SPJI 2015 by Student Psychology Journal of Ireland

Student Psychology Journal of Ireland

Volume VI

Published by the Student Psychology Journal of Ireland C/O Department of Psychology, Trinity College, Dublin 2, Republic of Ireland

All views expressed herein are those of the authors and do not necessarily reflect the views of the editors or sponsors.

Correspondance or complaints may be addressed to: Student Psychology Journal of Ireland, C/O Department of Psychology Trinity College, Dublin Republic of Ireland or email: journal@tcd.ie

The Student Psychology Journal of Ireland volume VI, as well as previous volumes, are available online at SPJI.ie

peer reviewers The Committee would like to extend our immense gratitude to the peer reviewers for their time and invaluable input. David Bolton Charlotte Kathleen Callaghan Aoife Cartwright Aurelio Castro Sean Commins Antoinette Copley Deirdre Cowman Brendan Cullen Susan Delaney Paul Dockree Malte Elson Lia Emanuel Catherine Hamilton-Giachritsis Ashleigh Haynes David Hevey Michael Hogan Melrona Kirrane Francesca Lionetti Rik Loose Pawel Matulewicz Rosaleen McElvaney Geraldine Moane Karen Morgan Ed Morrison Elizabeth Nixon Chris Noonan Katriona Oâ&#x20AC;&#x2122;Sullivan Jean Quigley Pablo Vidal-Ribas Shane Timmons Elizabeth Yu Tina Yu

the committee

Co-Editor, Jess Dully Co-Editor, Julie Lynch Co-Editor, Holly Ryan General Manager, Nathalie Freysinger Finance Officer, Mairead Ryan Public Relations Officer, Sarah Martin Design & Publications Officer, Darragh McArdle Events Manager, Lisa Gannon

The committe of SPJI 2015 would like to warmly welcome Jamie Cummins, Selena Oâ&#x20AC;&#x2122;Connell, Gemma Cullina, Robert Soper, Senan Tuohy-Hamill, Cora Bolger and Laoise Oâ&#x20AC;&#x2122;Reilly to the new committee of the SPJI 2016. We are also delighted that Darragh will be returning for another year. We look forward to your success.

table of contents

Preface Introduction

viii ix

BEST SUBMISSION 2015 Compassion Fatigue in Funeral Directors:The roles of social support, training and self-sare (Ger McCormack)

EMPIRICAL INVESTIGATIONS Ambivalent Sexism and Perceptions of Rape in an Irish Undergraduate Sample (Claire Brennan)

The Relationships Between Body Appreciation and Health-Related and Risk-Taking Behaviours: Does gender moderate these relationships? (Robyn Brown)

The Effect of Autonomy and Perceived Parental Control on Irish Adolescent Eating Habits (Ellen Butler)

Exploring Perceptions of Partnersâ&#x20AC;&#x2122; Facial Attractiveness and Relationship Satisfaction (Niamh Daly Ryan)

A Study of the Perceived Warmth and Competence of Parents in Politics (Aisling Gilligan)

Response Inhibition Performance Correlates with Pragmatic Language 121 Ability in Neurotypical Children Aged 10-12 (Cal McDonagh)

101

table of contents

LITERATURE REVIEWS Discourse and Diagnosis: A Comparison between the Medical Model and Lacanian Approach to Diagnosis using a Clinical Example of Anorexia Nervosa (Jennifer Barry)

142

The Interaction Between Control Beliefs and Cognitive Function (Niamh Doyle)

151

A Critical Evaluation of the Essentialist Debate: Do fathers make a unique contribution to child development? (Maedbh King)

162

Cesare Lombrosoâ&#x20AC;&#x2122;s Biological Explanations of Crime: How relevant are 171 they to modern criminal psychology? (James Larkin)

The role of the Irish Psychologist in Responding to Cases of Child Sexual Abuse (Jennifer Lennon)

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The Effect of Early Institutional Care on Cognitive and Social-emotional 193 development: A Critical Review (Rachel Potterton) A Critical Account Of Key Neurological Features Of Parkinsonâ&#x20AC;&#x2122;s 202 Disease (Katie Ryan)

Preface The Student Psychology of Ireland (SPJI) is a double-blind, peer-reviewed academic journal that was created for and by undergraduate psychology students in Ireland. The Journal was founded in 2009 by a group of TCD students who realised the merit of undergraduate research and insights. The committee behind the Journal continues to be made of undergraduate student volunteers, though now the team includes students from TCD, UCD, DBS and NUIG. The Journal serves to highlight the exceptional work of undergraduate students, engage students in the publication process and to foster a passion for research. We are excited and proud to offer an outlet for Ireland’s psychology undergraduates. I would like to extend thanks on behalf of all those involved in SPJI 2015, to our generous sponsor, The National University of Ireland, Galway. I would further like to thank to Dr. Rosaleen McElvaney who kindly agreed to be the keynote speaker at our 2015 launch event. The Journal would not be possible without the support we receieved from over 40 peer reviewers, both within Ireland and around the world, who offered their time and expertise to students who submitted to the Journal. Lastly, I would like to thank the committee for their positivity and dedication to the project. To Jess, Julie and Holly, our devoted Editors, who together read and advised on over 40 submissions in addition to sourcing and liaising between peer-reviewers and authors for 6 months, ‘thank you’. I am also grateful for the hard work put in by our Finance Officer, Mairead, who dealt with a much shorter timeline than could have been anticipated, but who has once again coordinated the means for the Journal to carry on. Thank you Sarah, our Public Relations Officer, for the excellent work communicating between the Committee and Psychology students and departments throughout Ireland while growing our social network significantly. Lisa, our Events Manager, well done on the Launch Night, you did an excellent job securing all the necessary aspects for a successful event, from your choice of speaker to the procurement of a venue and snacks. Finally, thank you to Darragh who has worked tirelessly to assemble this Journal as you see it as well as to redesign our website, which will be available shortly. I hope you enjoy the 2015 Student Psychology Journal of Ireland, Nathalie Ann Freysinger General Manager, 2015

from the editors The field of psychology has developed exponentially since its naissance, and thankfully we now feel the same can be said for the Student Psychology Journal of Ireland. The Journal, now in its sixth year of publication, was originally founded in 2009 by a group of students from Trinity College Dublin, who recognised the lack of opportunity for psychology students to publish their undergraduate work. The following year, the Journal opened its doors to all undergraduate students in Ireland to showcase their enthusiasm and have their exceptional work recognised. The SPJI remains Irelandâ&#x20AC;&#x2122;s only student-led initiative dedicated solely to providing an outlet for the outstanding contributions that Irish undergraduate students offer to our understanding of human behaviour. It seeks to encourage students to have confidence in their academic abilities from the very onset of their psychological craft, while also providing them with a chance to have their voice heard by the psychological community. Further to this, we hope that SPJI will nourish a taste for knowledge, a keen interest in research and an appreciation for academia in our authors. This year has been one of exciting progress and unprecedented growth. The number of submissions reached a record high, and had greater diversity than ever before, not only in the research topics, but also in the universities we received submissions from. The articles included in this edition feature an array of pertinent topics within the modern field of psychology, with submissions focusing on areas from compassion fatigue in funeral directors, to parental control in adolescent eating habits. We would like to extend our sincere thanks and appreciation to the authors for their hard work and dedication throughout the review process, to countless supervisors, faculty members and our expert peer-reviewers for their invaluable guidance and direction, and finally the rest of the committee, a truly dedicated and passionate bunch of people who have made the whole process an absolute pleasure to engage with.

Jessica Dully, Julie Lynch and Holly Ryan Editors, 2015

Sponsor, 2015

Sponsors, 2014 Trinity College Dublin Maynooth University University College Dublin Maastricht University

Best Submission, 2015

Student Psychology Journal of Ireland, 2015, 2-23

Compassion Fatigue in Funeral Directors: The Roles of Social Support, Training and Self-Care Ger McCormack

Supervisor: Chris Gibbons

Dublin Business School

Correspondence: gmccormac@tcd.ie

abstract Human service workers are susceptible to negative phenomena such as compassion fatigue through their work with people experiencing trauma and extreme emotions. The aim of the study was to examine compassion fatigue (burnout and secondary traumatic stress) in Irish funeral directors, and the role of age, length of service, social support, and self-care as possible protective factors. Measures included: a short demographic questionnaire, the Professional Quality of Life Scale (Stamm, 2009) which examines compassion satisfaction and compassion fatigue, the Multidimensional Scale of Perceived Social Support (MSPSS) (Zimet et al., 1988), 2 self-constructed items examining training attendance, and a purpose designed item exploring self-care practices. Employing a questionnaire based correlational design, purposive sampling acquired a sample (N=60) of 48 males and 12 females. Findings indicate that funeral directors do not possess high levels of compassion fatigue, burnout or secondary traumatic stress; although their high levels of compassion satisfaction may reduce the possibility of burnout. Social support from family was rated the most essential, while perceived social support from friends was negatively correlated with length of service as a funeral director. A discussion of the findings, suggestions for future research and limitations of the study are addressed. Keywords: Compassion, Burnout, Stress, Trauma, Support, Funeral, Death.

Introduction

General Introduction

â&#x20AC;&#x153;The funeral director operates in a market with a seemingly endless source of supply â&#x20AC;&#x201C; death will always occur and this

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COMPASSION FATIGUE IN FUNERAL DIRECTORS service will always be required” (Parsons, 2003, p. 70). One of the primary caregivers to the newly bereaved is the funeral director (Parsons, 2003). They are among a group of occupations that witness death on a regular basis (Harrawood, White, & Benshoff, 2008). It is estimated that there are 600 funeral service providers in Ireland (Irish Hospice Foundation, 2011), responsible for the burial or cremation of up to 30,000 people a year. An examination of the available literature highlights scant research on funeral directors, especially so in Ireland. Additionally, no published literature of any kind has been found that examined compassion fatigue or burnout in funeral directors. The current study is the first to investigate these phenomena in a national sample of Irish funeral directors. As such, this paper will incorporate findings from other human service professionals that are similarly exposed to suffering, trauma, or death through their work duties. Professional Quality of Life Professional Quality of Life (ProQOL) is the quality a worker feels in relation to their job as a helper (Stamm, 2010, p. 8). ProQOL (Figure 1) is composed of two aspects, compassion satisfaction (CS) and compassion fatigue (CF).

Compassion satisfaction is the positive aspects of helping, with CF being the negative (Stamm, 2012). Compassion fatigue breaks into two parts, burnout and secondary traumatic stress (STS). Utilised in the present study, the most widely used instrument for examining positive and negative effects of working with people who have experienced extremely stressful events is The Professional Quality of Life Scale (Stamm, 2009). Compassion Satisfaction Human service professionals will empathize with clients and use compassion as an altruistic desire to improve people’s conditions (Radey & Figley, 2007). Compassion is a “sympathetic consciousness of others’ distress together with a desire to alleviate it” (Merriam-Webster Online Dictionary, n.d). Pleasure in helping others through one’s work, positivity about one’s contributions to a helping organisation, and feelings of satisfaction in one’s ability to be an effective caregiver are all elements of compassion satisfaction (Stamm, 2012). Research on human services shows how CS can play an important protective role against CF. Sprang and colleagues (2007) note that CS can have a positive

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effect on a workers self-efficacy and can be an energy-enhancing experience, additionally, Yoder (2010) discovered that nurses with high CS were better able to deal with negative occupational feelings. Working around the deceased and the bereaved is for some the ultimate caring profession (Kiernan, 2014). Whether it is a desire or a vocation, it is realistic to suggest that funeral directors will operate with a sense of compassion towards the bereaved. However, as a worker’s heart goes out to their client through continued displays of compassion, their hearts can give out from fatigue (Radey & Figley, 2007, p. 207). Compassion Fatigue The negative aspects of helping are known as compassion fatigue (Stamm, 2012, p. 1). Being indirectly exposed to trauma can increase the risk of emotional problems for the helper (Bride, 2004; Bride, Radey, & Figley, 2007; Kadambi & Truscott, 2003; Simpson & Starkey, 2006; Sprang et al., 2007). This phenomenon is often referred to in literature by various terms such as vicarious traumatisation (McCann & Pearlman, 1990; Pearlman & Saakvitne, 1995), compassion fatigue (Figley, 1995), and secondary traumatic stress (STS) (Stamm, 2009, 2010, 2012). While there is much overlap, a common theme is working around traumatised populations (Sexton, 1999).

CF can have a sudden onset (Eastwood & Ecklund, 2008). It can arise from experiencing traumatic events such as abuse, terminal illness, or accidents (Yoder, 2010). The symptoms of STS can include being afraid, or the return of images from an upsetting event (Stamm, 2010, p. 17). It is essentially characterised by a preoccupation of thoughts about people one has helped (Stamm, 2010). Religious roles can develop CF through the support they offer to mourners (Roberts et al., 2003). Likewise, funeral directors work face-to-face with the bereaved, who seek consolation and comfort in a time of crisis (Hyland & Morse, 1995). Interestingly, secularisation in modern times can lead to clergy being less involved with end-of-life ceremonies, therefore the funeral director becomes the sole point of contact for a mourner wishing to receive grief support (Emke, 2002). Accordingly, the alternative title of “funeral counsellor” could be a more fitting work description (Bremborg, 2006). The main risk factor for STS, or what Figley (1995) calls compassion fatigue, is from exposure to traumatic events as a result of working with the traumatised (Bride, 2004). Some undertaking may be simply about guiding a family through proceedings (Holloway et al., 2013), however more difficult situations may also present. Individuals bereaved by homicide can experience overwhelming emotions and suffering (Malone, 2007). In

Best Submission

COMPASSION FATIGUE IN FUNERAL DIRECTORS organising funeral arrangements for these mourners, what is presented to the funeral director is most certainly a negotiation with a traumatised population. Ireland has one of the highest rates of homicide in Europe (O’Keefe, 2014), and with 83 cases in 2013 alone (Central Statistics Office, 2014), it may be suggested that some funeral directors are operating in an environment at risk of STS. Burnout For those in human service institutions, work entails spending large amounts of intense involvement with other people (Maslach & Jackson, 1981). These interactions involve dealing with people’s difficulties, consequently, feelings of anger and despair are common. As a result, the helper can endure chronic stress and poses the risk of burnout (Maslach & Jackson, 1981). Burnout, first discussed by Freudenberger (1974), is regarded as an occupational hazard for the “dedicated and the committed” (Freudenberger, 1974, p. 161). Burnout and STS are the two components of CF (Stamm, 2012). A distinction is that STS has a rapid onset, while burnout is typically gradual (Stamm, 2012). Human service workers entering the field with an enthusiastic outlook, will often put the needs of others before their own (Maslach & Goldberg, 1998), or strive for meaning in their own lives by acting as a saviour in their field (Perkins & Sprang, 2013). Often in the pursuit of career goals, highly dedicated workers can

take on too much resulting in exhaustion (Maslach et al., 2001). Relationships with Age High levels of burnout are experienced by younger human service professionals between the ages of 30 and 40 (Tomic, Tomic & Evers, 2004). Younger workers may be more vulnerable to work pressures than those in higher age categories (Tomic et al., 2004). In a study of physicians, age was discovered to be negatively correlated with emotional exhaustion (Bruce, Conaglen & Conaglen, 2005). After the September 11th terrorist attacks, age was found to be inversely related to burnout in a sample of New York clergy (Roberts et al., 2003). Although burnout is more likely to appear in the early career stages (Maslach et al., 2001), a counter argument is that levels of burnout tend to be relatively stable over time, and can instead be a prolonged response to chronic job stressors (Maslach et al., 2001). In the field of oncology nursing, no correlations were discovered between age and CF or burnout (Potter et al., 2010). Gender differences A literature review on Irish funeral directors revealed only one article (Kelly & Reid, 2011). The gender composition of males and females in this study (N=129) were 112 and 17 respectively (Kelly & Reid, 2011, p. 572). This indicates that the Irish funeral industry seems to be predominantly male occupied. A few decades ago,

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funeral directors were mostly males (Cathles, Harrington & Krynski, 2010; Harrawood, White, & Benshoff, 2008). Women were usually responsible for laying out the body (Kearl, 1997), and there was a belief they could not handle the distressing sights that their male counterparts witnessed (Cathles et al., 2010). Abendroth and Flannery (2006) discovered that female hospice workers were more at risk for moderate levels of CF. Female nurses may be more vulnerable to developing burnout as per their family role which can involve raising children (Cohen-Katz et al., 2005; Killian, 2008). Similar results with mental health providers by Sprang and colleagues (2007), found that female gender increased the risks of CF and burnout (p. 266). Conversely, in a study examining mental health professionals, no differences existed between gender and CF (Ray et al., 2013). Others argue that gender is not a factor for developing burnout (Maslach & Jackson, 1985), and if any differences exist they are usually quite small (Maslach & Jackson, 1981, 1985). Length of Service Relationships between length of occupational service, and CF and burnout are also highlighted. Potter and colleagues (2010) acknowledge the demands faced by oncology nurses. This occupation group is vulnerable to CF due to exposure of patients suffering side effects of treatment. Using a version of the current study’s measurement for CF, Potter and

associates (2010) looked at relationships to job experience. Staff with 11-20 years of experience had the highest percentage of high-risk CF scores, followed by 6-10 years, and then those in the 1-5 category (Potter et al., 2010, p. 58). This portrays an incremental trend, suggesting that workers may be more at risk for CF the longer they are in the field. Social Support Simpson and Starkey (2006) note that differences in coping techniques can play an important role in CF. Sarason and colleagues (1983) describe social support “as the existence or availability of people on whom we can rely, people who let us know that they care about, value, and love us” (p. 127). Paramedics working with the suffering of those they help have described how personal support networks are paramount in helping them deal with traumatic experiences (Regehr, Goldberg & Hughes, 2002). Similarly, funeral directors are systematically exposed to death (Linley & Joseph, 2005), therefore, it can be suggested that high levels of social support will be a necessary coping mechanism for funeral workers. Ariapooran (2014) examined the possible benefits of social support for protection against CF and burnout. As another caring profession, nurses support those struggling with trauma (Ariapooran, 2014). Similar to the present study, the Multidimensional Scale of Perceived

Best Submission

COMPASSION FATIGUE IN FUNERAL DIRECTORS Social Support (Zimet et al., 1988) was incorporated to measure social support. Findings revealed a negative correlation between CF and social support from family (Ariapooran, 2014, p. 282). It is unclear why CF did not have a negative correlation with support from friends (Ariapooran, 2014), however one explanation may be that social support from these sources are perceived differently as it may take place “between the lines” (Bolger & Amarel, 2007). Further research reveals how confidentiality might act as a barrier to workers seeking to utilise support networks (Løvseth & Aasland, 2010). In a Norwegian study comprising of funeral directors, nurses, chaplains, police officers, and rescue workers; Løvseth and Aasland (2010) examined how client privacy and professional reputation may come before the well-being of the helper. Ethical obligations for confidentiality revealed most participants only disclosed occupational difficulties to fellow workers. Many funeral professionals spend their time working as part of a family run business (Funeral Director, 2010; Parsons, 1999), so social support from familial sources may be more accessible. Furthermore, funeral directors can be conscious of their profession (Kephart, 1950), and with a stigma of body handling the dead (Parsons, 2003) evoking a creepy or morbid image in some people (Van Beck,

2013), it may hinder their ability to seek social support through friends. Training Simpson and Starkey (2006) highlight that educational programs that involve training around topics such as CF may help minimise negative experiences. For example, counselling is regarded as another emotionally demanding career (Simpson & Starkey, 2006). The authors argue that if counsellors are informed of the possibility of experiencing naturally occurring phenomena like CF, they can be better prepared to halt its progress. According to Smith and Hough (2011), specific training should be provided to workers in settings where death occurs. The authors examined medicine interns who worked in an endof-life care-setting. Interns cited perceived deficiencies in death-specific education and were unable to manage their own feelings around patient death. However, supplementing the worker’s qualifications with death-specific training could help mitigate feelings such as burnout (Smith & Hough, 2011). Educational interventions are also highlighted as important for junior doctors exposed to dying (Linklater, 2010). The benefit can be a better understanding of their own distress surrounding patient death (Linklater, 2010). Self-Care A characteristic of CF is an inability to separate one’s private life from professional roles (Stamm, 2010). Considering

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the emotionally-taxing work of funeral directors, those in human service careers involved with end-of-life issues should address protective factors against phenomena like CF (Holland & Neimeyer, 2005). Figley (2002) remarks that the cost of caring can have negative consequences, and where CF is experienced there is often a chronic lack of self-care. Self-care can include being aware of indicators that work is taking a toll (Figley, Figley & Norman, 2002). Swetz and colleagues (2009) addressed self-care in hospice and palliative medicine staff due to the potential for burnout. Responses included: exercise, cooking, travel, literature, and religion. Workers cited physical well-being as most useful for protection against burnout (60%), while “time away” and humour were also deemed beneficial (Swetz et al., 2009, p. 776). Killian (2008) examined therapist self-care, finding that increased leisure time and spirituality were reported as vital. Therapists may need to be pro-active in maintaining self-care strategies, as no therapists had received specific training (Killian, 2008). Research on spirituality has also revealed that palliative care workers who regularly utilised it reported lower burnout (Holland & Neimeyer, 2005). McCarroll and colleagues (1993) note how humour can act as a beneficial tension reducer. Disaster workers handling bodies after violent deaths reported that “gallows

humour” was often employed in professional time. Radey and Figley (2007) note, although there is a belief that lessons in self-care will promote a more resilient worker, the research does not fully support this notion. Eastwood and Ecklund (2008) add that while self-care practices can act as a buffer against burnout, they do not directly lessen the risk for CF. The research on funeral directors is limited in Ireland. The above review does indeed utilise research from other human services that may not match the unique duties of funeral directors. However, the American Board of Funeral Service Education does regard the funeral director to be a human service profession, as little time is spent actually working on the deceased, with the majority spent directly with the bereaved (Funeral Director, 2010). Hypotheses Based on the literature review, the proposed hypotheses are: H1: Compassion fatigue. Funeral directors will report high levels of compassion fatigue (both components) (i) burnout (ii) secondary traumatic stress, (compared to a population sample). H2: Gender. Female funeral directors will have significantly higher levels of compassion fatigue compared to males. H3 (i): Compassion satisfaction and burnout. There will be a significant negative correlation between CS and burnout.

Best Submission

COMPASSION FATIGUE IN FUNERAL DIRECTORS H3 (ii): Compassion satisfaction and secondary traumatic stress. There will be a significant negative correlation between CS and STS. H4: Age. There will be a significant negative correlation between burnout and age. H5: Length of service as a funeral director. There will be a significant positive correlation between CF and the number of years working as a funeral director. H6: Social support and compassion fatigue. There will be a significant negative correlation between CF and levels of perceived social support. H7: Social support from friends and length of service. There will be a significant negative correlation between length of service and perceived social support from friends. H8 (i): Training. There will be a significant negative correlation between CF and attendance at death-specific/grief workshops/training. H8 (ii): Training. There will be a significant negative correlation between CF and attendance at self-care workshops/training. Self-Care Strategies A purpose designed question examined perceived usefulness of eight self-care strategies (Exercise, Reading, Religious/ Spiritual Activity, Humour, Watching Television, Travel/Vacations, Socialising, and Nutrition/Healthy Eating). Inferential statistics were not deemed appropriate, therefore results were descriptive and exploratory in nature. Additional responses

that funeral directors stated will also be addressed. Methodology Participants The study specifically examined funeral directors from the Republic of Ireland and Northern Ireland, employing non-probability purposive sampling. Participants (N=60) were recruited using emails from directory listings on rip.ie and iafd.ie. An additional 25 questionnaires were posted to those without an email address. Responses were anonymous, therefore demographic breakdown for the Republic of Ireland and Northern Ireland is unknown. Design A questionnaire-based correlational design was employed to investigate relationships between variables. The study was both quantitative and qualitative in description. The predictor variables were social support, training in self-care, training in grief-specific/bereavement training, length of service, age, and gender. The criterion variable was scores on the Professional Quality of Life Scale (Stamm, 2009). Therefore the criterion variable has three subscales: CS, burnout, and STS. Materials The questionnaire contained five sections. Section one contained a demographic questionnaire which sought age, gender,

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and length of service. Sections two and three incorporated two published questionnaires. Professional Quality of Life Scale (ProQOL) – Version 5 (Stamm, 2009). The most commonly used measurement to assess the positive and negative effects of working with people who have experienced extremely stressful events (Stamm, 2010, p. 12). The current ProQOL-V has 30 items measuring respondents on three discreet scales (CS, Burnout, STS). Participants respond on a 1 (never) to 5 (very often) Likert scale. Scores on each scale are determined by summing the item answers. Low level scores are 22 or less, and high levels are 42 or more. Scores that may highlight a problem are CS below 40, and scores above 57 for burnout and STS. The reliability of the scales are reported by Stamm (2010, p. 28) as: CS (α=.88), Burnout (α=.75), and STS (α=.81). There is good construct validity with support from over 200 published papers (Stamm, 2010). Multidimensional Scale of Perceived Social Support (MSPSS) (Zimet et al., 1988). A 12 item self-report measure designed by Zimet and colleagues (1988). It measures subjective levels of perceived social support. It contains three subscales: significant other (SO), family (FAM), and friends (FRI). Additionally, the measure gives a total subjective score of perceived

social support. Participants rate items on a Likert scale from 1 (very strongly disagree) – 7 (very strongly agree). Total score is determined by the sum of all 12 items. Total scores range from 12 – 84 (12 – 48 = Low Acuity, 49 – 68 = Moderate Acuity, 69 – 84 = High Acuity). The MSPSS has good internal consistency, with a Cronbach’s coefficient alpha of .88 for the total scale. Good internal reliability was found for the subscales; SO (α=.91), FAM (α=.87), and FRI (α=.85). The authors demonstrated adequate test-retest reliability, reporting a Cronbach’s coefficient alpha of .85 (Zimet et al., 1988, p. 36), indicating that the MSPSS is a psychometrically sound instrument. Section four contained two purpose-designed questions seeking information on training in self-care, and training in death-specific/bereavement education: (1) “Please indicate if you have ever completed any form of further training / continuing professional development / workshops etc. around the topic of selfcare”. (2) “Please indicate if you have ever completed any death-specific/bereavement training”. Section five (purpose-designed) investigated the perceived usefulness of self-care practices. The measure consisted of eight strategies, and asked participants to rate each for its benefit in helping them separate their work from their professional life (Exercise, Reading, Religious/Spiritu-

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COMPASSION FATIGUE IN FUNERAL DIRECTORS al Activity, Humour, Watching Television, Travel/Vacations, Socialising, and Nutrition/Healthy Eating). Rating was based on a 5-point Likert-scale system. This section included an optional question on personal self-care. Procedure To acquire the sample (N=60), four hundred surveys were distributed. Funeral directors with emails on rip.ie and iafd. ie were used for online-surveys (n=375). Rip.ie displays death notices and contacts for funeral directors. Iafd.ie is for members of the Irish Association of Funeral Directors (IAFD). Some funeral directors on rip.ie are not IAFD members, therefore this study had a sample of both members and non-members. The online-survey was created using Google Docs. Twenty-five questionnaires were posted where no email address was found. This included a stamped-addressed envelope for return. Of the 400 questionnaires, 54 online-surveys were completed, and 6 postal surveys returned (response rate of 15%). An information sheet outlining the purpose of the study preceded the questionnaire, stating the time taken to complete the survey and that participation was voluntary. A single reminder email was sent six weeks after the initial emailed surveys. To address any concerns, appropriate contacts were provided at the end of the survey. Results

Descriptive Statistics Demographic descriptives Table 1 shows the sample (N=60) consisted of 48 males (80%) and 12 females (20%). The mean age was 51.43 years (SD=10.78). The youngest funeral director was 25 and the oldest 73. The majority (71.7%) were over the age of 46, with only 28.3% under this age. Only 2 participants were between the ages of 18 to 30 years. Regarding length of service, the mean was 22.23 years (SD=12.59), with a range of 2 to 40 years. Most funeral directors had worked for 31 years or more (30%).

