefs can seem highly unorthodox. But the Daily Mail reports that 22% of Americans believe the world will end in their lifetime, and the belief that a religious figure will return to “save” a chosen few is still commonplace. The National Geographic Channel has dedicated a popular television series to people who believe the world may soon end: Doomsday Preppers follows individuals—sometimes referred to as survivalists—and their families as they plan and prepare for the end of civilization.

Psychology can offer some insight into this phenomenon.

Risk and Preparedness
We live in an increasingly complex and often frightening world. Massive tsunamis can kill thousands, and electrical outages can cripple a city, state, or country. The threat of nuclear war is omnipresent, and protests around the world can make government and order seem increasingly unstable. Many people actively fear the prospect of terrorist attacks, pandemics, fuel shortages, and societal or economic collapse.

Most people prepare to some degree for “what-if” scenarios. People buy flood insurance, swarm the grocery store before a storm, and buy generators to ensure their businesses can keep running if there’s a power outage. The difference between those who take it to the extreme—such as doomsday preppers—and those who simply plan for a rainy day may simply be a matter of degree.

Trauma and Experience
People who believe in conspiracies and doomsday scenarios likely would caution that, if they’re right, they don’t look so strange after all. And when a person’s experiences are taken into account, their worries may even seem justified. A person who has experienced war might be more frightened that war could end the world, while trauma victims and people with posttraumatic stress may have more difficulty assessing risk.

Belief Systems
People tend to accept evidence that supports their belief systems and ignore evidence that doesn’t—a phenomenon called confirmation bias. In some cases, people may believe conspiracy theories because these theories support their most fundamental or earliest-established beliefs. A person whose mother claims to have been kidnapped by aliens might, for example, fervently cling to a belief in aliens because believing in aliens allows him to believe his mother. A highly religious person who believes she experienced a prophecy that the world will soon end is unlikely to abandon such a belief because doing so undermines her religious experience.

Once a doomsday scenario or conspiracy theory becomes part of a person’s belief system, he or she is unlikely to abandon it even in the face of conflicting evidence. This isn’t unique to doomsday preppers. We all have things we believe without evidence, sometimes even in the face of contradictory evidence.

Mental Health Conditions
Some people who believe in conspiracy theories and end-of-days scenarios may be experiencing a mental health issue. Conditions that can contribute to such beliefs include:

• Schizophrenia, which can result in delusions and hallucinations that could convince a person the end of the world is near or that an entity is out to get him or her.
• Paranoid personality disorder, which manifests as constant suspicion, often in the form of fear of the government.
• Persecutory delusion, which may cause a person to believe that another person or entity is out to get him or her and will not stop until harm is done.

References:

1. Cruz, N. (2012, April 3). National Geographic’s troubling, addictive show about survivalists. Slate. Retrieved from http://www.slate.com/blogs/browbeat/2012/04/03/doomsday_preppers_on_national_geographic_is_the_survivalist_reality_show_exploitative_.html
2. Guyatt, N. (2007). Have a nice doomsday: Why millions of Americans are looking forward to the end of the world. New York, NY: Harper Perennial.
3. Hanlon, C. (2012, May 2). 22% of Americans believe world will end in their lifetime (and 10% think the apocalypse is coming this year). Mail Online. Retrieved from http://www.dailymail.co.uk/news/article-2138449/The-end-nigh–Americans-think-world-end-year.html