Using Arousal Suppression Exercises to Decrease Inappropriate Sexual Arousal in Detained Adolescent Males: Three Clinical Demonstrations

Abstract

Reyes, Vollmer, and Hall (2011) found that 2 arousal suppression strategies, 1 of which involved counting backward from 100 to 0, decreased sexual arousal for 2 male sex offenders with intellectual disabilities. In the current clinical study, we taught 3 adolescent males who had been adjudicated for illegal sexual behavior to self-report arousal when they were presented with sexually arousing visual stimuli. Based on the procedures in the Reyes et al. (2011) study, we taught participants to count backward from 100 to 0 when they verbally reported a criterion level of sexual arousal in the presence of visual media. Subsequently, we gradually faded therapists’ instructions for 2 participants until they independently used the arousal suppression exercise. Results showed that each participant’s self-reported sexual arousal decreased upon implementation of treatment relative to baseline. Decreased sexual arousal continued even under conditions of faded therapist instructions for 2 participants. The relative merits of using self-report measures are discussed.

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Notes

  1. 1.

    Laws regarding consent and age of consent differ by state. In Alabama, where the study was conducted, 16 is the age of consent. This means that any individual under the age of 16 may not consent to any sexual acts.

  2. 2.

    Although all participants were biologically male, gender neutral pronouns will be used throughout the current article.

  3. 3.

    3 All participant names used in the article are aliases. No real names were used to protect participants’ identities.

References

  1. AL Code § 15-20A-26. (2016). Juvenile sex offender treatment; Risk assessment. https://law.justia.com/codes/alabama/2016/title-15/chapter-20a/section-15-20a-26/.

  2. Abel, G. G., Blanchard, E. B., & Barlow, D. H. (1981). Measurement of sexual arousal in several paraphilias: The effects of stimulus modality, instructional set and stimulus content on the objective. Behaviour Research and Therapy, 19(1), 25–33. https://doi.org/10.1016/0005-7967(81)90109-1.

  3. Association for the Treatment of Sexual Abusers. (2017). Adolescents who have engaged in sexually abusive behavior: Effective policies and practices. Retrieved from http://www.atsa.com/adolescents-engaged-in-sexually-abusive-behavior

  4. Baer, D. M., Wolf, M. M., & Risley, T. R. (1987). Some still-current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 20(4), 313–327. https://doi.org/10.1901/jaba.1987.20-313.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Brandes, B. J., & Cheung, M. (2009). Supervision and treatment of juveniles with sexual behavior problems. Child and Adolescent Social Work Journal, 26(3), 179–196. https://doi.org/10.1007/s10560-009-0170-4.

    Article  Google Scholar 

  6. Brogan, K. M., Falligant, J. M., & Rapp, J. T. (2017a). Interdependent group contingencies decrease adolescents’ disruptive behaviors during group therapy: A practitioner’s demonstration. Behavior Modification, 41, 405–421. https://doi.org/10.1177/0145445517693812.

    Article  PubMed  Google Scholar 

  7. Brogan, K. M., Rapp, J. T., Chinnappan, B., Edgemon, A. K., Almanza, A., Hamrick, S., . . . Burkhart, B. R. (2018a). A comparison of two brief preference assessments to a standard MSWO assessment for detained adolescent males. Manuscript submitted for publication.

  8. Brogan, K. M., Rapp, J. T., Niedfeld, A. M., Coon, J. C., Everhart Newman, J. L., & Burkhart, B. R. (2017b). Increasing quiet compliance by detained male adolescents. Behavior Modification, 41, 788–807. https://doi.org/10.1177/0145445517716675.

    Article  PubMed  Google Scholar 

  9. Brogan, K. M., Richling, S. M., Rapp, J. T., Thompson, K. R., & Burkhart, B. R. (2018b). Activism and advocacy note: Collaborative efforts by the Auburn University applied behavior analysis program in the treatment of adolescents adjudicated for illegal sexual behavior. Behavior and Social Issues, 27, 11–13. https://doi.org/10.5210/bsi.v.27i0.8267.

    Article  Google Scholar 

  10. Brusman Lovins, L., Yoder, J. R., & Berry, S. (2017). Evaluation I: Recidivism outcomes from a management program for youth who have committed a sexual crime. Journal of Offender Rehabilitation, 56(6), 394–411.

    Article  Google Scholar 

  11. Carr, J. E. (2005). Recommendations for reporting multiple-baseline designs across participants. Behavioral Interventions, 20, 219–224. https://doi.org/10.1002/bin.191.

    Article  Google Scholar 

  12. Carr, J. E., Nicolson, A. C., & Higbee, T. S. (2000). Evaluation of a brief multiple-stimulus preference assessment in a naturalistic context. Journal of Applied Behavior Analysis, 33, 353–357. https://doi.org/10.1901/jaba.2000.33-353.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Catania, A. C. (2013). Learning (interim 5th ed.). USA: Sloan Publishing.