Predictor descriptives Predictor variable scores are displayed in Table 2. On the MSPSS (Zimet et al., 1988), participants had a mean of 67.47 (SD=13.58), indicating that this sample of funeral directors perceive moderate levels of social support. The sample perceived high support from all subscale sources, with highest perceived support from family (mean=5.85, SD=1.28), followed by significant others (mean=5.79, SD=1.41),

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with friend support perceived as the lowest (mean=5.22, SD=1.35). Training on death-specific/bereavement education had a mean score of 0.95 days attended (SD=1.35), while the number of days attended at training on selfcare was slightly higher with a mean score of 1.12 (SD=1.47). Analysis revealed that 34 participants (57%) never attended death-specific/bereavement training, and only 2 participants attended five or more. For self-care training, 30 participants (50%) had never attended a workshop, and only 3 participants attended five or more.

Criterion variable descriptives Participant’s total mean scores on the ProQOL-V (Stamm, 2009) are displayed in Table 3. Funeral directors’ mean total score for CS was 43.37 (SD=4.83), indicating that this sample scored in the high level for CS. The minimum score was 30 (average level) and the maximum was 50. The total mean score for burnout was 20.57 (SD=5.03), indicating low levels

of burnout. Low levels of STS were also reported, with a total mean score of 21.07 (SD=5.77). Maximum scores for burnout and STS were 32, indicating that average levels of these components were experienced by some.

Self -care descriptives As this was a self-created measure, it was deemed inappropriate to compute a total score for analyses of the self-care strategies. The scores for each were calculated into mean values, and the results are outlined in a descriptive nature below. Table 4 below shows how funeral directors rated each self-care strategy. Humour was rated as most useful. Socialising, travel/vacations, and watching TV were rated second, third, and fourth most useful respectively. No participants rated humour or socialising as “never useful”. Interestingly, religious/spiritual activity was deemed the least useful, with 22 participants (37%) stating that it was either “never useful” or “rarely useful”.

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COMPASSION FATIGUE IN FUNERAL DIRECTORS

Qualitative question on self-care Twenty-eight participants chose to answer this item (N=60). Responses included, suppression of feelings, fishing, meditation, and gardening. Other novel responses were keeping a journal for reflecting on previous funerals, farming, and using a previous qualification in psychotherapy for help with funeral care. Some funeral directors remarked how child deaths and suicides were more difficult to work with, and how the hours are long. All responses are contained at the end of this paper. Inferential Statistics H1 Compassion fatigue compared to population sample. The comparison study to compare funeral directorsâ&#x20AC;&#x2122; CF levels against is a paper from Thieleman and Cacciatore (2014). The researchers used the same measure to examine CF in a sample of 41 traumatic bereavement volunteers/professionals.

(i) Burnout: The current study had a mean for burnout of 20.57 (SD=5.03) which was higher than the comparison mean of 19.63. A one sample t-test found no significant difference between the means (t (59)= 1.44, p=.154, 95% CI = -.36 and 2.24). (ii) Secondary traumatic stress: The current study had a mean for STS of 21.07 (SD=5.77) which was higher than the research mean of 20.66. A one sample t-test showed no significant difference between the means (t (59)= 0.55, p=.587, 95% CI = -1.08 and 1.90). H2 Gender. An independent samples t-test found no gender differences in burnout (Female M = 20.67 vs. Male M = 20.54, t (58)= -.07, p = .939, 95% CI = -3.40 and 3.15) or STS (Female M = 22.08 vs. Male M = 20.81, t (58)= -.68, p=.50, 95% CI = -5.02 and 2.48). H3 (i) Compassion satisfaction and burnout. The mean scores for CS was 43.37 (SD=4.83) and for burnout was

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20.57 (SD=5.03). A Pearson correlation coefficient found a moderate negative significant relationship between CS and burnout (r (60)= -.484, p < .001). H3 (ii) Compassion satisfaction and secondary traumatic stress. CS (M = 43.37) and STS (M = 21.07) had no significant relationship (r (60) = -.073, p=.578). H4 Age. There were no significant relationships with burnout. H5 Length of service. Pearsonâ&#x20AC;&#x2122;s correlation coefficients found no significant relationships between CF (burnout or STS) and the number of years working as a funeral director. Although not significant, length of service and the STS component of CF may have been approaching significance (p=.054).

H6 Social support. There were no significant relationships with CF (burnout or STS). H7 Social support from friends and length of service. The mean scores for perceived social support from friends was 5.22 (SD=1.35) and for length of service 22.23 (SD=12.59). A Pearson correlation coefficient found a significant weak negative relationship between perceived social support from friends and length of service (r (60)= -.297, p=.021). H8 (i) and H8 (ii) Training. No significant correlations were found between CF (burnout and STS) and (i) training in death-specific/bereavement education or (ii) training in self-care.

Discussion

The goal of this study was to determine if funeral directors are at risk of suffering from CF, and whether social

Key findings

Best Submission

COMPASSION FATIGUE IN FUNERAL DIRECTORS support, training, age, and length of service could lessen any risk. The study also explored self-care. The preceding analysis revealed that funeral directors in this sample are not at risk of suffering CF. Positively, they obtained low scores in burnout and STS. This is in contrast to literature that shows the human services are highly susceptible to these work phenomena through dealing with traumatised populations (Stamm, 2010).

component, results revealing a significant moderate negative relationship (p<.001). It is unclear why CS was only correlated to burnout (H3-i), and not with STS (H3ii). Possibly, high job satisfaction may offset burnout development which is related more to exhaustion and temporal elements (Freudenberger, 1974; Maslach et al., 2001), in contrast to STS which centres around more immediate experiences of witnessing trauma (Stamm, 2010).

Funeral directors had no significant differences in burnout and STS when compared to another population norm (H1). One interpretation for this is that the population comparison (traumatic bereavement volunteers and professionals) spend far more time with the traumatised population compared to funeral directors.

Results did not report a significant negative correlation between burnout and age (H4), suggesting that age is not a risk factor for burnout. This is contradictory to literature arguing that younger workers are at a higher risk for burnout (Tomic et al., 2004). Only two participants were between the ages of 18-30, which may have made it difficult to detect significant results. Although Roberts et al. (2003) found age to be negatively correlated with burnout in a clergy sample, research was conducted after the 9-11 terrorist attacks which may have involved clergy facing much more human contact in the immediate aftermath.

H2 did not show support for gender being a CF risk factor. Despite females having a higher mean score for burnout and STS, differences were not significant. This supports research that states; if gender differences exist - they are relatively low (Maslach & Jackson, 1981, 1985). A surprising finding was the higher than expected female responses (20%), which dispels the notion that females are not capable of dealing with such traumatic work (Cathles et al., 2010). Support for H3 was found for CS being a buffer against CF (Eastwood & Ecklund, 2008), if only for the burnout

A relatively even distribution for length of service existed in the sample. Potter and co-workers (2010) highlighted that the risk for CF may increase with length of service, however no significant negative correlations were discovered (H5). One implication of this is that as many go on to inherit family establish-

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ments (Funeral Director, 2010; Parsons, 1999), length of service should not pose a concern. The finding suggests that those funeral directors serving the longest are no more at risk for CF than those new to the occupation. H6 did not find significant negative correlations between CF and total perceived social support or subscales. This does not support research that perceived social support from family may minimize CF effects (Ariapooran, 2014). However, this sample reported high total mean levels of perceived social support, as well as high levels from significant others, family, and friends. Positively, this highlights that funeral directors feel supported in their lives. One possible reason for no significance is the point on how confidentiality may function as a barrier to social support (LĂ¸vseth & Aasland, 2010). Ethical obligations for some funeral directors may have influenced how they self-reported. This is further underlined by the low response rate (15%). Support was found for H7, which sought a significant negative correlation between length of service and social support from friends. Although a weak correlation, it does suggest that funeral workers in the profession for longer will perceive less support from friends. Family run funeral establishments are common (Funeral Director, 2010; Parsons, 1999), and with the passage of years, close bonds

may be forged with fellow family members. This may result in friends becoming distant or surplus to the support already received from family. Attendance at death-specific/bereavement training (H8â&#x20AC;&#x201C;i) or self-care training (H8â&#x20AC;&#x201C;ii) did not have significant negative correlations with CF. This does not support the view that educational programmes can minimise problems such as perceived death-specific inadequacies (Linklater, 2010; Smith & Hough, 2011), self-care neglect (Figley, 2002), or CF (Meadors & Lamson, 2008; Simpson & Starkey, 2006). The sample was made up from IAFD members and non-members. The IAFD code of practice states that vocational training will be provided to members, to enhance the service they provide (Irish Association of Funeral Directors, n.d.). Training around occupational health hazards such as infectious diseases are addressed with IAFD members (Kelly & Reid, 2011), but it is unclear what training is offered for the occupational mental health hazards. It is therefore unclear in the present study whom the results apply to. Perhaps IAFD members are offered training in death-specific/bereavement and self-care, but this is uncertain. Future studies could undertake an independent groups design examining members and non-members for a detailed insight into the effects of specific training on CF.

Final attention is drawn to the find-

Best Submission

COMPASSION FATIGUE IN FUNERAL DIRECTORS ings on self-care strategies. Funeral directors believed humour to be most useful as a form of self-care. This was a similar strategy reported by disaster workers handling human remains (McCarroll et al., 1993). Socialising, travel/vacations, and watching TV were second, third, and fourth most useful. Exercise and nutrition/ healthy eating were perceived as “very often useful” by 31% and 23% respectively. As many funerals are church related (Parsons, 2003), it was surprising how religious/spiritual activities were deemed least useful. It could be suggested that funeral directors spend much time in this setting and wish to distance themselves from it in their personal life. Twenty-eight replies were received for the optional item on self-care. Responses included exercise, walking, playing golf, fishing, music, arts, and gardening, as well as practical techniques such as journal writing and meditation. This data also provided an insight into two recurring themes. The first was how suicides and the deaths of children were more difficult, stressing the need for self-care maintenance in this occupation. Secondly, many stated how busy the job can be. This could be further compounded by other roles in life, with farming and child minding also reported. Eastwood and Ecklund (2008) stated how self-care practices may function as a buffer against burnout, but not STS. With such low levels reported for both in this sample, it could be argued that

funeral directors’ wide variety of self-care strategies do indeed function to lessen the effects of both in this unique occupation. Limitations and suggestions for future research Additional attention should be drawn to the low sample size, a methodological shortcoming of the present study. This research only examined sixty funeral workers, which equates to 10% of the total reported 600 working in Ireland and Northern Ireland (Irish Hospice Foundation, 2011). The low levels of CF reported here should be interpreted with caution, and may not be an accurate representation of this population of workers. Furthermore, the low sample size may have had an influence on the statistical power. Future research that incorporated a larger sample would not only serve as a better representation of these workers, but may also be beneficial for exploring statistically significant relationships if present. Lastly, a possible future line of research could examine why funeral directors appear to be a very resilient work force. As previously discussed above, this sample had mean scores in the low ranges for CF (burnout and STS). Considering self-care may not necessarily promote a more resilient worker (Radey & Figley, 2007), it could be speculated that this profession may attract those who are naturally resilient individuals. Research that considered a valid measure such as The Connor-Davidson Resilience Scale (CD-RISC) (2003) may

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yield further insights on this profession. Conclusion Although CFâ&#x20AC;&#x2122;s components burnout and STS are the negative sequelae of working in the human services, these funeral directors do not seem to be at risk. Workers scored high in CS suggesting that they derive a great deal of pleasure from their profession. Although CS had no significant correlation with STS, the study suggests it can serve as a buffer against burnout. Gender, age, and length of service are not factors related to the development of CF in these workers. Despite funeral directors having a strongly perceived social support network from significant others, family and friends, the present study indicates that perceived support from friends may decline the longer the individual remains in this profession. This paper did not show any benefits of attending training in grief-specific/bereavement education or self-care training to lessen the risks of CF. However, funeral directors do employ a wide range of personal self-care strategies. Consequently, this may ultimately lessen their need for guidance in how to adequately separate difficult occupational challenges from their personal lives. References Abendroth, M., & Flannery, J. (2006). Predicting the Risk of Compassion Fatigue: A Study of Hospice

Nurses. Journal of Hospice and Palliative Nursing, 8 (6), 346-356. Ariapooran, S. (2014). Compassion Fatigue and Burnout in Iranian Nurses: The role of perceived social support. Iranian Journal of Nursing and Midwifery Research, 19 (3), 279-284. Bolger, N., & Amarel, D. (2007). Effects of Social Support Visibility on Adjustment to Stress: Experimental Evidence. Journal of Personality and Social Psychology, 92 (3), 458-475. Bremborg, A. D. (2006). Professionalization without Dead Bodies: the case of Swedish Funeral Directors. Mortality, 11 (3), 270-285. Bride, B. E. (2004). The Impact of Providing Psychosocial Services to Traumatized Populations. Stress, Trauma, and Crisis, 7 (1), 29-46. Bride, B. E., Radey, M., & Figley, C. R. (2007). Measuring Compassion Fatigue. Clinical Social Work Journal, 35 (3), 155-163. Bruce, S. M., Conaglen, H. M., & Conaglen, J. V. (2005). Burnout in Physicians: A case for Peer-support. Internal Medicine Journal, 35 (5), 272-278. Buchanan, M., Anderson, J. O., Uhlemann, M. R., & Horwitz, E. (2006). Secondary Traumatic Stress: An Investigation of Canadian Mental Health Workers. Traumatology, 12 (4), 272-281. Cathles, A., Harrington, D. E., & Krynski, K. (2010). The Gender Gap in Funeral

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COMPASSION FATIGUE IN FUNERAL DIRECTORS Directors: Burying Women with Ready-to-Embalm Laws? British Journal of Industrial Relations, 48 (4), 688-705. Central Statistics Office (2014). Homicide offences, (CJA01). Cohen, S., & Wills, T. A. (1985). Stress, Social Support, and the Buffering Hypothesis. Psychological Bulletin, 98 (2), 310-357. Cohen-Katz, J., Wiley, S., Capuano, T., Baker, D. M., Deitrick, L., & Shapiro, S. (2005). The Effects of Mindfulness-based Stress Reduction on Nurse Stress and Burnout. Holistic Nursing Practice, 19 (2), 78-86. Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor Davidson Resilience Scale (CD-RISC). Depression & Anxiety, 18 (2), 76-82. Dahlem, N. W., Zimet, G. D., & Walker, R. R. (1991). The Multidimensional Scale of Perceived Social Support: A confirmation study. Journal of Clinical Psychology, 47 (6), 756-761. Eastwood, C. D., & Ecklund, K. (2008). Compassion Fatigue Risk and SelfCare Practices Among Residential Treatment Center Childcare Workers. Residential Treatment for Children & Youth, 25 (2), 103-122. Emke, I. (2002). Why the Sad Face? Secularization and the changing function of Funerals in Newfoundland. Mortality, 7 (3), 269-284.

Figley, C. R., Figley, K. R., & Norman, J. (2002). Tuesday Morning September 11, 2001: The Green Cross Projectsâ&#x20AC;&#x2122; Role as a Case Study in Community-based Traumatology Services. Journal of Trauma Practice, 1 (3/4), 13-36. Figley, C. R. (1995). Compassion fatigue: Coping with Secondary Traumatic Stress Disorder in those who treat the Traumatized. New York: Brunner-Mazel. Figley, C. R. (2002). Compassion Fatigue: Psychotherapistsâ&#x20AC;&#x2122; Chronic Lack of Self-care [SUP1].Journal of Clinical Psychology 58 (11), 1433-1441. Figley, C. R., & Figley, K. R. (2009). Stemming the Tide of Trauma Systematically: The Role of Family Therapy. The Australian and New Zealand Journal of Family Therapy, 30 (3), 173-183. Freudenberger, H. J. (1974). Staff BurnOut. Journal of Social Issues, 30 (1), 159-165. Funeral Director. (2010). Techniques, 85 (8), 58. Harrawood, L. K., White L. J., & Benshoff, J. J. (2008). Death Anxiety in a national sample of United States Funeral Directors and its relationship with Death Exposure, Age, and Sex. Omega: Journal of Death and Dying, 58 (2), 131-148.

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Holland, J. M., & Neimeyer, R. A. (2005). Reducing the risk of Burnout in Endof-life Care settings: The role of daily spiritual experiences and training. Palliative and Supportive Care, 3 (3), 173-181. Holloway, M., Adamson, S., Argyrou, V., Draper, P., & Mariau, D. (2013). “Funerals aren’t nice but it couldn’t have been nicer”. The makings of a good funeral. Mortality, 18 (1), 30-53. Hyland, L., & Morse, J. M. (1995). Orchestrating Comfort: The Role of Funeral Directors. Death Studies, 19 (5), 453-474. Irish Association of Funeral Directors (n.d.). IAFD code of practice. Dublin, Ireland. Irish Hospice Foundation. (2011, April). The funeral industry in Ireland: The Case for Reform and Regulation. R Joinson, C. (1992). Coping with Compassion Fatigue. Nursing, 22 (4), 118121. Kadambi, M. A., & Truscott, D. (2003). Vicarious Traumatization and Burnout Among Therapists Working with Sex Offenders. Traumatology, 9 (4), 216-230.

Kelly, N., & Reid, A. (2011). A Health and Safety Survey of Irish Funeral Industry Workers. Occupational Medicine, 61 (8), 570-575. Kephart, W. M. (1950). Status after Death. American Sociological Review, 15, 635–643. Kiernan, J. (2014, August 23). Dead end jobs. Irish Independent [Weekend], 16-19. Killian, K. D. (2008). Helping Till It Hurts? A Multimethod Study of Compassion Fatigue, Burnout, and Self-Care in Clinicians Working With Trauma Survivors. Traumatology, 14 (2), 32-44. Linklater, G. T. (2010). Educational Needs of Foundation Doctors Caring for Dying Patients. Journal of the Royal College of Physicians of Edinburgh, 40 (1), 13-18. Linley, P. A., & Joseph, S. (2005). Positive and Negative Changes Following Occupational Death Exposure. Journal of Traumatic Stress, 18 (6), 751758.

Kearl, M. C. (1997). Last Rites: The Work of the Modern Funeral Director. American Journal of S o c i o l o g y, 102 (4), 1210-1212.

Løvseth, L. T., & Aasland, O. G. (2010). Confidentiality as a Barrier to Social Support: A Cross Sectional Study of Norwegian Emergency and Human Service Workers. International Journal of Stress Management, 17 (3), 214-231.

Kearney, B. Y., & Fleischer, B. J. (1979). Development of an Instrument to measure Self-care Agency. Research in Nursing and Health, 2 (1), 25-34.

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COMPASSION FATIGUE IN FUNERAL DIRECTORS Maslach, C., & Goldberg, J. (1998). Prevention of Burnout: New Perspectives. Applied and Preventative Psychology, 7 (1), 63-74. Maslach, C., & Jackson, S. E. (1981). The Measurement of Experienced Burnout. Journal of Occupational Behaviour, 2 (2), 99-113. Maslach, C., & Jackson, S. E. (1985). The Role of Sex and Family Variables in Burnout. Sex Roles, 12 (7-8), 837851. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job Burnout. Annual Review of Psychology, 52, 397-422. McCann, I. L., & Pearlman, L. A. (1990). Vicarious Traumatization: A Framework for Understanding the Psychological Effects of Working with Victims. Journal of Traumatic Stress, 3 (1), 131-149. McCarroll, J. E., Ursano, R. J., Wright, K. M., & Fullerton, C. S. (1993). Handling Bodies After Violent Death: Strategies for Coping. American Journal of Orthopsychiatry, 63 (2), 209-214. Meadors, P., & Lamson, A. (2008). Compassion Fatigue and Secondary Traumatization: Provider Self-care on Intensive Care Units for Children. Journal of Pediatric Healthcare, 22 (1), 24-34. Merriam-Webster Online (n.d). Compassion.

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Oâ&#x20AC;&#x2122;Keefe, C. (2014, April 11). Rate of homicide among highest in Europe. Irish Examiner. Parsons, B. (1999). Yesterday, Today and Tomorrow. The Lifecycle of the UK Funeral Industry. Mortality, 4 (2), 127-145. Parsons, B. (2003). Conflict in the Context of Care: An Examination of Role Conflict between the Bereaved and the Funeral Director in the UK. Mortality, 8 (1), 67-87. Pearlman, L. A., & Saakvitne, K. W. (1995). Treating Therapists with Vicarious Traumatization and Secondary Traumatic Stress Disorders. In C. R. Figley (Ed.), Compassion fatigue: Coping with Secondary Traumatic Stress Disorder in those who treat the Traumatized (pp. 150-177). New York: Brunner-Mazel. Perkins, E. B., & Sprang, G. (2013). Results from the Pro-QOL-IV for Substance Abuse Counselors Working With Offenders. International Journal of Mental Health Addiction, 11 (2), 199-213. Potter, P., Deshields, T., Divanbeigi, J., Berger, J., Cipriano, D., Norris, L., & Olsen, S. (2010). Compassion Fatigue and Burnout: Prevalence Among Oncology Nurses. Clinical Journal of Oncology Nursing, 14 (5), E56-E62. Radey, M., & Figley, C. R. (2007). The Social Psychology of Compassion. Clinical Social Work Journal, 35 (3), 207-214.

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Ray, S., Wong, C., White, D., & Heaslip, K. (2013). Compassion Satisfaction, Compassion Fatigue, Work Life Conditions, and Burnout Among Frontline Mental Health Care Professionals. Traumatology, 19 (4), 255267. Regehr, C., Goldberg, G., & Hughes, J. (2002). Exposure to Human Tragedy, Empathy, and Trauma in Ambulance Paramedics. American Journal of Orthopsychiatry, 72 (4), 505-513. Roberts, S. B., Flannelly, K. J., Weaver, A. J., & Figley, C. R. (2003). Compassion Fatigue Among Chaplains, Clergy, and Other Respondents After September 11th. The Journal of Nervous and Mental Disease, 191 (11), 756-758. Sarason, I. G., Levine, H. M., Basham, R. B., & Sarason, B. R. (1983). Assessing Social Support: The Social Support Questionnaire. Journal of Personality and Social Psychology, 44 (1), 127 -139. Schafer, C. (2012). Corpses, Conflict and Insignificance? A Critical Analysis of Post-mortem Practices. Mortality, 17 (4), 305-321. Sexton, L. (1999). Vicarious Traumatisation of Counsellors and Effects on their Workplaces. British Journal of Guidance & Counselling, 27 (3), 393403. Simpson, L. R., & Starkey, D. S. (2006). Secondary Traumatic Stress, Compassion Fatigue, and C o u n s e l o r Spirituality: Implications for Counsel-

ors working with Trauma. VISTAS 2006 Online Library. Smith, L., & Hough, C. L. (2011). Using Death Rounds to Improve End-of-life Education for Internal M e d i c i n e Residents. Journal of Palliative Medicine, 14 (1), 55-58. Sprang, G., Clark, J. J., & Whitt-Woosley, A. (2007). Compassion Fatigue, Compassion Satisfaction, And Burnout: Factors Impacting A Professionalâ&#x20AC;&#x2122;s Quality of Life. Journal of Loss and Trauma, 12 (3), 259-280. Stamm, B. H. (2009). Professional Quality of Life: Compassion Satisfaction and Fatigue. Version 5 (ProQOL). Stamm, B. H. (2010). The Concise ProQOL Manual (2nd ed.). Pocatello, ID: ProQOL.org. Stamm, B. H. (2012). Helping the helpers: Compassion Satisfaction and Compassion Fatigue in Self-care, Management, and Policy. In A. D. Kirkwood & B. H. Stamm, Resources for Community Suicide Prevention. [CD]. Meridian and Pocatello, ID: Idaho State University. Swetz, K. M., Harrington, S. E., Matsuyama, R. K., Shanafelt, T. D., & Lyckholm, L. J. (2009). Strategies for Avoiding Burnout in Hospice and Palliative Medicine: Peer Advice for Physicians on Achieving Longevity and Fulfillment. Journal of Palliative Medicine, 12 (9), 773-777.

Best Submission COMPASSION FATIGUE IN FUNERAL DIRECTORS Thieleman, K., & Cacciatore, J. (2014). Witness to Suffering: Mindfulness and Compassion Satisfaction among Traumatic Bereavement Volunteers and Professionals. Social Work, 59 (1), 34-41. Tomic, W., Tomic, D. M., & Evers, W. J. (2004). A Question of Burnout among Reformed Church Ministers in the Netherlands. Mental Health, Religion & Culture, 7 (3), 225-247. Van Beck, T. (2013, August). The Blessings and Curses of Being a Funeral Director – Part IV. Canadian funeral news, 41 (8), 10-12. Retrieved from Yoder, E. A. (2010). Compassion Fatigue in Nurses. Applied Nursing Research, 23 (4), 191-197. Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52 (1), 30-41. Leshem, R & Glicksohn, J. (2007). The construct of impulsivity revisited. Personality and Individual Differences, 43(4), 681-691. Littlefield, A.K., Sher, K.J., & Wood, P.K. (2009). Is ‘maturing out’ of problematic alcohol involvement related to personality change? Journal of Abnormal Psychology, 118, 360-374.

Empirical Investigations

Student Psychology Journal of Ireland, 2015, 25-43

Ambivalent sexism and perceptions of rape in an Irish undergraduate sample Claire Brennan

Supervisor: Dr. Michael Gormley

Trinity College Dublin

Correspondence: csbrenna@tcd.ie

abstract

This study aimed to investigate the role of ambivalent sexism, type of rape, gender and pornography use in attributions of blame towards rape victims. 157 Irish undergraduate students aged 18-24 read either a scenario in which a woman was raped by a stranger, an acquaintance or someone she had formed a friendship with online. A victim blame measure was completed along with a measure of frequency of pornography use and the Ambivalent Sexism Inventory. Hostile sexism, benevolent sexism and victim blame scores were relatively low. Hierarchical regression analyses revealed that only hostile sexism and type of rape had a significant relationship with victim blame. Acquaintance rape victims were blamed significantly more than online and stranger rape victims. Online rape victims were blamed marginally more than stranger rape victims. No moderating effects were detected. The results suggest that Irish undergraduate students incorporate rape myths into their attributions of blame. Benevolent sexism, gender and pornography use do not play a role in victim blame for these students. Irish undergraduate students may possess less sexist attitudes but still require education to dispel rape myths. Introduction Rape is a serious issue which affects many individuals, both male and female. In Ireland, Section 2 of the Criminal Law (Rape) Act (1981) states that a man commits rape if â&#x20AC;&#x153;he has unlawful sexu-

al intercourse with a woman who at the time of the intercourse does not consent to it, and at that time he knows that she does not consent to the intercourse or he is reckless as to whether she does or does not consent to it.â&#x20AC;? According to this definition rape can only be committed by a

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man against a woman. However, Section 4 of the Criminal Law (Rape) (Amendment) Act (1990) defines a gender neutral form of rape as “a sexual assault that includes penetration (however slight) of the anus or mouth by the penis, or penetration (however slight) of the vagina by any object held or manipulated by another person.” In recent times, universities in the UK and Ireland have begun to place particular focus on understanding students’ experiences of sexual violence. A report by the Union of Students in Ireland (2013) found that 5% of female respondents had been the victim of rape with an additional 3% being the victim of attempted rape, while less than 1% of male respondents had been the victim of rape or attempted rape. A similar report by the UK’s National Union of Students (2010) only assessed female students’ experiences of unwanted sexual contact and found that 7% of respondents had been the victim of “serious sexual assault,” defined as “rape, attempted rape or assault by penetration.” Both reports found that in the majority of cases the perpetrator was known to the victim. Female respondents in Ireland were less likely to report serious sexual assault to the authorities (UK = 10%; Ireland = 2%) due to feelings of shame or embarrassment (UK = 50%; Ireland = 21%), and fearing that they would be blamed for what happened (UK = 43%; Ireland = 22%). It is evident from these

reports that the effects of negative social perceptions of rape, such as blaming the victim, are felt among university students in the UK and Ireland and can prevent victims from reporting their experiences and seeking the support they need. The current research seeks to understand Irish undergraduate students’ perceptions of rape by examining whether sexist attitudes and pornography use influence the way in which they attribute blame to the victims of different types of rape. The sex role socialisation analysis of rape (Burt, 1980) is a theory which has received much attention in research examining perceptions of rape and victim blame. This theory proposes that men and women’s gender role behaviours and attitudes develop according to societal norms of what is considered appropriate for their gender, with men being sexually dominant and women being resistant of sexual advances. These norms are adopted into traditional gender role schemas which influence how information about sexual interactions is processed, such that acquaintance rape is more likely than stranger rape to be perceived as an extreme extension of traditional heterosexual interaction (Burt, 1980). Furthermore, Burt (1980) suggests that traditional gender role attitudes promote the acceptance of cultural beliefs known as rape myths. Rape myths have been defined as “attitudes and beliefs that are generally false but are widely and persistently held, and

Empirical Investigations

AMBIVALENT SEXISM AND PERCEPTIONS OF RAPE that serve to deny and justify male sexual aggression against women” (Lonsway & Fitzgerald, 1994, p. 134). Examples of rape myths include the belief that the victim “asked” for it or enjoyed being raped and that it wasn’t really rape (Payne, Lonsway & Fitzgerald, 1999). Rape myth acceptance has generally been found to be related to a higher level of victim blame (Grub & Turner, 2012; Hammond, Berry & Rodriguez, 2011). Several studies have provided evidence for the sex role socialisation analysis of rape by indicating that traditional gender role attitudes and rape myths were more likely to be applied to acquaintance rape than stranger rape, resulting in a higher degree of blame and minimisation of the seriousness of the situation for these victims (Ben-David & Schneider, 2005; Bridges & McGrail, 1989; Bridges, 1991; Check & Malamuth, 1983; Simonson & Subich, 1999). These studies highlight the contribution of gender role attitudes to understanding why some individuals are more likely than others to attribute blame to rape victims, especially acquaintance rape victims. Research examining gender differences in victim blame have been inconsistent, with some studies showing that men are more likely to blame the victim than women and others finding no significant gender differences (Grub & Turner, 2012). It has been suggested that gender role attitude rather than gender is a better predictor of vic-

tim blame (Angelone, Mitchell & Lucent, 2012). The research which has been discussed thus far in support of the sex role socialisation analysis of rape has conceptualised gender role traditionality as a purely negative attitude towards women. However, it has more recently been proposed that traditional or sexist attitudes may also be comprised of seemingly positive attitudes towards women. Glick and Fiske (1996) propose a theory of ambivalent sexism in an attempt to explain the ways in which sexism is manifested in contemporary society. Ambivalent sexism is made up of two separate but related aspects. Firstly, hostile sexism (HS) is akin to the traditional conception of sexism as it is characterised by negative attitudes towards women. An example of a hostile sexist belief is that women exaggerate their problems and seek to control men. In contrast, benevolent sexism (BS) is characterised by subjectively positive attitudes towards women which often give rise to pro-social and intimacy-seeking behaviours and which are therefore less likely to be confronted by society. An example of a benevolent sexist belief is that women should be cherished and protected by men (Glick & Fiske, 1996). A cross-cultural study involving 15000 participants across 19 nations provides strong evidence for the co-existence of HS and BS (Glick et al., 2000). While this study found HS and BS to be moderate-

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ly positively correlated, Glick and Fiske (1996) maintain that HS and BS work together to justify male dominance over women. Following on from research investigating the role of traditional gender role attitudes in victim blame, the potential relationship between ambivalent sexism and victim blame has been examined. A study by Abrams, Viki, Boehner and Masser (2003) assessed the ability of BS to explain differences in victim blame for acquaintance rape victims compared to stranger rape victims. This hypothesis was based on research which has found that women who have consumed alcohol (Sims, Noel & Maisto, 2007) and who are dressed provocatively (Whatley, 2005) are blamed more for their rape. These women may be categorised as “bad” by benevolent sexists as they have violated the traditional gender norms which these individuals so highly value. The classification of women into “good” and “bad” categories by benevolent sexists functions to justify aggressive behaviour towards some (“bad”) women while condemning such behaviour towards other (“good”) women. In an acquaintance rape scenario benevolent sexists consider the woman to be violating their expectations of purity and sexual morality as they believe she has put herself in a situation where consent for sex is implied. Therefore this victim will be blamed more by benevolent sexists.

Abrams and associates (2003) found support for this hypothesis as after reading an acquaintance rape scenario, individuals high in BS, but not HS, were more likely to attribute blame to this victim compared to those low in BS. BS was not related to victim blame after reading a stranger rape scenario. Similarly, Yamawaki (2007) found that BS and gender-role traditionality, measured using the Sex Role Egalitarianism Scale, had the same moderating effect. The hypothesis of Abrams and associates (2003) is strengthened by the research of Viki and Abrams (2002) who found that individuals high in BS blamed an acquaintance rape victim who was depicted as a married mother significantly more than an acquaintance rape victim for whom no personal information was provided, compared to individuals low in BS. The married mother victim is violating benevolent sexist expectations by putting herself in a situation which could be interpreted as cheating on her husband and is therefore blamed more. Furthermore, Viki, Abrams and Masser (2004) found that compared to those low in BS, individuals high in BS attributed significantly less blame and assigned shorter sentences to the perpetrator of an acquaintance rape but not a stranger rape, suggesting that BS excuse the actions of the perpetrator when gender norms are violated by the victim. In contrast HS has been found to be related to rape proclivity towards an acquaintance rape victim, as acceptance

Empirical Investigations

AMBIVALENT SEXISM AND PERCEPTIONS OF RAPE of HS functions to justify the sexual aggression of these individuals (Abrams et al., 2003). The previously discussed studies did not consider the role of pornography use in victim blame. Pornography use is extremely common among university students. A survey of 817 students in the United States demonstrated that 67% of men and 49% of women felt that viewing pornography is an appropriate means of expressing sexuality (Carroll et al., 2008). This survey also revealed that 87% of men and 31% of women reported viewing pornography in the last year, with 5.2% of males viewing pornography every day or almost every day compared to 0.2% of women. To the researchers knowledge no such statistics are available for Irish university students. Pornography often depicts dehumanising and aggressive acts towards women and concern has been raised over the effects this may have on attitudes towards sexual aggression. Indeed several studies have found a link between pornography exposure and acceptance of aggression towards women and rape myths (Foubert, Brosi & Bannon, 2011; Hald, Malamuth & Yuen, 2010; Malamuth & Check, 1985;). Milburn, Maher and Conrad (2000) found that male participants who viewed a sexually degrading movie scene were more likely than control participants to believe that the victim of a date rape enjoyed the rape and had been asking

for it compared to a stranger rape victim. They explain this finding in terms of the sex role socialisation analysis of rape. Viewing gender-stereotypic pornography makes gender role schema more accessible and these schema are more likely to be applied to acquaintance rape as it is an extension of traditional heterosexual interaction. The current study is based on the work of Abrams and associates (2003) and aims to explore the factors which influence the way in which Irish undergraduate students attribute blame to victims of different types of rape. Due to the lack of research into the perceptions of rape committed by individuals who have become acquainted with their victim online, participants will read a scenario depicting either this event or the acquaintance or stranger rape scenarios utilised by Abrams and associates (2003) before victim blame is assessed. HS and BS will be measured using the Ambivalent Sexism Inventory (Glick & Fiske, 1996). In addition, frequency of pornography use will be measured as this was not included in the research by Abrams and associates (2003). The current study hypothesises that acquaintance rape victims will be attributed the most blame, with online rape victims being similarly blamed and stranger rape victims being blamed the least, and that higher HS, BS and pornography use will be related to higher victim blame scores overall. The current study

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also hypothesises that BS, but not HS, will moderate the relationship between victim blame and type of rape such that participants high in BS will blame the acquaintance and online rape victims, but not the stranger rape victim, significantly more than those low in BS. Method Design This study used a between-groups design with participants being randomly assigned to one of three groups. Each group was required to read a scenario in which a female was raped by a male perpetrator. The scenarios differed in terms of type of rape, with the scenario depicting either rape by a stranger, by an acquaintance or by an individual whom the victim had met online. The extent to which the participants in each group blamed the victim for the event was assessed. Hostile sexism, benevolent sexism and frequency of pornography viewing were also measured as independent predictor variables of victim blame. Participants A total of 157 (73 male, 84 female) undergraduate students from universities around Ireland participated in this study. Participation was entirely voluntary. All participants were between 18 and 24 years of age and were recruited via a link shared on www.facebook.com. Participants were randomly assigned to the stranger, ac-

quaintance or online scenario, with 47 (18 male, 29 female) participants assigned to the stranger scenario, 53 (25 male, 28 female) participants assigned to the acquaintance scenario and 57 (30 male, 27 female) participants assigned to the online scenario. The uneven number of participants across the three scenarios, as well as the uneven distribution of males and females, is due to the nature of the randomisation feature of the survey website used, which resulted in a truly random distribution of participants rather than a pseudo-random distribution. Materials Scenarios: The scenarios used in this study are short paragraphs adapted from Abrams and associates (2003), with the stranger and acquaintance scenarios being taken directly from this study. The online scenario was created specifically for the current research but is based on those used in Abrams and associates (2003). In the stranger scenario a woman is walking home alone when she is approached by a man who attacks her in an unlit part of the street. In the acquaintance scenario a woman invites a man home from a party. In the online scenario a woman and man who have become acquainted in an online music forum meet in a public park. In each scenario the female clearly asks the male to desist his sexual advances. The male ignores this and completes intercourse. The word rape is not used in any of the scenarios in order to avoid confounding

Empirical Investigations

AMBIVALENT SEXISM AND PERCEPTIONS OF RAPE the results by influencing the participants’ perception of the situation. Victim Blame Measure: This measure is adapted from Abrams and associates (2003). It consists of seven items assessing the extent to which participants attributed blame to the victim of the scenario read. Sample items are “How much do you think the woman should blame herself for what happened?” and “How much sympathy do you feel for the woman?” In order to assess victim blame in response to the online scenario Item 4 of this measure is modified slightly. All items were responded to on a 7-point Likert scale from 1 (none/not at all) to 7 (completely/total). A Cronbach’s α of .75 was reported for this measure. Scores are averaged to provide a victim blame score. Ambivalent Sexism Inventory: This measure was developed by Glick and Fiske (1996). It is a 22-item measure with two 11-item subscales measuring HS and BS. A sample item from the HS subscale is “Most women interpret innocent remarks or acts as being sexist,” and from the BS subscale “Men are incomplete without women.” Each item is responded to on a 6-point Likert scale from 0 (disagree strongly) to 5 (agree strongly). The reported reliability for BS, HS and total ASI were 0.89, 0.81, and 0.90 respectively (Glick & Fiske, 1996). Scores on each subscale are averaged to provide a BS and HS score.

Pornography: This measure is taken from Carroll and associates (2008) and consists of one item assessing frequency of pornography consumption. It is responded to on a 6-point Likert scale ranging from 0 (none) to 5 (every day or almost every day). Procedure Participants received a link to the online survey. Information regarding the aims of the study was presented to participants and due to the nature of the research participants were warned that the scenarios may depict sexual coercion which may make some individuals uncomfortable. Participants were made aware that they were free to withdraw their participation at any time and full consent was necessary for participation. Participants were first required to provide demographic information including age and sex before completing the pornography measure. Following this, participants were presented with one of three scenarios and were instructed to read it carefully. After reading the scenario participants were instructed to complete the victim blame measure, with title omitted. Finally, participants were instructed to respond to the ASI, with title omitted. Upon completion of the survey participants were presented with debriefing information. Results Descriptive Statistics

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Results indicated that the acquaintance scenario had the highest mean victim blame score (M = 2.44, SD = 0.81), followed by the online scenario (M = 1.96, SD = 0.62) and the stranger scenario (M = 1.88, SD = 0.57). Mean male and female victim blame scores for the different types of rape are provided in Table 1. Gender differences in mean scores for BS,

HS, pornography use and victim blame are provided in Table 2. Table 3 provides mean HS, BS and pornography use scores across the three different scenarios. The acquaintance group had the highest mean BS score while the online group had the highest mean HS and pornography use scores. Overall, BS, HS and pornography use scores were relatively low.

Hierarchical Regression Analyses Multiple hierarchical regression analyses were carried out to determine the effects of BS, HS, type of rape, gender and pornography use on victim blame. HS, BS and pornography were centred prior to analysis as this reduced the variance inflation factors to an acceptable level and reduced problems with multicollinearity associated with the introduction of an interaction term (Aiken & West, 1991). It

was necessary to run all regression models twice due to the nature of the scenario variable which was categorical and consisted of three levels: stranger, acquaintance and online. For the first set of analyses two dummy variables were created with the acquaintance scenario being the reference group, allowing a comparison of the stranger and online scenarios with the acquaintance scenario. These dummy variables will be referred to as stranger and

Empirical Investigations

AMBIVALENT SEXISM AND PERCEPTIONS OF RAPE online. For the second set of analyses another pair of dummy variables was created with the online scenario being the reference group, allowing a comparison of the stranger and acquaintance scenarios with the online scenario. These variables will be referred to as stranger1 and acquain-

tance

Hierarchical regression of the effects of BS and type of rape on victim blame.

F(3, 153) = 10.899, p < .001. Stranger and online displayed significant negative relationships with victim blame, indicating that individuals who read the stranger and online scenarios attributed less blame to the victim compared to those who read the acquaintance scenario. BS had a significant positive relationship with victim blame indicating that higher BS scores were associated with higher victim blame scores (see Table 5). The addition of the interaction terms in Step 2 did not significantly improve prediction of victim blame, R-square change = .002, F change (2, 151) = .213, p = .808. The interaction terms were not significant, suggesting that

Previous research has suggested that BS moderates the relationship between type of rape and victim blame (Abrams et al., 2003). To examine this hypothesis a hierarchical regression was performed. BS, stranger and online were entered in Step 1 to analyse the main effects of BS and type of rape on victim blame. The interaction terms BS X Stranger and BS X Online were entered in Step 2 to test for a moderating effect of BS. Step 1 was significant and explained 17.6% of the variance in victim blame, R square = .176,

Correlations The Pearson correlation coefficients among all variables included in the study are presented in Table 4.

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BS does not moderate the relationship between type of rape and victim blame. Furthermore, BS no longer had a significant main effect on victim blame. This regression was repeated using the stranger1 and acquaintance dummy variables. The same

pattern of results was obtained (see Table 6). The acquaintance group scored significantly higher on victim-blame than the online group but there was no significant difference between the stranger and online group.

Hierarchical regression of the effects of BS, HS, type of rape, gender and pornography on victim-blame. A second hierarchical regression analysis containing all of the predictor variables (BS, HS, type of rape, gender and pornography) was subsequently performed. Following the example of Abrams and associates (2003) main effects were assessed before interaction effects, with BS, HS,

stranger and online being entered in Step 1. Gender and pornography use were entered in Step 2. Gender was entered at this stage due to the inconsistency of previous research evaluating its relationship with victim blame (Grubb & Turner, 2012). Pornography use was entered at this stage as it is a new variable of interest. In Step 3 the interaction terms Stranger X BS, Online X BS, Stranger x HS, Online x HS and

Empirical Investigations

AMBIVALENT SEXISM AND PERCEPTIONS OF RAPE HS X BS were entered. The interaction terms Pornography X Stranger and Pornography X Online were entered in Step 4 as previous research suggested exposure to sexually explicit material moderated the relationship between victim blame and type of rape (Milburn et al., 2000). Results indicated that the model specified in Step 1 was the preferred model as it significantly explained 23.4% of the variance in victim blame, R square = .234, F(4, 152) = 11.617, p < .001. Again, stranger and online had significant negative relationships with victim blame. HS had a significant positive relationship

Results Summary Descriptive statistics indicated that acquaintance rape victim was attributed the most blame, followed by the online victim and finally the stranger rape victim. An initial hierarchical regression replicat-

with victim blame suggesting that higher HS scores were associated with higher victim-blame scores overall. BS was not a significant predictor of victim blame (see Table 7). Steps 2, 3 and 4 did not significantly improve prediction of victim blame. For Step 2 R square change = .011, F change (2, 150) = 1.109, p = .333. For Step 3 R square change = .042, F change (5, 145) = 1.695, p = .139. For Step 4 R square change = .006, F change (2, 143) = .584, p = .559. This regression was repeated using the stranger1 and acquaintance variables. The same pattern of results was obtained (see Table 8).

ed this result and found that higher BS was associated with higher victim blame scores. However, the introduction of the interaction terms did not find evidence that BS moderates the relationship between type of rape and victim blame and BS no

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longer had a significant main effect on victim blame. A second hierarchical regression analysis containing all of the predictor variables (BS, HS, type of rape, gender and pornography) found that BS was not a significant predictor of victim blame. Instead, higher HS scores were associated with higher victim-blame scores overall. Discussion The aim of this study was to explore whether sexism, pornography use and gender influence Irish undergraduate students’ perceptions of different types of rape. The study hypothesised that acquaintance rape victims would be blamed most, followed by online rape victims and finally stranger rape victims, and individuals with higher HS, BS and pornography use scores would be more likely to blame victims of rape in general. The current study also hypothesised that BS, but not HS, would moderate the relationship between victim blame and type of rape such that participants high in BS would blame the acquaintance and online rape victims, but not the stranger rape victim, significantly more than those low in BS. The first hypothesis was supported. The acquaintance rape victim was blamed significantly more than the stranger rape victim. This finding is consistent with previous research (Abrams et al., 2003; Ben-David & Schneider, 2005; Bridges & McGrail, 1989; Bridges, 1991; Check

& Malamuth, 1983; Simonson & Subich, 1999; Yamawaki, 2007). The acquaintance rape victim was also blamed significantly more than the online rape victim. There was no significant difference in victim blame for the stranger rape victim compared to the online rape victim. However, the mean victim blame score for the online rape victim was higher and was therefore in the expected direction. These findings suggest that Irish undergraduate students react more negatively to the victims of acquaintance rape compared to those who are raped by somebody they have become acquainted with online and those who are raped by a stranger. Furthermore, this study is the first piece of research to the researcher’s knowledge to examine perceptions of victims of rape by someone whom they have become acquainted with online. Little is known about these types of rapes as most research has focused on sexual predators’ use of the internet to sexually victimise adolescents (Briggs, Simon & Simonson, 2011) or on adult’s use of the internet specifically to find sexual partners, mostly using online dating services (Daneback, Mansson & Ross, 2007; Quin & Forsyth, 2005). However, the victim and perpetrator in the current research were not depicted as using the internet for these purposes and instead were portrayed as developing a friendship over time after meeting on a chat room targeted at music fans. The media in Ireland has recently drawn attention

Empirical Investigations

AMBIVALENT SEXISM AND PERCEPTIONS OF RAPE to situations in which women have been raped and murdered after meeting with someone whom they had met online. Doring (2009) warned that media accounts of such incidents may be contributing to the rape myth that these women in some way deserve to be raped because they behaved carelessly. The marginal increase in blame of the online rape victim compared to the stranger rape victim is consistent with this warning. The findings provided mixed support for the remaining hypotheses. There was no significant main effect of BS and it did not moderate the relationship between type of rape and victim blame. However, there was a significant main effect of HS such that individuals high in HS attributed more blame to the victim, irrespective of type of rape. There are several possible explanations for these findings. The basis of the hypothesis that BS would moderate the relationship between type of rape and victim blame was that individuals who are more concerned with preserving traditional gender norms would be more likely to blame the victim of an acquaintance or online rape because they violated these norms (Viki & Abrams, 2002). Indeed, in addition to finding a moderating effect of BS, Abrams and associates (2003) found that the relationship between BS and victim blame was mediated by the perceived gender-appropriateness of the victim’s behaviour. However, this study was conducted over ten years ago in the UK.

The failure to detect a significant main or moderating effect of BS in the current research may be due to the nature of the sample. Mean BS, HS and victim blame scores were all relatively low. These low scores may reflect the more progressive and egalitarian attitudes of well-educated undergraduate students in Ireland today. The experience of attending university has been found to increase egalitarian attitudes (Bryant, 2003) and the Union of Students in Ireland is mandated to campaign as a pro-choice organisation, reflecting the declining importance of traditional gender roles among students (USI Equality Campaign, 2012). As a result, the violation of gender norms by the acquaintance and online rape victims may have been less salient to participants and therefore BS did not predict or moderate victim blame. These findings suggest that the sex role socialisation analysis of rape (Burt, 1980) may not be applicable in the modern Irish context. The significant main effect of HS may be understood by considering the statements which are endorsed by hostile sexists. For example, HS incorporates the belief that “Many women get a kick out of teasing men by seeming sexually available and then refusing male sexual advances” (Glick & Fiske, 1996). Individuals high in HS may hold the victim responsible for her rape because they view the victim as leading the perpetrator on in some way and therefore consider the victim to be

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deserving of rape. These individuals may also sympathise more with the perpetrator because he was â&#x20AC;&#x153;trickedâ&#x20AC;? or manipulated by the victim. Previous research has found that HS is related to increased rape proclivity among males and is theorised to act as a means of rationalising this behaviour (Abrams et al., 2003). HS is also related to the minimisation of rape (Yamawaki, 2007). It is therefore possible that individuals high in HS who rationalise and minimise the behaviour of rapists may also blame the victim more while excusing the perpetrator. Gender was not found to have a significant relationship with victim blame. Research into gender differences in victim blame has been inconsistent but this finding is in line with several studies which have also found that gender is not a predictor of victim blame (Abrams et al., 2003; Viki & Abrams, 2002; Viki et al., 2004; Yamawaki, 2007). The hypothesis that frequent pornography use would be associated with greater victim blame and moderate the relationship between type of rape and victim blame was not supported. The mean pornography use scores were quite low overall, particularly for women. It may be that the participants do not use pornography at a frequent enough rate for their perceptions of rape to be influenced by pornographyâ&#x20AC;&#x2122;s portrayals of sexual interactions which are often degrading and aggressive towards women as well as being gender-stereotypic.

Limitations and future research There are several limitations to this study. Firstly, as noted in the original research by Abrams and associates (2003), the scenarios may have influenced the results in unintended ways. While every effort was maintained to ensure that only the relevant aspects were manipulated, results may be due to differences between the scenarios other than whether or not the victim violated BS gender role expectations. Masser, Lee and McKimmie (2010) explored this possibility by manipulating both the gender stereotypicality and victim stereotypicality of an acquaintance rape victim. The counter-stereotypical victim said no to the perpetrators advances but did not attempt to fight him off and did not cooperate with police. This study found that BS was not as important a predictor as suggested by other studies (Abrams et al., 2003; Viki & Abrams, 2002; Viki et al., 2004, Yamawaki, 2007). High BS was only associated with increased blame of the gender counter-stereotypical victim when the victim also violated victim stereotypes. The researchers propose that gender stereotypicality only plays a significant role in victim blame after victim stereotypes have failed to explain events. Therefore it is possible that the current research failed to find a significant main or interaction effect because the stereotypicality of the victim was more salient to respondents than whether or not she violated traditional gender expectations. It may also be the case that participants

Empirical Investigations

AMBIVALENT SEXISM AND PERCEPTIONS OF RAPE based their judgements of blame on their perceived danger of the situation. University students often encounter rape prevention campaigns which offer advice on how to stay safe. The acquaintance and online victims may have been blamed more as participants considered these victims to be putting themselves in an unsafe situation with the potential for rape. This is in itself a rape myth which should be investigated in future research. This limitation is consistent with criticisms of the use of scenarios in this type of research in general. Burt and Albin (1981) argue that the researcher assumes that all participants will interpret the manipulations in the scenario in the way that the researcher intended. Methods other than the use of scenarios should be applied to the study of victim blame and could be more exploratory of the opinions held by the public about the character of rape victims, rather than making assumptions of what their opinions might be and incorporating these assumptions into the research. As has been discussed, participants may not have interpreted the acquaintance and online rape victims to be violating gender expectations as was intended by the researcher. A further limitation of this study is its failure to include a manipulation check of whether the behaviour of these victims was perceived as inappropriate for their gender. In addition, this study focused solely on attitudes towards female rape victims and the gender-appropriateness of their behaviour.

It would be beneficial for future research to assess whether gender-typicality plays an important role in the perception of male rape victims. The previously discussed homogeneity of the sample is another limitation of this study. Future research should endeavour to make use of a more diverse range of participants outside of a student population. It would be particularly interesting to explore generational differences in BS, HS and victim blame to determine whether it is the more egalitarian attitudes of the younger generation which resulted in low victim blame scores. Further research is also required in order to more deeply explore the perceptions of victims who are raped by someone whom they have become acquainted with online. Conclusion Participants in this study attributed more blame to acquaintance rape victims than to stranger and online victims and marginally more blame to online victims, suggesting that rape myths are more likely to be applied to acquaintance and online rape scenarios. HS was the only variable measured to have a significant relationship with victim blame. This finding contradicts the work of several researchers (Abrams et al., 2003; Viki & Abrams, 2002; Viki et al., 2004; Yamawaki, 2007) and suggests that a re-examination of the relationship between ambivalent sexism and victim

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blame in contemporary Irish society would be worthwhile. While the relatively low BS, HS and victim blame scores overall show promise that undergraduate students in Ireland possess egalitarian attitudes and are understanding of the issue of rape, the significant increase in victim blame for the acquaintance rape victim is nevertheless cause for concern. Further attempts should be made to teach young people that rape is rape and to dispel rape myths. Education campaigns should target the potential perpetrators of rape rather than asking victims to change their behaviours to avoid being raped. For example, the Don’t Be That Guy campaign was recently implemented by the Union of Students in Ireland after the same campaign was related to a 10% decrease in sexual assaults in Vancouver in 2011 (Defoe, 2011). References Aiken, L.S. & West, S.G. (1991). Multiple regression: Testing and interpreting interactions. New York, NY: Sage. Abrams, D., Viki, G. T., Masser, B., & Bohner, G. (2003). Perceptions of stranger and acquaintance rape: The role of benevolent and hostile sexism in victim blame and rape proclivity. Journal of Personality and Social psychology, 84(1), 111 – 125. Ben-David, S., & Schneider, O. (2005). Rape perceptions, gender role attitudes, and victim-perpetrator acquain-

tance. Sex Roles, 53(5-6), 385-399. Bridges, J. S., & McGrail, C. A. (1989). Attributions of responsibility for date and stranger rape. Sex Roles, 21(34), 273-286. Bridges, J. S. (1991). Perceptions of date and stranger rape: A difference in sex role expectations and rape-supportive beliefs. Sex Roles, 24(5-6), 291-307. Briggs, P., Simon, W. T., & Simonsen, S. (2011). An exploratory study of Internet-initiated sexual offenses and the chat room sex offender: Has the Internet enabled a new typology of sex offender? Sexual Abuse: A Journal of Research and Treatment, 23(1), 72-91. Bryant, A. N. (2003). Changes in attitudes toward women’s roles: Predicting gender-role traditionalism among college students. Sex Roles, 48(3-4), 131 142. Burt, M. R. (1980). Cultural myths and supports for rape. Journal of Personality and Social Psychology, 38(2), 217-230. Burt, M. R., & Albin, R. S. (1981). Rape myths, rape definitions, and probability of conviction. Journal of Applied Social Psychology, 11(3), 212-230.