  14. Chivers, M. L., Seto, M. C., Lalumière, M. L., Laan, E., & Grimbos, T. (2010). Agreement of self-reported and genital measures of sexual arousal in men and women: A meta-analysis. Archives of Sexual Behavior, 39(1), 5–56. https://doi.org/10.1007/s10508-009-9556-9.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Coon, J., & Rapp, J. T. (2018). Application of multiple baseline designs in behavior analytic research: Evidence for the influence of new guidelines. Behavioral Interventions, 33, 160–172. https://doi.org/10.1002/bin.1510.

    Article  Google Scholar 

  16. Cooper, J. O., Heron, T. E., & Heward, W. L. (2007). Applied behavior analysis. Upper Saddle River, NJ: Pearson.

    Google Scholar 

  17. Critchfield, T. S., & Kollins, S. H. (2001). Temporal discounting: Basic research and the analysis of socially important behavior. Journal of Applied Behavior Analysis, 34, 101–122. https://doi.org/10.1901/jaba.2001.34-101.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Dariotis, J. K., & Johnson, M. W. (2015). Sexual discounting among high-risk youth ages 18–24: Implications for sexual and substance use risk behaviors. Experimental and Clinical Psychopharmacology, 23(1), 49. https://doi.org/10.1037/a0038399.

    Article  PubMed  Google Scholar 

  19. DeLeon, I. G., & Iwata, B. A. (1996). Evaluation of a multiple-stimulus presentation format for assessing reinforcer preferences. Journal of Applied Behavior Analysis, 29(4), 519–533. https://doi.org/10.1901/jaba.1996.29-519.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Department of Justice Office of Juvenile Justice and Delinquency Programs. (2017, September 15). Easy access to the census of juveniles in residential placement: 1997–2015. Retrieved from https://www.ojjdp.gov/ojstatbb/corrections/data.html

  21. Dixon, M. R., Hayes, L. J., Binder, L. M., Manthey, S., Sigman, C., & Zdanowski, D. M. (1998). Using a self-control training procedure to increase appropriate behavior. Journal of Applied Behavior Analysis, 31, 203–210. https://doi.org/10.1901/jaba.1998.31-203.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Huddy, V., Kitchenham, N., Roberts, A., Jarrett, M., Phillip, P., Forrester, A., et al. (2017). Self-report and behavioural measures of impulsivity as predictors of impulsive behaviour and psychopathology in male prisoners. Personality and Individual Differences, 113, 173–177. https://doi.org/10.1016/j.paid.2017.03.010.

    Article  Google Scholar 

  23. Jarmolowicz, D. P., Lemley, S. M., Mateos, A., & Sofis, M. J. (2016). A multiple-stimulus-without-replacement assessment for sexual partners: Purchase task validation. Journal of Applied Behavior Analysis, 49(3), 723–729. https://doi.org/10.1002/jaba.313.

  24. Johnson, M. W., & Bickel, W. K. (2002). Within-subject comparison of real and hypothetical money rewards in delay discounting. Journal of the Experimental Analysis of Behavior, 77(2), 129–146. https://doi.org/10.1901/jeab.2002.77-129.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Johnson, M. W., Johnson, P. S., Herrmann, E. S., & Sweeney, M. M. (2015). Delay and probability discounting of sexual and monetary outcomes in individuals with cocaine use disorders and matched controls. PLoS One, 10(5), e0128641. https://doi.org/10.1371/journal.pone.0128641.

    Article  PubMed Central  PubMed  Google Scholar 

  26. Jones, J., & Sullivan, P. S. (2016). Age-dependent effects in the association between monetary delay discounting and risky sexual behavior. SpringerPlus, 5(1), 852. https://doi.org/10.1186/s40064-016-2570-1.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Kazdin, A. (2011). Single-case research designs: Methods for clinical and applied settings (2nd ed.). New York, NY: Oxford University Press.

    Google Scholar 

  28. Lane, C., Goldstein, N. E., Heilbrun, K., Cruise, K. R., & Pennacchia, D. (2012). Obstacles to research in residential juvenile justice facilities: Recommendations for researchers. Behavioral Sciences & the Law, 30(1), 49–68. https://doi.org/10.1002/bsl.1991.

    Article  Google Scholar 

  29. Laraway, S., Snycerski, S., Michael, J., & Poling, A. (2003). Motivating operations and terms to describe them: Some further refinements. Journal of Applied Behavior Analysis, 36, 407–414. https://doi.org/10.1901/jaba.2003.36-407.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Lawyer, S. R., & Schoepflin, F. J. (2013). Predicting domain-specific outcomes using delay and probability discounting for sexual versus monetary outcomes. Behavioural Processes, 96, 71–78. https://doi.org/10.1016/j.beproc.2013.03.001.

    Article  PubMed  Google Scholar 

  31. Letourneau, E. J., Henggeler, S. W., Borduin, C. M., Schewe, P. A., McCart, M. R., Chapman, J. E., & Saldana, L. (2009). Multisystemic therapy for juvenile sexual offenders: 1-year results from a randomized effectiveness trial. Journal of Family Psychology, 23(1), 89–102. https://doi.org/10.1037/a0014352.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Madden, G. J., Begotka, A. M., Raiff, B. R., & Kastern, L. L. (2003). Delay discounting of real and hypothetical rewards. Experimental and Clinical Psychopharmacology, 11(2), 139. https://doi.org/10.1037/1064-1297.11.2.139.