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AMBIVALENT SEXISM AND PERCEPTIONS OF RAPE Carroll, J. S., Padilla-Walker, L. M., Nelson, L. J., Olson, C. D., Barry, C. M., & Madsen, S. D. (2008). Generation XXX: Pornography acceptance and use among emerging adults. Journal of Adolescent Research, 23(1), 6-30. Check, J. V., & Malamuth, N. M. (1983). Sex role stereotyping and reactions to depictions of stranger versus acquaintance rape. Journal of Personality and Social Psychology, 45(2), 344 - 356. Criminal Law (Rape) Act 1981 s.2 (Ireland). Criminal Law (Rape) (Amendment) Act 1990 s.4 (Ireland). Daneback, K., Månsson, S. A., & Ross, M. (2007). Using the Internet to find offline sex partners. CyberPsychology & Behavior, 10(1), 100-107. Defoe, S. (2013). USI launch Don’t be that Guy campaign. Döring, N. M. (2009). The Internet’s impact on sexuality: A critical review of 15 years of research. Computers in Human Behavior, 25(5), 1089-1101. Foubert, J. D., Brosi, M. W., & Bannon, R. S. (2011). Pornography viewing among fraternity men: Effects on bystander intervention, rape myth acceptance and behavioral intent to commit sexual assault. Sexual Addiction &

Compulsivity, 18(4), 212-231.

Glick, P., & Fiske, S. T. (1996). The Ambivalent Sexism Inventory: Differentiating hostile and benevolent sexism. Journal of Personality and Social Psychology, 70(3), 491 – 512. Glick, P., Fiske, S. T., Mladinic, A., Saiz, J. L., Abrams, D., Masser, B., ... & López, W. L. (2000). Beyond prejudice as simple antipathy: Hostile and benevolent sexism across cultures. Journal of Personality and Social Psychology, 79(5), 763. Grubb, A., & Turner, E. (2012). Attribution of blame in rape cases: A review of the impact of rape myth acceptance, gender role conformity and substance use on victim blaming. Aggression and Violent Behavior, 17(5), 443-452. Hald, G. M., Malamuth, N. M., & Yuen, C. (2010). Pornography and attitudes supporting violence against women: Revisiting the relationship in nonexperimental studies. Aggressive Behavior, 36(1), 14-20. Hammond, E. M., Berry, M. A., & Rodriguez, D. N. (2011). The influence of rape myth acceptance, sexual attitudes, and belief in a just world on attributions of responsibility in a date rape scenario. Legal and Criminological Psychology, 16(2), 242-252.

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Lonsway, K. A., & Fitzgerald, L. F. (1994). Rape myths in review. Psychology of Women Quarterly, 18(2), 133-164. Malamuth, N. M., & Check, J. V. (1985). The effects of aggressive pornography on beliefs in rape myths: Individual differences. Journal of Research in Personality, 19(3), 299-320. Masser, B., Lee, K., & McKimmie, B. M. (2010). Bad woman, bad victim? Disentangling the effects of victim stereotypicality, gender stereotypicality and benevolent sexism on acquaintance rape victim blame. Sex Roles, 62(7-8), 494-504. Milburn, M. A., Mather, R., & Conrad, S. D. (2000). The effects of viewing R-rated movie scenes that objectify women on perceptions of date rape. Sex Roles, 43(9-10), 645-664. National Union of Students (2010). Hidden marks: A study of women studentsâ&#x20AC;&#x2122; experiences of harassment, stalking, violence and sexual assault. Payne, D. L., Lonsway, K. A., & Fitzgerald, L. F. (1999). Rape myth acceptance: Exploration of its structure and its measurement Using the Illinois Rape Myth Acceptance Scale. Journal of Research in Personality, 33(1), 2768.

Quinn, J. F., & Forsyth, C. J. (2005). Describing sexual behavior in the era of the Internet: A typology for empirical research. Deviant Behavior, 26(3), 191-207 Sims, C. M., Noel, N. E., & Maisto, S. A. (2007). Rape blame as a function of alcohol presence and resistance type. Addictive Behaviors, 32(12), 2766-2775. Simonson, K., & Subich, L. M. (1999). Rape perceptions as a function of gender-role traditionality and victim-perpetrator association. Sex Roles, 40(78), 617-634. Union of Students in Ireland (2012). USI Equality Campaign. Union of Students in Ireland (2013). Say something: A study of studentsâ&#x20AC;&#x2122; experiences of harassment, stalking, violence and sexual assault. Viki, G. T., & Abrams, D. (2002). But she was unfaithful: Benevolent sexism and reactions to rape victims who violate traditional gender role expectations. Sex Roles, 47(5-6), 289-293. Viki, G. T., Abrams, D., & Masser, B. (2004). Evaluating stranger and acquaintance rape. Law and Human Behavior, 28(3), 295-303.

Empirical Investigations AMBIVALENT SEXISM AND PERCEPTIONS OF RAPE Whatley, M. A. (2005). The effect of participant sex, victim dress, and traditional attitudes on causal judgments for marital rape victims. Journal of Family Violence, 20(3), 191-200. Yamawaki, N. (2007). Rape perception and the function of ambivalent sexism and gender-role traditionality. Journal of Interpersonal Violence, 22(4), 406423.

Student Psychology Journal of Ireland, 2015, 44-64

The relationships between body appreciation and health-related and risk-taking behaviours: Does gender moderate these relationships? Robyn Browne

Supervisor: Dr. Amanda Fitzgerald

University College Dublin

Correspondence: robyn.de-brun@ucdconnect.ie

abstract The present study examined gender differences in the relationships between body appreciation (BA) and a range of health-related and risk-taking behaviours. Participants were 132 females and 109 males aged 18-25 (M=21.85, SD=1.40). Data consisted of participant scores on the revised Body Appreciation Scale (Tylka & Wood-Barcalow, 2015), the Body Areas Satisfaction Scale (Cash, 2000), the Fitness Orientation Scale (Cash, 2000), the consumption subscale of the Alcohol Use Disorders Identification Test (Bush, Kivlahan, McDonell, Fihn, & Bradley, 1998), and measures of weight control behaviours, tobacco and cannabis consumption, skin-screening, driving-related safety precautions, and sleep duration. Regression analyses assessed whether BA predicted these behaviours. An unexpected finding was that BA did not predict less hazardous levels of alcohol consumption, but rather was significantly positively correlated with alcohol consumption. BA significantly predicted higher fitness orientation and lower unhealthy weight control behaviours. A significant interaction effect was observed between BA and gender on the latter variables, revealing that males with high BA exhibited significantly higher fitness orientation than their female counterparts, while females with high BA exhibited significantly lower unhealthy weight control behaviours than males. Practical implications, such as pursuing positive body image promotion for more effective eating disorder interventions, were also addressed. Keywords: Body Appreciation, Gender, Health, Risk-Taking, Fitness, Weight Control.

Empirical Investigations

BODY APPRECIATION AND HEALTH: COMPARING GENDERS Introduction Body appreciation (BA) involves respecting, holding favorable opinions toward, and accepting one’s body, while also rejecting the pressures of unrealistic media-promoted ideals (Avalos, Tylka, & Wood-Barcalow, 2005). Although empirical investigations of the relationship between BA and health-related outcomes have proliferated in recent years (Andrew, Tiggeman, & Clark, 2014), few have attended to college samples that incorporate both males and females (Gillen, 2015), or to pertinent risk-taking behaviours amongst this population, including alcohol consumption (Cannon, Coughlan, Clarke, Harley, & Kelleher, 2013). Research has traditionally focused on the negative aspects of body image, including body shame and body dissatisfaction (Tylka & Wood-Barcalow, 2015). More recently, however, the field has been influenced by the theoretical underpinnings of positive psychology (Gudmundsdottir, 2011), departing from the pathology-oriented approach (Tylka, 2011), and attending to the positive facets of the construct (Tylka & Wood-Barcalow, 2015). Tylka (2011) argued that this shift in focus was facilitated by the recently developed concept of BA (Avalos et al., 2005). The psychometrically sound Body Appreciation Scale measures favorable attitudes towards the

body, acceptance of the body, respect for the body, and protection of the body by rejecting unrealistic media-promoted ideals (BAS; Avalos et al., 2005). BA is frequently misconstrued as being equivalent to an absence of body dissatisfaction (Abbott & Barber, 2010). On the contrary, empirical evidence has supported conceptual distinctions between BA and body dissatisfaction, indicating that positive body image encapsulates its own unique properties (Wood-Barcalow, Tylka, & Augustus-Horvath, 2010). Moreover, evidence has supported BA’s prediction of additional variance in health outcomes after controlling for negative body image factors (Andrew et al., 2014). This highlights the importance of assessing BA’s unique influence on behavioural outcomes and has led to the development of a revised version of the BAS (BAS-2; Tylka & Wood-Barcalow, 2015). Cash and Smolak (2011) posited that focusing on the positive elements of body image is crucial to the future development of the field. This positively-oriented approach prompted exploration of the relationship between BA and both health-promoting and health-compromising behaviours (Andrew et al., 2014). Associations between negative body image and health-compromising behaviours have been well-documented in the literature, most notably with reference to dieting

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practices (Andrew et al., 2014). A significant positive relationship has been documented between body dissatisfaction and unhealthy weight control practices in young males and females (Neumark-Sztainer, Paxton, Hannan, Haines, & Story, 2006), indicating associations between negative body image and maladaptive health behaviour. Conversely, BA is conceptualized as an orientation of cognitive processes and behaviours towards valuing, respecting, and protecting the body (Avalos et al., 2005). Thus, individuals with high BA are predicted to adopt tendencies congruous with this description by engaging in health-promoting practices and avoiding health-compromising ones. Unsurprisingly, therefore, the relationship between BA and unhealthy dieting behaviour has proven to be negative in samples of young women (Andrew et al., 2014). Despite valuable contributions of eating practices research for treatment and intervention methods (Neumark-Sztainer, Wall, Larson, Eisenberg & Loth, 2011), the expanding range of modern health risks among young populations (Kann et al., 2014) has beckoned consideration of more tangible, real-world outcomes (Tylka, 2011). Such research has consistently supported the health protective functions of positive body image. One study outlined BAâ&#x20AC;&#x2122;s association with safe sexual practices in college females (Winter & Satinsky, 2014), while another demon-

strated that BA was predictive of female sexual function and satisfaction (Satinsky, Reece, Dennis, Sanders, & Bardzell, 2012). Others have demonstrated BAâ&#x20AC;&#x2122;s conferred protection against the pressures of media-promoted ideals (Halliwell, 2013). A recent study by Andrew and colleagues (2014) further expanded the scope of health behaviours associated with BA by assessing contextually relevant behaviours in an Australian female sample. These included sun protection use, seeking medical attention, tobacco and alcohol consumption, weight loss behaviour, and skin cancer screening. A positive relationship was demonstrated between BA and adaptive health behaviours like skin screening and sun protection use, while a negative relationship was identified between BA and weight loss behaviour. These findings reaffirm that BA enhances health-promoting behaviours and protects against health-compromising ones. Inconsistent with this assertion, however, was the finding that alcohol consumption was not significantly negatively correlated with positive body image. The latter relationship has been underexplored in the literature, where Andrew and colleagues (2014) were the first to address it. However, their conclusions are derived from an exclusively female Australian sample and, therefore, cannot be generalized across cultures and sexes. In an Irish context, empirical evidence has indicated that

Empirical Investigations

BODY APPRECIATION AND HEALTH: COMPARING GENDERS over one in twenty 18-24 year olds report abusive substance use behaviour, with an alarming 75% meeting lifetime criteria for binge drinking (Cannon et al., 2013). The present study seeks to further explore the association between BA and alcohol consumption in an Irish sample.

dressed with female samples only. Moreover, this study was limited by its failure to employ the recently revised version of the BAS, which is more adapted than its predecessor to current knowledge in positive body image research (Tylka & Wood-Barcalow, 2015).

Although the scope of health outcomes has expanded, the body image research has been criticized for its overwhelming focus on females (Holmqvist & Frisén, 2010). The available research has indicated that men display higher BA levels than their female counterparts (Benford & Swami, 2014; Tylka & Wood-Barcalow, 2015). Although an abundance of research has demonstrated the potential health benefits associated with female BA (Andrew et al., 2014), researchers have asserted that these should not be assumed to be uniform across genders (Gillen, 2015). Gillen (2015) examined the relationship between BA and a range of mental and physical health outcomes in an undergraduate male and female sample. Those with greater BA reported less depression, higher self-esteem, fewer unhealthy dieting practices, and greater intentions to engage in sun protection. Gender was not found to moderate the relationship between BA and health outcomes. Nevertheless, Gillen argued that further gender comparative research is critical in order to explore a broader range of health-related behaviours that have been previously ad-

Western culture exposes males and females respectively to different body ideals. While the ideal male physique is depicted as muscular and strong (Petrie, Greenleaf, Reel, & Carter, 2008), the ideal female body is promoted as thin and slender (Chrisler, Marván, Gormon, & Rossini, 2015). On foot of this, males and females are likely to value their bodies differently. Evidence suggests that females place greater emphasis on aesthetic qualities, while males are more concerned with functionality (Abbott & Barber, 2010). Therefore, BA may have a different behavioural impact for males and females respectively. Evidence suggests that holding a functional view of the body is a core component of BA (Swami & Tovée, 2009). A qualitative analysis of positive body image in male and female adolescents revealed that only one in 15 female participants referred specifically to physical functionality when describing reasons for valuing certain body parts (Frisén & Holmqvist, 2010). By contrast, males focused predominantly on valuing what their body parts can accomplish. More-

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over, Slater and Tiggeman (2011) found that young males with high BA exhibited greater active involvement in sport and exercise than females. Taken together, these findings suggest that physical activity for the maintenance of functionality may be more salient for males with a positive body image than for their female counterparts. The Present Study The present study investigates gender differences in the relationship between BA and a range of health-related and risk-taking behaviours, such as exercise and alcohol consumption respectively. To the authorâ&#x20AC;&#x2122;s knowledge, no study has assessed BA in a predominantly Irish sample of college-aged students. Risk-taking behaviours (e.g. driving under the influence of alcohol) were adapted from a recent Youth Risk Surveillance Survey conducted in the US with a large sample of high school students (Kann et al., 2014), thus representing some of the most prevalent health risks afflicting the youth of today. The literature has not yet explored these risk-taking behaviours in the context of positive body image. This study set out to test the following hypotheses: Hypothesis 1: Individuals with higher levels of body appreciation will engage in a less hazardous level of alcohol consumption. Hypothesis 2: Individuals with higher levels of body appreciation will

maintain a more positive attitude to, and engage more frequently in, physical exercise activities. Hypothesis 3: Gender will moderate the relationship between body appreciation and both health-related and risk-taking behaviours. Hypothesis 4: Body appreciation will explain unique variance, over and above body dissatisfaction, in health-related and risk-taking outcomes. Method Research Design The present study employed a quantitative independent group design that was cross-sectional in nature. Data were collected by means of an online survey designed using the software tool Qualtrics (2013). The independent variables were body appreciation and body dissatisfaction. The dependent variables included health-promoting behaviours (fitness orientation, healthy weight control behaviours, skin screening, seatbelt-wearing, and sleep duration) and risk-taking behaviours (alcohol consumption, tobacco and marijuana consumption, unhealthy weight-control behaviours, and unsafe driving-related practices). Pilot Study A pilot study assessed the appropriateness of questionnaire items. Participants were two males and two females aged 18-25 years (M=22.5, SD=0.87).

Empirical Investigations

BODY APPRECIATION AND HEALTH: COMPARING GENDERS Feedback from males indicated that some body image items may be more salient to females. On foot of this, a question was included after the â&#x20AC;&#x2DC;Body Imageâ&#x20AC;&#x2122; portion of the survey asking participants if they felt that items were relevant to them (see Appendix A). Participants Participants were 132 women (54.8%) and 109 men aged 18-25 years (M=21.85, SD=1.40). Participants were predominantly caucasian (92.1%) and of an undergraduate student level (72.2%). Materials Participants completed an online questionnaire consisting of the measures listed below, which took approximately 10 minutes to complete. Online consent was obtained and then demographic information was provided. Measures were counterbalanced to control for order effects. Demographic information. Participants provided their gender, age, ethnicity, education level, weight, and height (see Appendix B). BMI was calculated as weight (kg)/height2 (m2). Body appreciation. Body appreciation was assessed using the 10-item revised Body Appreciation Scale (BAS-2; Tylka & Wood-Barcalow, 2015; see Appendix C), which measured the degree of acceptance, respect, and appreciation held by the individual for his/her body.

All items were positively scored and rated on a 5-point Likert scale (1 = never, 5 = always). Responses were summed and averaged, where higher values depicted greater body appreciation. The BAS-2 has demonstrated gender invariance, internal consistency (.97 and .96 for women and men respectively), and test-retest reliability (r=.90) in college samples (Tylka & Wood-Barcalow, 2015). Body dissatisfaction. The 9-item Body Areas Satisfaction Scale (BASS), a subscale of the Multidimensional Body Self-Relations Questionnaire (MBSRQ; Cash, 2000), assessed how dissatisfied participants were with specified body areas, as rated on a 5-point Likert scale (1 = very dissatisfied, 5 = very satisfied). Responses were reverse scored, summed, and averaged to create a body dissatisfaction measure (see Appendix D) . This scale has demonstrated good internal reliability in males and females (.82 and .83 respectively; Giovannelli, Cash, Henson, & Engle, 2008), and good test-retest reliability for both groups (.86 and .74; Cash, 2000). Fitness orientation. Attitudes toward, and engagement in, exercise were assessed by the Fitness Orientation subscale of the MBSRQ (Cash, 2000). Participants rated their agreement with 13 statements on a 5-point Likert scale (1 = definitely disagree, 5 = definitely agree). After reverse scoring (see Appendix E), responses were summed and

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averaged, where higher values denoted greater fitness orientation. This scale has demonstrated internal reliability for men and women (.91 and .90 respectively; Cash, 2000), test-retest reliability for both groups (.73 and .94), and invariance across gender (Rusticus & Hubley, 2006). Alcohol consumption. The 3-item Alcohol Use Disorders Identification Test-Consumption (AUDIT-C; Bush et al., 1998) measured the frequency and quantity of alcohol consumption. A chart depicted the standard units of alcohol to participants (see Appendix F). Participants selected one of five response options for each item. Each response was scored from 0 to 4 and then summed, yielding a maximum possible score of 12. Gender stratified cut-off scores of 7 for males and 5 for females were applied for at-risk drinking (DeMartini & Carey, 2012). The AUDIT-C has demonstrated sound psychometric qualities and is suitable for use with college samples (Barry, Chaney, Stellefson, & Dodd, 2013). Tobacco and cannabis consumption. These were assessed with the question ‘How often do you smoke: a) cigarettes, and b) cannabis?’ (adapted from Neumark-Sztainer et al., 2006). Responses were recorded on a 4-point frequency scale (‘daily’ to ‘not at all’). Weight control behaviours. Dieting was assessed with the question: ‘Have you gone on a diet in the past year?’ (‘yes’

or ‘no’; adapted from Neumark-Sztainer et al., 2006). Specific weight control behaviours were assessed with the multipart item: ‘How often have you done any of the following in order to change your weight or body shape in the last year?’, followed by a list of healthy and unhealthy weight control behaviours such as ‘ate more fruits and vegetables’ and ‘used laxatives’ respectively (see Appendix G). Participants responded on a 5-point Likert scale (1 = never, 5 = very often). Skin screening. Skin screening was assessed with two questions regarding the frequency of self-checking moles and having moles checked by a health professional, as rated on a 5-point Likert scale (1 = never, 5 = always). Responses were summed and averaged to create a skin screening measure. Road safety precautions. Five questions assessed safe driver/passenger practices (adapted from Kann et al., 2014). The first two items assessed how frequently participants wear seatbelts and accept lifts with drivers who have consumed alcohol (1 = never, 5 = always). The third assessed whether participants were licensed drivers (‘yes’ or ‘no’). If yes, two further questions measured how often respondents text/email while driving, or drive after consuming alcohol.

Sleep Duration. This was assessed

Empirical Investigations

BODY APPRECIATION AND HEALTH: COMPARING GENDERS with the question: ‘How much sleep do you usually get each night?’ (‘less than 6 hours’, ‘6-8 hours’, or ‘more than 8 hours’). Procedure Permission for use of standardised scales was either not required or was obtained by emailing scale developers (see Appendix H). A weblink was disseminated to participants via social media, which led to an online information sheet and consent form (see Appendices I & J respectively). Following provision of demographic details, participants completed the battery of measures concerned with body image and health-related and risk-taking behaviours. On completion, participants were presented with a debriefing sheet, which provided information on support resources for anyone who may have felt upset by the questionnaire content. Ethics This study was approved by the UCD Undergraduate Research Ethics Committee in the School of Psychology (see Appendix K).

ple comprised 265 participants. On account of significant proportions of missing data, however, 24 participants were deleted prior to statistical analysis. The final dataset comprised 132 females and 109 males (N=241). Data were screened for univariate and multivariate outliers in line with data checking procedures. This was achieved by assessing standardized residuals, where those with absolute values greater than 3.29 were considered concerning (Field, 2013). Such instances were subsequently excluded from the appropriate analyses.. Reliability Analyses Cronbach’s alpha was used to assess the reliability of scales (see Table 1). All scales but one (AUDIT-C) had good internal reliability according to Coolican (2014), who recommends a minimum value of 0.75.

Results Data management and statistical analysis were conducted using Statistical Package of Social Science (SPSS) software for Macintosh (Version 22.0; SPSS, Armonk, NY). The original sam-

The AUDIT-C, which contains three items, demonstrated low internal reliability in the present sample (see Table 1). This may be explained by the low number of items in this measure (Pallant,

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2013). Inter-item correlations (see Table 2) were also produced but did not fall within the optimal range of 0.2 and 0.4 (Briggs & Cheek, 1986).

Mean Scores Mean scores on all analytic variables are presented in Table 3, both for the entire sample and separately by gender. The mean Body Mass Index (BMI) was 22.92 (23.96 for men and 22.07 for women). According to established guidelines, this mean falls in the higher portion of the normal range (normal: 18.5-24.9; CDC, 2014). The mean score for body appreciation (BA) was moderately high (M=3.51; SD=.79), which was comparable to means from previous college samples of males and females (Gillen, 2015; N=284; M=3.80). The sample mean for body dissatisfaction approximated the mid-range point (M=2.61; SD=.65), which is also similar to college samples in past research using the BASS (Andrew et al., 2014). Gender Differences A series of independent t-tests were conducted to test for gender differenc-

es in key variables (see Table 3). The Bonferroni multiple comparison correction was applied in order to set the alpha value at a more stringent level (Shaffer, 1995). This procedure lowered the significance level to .003. As expected based on previous research (Tylka & Wood-Barcalow, 2015), male BA (M=3.76, SD=.67) was significantly higher than that for females (M=3.31, SD=.82), t(238)=4.73, p<.001. Females, however, exhibited significantly higher body dissatisfaction (M=2.82, SD=.70) than males (M=2.35, SD=.48), t(228.74)=-6.11, p<.001. Overall, women reported lower BMI, lower BA, higher body dissatisfaction, lower fitness orientation, and lower levels of alcohol and cannabis consumption (see Table 3).

Correlations

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BODY APPRECIATION AND HEALTH: COMPARING GENDERS To examine bivariate associations, correlations were calculated for all analytic variables (see Table 4). As expected, BA was significantly negatively correlated with body dissatisfaction (r=-.80, p<.01) and significantly positively correlated with fitness orientation (r=.23, p<.01). Although negative correlations between alcohol consumption and BA have not reached statistical significane in past research (Andrew et al., 2014), the present study found an unexpected positive association between these variables, where higher BA was associated with higher alcohol consumption (r=.13,

p<.05). However, this relationship was weak. Conversely, body dissatisfaction did not correlate significantly in either direction with alcohol consumption. Also unexpected was the positive correlation between BA and driving while under the influence of alcohol (r=.20, p<.05), which is contradictive of the protective nature of the construct (Avalos et al., 2005). In line with previous empirical evidence (Andrew et al., 2014), a significant negative correlation was observed between BA and unhealthy weight control behaviours (r=-.39, p<.01).

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Statistical Analyses Hypothesis 1. Hypothesis 1 asserted that individuals with higher levels of BA would engage in less hazardous alcohol consumption. Albeit weak, a significant positive relationship was observed between alcohol consumption and BA (r=.13, p<.05), thus indicating that Hypothesis 1 would not be supported (see Table 3 for mean scores). Nevertheless, a stepwise linear regression was conducted to assess whether BA was a significant predictor of alcohol consumption overall. The stepwise method was preferred in this instance on account of there being limited previous research on the strength of BA as a predictor of alcohol consumption (Field, 2013). Gender (1=men, 2=women), BMI, and ethnicity were entered as covariates in Step 1 and BA was entered in Step 2. Hypothesis 1 was not supported. Gender and ethnicity were the only variables entered into the stepwise equation. Therefore, BA did not predict any variance in AUDIT-C scores. The model produced was significant, where gender acted as the most important predictor of alcohol consumption, followed by ethnicity. Observation of the R square value in the first model indicated that gender accounted for 7.1% of the variance in AUDIT-C scores. The R square change (.033) value in the second model denoted the additional variance explained by ethnicity, which was 3.3%. In total, the model produced

accounted for 10.4% of the variance in alcohol consumption but none of this was attributable to BA. Hypothesis 2. Hypothesis 2 asserted that participants with higher levels of BA would exhibit higher fitness orientation. To test this, a hierarchical multiple regression was conducted. A positive linear relationship was observed between BA and fitness orientation (see Table 4). This association was weak but significant at the .01 level (r=.23, p<.01; see Table 3 for mean scores). Gender, BMI, and ethnicity were entered as covariates in Step 1 and BA was entered in Step 2. The results of this analysis provided support for the second hypothesis. Step 2, which included BA, added a significant amount of variance to the regression model, F (4,233)=10.342, p<.001. Overall, the model significantly accounted for 15.1% of the variance in fitness orientation (R square at Step 2=.151). Step 1 variables accounted for 12.3% of the variance in fitness orientation, with BA adding an additional 2.8% at Step 2 (R square change=.028). Analysis of the standardized coefficients revealed that gender made the strongest unique contribution to the prediction of fitness orientation (Î˛=-.232), while BA made the second most important contribution (Î˛=.180). BMI also offered significant prediction in the model, albeit to a

Empirical Investigations

BODY APPRECIATION AND HEALTH: COMPARING GENDERS lesser degree (β=.157). Hypothesis 3. The third hypothesis asserted that gender would moderate the relationship between BA and both health-related and risk-taking behaviours. In order to test this, a series of hierarchical linear regressions were conducted. Based on the significant relationships indicated by correlational data (see Table 4), four separate hierarchical multiple regressions were conducted to assess gender as a moderator variable in the associations between BA and alcohol consumption, fitness orientation, driving under the influence of alcohol, and unhealthy weight control behaviours. The hierarchical regression method enabled assessment of the main effects of BA, while simultaneously assessing the interaction effects between BA and gender. Entering BA and its interaction term with gender enabled assessment of whether BA has similar health benefits for both sexes (significant main effect), or if these benefits vary across sexes (significant Body Appreciation×Gender interaction effect). In order to control for demographic variables, gender, BMI (centered at its mean), and ethnicity were entered as covariates in Step 1. BA (centered at its mean) was entered in Step 2. Finally, the Body Appreciation×Gender interaction

was entered in Step 3. These steps remained the same in all four regressions. BMI and BA were centered in order to counteract multicollinearity effects (Aiken & West, 1991). Results indicated a significant interaction effect for fitness orientation and unhealthy weight control behaviours. Step 3 did not contribute significant prediction for alcohol consumption or drink-driving behaviour. The significant interactions were plotted and both were disordinal in nature (see Figure 1 and 2). The regression model for fitness orientation indicated that Step 3 explained significant variance at the .05 level, F (5,232)=9.152, p≤.05. The interaction exhibited the highest absolute Beta value, suggesting that it contributed the most important unique variance in the model (β=-.631). This interaction was observed to be disordinal in nature (see Figure 1). The plot suggests that higher BA is more significantly associated with enhanced fitness orientation for males than it is for females. The overall model accounted for 17% variance in fitness orientation (see Table 5). With respect to unhealthy weight control behaviour, a significant interaction effect was also observed, F (5,231)=10.536, p<.001. The standardised coefficient values denoted that the interaction between BA and gender contributed the most important predic-

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tion in the overall model (Î˛=-.834). The plot indicated a disordinal interaction, where high BA in females was associated with less frequent unhealthy weight control behaviours, as compared with high

BA in males (see Figure 2). Similar to the fitness orientation model, this model significantly accounted for 17% of the variance in unhealthy weight control behaviour (see Table 5).

Empirical Investigations

BODY APPRECIATION AND HEALTH: COMPARING GENDERS Hypothesis 4. Hypothesis 4 posited that BA would predict significant variance in health-related and risk-taking behaviours, over and above body dissatisfaction. A series of hierarchical multiple regressions were conducted to investigate this. For each of these, body dissatisfaction was entered in Step 1 and BA was entered in Step 2. The results of these procedures are presented in Table 6 below. The R2change and Fchange values in Step 2 indicated whether hypothesis 4 was supported for individ-

ual health behaviours or not. As presented in Table 6, BA explained significant unique variance in unhealthy weight control behaviours. This aligns with findings from previous research, where BA offered predictive value of weight-loss behaviour, over and above body dissatisfaction (Andrew et al., 2014). The only initially significant health and risk-taking behaviours for which BA did not explain unique variance were fitness orientation and driving under the influence of alcohol (see Table 6).

Discussion

unique because it incorporated both male and female participants, which enabled an exploration of gender differences in such relationships. It was hypothesised that BA would predict higher health-promoting and lower risk-taking behaviours, but that gender would moderate the strength of

The present study sought to investigate the relationship between positive body image and a range of health-related and risk-taking behaviours in a sample of young males and females. This study was

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these relationships. A series of hierarchical regressions assessed BA as a predictor of outcome variables. Contrary to findings from a recent study where BAâ&#x20AC;&#x2122;s health outcomes were uniform across sexes (Gillen, 2015), the present study identified significant gender interaction effects for both fitness orientation and unhealthy weight control behaviours. The interaction effects revealed that BA was a more important predictor of higher fitness orientation for males, while it was a more significant buffer against unhealthy weight control behaviours for females. These findings are consistent with the body image literature, which suggests that physical fitness and functionality are predominant aspects of male body image (Abbott & Barber, 2010), while dieting behaviour is a more salient feature for females (Furnham, Badmin, & Sneade, 2002). The present study made a unique contribution to the literature by demonstrating that BA is more important for male fitness orientation than it is for that of females, as previous research in this area has focused exclusively on female samples (Homan & Tylka, 2014). This finding aligns with evidence that young males typically participate in more sport and physical activity than their female counterparts (Slater & Tiggeman, 2011). Furthermore, qualitative analyses have suggested that maintaining a functional view of the body is a key

feature of BA (FrisĂŠn & Holmqvist, 2010; Wood-Barcalow et al., 2010). Therefore, the enhanced health-promoting effects of BA for fitness orientation in males may be explained by the fact that they are more likely than females to be concerned with the development or maintenance of the bodyâ&#x20AC;&#x2122;s instrumentality (Abbott & Barber, 2010). Both males and females who are body dissatisfied engage in unhealthy dieting practices to control their weight or shape (Neumark-Sztainer et al., 2006). This finding was replicated in the current sample, where high body dissatisfaction was associated with higher engagement in such practices. Individuals with a positive body image, however, tend to engage in significantly less unhealthy dieting behaviours (Andrew et al., 2014; Avalos et al., 2005). Again, the findings from the present study confirm this negative association. However, BA was a more significant buffer against unhealthy weight control behaviours for females than for males. As BA focuses on the internal characteristics of love, acceptance, and respect for the body, while deemphasising external physical appearance (Tylka & Wood-Barcalow, 2015), women with high BA may be less likely to seek to alter their physical appearance using harmful behaviours like fasting or taking laxatives. The literature conceptualizes BA as something more than the mere absence

Empirical Investigations

BODY APPRECIATION AND HEALTH: COMPARING GENDERS of body dissatisfaction (Tiggeman & McCourt, 2013). Qualitative studies have outlined positive body image characteristics that go considerably beyond those of body dissatisfaction, including optimism, viewing the body from a functional perspective, and holding less restricted beliefs about what constitutes beauty (FrisĂŠn & Holmqvist, 2010; Wood-Barcalow et al., 2010). The present study supported this, demonstrating that BA explained a proportion of unique variance, over and above body dissatisfaction, in unhealthy weight control behaviours. This provides compelling evidence that BA plays a distinct role in lowering unhealthy dieting practices, which may have important implications for anti-dieting and eating disorder interventions. Moreover, this finding has theoretical implications for the conceptualisation of BA as something more than the absence of body dissatisfaction. Contrary to previous findings (Andrew et al., 2014), the present study found no significant relationship between BA and skin screening behaviour. The latter study, however, was conducted with an Australian sample, where sun protection and skin screening are highly contextually relevant. By contrast, the current sample was predominantly Irish. It is likely, therefore, that such behaviours were simply less salient amongst the current sample on account of significantly less sun exposure. In support of this assertion, only 25.3% of the current sample reported having

sun-sensitive skin. More relevant to the specific cultural context of the present study was the assessment of BAâ&#x20AC;&#x2122;s relationship with alcohol consumption, which is a highly prevalent behaviour amongst Irish youth (Cannon et al., 2013). It was hypothesised that an inverse relationship would emerge between these two variables. This was posited on the grounds that BA is conceptualised as encompassing body respect by engaging in healthy behaviours that nurture the body and avoiding potentially harmful behaviours that undermine the bodyâ&#x20AC;&#x2122;s value (Avalos et al., 2005). Results, however, did not support this. Albeit weak, a significant positive relationship emerged, denoting that individuals with higher BA tended to engage in heavier and more frequent alcohol consumption. This is an interesting finding that cannot be adequately explained, as the literature lacks sufficient evidence regarding the nature of this relationship (Andrew et al., 2014). Future research should explore this association using mixed methods for enhanced clarity. Strengths and Limitations The measures in the online questionnaire were counterbalanced in order to control for possible order effects and all data were provided anonymously, thus increasing the likelihood of honest responses and enhancing the integrity of the findings. A considerable strength of the present study relative to past research was

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the employment of the revised version of the Body Appreciation Scale (BAS-2; Tylka & Wood-Barcalow, 2015), which is more adapted to current knowledge in body image research than its predecessor (BAS; Avalos et al., 2005). The BAS-2 has demonstrated sound psychometric qualities among male and female college students and does not require sex-specific versions (Tylka & Wood-Barcalow, 2015), thus making it an appropriate measure for the current sample. Limitations within the current body of literature were also addressed by incorportaing males in the sample, thus allowing gender to be explored as a moderator (Gillen, 2015). Finally, the present study examined associations between BA and a range of contextually relevant health-related and risk-taking behaviours that have been underexplored in positive body image research. However, this study must also be considered in light of its limitations. The reliability of the consumption subscale of the Alcohol Use Disorders Identification Test (AUDIT-C; Bush et al., 1998) in the present sample was low in comparison to previous studies with similar demographics (Barry et al., 2013; DeMartini & Carey, 2012). This may have contributed to the unexpected results regarding the relationship between BA and alcohol consumption, thus compromising the integrity of these findings. Furthermore, participants completed only self-report measures. Given the inclusion of items assessing sensi-

tive issues and law-breaking behaviours, responses may have been affected by the social desirability bias, whereby participants seek to present themselves in a more positive light (Krumpal, 2013). On foot of this, multi-informant methods could be useful for future research. Conclusion Findings from the present study indicate that it may be useful to promote BA within eating disorder intervention and prevention strategies, as this may simultaneously facilitate a reduction in unhealthy weight control behaviour and an increase in healthier approaches such as physical activity. One way that BA could be actively enhanced is through metacognitive acceptance training, which encourages individuals to be mindful, but not judgemental, of thoughts, feelings, and physical sensations (Baer, 2003). This technique has successfully enhanced body satisfaction in a sample of female college students (Atkinson & Wade, 2012). Given the identification of cognitive resilience factors associated with BA (FrisĂŠn & Holmqvist, 2010; Halliwell, 2013), targeting individualsâ&#x20AC;&#x2122; thinking patterns in this way may be particularly effective for increasing positive body image. Future research should explore the possibility of applying this acceptance-building approach for the promotion of BA in males and females. Engagement in activities that interconnect the cognitive and physical components of BA, or where the mind and the body are interconnected,

Empirical Investigations

BODY APPRECIATION AND HEALTH: COMPARING GENDERS could also serve to increase BA. Specifically, activities like yoga and belly dancing have been implicated as possible precursors to positive body image (Menzel & Levine, 2011; Tiggeman, Coutts, & Clark, 2014). To the authorâ&#x20AC;&#x2122;s knowledge, this is the first study to investigate gender differences in the relationships between BA and the set of health-related and risk-taking behaviours addressed here. The results indicate that BA is a more important promoter of health-promoting fitness attitudes and behaviours in males, while it is a more significant buffer against unhealthy weight control behaviours in females. These findings have key theoretical implications for the BA construct, as they suggest a need to address BA and its health outcomes separately across sexes. They also contradict the common belief that having a positive body image only benefits females (Gillen, 2015). Overall, these findings enrich our understanding of the differences between male and female experiences of positive body image.

Andrew, R., Tiggemann, M., & Clark, L. (2014). Positive body image and young womenâ&#x20AC;&#x2122;s health: Implications for sun protection, cancer screening, weight loss and alcohol consumption behaviours. Journal of Health Psychology. Epub ahead of print, 14 February 2014. Atkinson, M. J., & Wade, T. D. (2012). Impact of metacognitive acceptance on body dissatisfaction and negative affect: Engagement and efficacy. Journal of consulting and clinical psychology, 80(3), 416.

References

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Abbott, B. D., & Barber, B. L. (2010). Embodied image: Gender differences in functional and aesthetic body image among Australian adolescents. Body Image, 7(1), 22-31. Aiken, L. S. & West, S. G. (1991). Multiple regression: Testing and interpreting interactions. Newbury Park, London, Sage.

Avalos, L., Tylka, T. L., & Wood-Barcalow, N. (2005). The Body Appreciation Scale: Development and psychometric evaluation. Body Image, 2(3), 285-297. Baer, R. A. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical psychology: Science and practice, 10(2), 125-143. Barry, A. E., Chaney, B. H., Stellefson, M. L., & Dodd, V. (2013). Evaluating the psychometric properties of the AUDIT-C among college students. Journal of Substance Use, (0), 1-5.

Briggs, S. R., & Cheek, J. M. (1986). The role of factor analysis in the development and evaluation of personality scales. Journal of personality, 54(1), 106-148.

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Bush, K., Kivlahan, D. R., McDonnel, M. B., Fihn, S. D., & Bradley, K. A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Arch Intern Med, 16, 1789-1795. Cannon, M., Coughlan, H., Clarke, M., Harley, M., & Kelleher, I. (2013). The Mental Health of Young People in Ireland: A Report of the Psychiatric Epidemology Research across the Lifespan (PERL) Group. Dublin, Royal College of Surgeons. Cash, T. F. (2000). The Multidimensional Body-Self Relations Questionnaire user’s manual. Available from the author at www.body-images.com. Cash, T. F., & Smolak, L. (Ed.). (2011). Body image: A handbook of science, practice, and prevention. New York, Guilford Press.

Field, A. (2013). Discovering statistics using IBM SPSS statistics. Sage. Frisén, A., & Holmqvist, K. (2010). What characterizes early adolescents with a positive body image? A qualitative investigation of Swedish girls and boys. Body image, 7(3), 205-212. Furnham, A., Badmin, N., & Sneade, I. (2002). Body image dissatisfaction: Gender differences in eating attitudes, self-esteem, and reasons for exercise. The Journal of Psychology, 136(6), 581-596. Gillen, M. M. (2015). Associations between positive body image and indicators of men’s and women’s mental and physical health. Body Image, 13, 67-74.

Centers for Disease Control and Prevention. (2014). About BMI for adults.

Giovannelli, T. S., Cash, T. F., Henson, J. M., & Engle, E. K. (2008). The measurement of body-image dissatisfaction-satisfaction: Is rating importance important? Body Image, 5(2), 216223.

Chrisler, J. C., Marván, M. L., Gorman, J. A., & Rossini, M. (2015). Body appreciation and attitudes toward menstruation. Body Image, 12, 78-81.

Gudmundsdottir, D. G. (2011). Positive psychology and public health. In Positive Psychology as Social Change (pp. 109-122). Springer, Netherlands.

Coolican, H. (2014). Research methods and statistics in psychology. Psychology Press.

Halliwell, E. (2013). The impact of thin idealized media images on body satisfaction: Does body appreciation protect women from negative effects? Body Image, 10(4), 509-514.

DeMartini, K. S., & Carey, K. B. (2012). Optimizing the use of the AUDIT for alcohol screening in college students. Psychological Assessment, 24(4), 954.

Holmqvist, K., & Frisén, A. (2010). Body dissatisfaction across cultures: Findings and research problems. European Eating Disorders Review, 18(2), 133146.

Empirical Investigations

BODY APPRECIATION AND HEALTH: COMPARING GENDERS Homan, K. J., & Tylka, T. L. (2014). Appearance-based exercise motivation moderates the relationship between exercise frequency and positive body image. Body Image, 11(2), 101-108. IBM Corp. (2013). IBM SPSS Statistics for Macintosh, Version 22.0. Armonk, NY: IBM Corp. Kann, L., Kinchen, S., Shanklin, S. L., Flint, K. H., Kawkins, J., Harris, W. A., ... & Zaza, S. (2014). Youth risk behavior surveillanceâ&#x20AC;&#x201D;United States, 2013. Morbidity and Mortality Weekly Report Surveillance Summaries, 63(4), 1-168. Kline, R. B. (2013). Principles and practice of structural equation modeling (3rd ed.). Guilford Press: New York. Krumpal, I. (2013). Determinants of social desirability bias in sensitive surveys: A literature review. Quality & Quantity, 47(4), 2025-2047. Menzel, J. E. & Levine, M. P. (2011). Embodying Experiences and the Promotion of Positive Body Image: The Example of Competitive Athletics. In: R. M. Calogero, S. Tantleff-Dunn, & J. K. Thompson (Ed.). Self- objectification in women: Causes, consequences, and counteractions (pp. 163â&#x20AC;&#x201C;186). Washington, DC: American Psychological Association. Neumark-Sztainer, D., Paxton, S. J., Hannan, P. J., Haines, J., & Story, M. (2006). Does body satisfaction matter? Five-year longitudinal associations between body satisfaction

and health behaviors in adolescent females and males. Journal of Adolescent Health, 39(2), 244-251. Neumark-Sztainer, D., Wall, M., Larson, N. I., Eisenberg, M. E., & Loth, K. (2011). Dieting and disordered eating behaviors from adolescence to young adulthood: Findings from a 10-year longitudinal study. Journal of the American Dietetic Association, 111(7), 1004-1011. Pallant, J. (2013). SPSS survival manual. McGraw-Hill International. Petrie, T. A., Greenleaf, C., Reel, J., & Carter, J. (2008). Prevalence of eating disorders and disordered eating behaviors among male collegiate athletes. Psychology of Men & Masculinity, 9(4), 267. Qualtrics Labs, Inc. (2013). Survey Research Suite Software. Qualtrics Labs, Inc., Provo, Utah. Rusticus, S. A., & Hubley, A. M. (2006). Measurement invariance of the multidimensional body-self relations questionnaire: Can we compare across age and gender? Sex Roles, 55(11-12), 827-842. Satinsky, S., Reece, M., Dennis, B., Sanders, S., & Bardzell, S. (2012). An assessment of body appreciation and its relationship to sexual function in women. Body Image, 9(1), 137-144. Shaffer, J. P. (1995). Multiple hypothesis testing. Ann. Rev. Psych., 46, 561584.

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Slater, A., & Tiggemann, M. (2011). Gender differences in adolescent sport participation, teasing, self-objectification and body image concerns. Journal of Adolescence, 34(3), 455-463. Swami, V., & Tovée, M. J. (2009). A comparison of actual-ideal weight discrepancy, body appreciation, and media influence between street-dancers and non-dancers. Body Image, 6(4), 304-307. Tiggemann, M., Coutts, E., & Clark, L. (2014). Belly dance as an embodying activity?: A test of the embodiment model of positive body image. Sex Roles, 71(5-8), 197-207. Tiggemann, M., & McCourt, A. (2013). Body appreciation in adult women: Relationships with age and body satisfaction. Body Image, 10(4), 624627. Tylka, T. L. (2011). Positive Psychology Perspectives on Body Image. In T. F. Cash & L. Smolak (Ed.). Body image: A handbook of science, practice, and prevention (pp. 56-64). New York, Guilford Press. Tylka, T. L., & Wood-Barcalow, N. L. (2015). The Body Appreciation Scale-2: Item refinement and psychometric evaluation. Body Image, 12, 53-67. Winter, V. R., & Satinsky, S. (2014). Body appreciation, sexual relationship status, and protective sexual behaviors in women. Body Image, 11(1), 36-42.

Wood-Barcalow, N. L., Tylka, T. L., & Augustus-Horvath, C. L. (2010). “But I like my body”: Positive body image characteristics and a holistic model for young-adult women. Body Image, 7(2), 106-116.

Student Psychology Journal of Ireland, 2015, 65-83

The Effect of Autonomy and Perceived Parental Control on Irish Adolescent Eating Habits Ellen Butler

Supervisor: Dr. Elizabeth Nixon

Trinity College Dublin Correspondence: elbutler@tcd.ie

abstract

As adolescent eating habits have been a rising cause of concern in recent years, this study explored the impact of perceived parental control, level of autonomy and economic independence on Irish adolescentsâ&#x20AC;&#x2122; eating habits. Gender differences were also assessed. A cross-sectional design was implemented. The sample consisted of 162 adolescents (89 males and 73 females) from three secondary schools located in Dublin (N = 79) and Donegal (N = 83). First and fourth year students from 12-16 years of age (M = 13.97 years, S.D. = 1.53) completed four questionnaires: a demographics questionnaire, The Adolescent Food Habits Checklist (AFHC), The Parental Bonding Instrument (PBI) and The Adolescent Autonomy Questionnaire. Descriptive analysis found similar scores between males and females for eating habits, contrary to previous literature. In addition to this, mothers were perceived to have greater control than fathers. A multiple regression analysis revealed economic independence and emotional autonomy as the greatest contributors to adolescent food habits. A further regression found that the relationship between adolescent food habits and emotional autonomy was significant for adolescent females only. Economic independence and emotional autonomy will be important forms of autonomy to consider in future interventions targeting eating problems among Irish adolescents. Keywords: adolescents, eating habits, autonomy, parental control, development, gender

Introduction Research has suggested that health related behaviours and beliefs established during adolescence generally remain unchanged in later adulthood (Wadsworth, 1992). Habits developed during this peri-

od are likely to become deep-rooted due to the formation of identity and increased autonomy during this period of development (Kelder, Perry, Klepp & Lytle, 1994). Autonomy can be defined as â&#x20AC;&#x153;the freedom from external control or influ-

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ence” (Oxford Dictionaries, 2015) and is an important factor to consider in relation to behaviours during adolescence. Harmful adolescent behaviours related to eating (including food restriction and overeating) have been an increasing concern for researchers and medical experts in recent decades (Birch & Fisher, 1998; Van den Bulck, 2000). These behaviours have been associated with the later risk of immediate health problems including anaemia, obesity and eating disorders (Williams et al., 1995). They have also been associated with serious long-term illnesses such as Coronary Heart Disease, cancer and osteoporosis (Williams et al., 1995). Therefore eating patterns established during adolescence are likely to be of paramount importance to later wellbeing. Eating habits among adolescents: a need for concern? There are important developmental factors associated with being an adolescent that should be considered as influences on food choice. Adolescence is a period of great change in a person’s life, including physical changes in the body (Spear & Kulbok, 2001), changes in thought processes (Piaget, 1970) and increased autonomy (Kelder et al.,1994). Despite these important changes occurring during adolescence there has been little research into their effect on adolescent eating behaviour (Hill, 2002). Adolescence is also a period linked to not adhering to rules (Ministry of Health New Zealand, 1998) and therefore

not conforming may be expressed by not following healthy eating guidelines (Hill, Oliver & Rogers, 1992). These maturational developments along with interpersonal factors can significantly influence food choice by inhibiting healthy eating (Neumark-Sztainer, Story, Perry & Casey 1999; Stevenson, Doherty, Barnett, Muldoon & Trew, 2007), encouraging the overeating of energy rich foods or by promoting restrictive eating, all of which can give rise to serious health problems (Ridgwell, 1996). Statistically, Ireland has been found to have one of the highest levels of obesity among young people (Lissau, 2005). Taking into account international norms it was concluded that nearly one in four boys and more than one in four girls in Ireland could be classified as overweight or obese (Whelton et al., 2007). This establishes the need for research in Ireland on the psychosocial factors contributing to the trend among this age group. It can be argued that changes in society, including the promotion of unhealthy foods by the media and their widespread accessibility, has led to health problems of epidemic proportions among children and adolescents (Irving & Neumark-Sztainer, 2002). However the level of influence these external factors have are likely to be linked to an adolescent’s level of autonomy. In 2005, McKinley and colleagues explored teenagers’ views on food, which drew attention to negative attitudes towards healthy eating.

Empirical Investigations

AUTONOMY AND PERCEIVED PARENTAL CONTROL Young teenagers expressed disapproval at being encouraged to adopt healthier eating patterns, which suggests their objection to parental control when it comes to eating. As previously mentioned, restrictive eating patterns can be common during adolescence, which can give rise to eating disorders including anorexia nervosa (Barry, 2002). Research has found that anorexia is ranked as the third most common chronic illness among adolescents, following obesity and asthma (Sheppird, 2010). Health Research Board data in Ireland has demonstrated that in the case of child and adolescent psychiatric admissions in Ireland in 2009, eating disorders represented the second highest level of diagnosis at 18% (Daly & Walsh, 2010), highlighting the reason for concern in this area. Gender differences: Do they affect eating habits? Gender differences in eating patterns generally emerge in early adolescence as studies suggest that there is an increased pressure to be thin among girls (Rolls, Fedoroff & Guthrie, 1991; Vincent & McCabe, 2000). Girls have been found to be more motivated to eat healthily due to body weight concerns while boys appear more motivated to eat healthy to improve their physical performance (McKinley et al., 2005). The literature (e.g. Chen, 1999; Hops, Sherman, & Biglan, 1989) argues that adolescence is a more stressful developmental period for girls than for boys.