    Article  PubMed  Google Scholar 

  33. McCaul, K. D., Solomon, S., & Holmes, D. S. (1979). Effects of paced respiration and expectations on physiological and psychological responses to threat. Journal of Personality and Social Psychology, 37(4), 564. https://doi.org/10.1037/0022-3514.37.4.564.

    Article  PubMed  Google Scholar 

  34. McClernon, F. J., Westman, E. C., & Rose, J. E. (2004). The effects of controlled deep breathing on smoking withdrawal symptoms in dependent smokers. Addictive Behaviors, 29(4), 765–772. https://doi.org/10.1016/j.addbeh.2004.02.005.

    Article  PubMed  Google Scholar 

  35. Miltenberger, R. G. (2016). Behavior modification: Principles and procedures (6th ed.). Belmont, CA: Wadsworth.

    Google Scholar 

  36. Newman, J. L. E., Larsen, J. L., Cunningham, K. B., & Burkhart, B. R. (2015). An examination of the factor structure of the Millon adolescent clinical inventory in a sample of detained adolescent boys. Psychological Assessment, 27(3), 1022. https://doi.org/10.1037/a0038779.

    Article  PubMed  Google Scholar 

  37. Novotny, M. A., Sharp, K. J., Rapp, J. T., Jelinski, J. D., Lood, E. A., & Steffes, A. K. (2014). False positives with visual analysis for nonconcurrent multiple baseline designs and ABAB designs: Preliminary findings. Research in Autism Spectrum Disorders, 8, 933–943. https://doi.org/10.1016/j.rasd.2014.04.009.

    Article  Google Scholar 

  38. Polan, M. L., Desmond, J. E., Banner, L. L., Pryor, M. R., McCallum, S. W., Atlas, S. W., et al. (2003). Female sexual arousal: A behavioral analysis. Fertility and Sterility, 80(6), 1480–1487. https://doi.org/10.1016/S0015-0282(03)02210-6.

    Article  PubMed  Google Scholar 

  39. Rachlin, H. (2016). Self-control based on soft commitment. The Behavior Analyst, 39, 259–268. https://doi.org/10.1007/s40614-016-0054-9.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Rea, J. A., DeBriere, T., Butler, K., & Saunders, K. J. (1998). An analysis of four sexual offenders’ arousal in the natural environment through the use of a portable penile plethysmograph. Sexual Abuse: A Journal of Research and Treatment, 10(3), 239–255. https://doi.org/10.1023/A:1021322021823.

    Article  Google Scholar 

  41. Reyes, J. R., Vollmer, T. R., & Hall, A. (2011). The influence of presession factors in the assessment of deviant arousal. Journal of Applied Behavior Analysis, 44, 707–717. https://doi.org/10.1901/jaba.2011.44-707.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Reyes, J. R., Vollmer, T. R., & Hall, A. (2016). Comparison of arousal and preference assessment outcomes for sex offenders with intellectual disabilities. Journal of Applied Behavior Analysis, 50, 27–37. https://doi.org/10.1002/jaba.364.

    Article  PubMed  Google Scholar 

  43. Roche, B., & Barnes-Holmes, D. (2002). Human sexual arousal: A modern behavioral approach. The Behavior Analyst Today, 3(2), 145. https://doi.org/10.1037/h0099973.

    Article  Google Scholar 

  44. Sharma, L., Markon, K. E., & Clark, L. A. (2014). Toward a theory of distinct types of “impulsive” behaviors: A meta-analysis of self-report and behavioral measures. Psychological Bulletin, 140(2), 374–408. https://doi.org/10.1037/a0034418.

    Article  PubMed  Google Scholar 

  45. Watson, P. J., & Workman, E. A. (1981). The non-concurrent multiple baseline across-individuals design: An extension of the traditional multiple baseline design. Journal of Behavior Therapy and Experimental Psychiatry, 12, 257–259.

    Article  Google Scholar 

  46. Zautra, A. J., Fasman, R., Davis, M. C., & Arthur, D. (2010). The effects of slow breathing on affective responses to pain stimuli: An experimental study. PAIN, 149(1), 12–18. https://doi.org/10.1016/j.pain.2009.10.001.

    Article  PubMed  Google Scholar 

  47. Zuckerman, M. (1971). Physiological measures of sexual arousal in the human. Psychological Bulletin, 75(5), 297. https://doi.org/10.1037/h0030923.

    Article  PubMed  Google Scholar 

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Correspondence to John T. Rapp.

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The authors would like to thank the Alabama Department of Youth Services for their support, as well as the students who participated in the study.

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Brogan, K.M., Rapp, J.T., Niedfeld, A.M. et al. Using Arousal Suppression Exercises to Decrease Inappropriate Sexual Arousal in Detained Adolescent Males: Three Clinical Demonstrations. Behav Analysis Practice 13, 348–359 (2020). https://doi.org/10.1007/s40617-020-00408-z

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Keywords

  • Arousal suppression
  • Juvenile Justice
  • Self-report
  • Sexual arousal