Girls are generally socialised to value relationships within the family to a greater extent and violating family guidelines such as eating patterns may be of greater significance to them than boys (Chen, 1999). This suggests that girls may be more likely to adhere to family eating patterns rather than make their own food choices. Lawlor and Nixon (2009) found significant gender differences related to body image, which are likely to contribute to gender differences in eating habits. Most adolescent boys of an average weight were content with their body size however in contrast to this, more than three quarters of adolescent girls within the normal body mass range revealed unhappiness with their body size. This suggests girls may to be more motivated to adapt healthier eating patterns as body image can influence eating patterns (Thompson et al., 2006). Another key gender difference that may affect eating patterns is the desire for muscularity by boys in contrast to the desire to be thin by girls. McCreary and Sasse (2010) found that the drive for muscularity appears to be stronger in boys than in girls and that those who are motivated to become more muscular often adopt their diet to do so. Therefore desired body image appears to be a key difference between genders, which may be exhibited in differences in eating patterns. The role of the mother and father in adolescent eating habits â&#x20AC;&#x201C;

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Is there a difference? Parents can have a profound impact on the types of foods their children eat (Birch, Fisher & Grimm-Thomas, 1996). Research has suggested that mothers have a greater influence than fathers on their children’s eating behavior (Pettit, Brown, Mize, & Lindsey, 1998). This research suggested mothers tend to have a more powerful influence than fathers in socialising their children’s eating patterns and are more persistent in their efforts to ensure their children eat certain foods. This was further supported by Johannsen and colleagues (2012) who claimed that mothers have more power over their children’s weight and appeared more concerned about their children’s eating behaviours. These researchers found that mothers’ weight was strongly related to their daughters’ Body Mass Index (BMI) but there was no such association with their sons’ weight. These findings suggest either a genetic influence or the modeling of behaviour between mothers and daughters. Stevenson and colleagues (2007) found that parents were only rarely reported as encouraging their children to be healthy eaters and parents often made use of unhealthy foods as rewards. Furthermore many adolescents had little or no participation in deciding food choices at home, highlighting high parental control around eating habits. Costanzo and Woody (1985) believed that parental control over eating habits undermined an ad-

olescent’s capability to form self-control over eating. Restrictive feeding practices could encourage the intake of restricted foods by negatively affecting children’s own views on their ability to control food consumption. Overall Stevenson and colleagues (2007) found that adolescents viewed their healthy diet as dependent on their parents and their autonomy to be linked to unhealthy eating patterns. These findings were supported by the Irish Safefood Study (2007), which found that many parents reported losing control over their child’s diet when their child reached a certain age due to an increase in autonomy during adolescence. The relationship between food choice and independence is a complex matter for adolescents (Elridge & Murcott, 2000). Fisher and Birch (1999) suggested that there was a connection between the overeating of appetising food in the absence of hunger among girls and mothers’ restriction of these appetising foods, thus highlighting the effect mothers control may have on eating habits. This research suggests that restricting access to certain foods may have the negative effect by encouraging eating behaviours such as snacking in the absence of hunger. Longitudinal data has also highlighted that when daughters have restricted food intake guidelines implemented by their mothers they are more likely to engage in unrestrained overeating and be overweight (Birch, Fisher & Davison, 2003). These studies highlight the

Empirical Investigations

AUTONOMY AND PERCEIVED PARENTAL CONTROL negative effect of high parental control on adolescent food choices for girls and the need for more research in this area focusing on adolescent boys. When examining the role of parents in relation to restrictive eating disorders, theoretical accounts from both psychodynamic and family systems perspectives view anorexia as the difficulty in forming an individual identity (Bruch, 1973). This draws attention to the link between autonomy and these disorders. Strober and Humphrey (1987) found that the family environment for people with anorexia could inhibit the development of a stable identity, autonomy and self-efficacy. In addition to this, it was found that adolescent girls who perceived higher levels of parental control in terms of eating were more likely to report higher levels of restrictive eating patterns (Edmunds & Hill, 1999). The modeling of this behavior has also been proposed by Levine and colleagues (1994) who found that girls with mothers who diet and express concern about their weight were more likely than peers to develop unhealthy weight control habits. There is a deficit of research in this area related to boys. However Smolak and colleagues (1999) found that motherâ&#x20AC;&#x2122;s advice related to eating habits had a greater affect than fathers advice for sons and daughters and overall daughters were more affected by this advice than sons. Autonomy: How this Aspect of Adoles-

cence Influences Eating Habits Another key factor related to eating habits is the development of autonomy during adolescence (Havighurst, 1948). Autonomy has been described as maintaining relationships while developing self-regulation and independence (Hill & Holmbeck, 1986). However autonomy appears to be a multidimensional-construct that can be expressed in a variety of ways such as through eating habits or taking part in physical activity. Therefore as children reach their teenage years their increased level of autonomy can have many implications on their lifestyle. For example, research has found that due to an increased level of autonomy most adolescents are economically independent enough to be able to buy their own food and as a result they tend to snack between meals more frequently than adults (Anderson, MacIntyre & West, 1993). This is likely to have negative effects on their health in terms of weight control. Previous literature has suggested that dietary quality declines when children reach adolescence (Lien, Lytle & Klepp 2001; Lytle, Seifert, Greenstein & McGovern 2000). After the transition from primary to secondary school, consumption of breakfast, fruit, vegetables and milk decreased, while soft drink consumption increased (Lytle et al., 2000). When adolescents had control over their own food intake, Neumark-Sztainer and colleagues (1999) identified lifestyle factors such as

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convenience and time constraints as a primary influence on their food choice. They also found that as adolescents became more independent they developed worse eating habits. These findings are consistent with more recent research suggesting that autonomy is a risk factor for poor nutrition (Videon & Manning, 2003) and in situations where adolescents have more control their food choices they tend to be less healthy (De Bourdeaudhuij & Sallis, 2002). Significance and Current Aims of the Study The above literature suggests that autonomy, gender and other familial factors related to control can have an impact on adolescent eating patterns. However these combined factors have been under-investigated in an Irish context. The current study makes use of questionnaires in line with previous studies in this area (Kristal, Shattuck & Henry, 1990; Shannon, Kristal, Curry & Beresford, 1997). This methodology allows for a greater sample size and as replies are anonymous they are likely to yield honest answers particularly to any questions that may be considered of sensitive nature. The aim of the current study was to assess the eating habits of a sample of Irish adolescents and to investigate the factors that may be contributing to them. The hypotheses for this study were: H. 1 Girls have better eating habits then boys. H.2a Girls have higher levels of per-

ceived parental control. H.2b Boys have higher levels of autonomy. H. 3 Parents have an influence on adolescentsâ&#x20AC;&#x2122; eating habits. H. 4 As autonomy increases eating patterns will become less healthy. H.5 The significant difference in autonomy levels between genders will influence healthy eating scores. â&#x20AC;&#x192; Method Design A cross-sectional design was implemented. The dependent variable was healthy eating behaviour and the independent variables were gender, economic independence, perceived parental control, age and level of autonomy. Participants The sample comprised of 162 adolescents (89 males and 73 females) from three secondary schools, one in Donegal (N = 83) and two in Dublin (N = 79). Participants were recruited on a voluntary basis from regularly scheduled classes. All participants were first or fourth year students, ranging in age from 12-16 years (M = 13.97 years, S.D. = 1.53). These year groups were recruited to ensure adolescents with a broad age range were included. Materials Information for both parents and participants was distributed detailing the

Empirical Investigations

AUTONOMY AND PERCEIVED PARENTAL CONTROL study. A consent form was also provided requesting permission from the parent for their child’s participation and informed consent from the participant themselves. Participants also received a debriefing form. Four questionnaires were distributed to participants: The Demographics Questionnaire: This assessed general background information of participants such as gender, age, economic independence and number of siblings. 1. The Adolescent Food Habits Checklist (AFHC) (Johnson, Wardle & Griffith, 2002): This aimed to provide a measure of adolescent healthy eating behaviour while accounting for situations in which adolescents are likely to have some degree of personal control. The AFHC identifies areas of adolescent eating habits that may be of concern such as the consumption of energy dense foods. The measure also accounts for underlying cognitions, attitudes and circumstances that lead to healthy eating (Johnson, Wardle & Griffith, 2002). There are twenty-three items that can be answered “true” or “false”. Examples of items include “if I am having lunch away from home, I often choose a low-fat option” and “I make sure I eat at least one serving of vegetables or salad a day”. Participants are given a healthy eating score out of twenty-three. The current study demonstrated an acceptable internal

consistency according to Nunally’s (1978) criteria of 0.7 (α=0.83). 2. Parental Bonding Instrument (PBI) (Parker, Tupling & Brown, 1979): This questionnaire has two scales, “care” and “overprotection” which measure parenting styles as perceived by the child. Participants were told verbally and orally that they should only answer on parents whom they live with “most of the time” i.e. at least four out of seven days a week. The measure was completed separately for both mothers and fathers (were applicable) and included twenty-five items that could be answered by the following responses: very unlike, moderately unlike, moderately like or very like. Respectively these responses were scored 0, 1, 2 and 3 and were reversed on some items. Items included “spoke to me in a warm and friendly voice” and “tried to control everything I did”. The current study demonstrated internal consistencies just below Nunally’s (1978) criteria of 0.7: maternal care (α=0.65), maternal control = (α=0.52), paternal care (α=0.58) and paternal control (α=0.5). Therefore the results may not be completely reliable. Adolescent Autonomy Questionnaire (Noom, Dekovi´c & Meeus, 2001): This fifteen statement self-report measure assessed three aspects of autonomy: attitudinal, emotional and functional. Respondents were asked to rate each statement as how relevant it is to them on a five-point

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scale. The current study demonstrated an acceptable internal consistency according to Nunally’s (1978) criteria of 0.7: attitudinal autonomy (α=0.81) emotional autonomy (α=0.71) and functional autonomy (α=0.72). SPSS analytics software was used to assess the data. Procedure Ethical approval was sought and granted from the school of Psychology Research Ethics Committee. Information sheets and consent forms were distributed to all potential participants in each school and their parents. Consent forms were collected within a week of their distribution. Testing took place within the school setting. Participants who had parental consent and gave personal consent were asked to fill out the four questionnaires. Prior to dissemination of questionnaires, the researcher explained the purpose of the study. Emphasis was placed upon the confidentiality and anonymity of individuals’ responses. The voluntary nature of the study was highlighted and students were assured that no penalties would be incurred if they chose not to partake. The adolescents were then given the opportunity to ask any questions they had related to the study. Participants read the instructions on each of the questionnaires and filled out their answers to the questions. Once the questionnaires have been completed, participants were given debriefing forms and

accompanied back to their classrooms. There were no incentives provided to participants for their participation Results Preliminary Analysis Descriptive statistics were conducted to confirm normality among the results and check for outliers to ensure suitability for parametric testing. H. 1 Girls have better eating habits then boys. Descriptive statistics were initially performed to generate a mean and standard deviation for each variable to draw a comparison between gender differences (see Table 1). T-tests were subsequently carried out which showed there was no significant difference between genders for healthy eating score (t (160) = -0.639, p > .05, one-tailed). This result does not support the original hypothesis that girls have healthier eating habits than their male counterparts. H.2a Girls have higher levels of perceived parental control/ H.2b Boys have higher levels of autonomy. Independent sample t-tests were subsequently used to examine whether girls scored significantly higher than boys on perceived parental control measures and to examine whether boys had significantly higher levels of autonomy as hypothesised (see Table 1). To overcome the chance of committing a type one error the Bonferroni correction

Empirical Investigations

AUTONOMY AND PERCEIVED PARENTAL CONTROL was applied to all the analyses. Significant gender differences were observed for four variables: money received on a weekly basis for food (t (162) = - 3.114, p, .05, one-tailed), mother care (t (162) = -2.571, p< .05, one-tailed), emotional autonomy (t (162) = 3.016, p < .05, one-tailed) and functional autonomy (t (162) = 2.175, p< .05, one-tailed). The significance of the mother care variable supports the hypothesis that mothers are perceived to have more control by daughters in comparison to sons. Economic independence and

emotional autonomy remained significant under this criterion. As economic independence is a form of autonomy and this was significantly higher for girls, the original hypothesis that autonomy levels are higher for adolescent boys was not supported. However the significance of emotional autonomy does support the hypothesis as boys had a higher score on this measure. This finding highlights that only this type of autonomy, (not functional or attitudinal) was significantly higher for boys.

H. 3 Parents have an influence on adolescentsâ&#x20AC;&#x2122; eating patterns. Influence of mothers: Partial correlations were carried out on data to determine whether mothers had a greater influence on adolescent eating habits than fathers as originally hypothesised (see Table 2). The results

suggest that AFHC scores are unrelated to mother care (r (157) = .138, p > .05) or mother over protection (r (157) = .521, p> .05) when controlling for father care and over protection scores.

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Influence of fathers: Subsequently calculations were carried out to determine the influence of fathers on adolescent eating habits while controlling for the influence of mothers (see Table 3). The results suggest that AFHC scores were unrelated to father care (r (157) = .104, p > .05) or father over protection (r (157) = .112, p>

.05) when controlling for mother care and over protection scores. The overall impact of perceived parental control for mothers and fathers appeared to disappear when they were examined without overlap. This undermined the importance of this variable on adolescent eating habits.

H. 4 As autonomy increases health eating scores decrease. Forced entry multiple regression was used to measure the ability of age, gender, economic independence, father care, father overprotection, mother care, mother overprotection, attitudinal autonomy, emotional autonomy and functional autonomy to influence AFHC scores. The standardized Beta coefficients allowed comparisons across variables to examine their relative impact on AFHC score. The overall ANOVA model was not significant (f (7, 153)= 1.916, p>0.05) and the combined R2 figure (0.081) for the in-

formation explained was low. Economic independence (money received on a weekly basis for food) appeared to be the greatest contributor to AFHC score followed by emotional autonomy (see Table 4). The lack of model fit caused by the non-significant variables diluted the potential contribution of these two significant variables to the model.

Empirical Investigations

AUTONOMY AND PERCEIVED PARENTAL CONTROL

H.5 There is a significant difference in autonomy levels between genders, which impact healthy eating scores A further regression was carried out to test the hypothesis that functional, emotional and attitudinal autonomy impact the gender differences on AFHC scores. The overall ANOVA model was not significant for both genders (males= f (3, 85)= .854, p>0.05) (females = f (3, 69) = 1.746, p> 0.05). The combined R2 figure (males= .029; females = .071) for the information explained was low (see Tables 5 and 6). Effect of autonomy on adolescent male

eating habits: Although statistical significance was not found, the standardized coefficients allowed comparison of the impact of variables (see Table 5). It appeared for adolescent males that attitudinal and functional autonomy had a positive relationship with AFHC score, which does not support the original hypothesis. In contrast to this emotional autonomy had a negative relationship with healthy eating score which supported the hypothesis that as this type of autonomy increases healthy eating score decreases.

Effect of autonomy on female adolescent eating habits: Statistical significance was found for AFHC score and emotional autonomy for adolescent females (see Table 6). This result supports the hypothesis that as autonomy level increases healthy

eating score decreases however this does not support the hypothesis that this is more likely to occur in males. The standardised coefficients gave an insight into the impact of functional and attitudinal autonomy on eating habits. Although they were not sig-

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nificant they appeared to have the same effect as with adolescent males. This does not support the hypothesis that as these

levels increase they negatively impact healthy eating.

Discussion

adapting their diet to enhance physical performance in sports or perhaps achieve greater muscularity and to do so they are making healthier food choices (McCreary & Sasse, 2010). This is further supported by the findings that body image is a motivating factor in the decisions behind food choices (Thompson et al., 2006) however, this needs to be investigated further in terms of exploring what food choices are linked to ideal body image for both genders.

The aim of this study was to investigate the effect of autonomy and perceived parental control on adolescents’ eating habits and to assess gender differences. Results supported the hypothesis that girls have higher levels of perceived parental control and boys had higher levels of emotional, functional and attitudinal autonomy. In contrast to the previously outlined hypothesis, parents were not found to have a significant impact on adolescents’ eating habits. Economic independence and emotional autonomy were found to be the greatest contributors to healthy eating scores. However, emotional autonomy was found to only be a significant predictor for adolescent girls. Results indicated that girls and boys had similar healthy eating scores despite previous literature suggesting that adolescent girls tend to have healthier eating habits than boys (Rolls, Fedoroff & Guthrie, 1991; Vincent & McCabe, 2000). These results could be interpreted in line with previous findings, which suggest boys are

The significant difference between genders for the level of “mother care” supported the hypothesis that mothers are perceived to have more control by their daughters than their sons. This result suggests that daughters are more likely to adhere to their mother’s guidelines and this may be a reason for their lower autonomy scores on the Adolescent Autonomy Questionnaire. It also supports previous research that fewer autonomy opportunities may be granted to adolescent girls compared to boys (Bumpus, Crouter, & McHale, 2001). Scores for economic independence and emotional

Empirical Investigations

AUTONOMY AND PERCEIVED PARENTAL CONTROL autonomy were also significantly different for adolescent males and females, which suggests that different forms of autonomy may manifest themselves in different ways between boys and girls. Girls had a significantly higher level of economic independence, which can be viewed as a practical form of autonomy (Abramovitch, Freedman & Pliner 1991) while boys had a significantly higher level of emotional autonomy, which can be viewed as a developmental form of autonomy (Noom, Dekovic & Meeus 1999). In agreement with this, Chen (1999) argued that girls are generally socialised to value familial relationships more. These family ties are likely to restrict the development of autonomy (Steinberg & Silverberg 1986), which in turn may impact on aspects of lifestyle such as eating habits. Distinguishing between these forms is likely to be important for further investigations on how they influence adolescent decisions. Economic independence and emotional autonomy were found to be the greatest contributors to adolescent eating habits by the multiple regression model. Overall the more money adolescents received on a weekly basis to spend on food the lower their healthy eating score was likely to be. As emotional autonomy but not functional or attitudinal autonomy had a negative impact on adolescent eating habits this suggests that autonomy is a multidimensional construct that can impact adolescent lifestyle choices in

different ways. Emotional autonomy is related to having confidence about oneâ&#x20AC;&#x2122;s own choices and goals (Noom, Dekovic & Meuus 2001) and therefore will be an important psychological construct to address in health eating interventions. This factor could be incorporated into interventions which focus on the emotions associated with food choices. Although economic independence is an important aspect of adolescence for the development of self-regulation (Hill & Holmbeck, 1986), research on the level of economic independence suitable for adolescent age groups may be important for changing negative lifestyle habits such as bad food choices. Previous research that parents can have a profound impact on their adolescentâ&#x20AC;&#x2122;s eating habits (Birch, Fisher & Grimm-Thomas, 1996; Field et al., 2001) was not supported by the results as items on the perceived control measure were not significant in the multiple regression analysis for predicting healthy eating score. The relative importance of a motherâ&#x20AC;&#x2122;s role on adolescent food choices (Pettit, Brown, Mize, & Lindsey, 1998) is however supported by higher mean scores received on the perceived control measure. Partial correlations indicated when scores for the opposite parent were controlled for, the impact of parents on healthy eating scores diminished. These findings highlight the importance of autonomy rather than the perceived control of parents as impacting factors on adolescent eating habits.

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Overall, adolescent boys had higher autonomy levels than girls on the Adolescent Autonomy Questionnaire however girls had a higher level of economic independence. Girls appeared to receive significantly more money to spend on food on a weekly basis however this did not result in their eating habits being worse than their male counterparts. This finding for adolescent girls does not support previous research that suggested most adolescents viewed their autonomy as the opportunity to make unhealthy food choices (Costanzo and Woody 1985; Neumark-Sztainer et al., 1999). This type of autonomy for adolescent girls may aid self-regulation as it highlights their potential ability to make healthy food choices for themselves. A further regression model revealed only female adolescents had a significant relationship between their healthy eating score and their emotional autonomy level, which highlights an important gender difference for the impact of this variable. Examining components of emotional autonomy such as non-dependency, individuation, parental de-idealisation and perceiving oneâ&#x20AC;&#x2122;s parents as people (Steinberg & Silverberg 1986) will be important to investigate in future research for adolescent girls in relation to their eating habits to gain a greater understanding for the implementation of this construct in healthy eating strategies. Limitations The first limitation of the study was the resistance from adolescent girls and/

or their parents to participate. This resulted in the need for further recruitment of participants from this gender category. This may have caused a bias in the sample as perhaps those with eating concerns were those who did not participate. This occurred despite adolescent girls and boys being from the same geographical location and attending schools of the same socioeconomic status, which could possibly be interpreted as higher parental control over daughters in comparison to sons in relation to eating habits. The reliance on self-reported measures may be an additional limitation. Despite adolescents being perceived as the most realistic source of their personal experiences (Edelbrook et al., 1985) supplemental information from family members and peers may have been useful to gain a further insight into the role of parental control and autonomy on eating habits. Feedback from parents on their adolescentâ&#x20AC;&#x2122;s food choices and input from peers regarding types of autonomy may have further answered the research questions proposed. Unfortunately the scales on the perceived control measure did not meet the criteria for internal validity which may have impacted findings. Future research should further investigate suitability of this scale among adolescent populations. Future research recommendations

Empirical Investigations

AUTONOMY AND PERCEIVED PARENTAL CONTROL Further research should look at the socioeconomic differences, peer influences and the role of the media in relation to adolescent eating habits. These are all factors that may be linked to autonomy and impact food choices for adolescents (Irving & Neumark-Sztainer, 2002). Accounting for Body Mass Index (BMI) in future studies would be helpful to examine whether autonomy or perceived parental control had an impact on whether adolescents had a BMI score outside the norms. This would expand on the literature of whether low perceived parental control may be linked to restrictive eating habits (Strober and Humphrey 1987) or if high-perceived parental control may be linked to overeating (e.g. Anderson et al., 1993). Research demonstrating that in situations where adolescents have control they make less healthy food choices (De Bourdeaudhuij & Sallis, 2002) needs to be explored further. Qualitative research would likely gain in-depth answers into the processes that underlie food choices for adolescents when they are in control. This could also underpin possible motivating factors behind these choices such as body image, convenience or money restraints. Results from this could help to further answer the question of whether autonomy and self-control can negatively impact healthy eating habits and how interventions could target these processes. Conclusion

Irish adolescent males and females appeared to have similar healthy eating scores contrary to previous research (e.g. Vincent & McCabe, 2000). Adolescent males had higher levels of emotional, attitudinal and functional autonomy but lower levels of economic independence and perceived parental control in comparison to their female counterparts. The hypothesis that mothers have a greater influence than fathers over adolescent eating habits was supported. Further investigation into the influences on eating habits revealed the negative effect of high economic independence and high emotional autonomy as impacting factors on food choices among this population. These will be important factors to incorporate in healthy eating interventions for Irish adolescents. The significance of emotional autonomy on healthy eating scores for adolescent girls only highlights the importance of further examining this construct for gender specific interventions. References Abramovitch, R., Freedman, J., & Pliner, P. (1991) Children and money: Getting an allowance credit vs cash and handling of money. Journal of Economic Psychology, 12, 27-42. Anderson, A.S., MacIntyre, S., & West, P. (1993) Adolescent meal patterns: grazing habits in the west of Scotland. Health Bulletin (Edinburgh), 51, 158165.

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Barry, Patricia (2002). Mental health and mental illness (7th edition). Philadelphia, PA: Lippincott.

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Birch, L.L., Fisher, J.O., & Grimm-Thomas, K. (1996) The development of children’s eating habits. In: Meiselman, H.L., MacFie, H.J.H., editors. Food Choice, Acceptance and Consumption. London, England: Blackie Academic and Professional; 161–206.

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Birch, L. L. & Fisher, J. O. (1998) Development of Eating Behaviors Among Children and Adolescents. Pediatrics, 101, 2, 1, 539-549. Birch, L.L., Fisher, J.O., & Davison, K.K. (2003) Learning to Overeat: Maternal Use of Restrictive Feeding Practices Promotes Girls’ Eating in the Absence of Hunger. American Journal of Clinical Nutrition, 78(2): 215–220. Brunch, H. (1973) Eating Disorders: Anorexia Nervosa, obesity and the person within. New York: Basic Books. Bumpus, M. F., Crouter, A, C., & McHale, S. M. (2001) Parental autonomy granting during adolescence: Exploring gender differences in context. Developmental Psychology, 37(2), 163-173. Chen, Z. (1999) A gender comparison on the association of adolescent emotional autonomy with educational expectations and self-esteem. Applied Behavioural Science Review, 7, 1, 1-21. Costanzo, P.R. & Woody, E.Z. (1985) Domain-specific parenting styles and their impact on the child’s development of particular deviance: the ex-

De Bourdeaudhuij, I., & Sallis, D. (2002) Relative contribution of psychosocial variables to the explanation of physical activity in three population-based adult samples. Preventative Medicine, 34, 2, 279-288. Edelbrook, C., Costello, A.J., Dulcan, M., Kalas, R., & Conover, N. (1985). Age differences in the reliability of the psychiatric interview of the child. Child Development, 56, 265-275. Edmunds, H & Hill, A.J. (1999) Dieting and the family context of eating in young adolescent children. International Journal of Eating Disorders, 25(4): 435-40. Elridge, J. & Murcott, A. (2000) Adolescents’ dietary habits and attitudes: unpacking the “problem” of parental influence. Health, 4, 25-49. Fisher, J. O. & Birch, L. L. (1999) Restricting access to foods and children’s eating. Appetite; 32(3): 405-19. Havighurst, R. (1948). Developmental Tasks and Education. New York: McKay. Hill, J. P., & Holmbeck, G. N. (1986). Attachment and autonomy during adolescence. Child Development. 3: 145–189.

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AUTONOMY AND PERCEIVED PARENTAL CONTROL Hill, A.J., Oliver, S. & Rogers, P.J. (1992) Eating in an adult world: The rising of dieting in childhood and adolescence. British Journal of Clinical Psychology, 31, 95-105. Hill, A. J. (2002). Developmental issues in attitudes to food and diet. Proceedings of the Nutrition Society, 61, 259–266. Hops, H., Sherman, L., & Biglan, A. (1989). Maternal depression, marital discord, and children’s behavior: A developmental perspective. In G. R. Patterson (Ed.), Depression and aggression in family interactions (pp. 185-208). Hillsdale, New Jersey: Erlbaum. Irving, L.M. & Neumark-Sztainer, D. (2002) Integrating the prevention of eating disorders nnnnnnand obesity: Feasible or futile. Preventative Medicine. 34, 299-309. Johannsen, D.L., Johannsen, J.M., & Specker, B. (2012) Influence of parents’ eating behaviours and child feeding practices on children’s weight status. Obesity, 14, 3, 431–439. Johnson, F., Wardle, J., & Griffith, J. (2002) The Adolescent Food Habits Checklist: reliability and validity of a measure of healthy eating behaviour in adolescents. European Journal of Clinical Nutrition 56, 644–649. Kelder, S.H., Perry, C.L., Klepp, K.I., & Lytle, L.L. (1994) Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors. American Journal of Public Health, 84(7): 1121–1126.

Kristal, A.R., Shattuck, A.L., & Henry, H.J. (1990) Patterns of dietary behaviour associated with selecting diets low in fat: reliability and validity of a behavioural approach to dietary assessment. Journal of the American Dietetic Association. 90, 214–220. Lawler, M. & Nixon, E. (2011) Body Dissatisfaction Among Adolescent Boys and Girls: The Effects of Body Mass, Peer Appearance Culture and Internalization of Appearance Ideals. Journal of Youth Adolescence 40: 59–71. Levine M. P., Smolak, L., Moodey, M.D., & Hessen, L.D. (1994) Normative developmental challenges and dieting and eating disturbances in middle school girls. International Journal of Eating Disorders, 15:11–20. Lien N., Lytle L. A., & Klepp K. (2001) Stability in consumption of fruit, vegetables, and sugary foods in a cohort from age 14 to age 21. Preventive Medicine; 33:217-226. Lissau, I., Overpeck, M.D., Ruan, W.J., Due, P., Holstein, B.E., & Hediger, M.L. (2004) Body mass index and overweight in adolescents in 13 European countries, Israel, and the United States. Archive Pediatric Adolescent Medicine; 158: 27– 33. Lytle, L.A., Seifert, S., Greenstein, J., & McGovern, P. (2000) How do children’s eating patterns and food choices change over time? Results from a cohort study. American Journal of Health Promotion; 14(4): 222–228.

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McCreary, D.R. & Sasse, D.K. (2010) An Exploration of the Drive for Muscularity in Adolescent Boys and Girls. Journal of American College Health, 48:6, 297-304. McKinley, M.C., Lowis, C., Robson, P.J., Wallace, J.M.W., Morrissey, M., Moran, A., et al. (2005) It’s good to talk: Children’s views on food and nutrition. European Journal of Clinical Nutrition. 59:542-51. Ministry of Health New Zealand (1998) Food and nutrition guidelines for healthy adolescents: A background paper. Wellington: New Zealand. Neumark-Sztainer, D., Story, M., Perry, C.L., & Casey, M.A. (1999). Factors influencing food choices of adolescents. Journal of the American Dietetic Association. 99, 929-936. Noom, M. J., Dekovic, M., & Meeus, W. H. (1999) Autonomy, attachment and psychosocial adjustment during adolescence: a double-edged sword? Journal of Adolescence, 22, 6. 771– 783. Noom, M. J., Deković, M., & Meeus, W. (2001) Conceptual Analysis and Measurement of Adolescent Autonomy. Journal of Youth and Adolescence, 30, 5, 577-595. Nunnally, J. (1978) Psychometric Theory. New York: McGraw-Hill.Oxford Dictionaries (2015). Parker, G., Tupling, H. & Brown, L. (1979). A parental bonding instrument. British Journal of Medical Psychology, 52, 1–10.

Pettit, G.S, Brown, E.G. Mize, J. & Lindsey, E. (1998) Mothers’ and fathers’ socializing behaviors in three contexts: Links with children’s peer competence. Merrill-Palmer Quarterly, 44, 2. Piaget, J. (1970) Piaget’s theory. In P.H. Mussen (Ed.) Carmichael’s manual of child psychology. (Vol. 1, pp. 703732.). New York: Wiley. Ridgwell, J. (1996) Examining Food and Nutrition. London: Heinemann Educational Books. Rolls, B.J., Fedoroff, I.C., & Guthrie, J.F. (1991). Gender Differences in eating behaviour and body weight regulation. Health Psychology, 4, 133-42. Safefood Research (2009). Consumer knowledge and practice in relation to drinks for children and young people. Dublin: Safefood. Shannon, J., Kristal, A.R., Curry, S.J., & Beresford, S.A.A. (1997) Application of a behavioural approach to measuring dietary change: the Fat- and Fiber-related Diet Behavior Questionnaire. Cancer, Epidemiology, Biomarkers & Prevention; 6:355– 361. Sheppird, S.F. (2010) 100 Questions & Answers About Anorexia Nervosa, Sudbury, Massachusetts: Jones and Bartlett Publishers Smolak, L., Levine, M.P. & Schermer, F. (1999) Parental input and weight concerns among elementary school children. International Journal of Eating Disorders, 25:263–271.

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Journal of adolescent health, 32, 5, 364-373. Vincent, M. A., & McCabe, M. P. (2000). Gender differences among adolescents in family, and peer influences on body dissatisfaction, weight loss, and binge eating disorders. Journal of Youth and Adolescence, 29, 205-221. Wadsworth, M. (1992) The imprint of time: Childhood, History and Adult life. Oxford: Clarendon press. Whelton, H., Harrington, J., Crowley, E., Kelleher, V., Cronin, M., & Perry, I. (2007) Prevalence of overweight and obesity on the island of Ireland: results from the North South Survey of Children’s Height, Weight and Body Mass Index, 2002. BioMed Central Public Health, 7:187. Williams, C.L., Bollella, M., & Wynder, E.L. (1995) A new recommendation for dietary fibre in childhood. Pediatrics, 96, 985-988.

Student Psychology Journal, 2013, 84- 100

Exploring Perceptions of Partners’ Facial Attractiveness and Relationship Satisfaction Niamh Daly Ryan

Supervisor: Dr. Nuala Brady

University College Dublin

Correspondence: niamh.daly-ryan@ucdconnect.ie

abstract The aim of the present study was to discover if individuals in successful relationships idealise each other’s facial attractiveness. Data were collected and analysed from 31 undergraduate UCD students in romantic relationships, of which there was 15 males and 16 females. The age range was 19-25 years (M=21.19 years; SD=1.79). Participants took part in pairs with their romantic partners. They completed a relationship satisfaction questionnaire and their faces were photographed. Faces were digitally manipulated with computer software to produce 3 increasingly feminised images and 3 increasingly masculinized images. One image that was not manipulated was kept as the original image. Participants were instructed to choose the best-likeness image of their partner from the 7 images. Hypothesis One, which stated that the male participants who are satisfied with their romantic relationships will choose a feminised image as the best-likeness image of their partner was not supported. Hypothesis Two, which stated that the female participants who are satisfied with their romantic relationships will pick the masculinized image as the best-likeness image of their partner, was not supported. Hypothesis Three, which stated that the observed frequencies of the males’ best-likeness image preferences will differ from that expected by chance, was supported. Hypothesis Four, which stated that the observed frequencies of the females’ best-likeness image preferences will differ from that expected by chance, was not supported. Participants’ photographs were presented electronically, which represented a methodological strength. However, a large number of participants chose the original image as the best-likeness image of their partner. Practical implications were discussed and it was suggested that future research should attempt to reduce the effect of social desirability. Keywords:attractiveness, facial attractiveness, relationships, relationship satisfaction, satisfaction, perception, romantic relationships

Empirical Investigations

ATTRACTIVENESS AND RELATIONSHIP SATISFACTION Introduction Opinions differ on what, exactly, constitutes an attractive face. The philosopher David Hume once claimed that beauty “is no quality in things themselves: it exists merely in the mind which contemplates them; and each mind perceives a different beauty” (Hume, 1757, pp. 208-209). However, people are influenced by culturally defined values of beauty (Little, Jones & DeBruine, 2011). From an evolutionary psychology perspective, attractiveness preferences can depend on hormonal (Penton-Voak et al., 1999) and environmental factors (Perrett et al., 2002). On the other hand, universal standards of facial attractiveness have been agreed upon between individuals within and across cultures (Little & Perrett, 2002; see Langlois et al., 2000 for a review). These standards include averageness , which is retrieved by averaging the facial characteristics of a similar gender and age group (Langlois & Roggman, 1990), symmetry (Thornhill & Gangestad, 1993), and sexual dimorphism (O’Toole et al., 1998; Perrett et al., 1998). Sexual dimorphism relates to the extent to which an individual is masculine or feminine in appearance (Little, Jones, DeBruine & Feinberg, 2008). Sexual dimorphic facial features develop with the onset of puberty, in which secondary sexual characteristics become pronounced (Komori, Kawamura & Ishihara, 2009). Facial shapes differ between males and females

because of variations in sex hormone levels such as testosterone and oestrogen (Little et al., 2011). Male faces are broader, more elongated and rectangular than female faces (Ferrario, Sforza, Pizzini, Vogel, & Miani, 1993; Samal, Subramani, & Marx, 2007), whereas a greater contrast in brightness between the eyes and lips is observed in female faces (Russell, 2003). Males and females differ in their preferences for sexual dimorphic facial features, which presents a research problem as the cause of these differences has not been determined. Furthermore, relationship satisfaction has recently been linked with facial attractiveness, where people in successful relationships tend to idealise their partner’s facial attractiveness (Penton-Voak, Rowe, & Williams, 2007). However, these results have not been replicated with other dimensions of attractiveness such as sexual dimorphism, which the current thesis examines. It is generally agreed that heterosexual males prefer feminine faces (Perrett et al., 1998; Smith et al., 2006; Little, Cohen, Jones, & Belsky, 2007; Rhodes, Hickford, & Jeffery). However, recent evidence suggests that males’ preferences for femininity are more complex than previously thought. When judging for short-term partners, attractive men favour facial femininity in women more than less attractive men do (Burriss, Welling & Puts, 2011). Evolutionary psychology provides

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one explanation of why males find femininity attractive in female faces. The immunocompetence-handicap hypothesis theorises that the increased amount of female sex hormones, which are required to develop feminine facial features, stresses the immune system (Folstad & Karter, 1992). Males may find feminine features in females desirable because it means that they are able to resist infection while still expressing sexually selected traits (Folstad & Karter, 1992). Furthermore, extremes of secondary sexual characteristics signify the presence of good genes, which represent a survival and reproductive advantage to potential offspring (Little et al., 2011). Thus the preference of females for masculine facial features is an adaptation for seeking healthy mates (Fink & Penton-Voak, 2002). However, oestrogen, a female sex hormone has been linked with cancer instead of health (Service, 1998) and to the authorâ&#x20AC;&#x2122;s knowledge only one study has noted a correlation between feminine female faces and good health (Thornhill & Gangestad, 2006). A more reasonable theory postulates that males prefer facial femininity in females as it is a signal of thriving reproductive health and fertility (Smith et al., 2006; Penton-Voak et al., 2003; Jones, 1995). Female preferences of male facial attractiveness are not so clear cut (Little et al., 2011; Rennels, Bronstad & Langlois, 2008). Some studies found that women prefer masculine male faces (Cunning-

ham, Barbee, & Pike, 1990; Grammer & Thornhill, 1994; Johnston, Hagel, Franklin, Fink & Grammer, 2001) while other findings reveal a preference for feminine male faces (Little & Hancock, 2002; Penton-Voak et al, 2003). Exactly why these inconsistencies among the literature occur is unknown and researchers continue to address this problem. Variations within females such as their stage of the menstrual cycle can alter attractiveness preferences (Penton-Voak & Perrett, 2001). Johnston and colleagues (2001) proposed that these changes in perception are as a result of adaptive trade-offs in mate preference. During periods of low likelihood for conception, females are more likely to prefer more feminised male faces, which are associated with higher levels of sociability and thus a higher likelihood of that male to invest effort in an offspring. However, when a femaleâ&#x20AC;&#x2122;s chance of conception is higher, a more masculine face (indicating higher testosterone levels) is preferred as it is more likely to result in pregnancy. Moreover, males with masculinised faces may be perceived as unbefitting parents, deceitful and less cooperative, whereas males with feminised faces may be viewed more positively (Perrett et at al., 1998). Other explanations include the immunocompetence-handicap hypothesis as masculine male faces and superior health are correlated (Rhodes, Chan, Zebrowitz, & Simmons, 2003; Thornhill & Gangestad, 2006) and the intended long-term or

Empirical Investigations

ATTRACTIVENESS AND RELATIONSHIP SATISFACTION short-term duration of a relationship (Little, Jones, Penton-Voak, Burt, & Perrett, 2002). However, according to Rennels and colleagues (2008) methodological differences in facial stimuli are to blame for the discrepancies. Other researchers hypothesise that women may prefer feminine male faces because they attribute stereotypical personalities to their facial features (Penton-Voak & Perrett, 2001). Males with masculinized faces may be perceived as unbefitting parents, deceitful and less cooperative, whereas males with feminised faces may be viewed more positively (Perrett et at al., 1998). The immunocompetence-handicap hypothesis has gained more support amongst female preferences for masculinity as masculine male faces and superior health are correlated (Rhodes, Chan, Zebrowitz, & Simmons, 2003; Thornhill & Gangestad, 2006). Sexual dimorphism is normally digitally manipulated in one of two ways; either by manipulating sexual dimorphism or by attaining ratings of perceived masculinity-femininity. The first method exaggerates the shape differences between average male and female faces, while the second method generates male and female averages from masculine and feminine faces (DeBruine, Jones, Smith, & Little, 2010). Some researchers criticise the manipulated sexual dimorphism method (Rhodes, 2006; Rennels et al., 2008), while others disagree that methodological issues are to blame for the differences ob-

served between females and their facial attractiveness ratings (DeBruine et al., 010). Both methods focus on moving face shapes away from the average (attained by averaging the facial characteristics of a similar gender and age group), similar to the generation of photographic anti-caricatures, in which distinctive facial features are de-emphasised in comparison with the average (Chang, Levine, & Benson, 2002). Allen, Brady, and Tredoux (2009) found that close friends, even though they were familiar with each othersâ&#x20AC;&#x2122; faces, chose the anti-caricature image as the best representation of their friend. This raises the idea that individuals may idealise the facial attractiveness of people close to them. Penton-Voak and colleagues (2007) demonstrated that couples idealise the facial attractiveness of one another based on their ratings of relationship satisfaction. Participants who were happy in their relationships chose the images that had been artificially manipulated to look more attractive, whereas those that were dissatisfied with their relationships picked the images that had been digitally manipulated to look less attractive, as the original image of their partner. As physical attractiveness is a vital attribute of a mate (Dijkstra & Buunk, 1998), it is no surprise that perceiving oneâ&#x20AC;&#x2122;s partner as attractive enhances relationship satisfaction (Murray, Holmes, & Griffin, 1996a; Barelds & Dijkstra, 2009; for a review, see Swami and Furnham, 2008).

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Positive illusions are the phenomena thought to be behind the tendency for people in relationships to idealise their partners’ physical attractiveness and personal attributes more than their own (Barelds-Dijkstra & Barelds, 2008; Murray, Holmes, Dolderman & Griffin, 2000). Positive illusions may serve a significant purpose in the maintenance of relationships as they cushion an individual’s self-esteem against the threat of harmful information (Taylor & Brown, 1988). However, they can be disadvantageous when negative behaviours such as jealousy result (Swami & Furnham, 2008). Moreover, individuals may be setting themselves up for disappointment and bitterness in the future (Gagné & Lydon, 2004). Positive illusions of facial attractiveness have not been extensively examined in the literature (Barelds & Dijkstra, 2009) as some argue that positive illusions only exist in partners’ imaginations and not through objective sources of information such as photographs (Neff & Karney, 2002; Barelds, Dijkstra, Koudenberg, & Swami, 2011). Nevertheless, women tend to idealise images of their partner’s facial attractiveness more than men do (Penton-Voak et al., 2007; Gagné & Lydon, 2003). Penton-Voak and colleagues (2007) speculate this occurs because women provide more parental investment than men. Therefore, women may hold more positive illusions and biases about her partner to decrease the chance of her self-esteem faltering after a relationship break-up (Haselton &

Funder, 2006). On the other hand, this explanation does not fit with Trivers’ parental investment model (1972), which states that females, who are purported to have higher levels of parental investment, will be choosier in selecting a mate than their male counterparts. Therefore, if females are increasingly likely to be choosier than males, then it should follow that females would be less likely to be affected by idealisation. The present study aims to discover if individuals in successful relationships will idealise each other’s facial attractiveness. Their facial shapes were digitally manipulated using computer software to produce three increasingly feminised and three increasingly masculinized images, while relationship satisfaction was measured with a scale. In the following set of experiments we asked whether male participants who are satisfied with their relationships would choose a feminised image as the best-likeness image of their partner and whether female participants who are satisfied with their relationships would select a masculinized image as the best-likeness image of their partner. We also hypothesised that the male best-likeness image preferences would differ significantly from what would be expected by chance and that the female best-likeness image preferences would differ significantly from what would be expected by chance.

Empirical Investigations

ATTRACTIVENESS AND RELATIONSHIP SATISFACTION Method Design The present study utilised a between-subjects design, with one dependent variable and two independent variables. The dependent variable was each participantâ&#x20AC;&#x2122;s choice of best-likeness image of their partner, in which 7 choices were provided (3 images were increasingly feminised, 1 was the original, and the other 3 were increasingly masculinized). The independent variables were relationship satisfaction and gender, where there were 2 levels to gender (males and females). The research design enabled the researcher to examine if differences between groups in their choice of best-likeness image correlated with relationship satisfaction or if they were correlated with gender. Participants In total 15 males and 16 females offered to take part in the study. 30 participants identified as heterosexual while 1 participant identified as homosexual. Participants were aged between 18 and 25 years (M=21.19 years; SD=1.79) and all had normal or corrected-to-normal vision. Participants took part in the experiment in pairs with their romantic partners At the time of conducting the experiment, participants were in romantic relationships ranging from 3 months to 5.5 years (M=1.87 years; SD =1.23). The participants were undergraduate students from University College Dublin and all of them were Irish.

Materials Each participant was photographed against a white background, in a location that had natural lighting, using a digital camera (Canon EOS 450D) and tripod. The photographs of the participants, posing with a neutral expression, were 3088 pixels in width x 2056 pixels in height, which were reduced in size to fit in a Microsoft Word document. Participants were asked to take off their glasses if wearing them, to not wear make-up, and to place any stray hair behind their ears. Participants completed the Couples Satisfaction Index (CSI; Funk & Rogge, 2007; see Appendix A), which consists of 16 items. Relationship satisfaction is given by an overall score, with 81 being the maximum. A meta-analysis of the reliability of relationship satisfaction scales found that the reliability of the CSI (Funk & Rogge, 2007) was moderately high (Graham, Diebels, & Barnow, 2011). The participantsâ&#x20AC;&#x2122; digital images were processed on a Dell Inspiron 1525 personal computer. The images were uploaded to Online Psychomorph (DeBruine, 2014), which contains online image-processing and photographic manipulation software. Templates of the images were created by delineating the shape of each face with 179 points, which were located along the contours of the main facial features and facial borders (see Tiddeman, Burt, & Perrett, 2001 for details), and by clicking on three points of the face; the left and right

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pupil, and the top of the bottom lip. This calibrated the face with the feminised and masculinized average images discussed below, which allowed the participants’ images to be transformed. Average faces, which were previously made by morphing the digital images of 70 young Irish male faces and 70 young female faces, were acquired from Allen, Brady and Tredoux’s (2009) work and were utilised in the present study (see Figure 1). The individuals who provided their images to the aforementioned study were Irish, either students of UCD or friends of UCD students, and were in a similar age range as the participants of the present study. The averages were uploaded

to the website, which only the researcher had access to. Templates of the averages were generated by the same delineation process mentioned previously. The shape of the averages were masculinized or feminised to an extreme degree in order to create ultra masculinized male and ultra feminised female faces (see Figure 2). All of the participants’ face shapes were increasingly masculinized across 3 levels; slightly (+100%), moderately (+150%), and extremely (+200%); and feminised across 3 levels; slightly (-100%), moderately (-150%), and extremely (-200%). The photograph that was not manipulated was kept as the original image (see Figure 3 for an example of a participant’s manipulated images).

Empirical Investigations

ATTRACTIVENESS AND RELATIONSHIP SATISFACTION Procedure Each participant viewed the 7 images of their partner’s face on a Dell Inspiron 1525 laptop for a maximum duration of 5 minutes and selected the best-likeness image of their partner. The 7 images were numbered and displayed alongside each other in random order in a Microsoft Word document along with instructions and a Microsoft Word table, where participants placed the choice of their partner’s best-likeness image. An online random number generator, www.stattrek.com, was used to decide the order in which images were presented to participants. The researcher ensured that the participants moved away from each other when choosing the best-likeness image. Ethics In accordance with University ethical guidelines, participants were assured that their photographs would be kept securely and would not be published or shown to anyone (except to the researcher) without their written consent. They were also informed that their photographs would be deleted from the researcher’s laptop within 12 months after the completion of the experiment, and that they had the right to withdraw from the experiment at any time. They were required to sign a consent form giving their permission to have their photographs taken and to be shown to their partner. Results Method of Data Management and Analysis

Data were collected and inputted into SPSS version 20 (2011). SPSS was used to conduct a reliability analysis of the Couples Satisfaction Index (CSI) and to examine the frequency distribution of the participants’ relationship duration, age and questionnaire data. It was also utilised to conduct an independent t-test between males and females and their relationship satisfaction scores, and a Pearson’s correlation between total relationship satisfaction scores and participants’ choice of best-likeness image. The Chi square (χ2) goodness of fit test, a non-parametric test, was carried out by hand as SPSS help manuals did not instruct how to conduct goodness of fit tests. The Chi square test was chosen to investigate if males’ and females’ choices of best-likeness images would differ from the expected frequencies under the null hypothesis, as the data on the dependent variable were nominal in nature and the assumptions of normality and homogeneity of variance could not be met. Reliability Analysis The reliability analysis of the CSI displayed a Cronbach’s alpha of 0.88, which indicates that the scale is above 0.7 and thus has acceptable internal reliability. Moreover, all items were positively associated with the total score, indicating that they are all tapping into a similar construct. Descriptive Statistics The data of 16 females and 15 males were analysed, which consisted of responses to the CSI (Funk & Rogge, 2007)

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and best-likeness preferences. Males and females reported a mean relationship satisfaction score of 72.51 (SD=6.75), where 81 was the highest possible score of the CSI (Funk & Rogge, 2007). Analysed independently, the mean relationship satisfaction score of the males was 71.2, while the mean relationship satisfaction score of the females was 73.75. An independent t-test between males and females and their relationship satisfaction scores verified that they did not differ, t(29) = -1.053, p < 0.05.

Results from the frequency analysis revealed differences between female and male preferences for best-likeness images. The following graphs depict the percentage of the different types of images chosen as the best-likeness image for the males and females for all 7 categories and the percentage of the different types of images chosen when the 3 masculinized, 3 feminised and the original image were collapsed into 3 categories (masculinized, feminised and original).

Empirical Investigations

ATTRACTIVENESS AND RELATIONSHIP SATISFACTION Inferential Statistics The male participants who were satisfied with their romantic relationships will did not choose the feminised image as the best-likeness image of their partner, r(6) = -0.42, p > 0.05. Similarly, the female participants who were satisfied with their romantic relationships did not choose the masculinized image as the best-likeness image of their partner, r(6) = -0.18, p > 0.05. Finally, the males’ best-likeness image preferences differed from that expected by chance, χ2(6) = 21.87, p < 0.01. The standard residual for the cell of the original image was greater than 2, indicating that most males picked the original image of their partner. However, when the three categories of manipulation (feminised, original, and masculinized) were grouped together for the males’ choices, no significance was found, χ2(2) = 2.8, p > 0.25. The females’ best-likeness image preferences did not differ from that expected by chance, χ2(6) = 5.92, p > 0.44. Moreover, no significance was noted when the 3 categories of manipulation for the females choices were grouped together, χ2(2) = 0.88, p > 0.66. Discussion The aim of the present study was to discover if individuals in successful relationships will idealise each other’s facial attractiveness. Hypothesis One, which stated that the male participants who are satisfied with their romantic relationships will choose a feminised image as the

best-likeness image of their partner was not supported, suggesting that males in successful relationships do not idealise their partners’ facial attractiveness. Hypothesis Two, which stated that the female participants who are satisfied with their romantic relationships will pick the masculinized image as the best-likeness image of their partner, was not supported, suggesting that females in successful relationships do not idealise their partners’ facial attractiveness. Hypothesis Three, which stated that the observed frequencies of the males’ best-likeness image preferences will differ from that expected by chance, was supported, implying that males were more likely to select the original image of their partner as the best-likeness image. However, when the 3 masculinized, 3 feminised and the original images were collapsed into 3 categories (masculinized, feminised and original) for the males’ choices, no significance was found. This suggests that, for the most part, males were equally likely to choose the feminised, original and masculinized images as the best-likeness images of their partners. Hypothesis Four, which stated that the observed frequencies of the females’ best-likeness image preferences will differ from that expected by chance, was not supported. Moreover, no significance was noted when the 3 masculinized, 3 feminised and the original images were collapsed into 3 categories (masculinized, feminised and original). This indicates that females were equally likely to choose the feminised, original, and masculinized images as the best-likeness images of their partners.

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In relation to previous findings, Penton-Voak and colleagues (2007) found a significant relationship between participants’ relationship satisfaction ratings and facial attractiveness preferences, where participants in happy relationships chose the more attractive images, while those in dissatisfactory relationships picked the less attractive images as the veridical image of their partners, suggesting that people in satisfied relationships idealise each other’s facial attractiveness. Interestingly, when the participants were analysed by sex, these effects were only observed for female participants. These findings do not match the present study’s observations. This may be due to the fact that the mean relationship duration of Penton-Voak and colleagues’ participant sample was 144 months (12 years) and that their relationship satisfaction data consisted of unhappy responses, whereas the average relationship length of participants in the present study was just over 1 year and 10 months and the mean relationship satisfaction score was extremely high. Perhaps individuals in short-term relationships do not idealise their partners’ facial attractiveness but people in long-term relationships do. For example, Barelds-Dijkstra and Barelds (2008) discovered that individuals in long-term relationships of 14 years maintain positive illusions about their romantic partners’ physical attractiveness. In fact, Bailey and Kelly (1984) revealed that undergraduates who had been dating for a short period of time, tended to perceive their dates as less attractive. With regards to the relationship satisfaction of the participants in the present study, although

they were informed that their responses would be kept anonymous, a certain amount of social desirability may have influenced their choices as they may have felt pressured to appear satisfied with their relationships. On the other hand, Burriss and colleagues’ (2011) research provides an insight into the present study’s findings concerning the tendency of the males to select the original image of their partner as the true image. It was initially thought that males simply prefer feminine faces and are not subject to the same individual differences that women are with respect to facial attractiveness preferences. However, attractive men favour facial femininity in women more than less attractive men do when seeking short-term relationships (Burriss et al., 2011). Likewise, the males’ propensity to choose the original image more so than the females, may have been influenced by their own individual factors. The present study did not take account of the males’ self-ratings of attractiveness and their intended relationship lengths, which may have influenced results. Furthermore, while the present study inferred that the female participants do not idealise their partners, some studies have found that females idealise their partners more so than men do (Penton-Voak et al., 2007; Gagné & Lydon, 2003; Murray et al., 1996a; Murray et al., 1996b). Gagné and Lydon (2003) postulate that this effect is modulated by relationship commitment; if males are committed to a long-term relationship then relationship illusions play

Empirical Investigations

ATTRACTIVENESS AND RELATIONSHIP SATISFACTION an important role, whereas commitment does not influence a womanâ&#x20AC;&#x2122;s degree of idealisation towards her partner. A female may idealise her partner more readily than a male does because she inputs more parental investment than a male does (Penton-Voak et al., 2007). Therefore, women may hold more positive illusions and positive biases about her partner to decrease the chance of their self-esteem faltering after a relationship break-up (Haselton & Funder, 2006). However, this explanation does not fit Triversâ&#x20AC;&#x2122; parental investment model (1972), which states that individuals with higher levels of parental investment will be choosier in selecting a mate than those who have lower levels of parental investment. If women are increasingly likely to be choosier, then women should not necessarily be affected by idealisation. The present study certainly does not show support for this theoretical consideration. The present study maintained a number of methodological strengths including the electronic presentation of the high quality images to the participants and the use of Online Psychomorph (DeBruine, 2014), a website that enabled the photographs to be digitally processed and manipulated, and the utilisation of a high quality digital camera. Electronically presenting the photographs to the participants guaranteed that the image quality and photographic details remained intact. Online Psychomorph (DeBruine, 2014) ensured that all of the photographs were manipulated to the exact same degree, providing a consistency to the manipulation of the images.

The present study was also confronted with various methodological weaknesses. 40.1% of the participant sample chose the original image as the best-likeness image of their partner. This may mean that the images were obviously manipulated and that the participant recognised this, although many of the participants claimed that the variations between the manipulated images were hardly noticeable. Perhaps if the images had been manipulated to slightly smaller percentages, a different effect could have been observed. Additionally, the researcher masculinized and feminised a male average, which exaggerated differences between male and female facial averages. This is a potential flaw of the present study as Rennels and colleagues (2008) argue that this method does not accurately reflect the relationship between attractiveness and sexual dimorphism. Moving an averaged male face away from an averaged female face can distort facial width, making the image appear less attractive. Furthermore, male and female faces are represented differently in the brain (Little et al., 2005). Thus, transforming a male facial average with a female facial average may differ from how faces are psychologically represented. Instead, Rennels and colleagues (2008) recommend that averages of masculine and feminine male faces should be used to masculinize or feminise the facial images of males. Nonetheless, DeBruine and colleagues (2010) criticise their work as when they replicated the study and controlled for non-face cues, they did not find a difference between the two methods of manipulating masculinity.

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Theoretical considerations of the present study contrast with other research. Males generally tend to prefer feminine female faces (Smith et al., 2006; Little et al., 2007) but in this case they displayed no preference. Penton-Voak and colleagues (2003) postulate that males prefer facial femininity in females because it is a signal of thriving reproductive health. Females show variations in their preferences for masculinity and femininity (Burriss et al., 2011). However, the present study did not identify such differences. Women’s preferences for masculinity can depend on factors such as their own attractiveness, waist-to hip ratio, voice pitch and their stage of the menstrual cycle, which the present study did not take account of (Little & Mannion, 2006; Smith et al., 2009; Vukovic et al., 2010; Penton-Voak & Perrett, 2001). Practical implications of the present study are not far reaching. Nonetheless, relationship satisfaction is not necessarily connected with idealised facial attractiveness. Couples may hold positive illusions of one another, but they may idealise their personal characteristics as opposed to their facial features. Future research should focus on recruiting a larger sample size and couples who are together for a longer period, using averages of feminine and masculine male faces to feminise or masculinize a male’s face, and request participants to place questionnaires into a drop-box to reduce the risk of socially desirable answers. In conclusion, it seems that no universal standards of beauty will ever be agreed upon and that beauty is in the eye of the beholder.

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ATTRACTIVENESS AND RELATIONSHIP SATISFACTION Cunningham, M. R., Barbee, A. P., & Pike, C. L. (1990). What do women want? Facialmetric assessment of multiple motives in the perception of male facial physical attractiveness. Journal of Personality and Social Psychology, 59(1), 61-72. DeBruine, L. M. (2014). Online Psychomorph. Retrieved September 28th, 2013. DeBruine, L. M., Jones, B. C., Smith, F. G., & Little, A. C. (2010). Are attractive men’s faces masculine or feminine? The importance of controlling confounds in face stimuli. Journal of Experimental Psychology: Human Perception and Performance, 36(3), 751-758. Dijkstra, P., & Buunk, B. P. (1998). Jealousy as a function of rival characteristics: An evolutionary perspective. Personality and Social Psychology Bulletin, 24(11), 1158-1166.face. Journal of Visual Communication and Image Representation, 18(6), 453463. Ferrario, V. F., Sforza, C., Pizzini, G., Vogel, G., & Miani, A. (1993). Sexual dimorphism in the human face assessed by euclidean distance matrix analysis. Journal of Anatomy, 183(Pt 3), 593-600. Fink, B., & Penton-Voak, I. (2002). Evolutionary psychology of facial attractiveness. Current Directions in Psychological Science, 11(5), 154-158. Folstad, I., & Karter, A. J. (1992). Parasites, bright males, and the immuno-

competence handicap. American Naturalist, 139(3), 603-622. Funk, J. L., & Rogge, R. D. (2007). Testing the ruler with item response theory: Increasing precision of measurement for relationship satisfaction with the couples satisfaction index. Journal of Family Psychology, 21(4), 572-583. Gagné, F. M., & Lydon, J. E. (2003). Identification and the commitment shift: Accounting for gender differences in relationship illusions. Personality and Social Psychology Bulletin, 29(7), 907-919. Gagné, F. M., & Lydon, J. E. (2004). Bias and accuracy in close relationships: An integrative review. Personality and Social Psychology Review, 8(4), 322-338. Graham, J. M., Diebels, K. J., & Barnow, Z. B. (2011). The reliability of relationship satisfaction: A reliability generalization meta-analysis. Journal of Family Psychology, 25(1), 39-48. Grammer, K., & Thornhill, R. (1994). Human (homo sapiens) facial attractiveness and sexual selection: The role of symmetry and averageness. Journal of Comparative Psychology, 108(3), 233-242. Haselton, M. G. & Funder, D. (2006). The evolution of accuracy and bias in social judgment. In Schaller, M., Kenrick, D. T., & Simpson, J. A. (Eds.), Evolution and Social Psychology (pp. 15-37). New York: Psychology Press.

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Hume, D. (1757). Four Dissertations. IV: Of the Standard of Taste. UK, London: Millar. Johnston, V. S., Hagel, R., Franklin, M., Fink, B., & Grammer, K. (2001). Male facial attractiveness: Evidence for hormone-mediated adaptive design. Evolution and Human Behaviour, 22(4), 251-267. Jones, D. Sexual selection, physical attractiveness, and facial neoteny. (1995). Current Anthropology, 36(5), 723748. Komori, M., Kawamura, S., & Ishihara, S. (2009). Effect of averageness and sexual dimorphism on the judgment of facial attractiveness. Vision research,49(8), 862-869. Langlois, J. H., & Roggman, L. A. (1990). Attractive faces are only average. Psychological Science, 1(2), 115-121. Langlois, J. H., Kalakanis, L., Rubenstein, A. J., Larson, A., Hallam, M., & Smoot, M. (2000). Maxims or myths of beauty? A meta-analytic and theoretical review. Psychological Bulletin, 126(3), 390-423. Little, A. & Perrett, D. (2002). Putting beauty back in the eye of the beholder. The Psychologist, 15(1), 28 â&#x20AC;&#x201C; 32. Little, A. C., & Hancock, P. J. (2002). The role of masculinity and distinctiveness in judgments of human male facial attractiveness. British Journal of Psychology, 93(4), 451-464.

Little, A. C., & Mannion, H. (2006). Viewing attractive or unattractive samesex individuals changes self-rated attractiveness and face preferences in women. Animal Behaviour, 72(5), 981-987. Little, A. C., Cohen, D. L., Jones, B. C., & Belsky, J. (2007). Human preferences for facial masculinity change with relationship type and environmental harshness. Behavioral Ecology and Sociobiology, 61(6), 967-973. Little, A. C., DeBruine, L. M., & Jones, B. C. (2005). Sex-contingent face after-effects suggest distinct neural populations code male and female faces. Proceedings of the Royal Society B: Biological Sciences, 272(1578), 2283-2287. Little, A. C., Jones, B. C., & DeBruine, L. M. (2011). Facial attractiveness: Evolutionary based research. Philosophical Transactions of the Royal Society B: Biological Sciences, 366(1571), 1638-1659. Little, A. C., Jones, B. C., DeBruine, L. M., & Feinberg, D. R. (2008). Symmetry and sexual dimorphism in human faces: Interrelated preferences suggest both signal quality. Behavioural Ecology, 19(4), 902-908. Little, A. C., Jones, B. C., Penton-Voak, I. S., Burt, D. M., & Perrett, D. I. (2002). Partnership status and the temporal context of relationships influence human female preferences for sexual dimorphism in male face shape. Proceedings of the Royal Society of London. Series B: Biological Sciences, 269(1496), 1095-1100.

Empirical Investigations

ATTRACTIVENESS AND RELATIONSHIP SATISFACTION Murray, S. L., Holmes, J. G., & Griffin, D. W. (1996a). The benefits of positive illusions: Idealization and the construction of satisfaction in close relationships. Journal of Personality and Social Psychology, 70(1), 79-98. Murray, S. L., Holmes, J. G., & Griffin, D. W. (1996b). The self-fulfilling nature of positive illusions in romantic relationships: Love is not blind, but prescient. Journal of Personality and Social Psychology, 71(6), 1155-1180. Neff, L. A., & Karney, B. R. (2002). Judgments of a relationship partner: Specific accuracy but global enhancement. Journal of personality, 70(6), 1079-1112. O’Toole, A. J., Deffenbacher, K. A., Valentin, D., McKee, K., Huff, D., & Abdi, H. (1998). The perception of face gender: The role of stimulus structure in recognition and classification. Memory & Cognition, 26(1), 146-160. Penton-Voak, I. S., & Perrett, D. I. (2001). Male facial attractiveness: perceived personality and shifting female preferences for male traits across the menstrual cycle. Advances in the Study of Behaviour, 30, 219-259. Penton-Voak, I. S., Little, A. C., Jones, B. C., Burt, D. M., Tiddeman, B. P., & Perrett, D. I. (2003). Female condition influences preferences for sexual dimorphism in faces of male humans (Homo sapiens). Journal of Comparative Psychology, 117(3), 264 –271. Penton-Voak, I. S., Perrett, D. I., Castles, D. L., Kobayashi, T., Burt, D. M., Murray, L. K., & Minamisawa, R.

(1999). Menstrual cycle alters face preference. Nature, 399(6738), 741742. Penton-Voak, I., Rowe, A. C., & Williams, J. (2007). Through rose-tinted glasses: Relationship satisfaction and representations of partners’ facial attractiveness. Journal of Evolutionary Psychology, 5(1-4), 169-181. Perrett, D. I., Lee, K. J., Penton-Voak, I., Rowland, D., Yoshikawa, S., Burt, D. M., . . . Akamatsu, S. (1998). Effects of sexual dimorphism on facial attractiveness. Nature, 394(6696), 884-887. Perrett, D., Penton-Voak, I. S., Little, A. C., Tiddeman, B. P., Burt, D. M., Schmidt, N., ... & Barrett, L. (2002). Facial attractiveness judgements reflect learning of parental age characteristics. Proceedings of the Royal Society of London. Series B: Biological Sciences, 269(1494), 873-880. Rennels, J. L., Bronstad, P. M., & Langlois, J. H. (2008). Are attractive men’s faces masculine or feminine? The importance of type of facial stimuli. Journal of Experimental Psychology: Human Perception and Performance, 34(4), 884. Rhodes, G. (2006). The evolutionary psychology of facial beauty. Annual Review of Psychology, 57, 199-226. Rhodes, G., Chan, J., Zebrowitz, L. A., & Simmons, L. W. (2003). Does sexual dimorphism in human faces signal health? Proceedings of the Royal Society of London. Series B: Biological Sciences, 270(Suppl 1), 93-95.

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Rhodes, G., Hickford, C., & Jeffery, L. (2000). Sex-typicality and attractiveness: are supermale and superfemale faces super-attractive? British Journal of Psychology, 91(Pt 1), 125-140.

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Thornhill, R., & Gangestad, S. W. (1993). Human facial beauty: Averageness, symmetry, and parasite resistance. Human Nature, 4(3), 237-269.

Samal, A., Subramani, V., & Marx, D. (2007). Analysis of sexual dimorphism in human face. Journal of Visual Communication and Image Representation, 18(6), 453-463.

Thornhill, R., & Gangestad, S. W. (2006). Facial sexual dimorphism, developmental stability, and susceptibility to disease in men and women. Evolution and Human Behaviour, 27(2), 131144.

Service, R. F. (1998). New role for estrogen in cancer? Science, 279(5357), 1631–1633. Smith, F. G., Jones, B. C., Welling, L. L., Little, A. C., Vukovic, J., Main, J. C., & DeBruine, L. M. (2009). Waist–hip ratio predicts women’s preferences for masculine male faces, but not perceptions of men’s trustworthiness. Personality and Individual Differences, 47(5), 476-480. Smith, M. J. L., Perrett, D. I., Jones, B. C., Cornwell, R. E., Moore, F. R., Feinberg, D. R., ... & Hillier, S. G. (2006). Facial appearance is a cue to oestrogen levels in women. Proceedings of the Royal Society B: Biological Sciences, 273(1583), 135-140. SPSS, I. (2011). IBM SPSS Statistics for Windows, Version 20.0. New York: IBM Corp. Swami, V., & Furnham, A. (2008). Is love really so blind? The Psychologist, 21(2), 108-111.

Tiddeman, B., Burt, M., & Perrett, D. (2001). Prototyping and transforming facial textures for perception research. Computer Graphics and Applications, IEEE, 21(5), 42-50. Trivers, R. L. (1972). Parental investment and sexual selection. In B. Campbell (Ed.), Sexual Selection and the Descent of Man (pp. 136-179). Chicago: Aldine. Vukovic, J., Jones, B. C., DeBruine, L., Feinberg, D. R., Smith, F. G., Little, A. C., ... & Main, J. (2010). Women’s own voice pitch predicts their preferences for masculinity in men’s voices. Behavioural Ecology, 21(4), 767-772.

Student Psychology Journal of Ireland, 2015, 101-120

A Study of the Perceived Warmth and Competence of Parents in Politics Aisling Gilligan

Supervisor: Dr. Joan Tiernan

University College Dublin

Correspondence: aisling.gilligan@ucdconnect.ie

abstract

The aim of this study was to examine the perceived warmth and competence of parents in politics and to examine the relationship of these perceptions to voting intention. Research, such as that of Cuddy, Fiske and Glick (2004), claims that differences exist in the perceptions of male and female parents. Such research indicates that female parents receive lower scores of perceived competence than their female non-parent counterparts (Cuddy, Fiske and Glick, 2004),.Female parents also receive higher scores of perceived warmth than female non-parents, while the perceived warmth and competence scores between male parents and non-parents showed no such fluctuation (Cuddy, Fiske and Glick, 2004), This study aims to examine these potential perceptual differences in a political context and thus determine their significance toward voting behaviour. The participant group consisted of 86 people ranging in age from 19 to 61 years (M = 37.47 years; SD = 12.1 years). The participant group consisted of 44 females and 42 males. Participants were required to read four fictitious political candidate profiles and to rank these candidates against each other on a number of characteristics, based on Cuddy, Fiske & Glickâ&#x20AC;&#x2122;s (2008) Stereotype Content Model. These characteristics measured the perceived warmth and competence levels of the participants toward the political candidates. Participants were also required to indicate their intention to vote for each candidate on a 5-item Likert scale. The overall perceived warmth and competence scores for each political candidate were calculated. These scores were subsequently examined in relation to the gender and parental status of the political candidates. Voting intention was examined in relation to warmth and competence scores. Spearmanâ&#x20AC;&#x2122;s correlations indicated the reliability of the warmth and competence scales. Through the use of four Wilcoxon Signed Ranks Tests, perceived warmth

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Student Psychology Journal, Volume VI GILLIGAN scores were observed to be significantly higher for candidates who were parents. However, differences in perceived competence scores between male parents and non-parents, and female parents and non-parents were found to be non-significant. Both perceived warmth and competence were found to have a significant positive correlation with voting intention. Methodological strengths of this study included the use of a Pilot study and the relatively equal distribution of male and female participants in the participant group. Methodological weaknesses of the study included the possible impact of the presence of the experimenter on participants and the use of paper-based surveys. Considerations for future research include the examination of gender differences in perceived warmth and competence scores of parents and non-parent political candidates, and the impact of participant gender on voting intention patterns. The theoretical implications of this study include the findings that both male and female parents observed an increase in perceived warmth scores, differing from previous studies in this field Keywords: Warmth, competence, voting intention, Stereotype Content Model, parental status, political candidates.

Introduction Overview of the Research Problem This research project aimed to examine the perceived warmth and competence levels of political candidates based on gender and on parental status. This project also aimed to examine the relationship of these perceptions to voting intention. Based on Cuddy, Fisk and Glickâ&#x20AC;&#x2122;s (2008) Stereotype Content Model, stereotyping can be conceptualised across two separate dimensions, warmth and competence. Utilising this model, this study aimed to examine if perceived warmth and competence levels alter depending on whether a political candidate is a male or female parent. The study also aimed to explore whether there was a relationship between perceived warmth and competence and voting intention. This

study therefore strives to examine whether parents in politics are perceived differently to their non-parent counterparts, and ultimately if these perceptions are linked to their chances of gaining votes in future elections. Stereotypes form simplified depictions of social groups and can often be associated with the development of prejudice (Myers, Abell, Kolstad and Sani, 2010). As explained by Myers, Abell, Kolstad and Sani (2010), stereotypes express generalisations about a group of people which may be true, as argued by Swim (1994), false or overgeneralised. Stereotypes cannot be categorised as prejudices but stereotypes may support the development of prejudice (Myers, Abell, Kolstad and Sani, 2010).

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A STUDY OF PARENTS IN POLITICS Gender Stereotypes As expressed by Myers, Abell, Kolstad and Sani (2010) gender is a factor often eliciting social stereotypes. According to a survey by Jackman and Senter (1981) gender stereotypes are often stronger than many other forms of stereotype including that of racial stereotypes. This survey found that a mere 22% of men believed males and females to be equally “emotional”. Gender stereotypes appear to persist across time and culture and as Williams (1999, 2000) states “throughout over 27 countries examined, individuals perceive women as more agreeable and men more outgoing”. Eagly et al., (1991) and Haddock and Zanna (1994) report that people do not respond to women with purely negative emotions as they often do to other groups. Women are, instead, often perceived as more understanding, kind and helpful (Eagly and Kite, 1987). However, as expressed by Glick & Fiske (1996, 2001), surveys examining 19 nations found that gender attitudes often combine benevolent sexism (e.g. “women have higher moral sensibilities”) with hostile sexism (e.g.“women put men in a relationship on a tight leash”). Male stereotypes also see such contrasting patterns. As outlined by Glick et al., (2004) benevolent attitudes toward men often perceive men as “powerful”, while hostile attitudes characterise men as “immoral”. The source of gender stereotypes is still largely a matter of debate. Goldberg

(1968) postulates that gender stereotypes do not derive from one gender group alone. Gonzales and Koestner (2005) suggest that while blatant gender stereotyping and prejudice is waning, subtle stereotyping still occurs. Gonzales and Koestner (2005) claim that, from birth, parents begin to describe their male children with the primary emphasis on their status and their female children with regard to the relationships they hold. Parental Status Stereotyping. Brescoll and Uhlmann (2005) discuss the difficulties facing females who are parents, claiming that this impact is singular to females and may impact on individuals not only in social contexts but throughout their professional fields. Deutsch and Saxon (1998) claim that stereotypes surrounding working mothers may derive from longstanding societal perceptions of men as the breadwinners and women as primary caregivers. This cultural perception is thus supported by the viewing of female parents as more “motherly”, nurturing or less task-orientated and may in turn result in less hiring and promotion of female parents within the workplace (Correll, Benard and Paik, 2007). Recent research suggests that the combination of gender and parental status variables elicit particular prejudice category patterns. A study by Cuddy, Fiske and Glick (2004) examined parents in a professional setting, placing particular emphasis on differences in perceived warmth and competence levels of male

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and female parents. This study found that female parents in the workplace fell into the paternalistic prejudice category of being warm and incompetent or fell into the envious prejudice category of being competent but cold (Cuddy, Fiske and Glick, 2008). This study concluded that as female professionals become mothers their perceived competence decreases while simultaneously their perceived warmth increases. However, as male professionals become parents their perceived competence remains at its normal level and perceived warmth simultaneously increases (Cuddy, Fiske and Glick, 2004). According to Biernat and Wortman, (1991) research has supported the continuing inequality in gender roles. Early research, such as Kelley’s (1979) study, claims that women often support these gender roles. This study demonstrated the strong reaction of women to sharing household tasks, ranking them as more desirable when asked to share them with a male, and expressing upset when gender roles were reversed and males were performing the household tasks. Crosby (1991) notes the significant imbalance in roles, with women engaging in more parenting and household activity when compared to men. Recent research continues to examine the issue of societal gender inequality. Acker (2006) claims the significant presence of gender inequality within the workplace and the need for inequality regimes to tackle this issue. Moen (2015) similarly identifies the enduring existence of gender inequality in the work-

place and the factors which fuel its existence. Deutsch (2001) however claims that this division of gender roles has been gradually narrowing over time. Stereotype Content Model. In recent years one of the most established models used for the study of stereotypes has been the Stereotype Content Model developed by Cuddy, Fiske and Glick (2004). As explained by Cuddy, Fiske and Glick (2008) the Stereotype Content Model examines two central dimensions of perception; “warmth” and “competence”. Janssens, Verkuyten and Khan (2015), outline that the Stereotype Content Model argues that upon encountering others, individuals immediately assess the intention and ability of the other person to harm them. Intention and ability factors are explained by two stereotype components. The “warmth” component detects traits relating to perceived intent e.g. friendliness, helpfulness, sincerity, trustworthiness, and morality (Janssens, Verkuyten and Khan, 2015). The “competence” component examines traits related to perceived ability e.g. intelligence, skilfulness, confidence and efficiency (Janssens, Verkuyten and Khan ,2015). John (2013) applies the warmth and competence components to the study of age-related stereotyping. He describes how different patterns of ratings along warmth and competence scales produce 4 different categories of stereotypes. The “envious” prejudice category applies to individuals who are perceived and rat-

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A STUDY OF PARENTS IN POLITICS ed as competent but simultaneously gain low warmth ratings. This group is regarded as being threatening or unfriendly by those who perceive them (Cuddy, Fiske and Glick, 2008). In contrast individuals who are regarded as warm but incompetent fall into the “paternalistic” prejudice category (Glick and Fiske, 1996). Those rated as both high in warmth and competence components are considered to be in the “admiration” prejudice category, while those of low warmth and competence are considered to belong to the “contemptuous” stereotype category (Cuddy, Fiske and Glick, 2008). These prejudice categories can be seen in the table below.

Behavioural Intention. According to Cuddy, Glick and Fiske (2004) recent preliminary data demonstrate that warmth and competence stereotypes can predict patterns of discriminatory behavioural intentions. Behavioural intention is an indication of the likelihood of an individual to carry out a particular behaviour (McKenna, 2012). Intention is assumed to be a direct antecedent of behaviour (McKenna, 2012). Determining behavioural intention requires the examination of the attitude

held by the individual toward the particular behaviour, the subjective norm and the perceived behavioural control (Armitage and Conner, 2001). Each of these factors is weighted according to the behaviour under examination and the sample population in question (Armitage and Conner, 2001). According to the theory of reasoned action (Ajzen and Fishbein, 1980) individuals’ actions are deemed to be predicted by their intentions. Intentions can be measured by individuals’ attitudes and the expectations of them held by others (McKenna, 2012). Ajzen’s (1991) amended ‘Theory of Planned Behaviour’ states that both attitudes and subjective norms are the two primary predictors of behavioural intention. Attitudes examine the beliefs associated with the consequences of certain behaviours while subjective norms examine the influences of others opinions toward the performing or not performing of these behaviours (Fishbein and Ajzen, 1975). Studies utilising the Theory of Planned Behaviour have proven to strongly predict varying behaviours including that of smoking (Topa and Moriano, 2010), blood donation (Giles, McClenahan, Cairns and Mallet, 2004) and technology use (Lee, Cerreto and Lee, 2010). The present study Utilising the Stereotype Content Model (Cuddy, Fiske and Glick, 2008) this study aimed to examine the perceived warmth and competence of parents in politics. The study sought to assess par-

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ticipantsâ&#x20AC;&#x2122; behavioural intentions to vote for these candidates. It further examined the existence of a relationship between warmth and competence levels and voting intentions. This study therefore aimed to examine the relevance of perceptions linked to male and female parents in a political context. By measuring warmth and competence scores, differences in the perceptions of parents and non-parents in politics could be assessed. The link between these scores and voting intention aimed to determine whether differences in perceptions of parents may have consequences for electoral outcomes. This study aimed to provide potential practical insights into the voting intentions of individuals and the consequences this may have on parents in politics. Hypotheses Hypothesis 1: That female parents will elicit significantly higher perceived warmth scores than female non-parents. Hypothesis 2: That female parents will elicit significantly lower perceived competence scores than female non-parents. Hypothesis 3: That there will be no statistically significant difference between male parent and male non-parent perceived warmth scores. Hypothesis 4: That there will be no statistically significant difference between male parent and male non-parent perceived competence scores. Hypothesis 5: That there will be a sta-

tistically significant correlation between perceived warmth scores and voting intentions. Hypothesis 6: That there will be a statistically significant correlation between perceived competence scores and voting intentions. Method Research Design This study used a quantitative, experimental research approach. The independent variable used was parental status which contained two categories, parent and non-parent. The dependent variables included warmth and competence scores. Warmth and competence scores were also examined toward their relationship to voting intention. Pilot Study A pilot study was carried out. This study consisted of 8 participants, ranging in age from 19 to 50 (M = 25.13 years; SD = 10.19 years). Half of the sample was female. Participants were provided with an information sheet containing the necessary information regarding the study, and a consent form (See Appendix A). Participants were then required to read four candidate profiles (See Appendix C) and to fill in a quality characteristics chart containing rankings from 1-4, indicating, using the initials of each candidate, the candidate that demonstrated the most and least of each characteristic. These char-

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A STUDY OF PARENTS IN POLITICS acteristics were based on the Stereotype Content Model (Cuddy, Fisk and Glick, 2008) and John’s (2013) ranking system. The characteristics listed on the ranking chart were Irritating, Good Heart, Friendly, Selfish, Sense of Humour, Difficulties Understanding Things, Can Help Other People, Successful, Requires Help of Others and Good Manual Skills. This ranking chart was subsequently altered for the main research project as participants found the use of candidate initials too confusing and time consuming. The layout of the chart used in the pilot was also altered in the main study in order to clarify each characteristic. Participants The participant group consisted of 86 people ranging in age from 19 to 61 (M = 37.47 years; SD = 12.1 years). Participants were required to be over 18 years of age as the study examined voter intentions and excluding those under the age of voting consent was deemed more valid. The participant group consisted of 44 females and 42 males. Materials or Apparatus The materials used in the study consisted of an information sheet, and consent form (See Appendix A), a questionnaire (See Appendix C,D,E,) and a debriefing form (See Appendix F). The Information Sheet outlined the main components of the study including its purpose, likely duration, procedures adopted, the use of

data and how records would be stored, the voluntary nature of the study, the commitment to anonymity and confidentiality and the outlining of ethical approval. The Consent Form required participants to confirm that they were willing to participate in the study, understood the purpose of the study, understood how the data collected would be used and that they could withdraw from the study prior to the submission of the data. The Questionnaire contained profiles of 4 political candidates (See Appendix C), a characteristic chart (See Appendix D) and a Voting Intention Scale (See Appendix E). Fictitious candidate profiles were devised using a table to ensure each profile was consistent, had the same criteria and only differed on the variables of gender and parental status (See Appendix B). Candidate profiles did not include pictures, to ensure participant decisions were not influenced by the appearance of the candidate. The characteristic chart was created using Cuddy, Fiske and Glick’s (2004) Stereotype Content Model’s 10 qualities of warmth and competence, and John’s (2013) ranking system, altered following the Pilot study. The ranking system employed by John (2013) required participants to rank particular candidates (using the initials of their name) on who they believed showed the most to the least of each listed characteristic. In this way John (2013) calculated the scores of the candidates producing the most to the least of each characteristic and could thus examine the patterns of overall perceived

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warmth and competence derived from these characteristics. Prior to the pilot study, this ranking chart was altered so as to require participants to rank candidates using the numbers one to four to indicate which candidate they believed displayed the most to the least of each characteristic. The Warmth Scale consisted of five items, friendly, irritating (reversed item), has a good sense of humour, good hearted, selfish (reversed item). The Competence Scale also consisted of five items, can help other people, has difficulties in understanding things (reversed item), is successful in his/her tasks, has good manual skills, requires help of others (reversed item). Using Spearmanâ&#x20AC;&#x2122;s rank order correlations, Johnâ&#x20AC;&#x2122;s (2013) study found that the average inter-item correlation within the warmth scale was Rw =.305, and within the competence scale was Rw =.295. These averages therefore indicated relatively strong associations between items on the same scale (Warmth or Competence). In contrast, the average correlation between items of the two different scales was Rw =.203. This finding suggests that items that have been associated with different scales, are not measuring the same construct (Warmth and Competence). The Voter Intention Scale was a Likert Scale asking participants to rate how likely they would be to vote for each candidate. (See Appendix E). The Debriefing Note outlined what the study was investigating and thanked the participants for taking part. All material was developed using Micro-

soft Word and was printed on a standard printer. Pens were provided to participants. SPSS Computer Software was used to conduct the statistical analysis of the results. Procedure Participants were recruited for the study in person and through emails, texts and posts to social media sites (e.g. Facebook). The use of social media and technology to request and recruit study participants has been used and promoted in varying studies, including Kapp, Peters and Oliverâ&#x20AC;&#x2122;s (2013) examination of the benefits of Facebook advertising in research recruitment. Participants were firstly asked to read through the Information Sheet and to sign the Consent Form if they were agreeable to participating in the study. They were then provided with the questionnaire on which they outlined their age and gender. Participants read through the four fictitious political candidate profiles and were required to complete the characteristics chart indicating, based on their first impressions, which candidate they felt displayed the most to the least of each quality. Participants were also required to outline their voting intentions by completing the Likert scale (1932) determining whether they were likely or unlikely to vote for each candidate in an election. When they had completed the questionnaire each participant was given the debriefing note.

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A STUDY OF PARENTS IN POLITICS Ethics Ethical approval for the project was received from the UCD Ethics Committee (See Appendix G). The project was considered to be in the low risk ethical category. Participation of people under the age of 18 years was not part of the study. Participants were provided with an information sheet prior to their participation in the study, which outlined the nature of the study and any relevant ethical criteria (See Appendix A). Participants were informed that their questionnaires would contain no identifying information, with only their age and gender outlined. Participants were provided with a consent form which asked them to confirm that they understood the aims of the study and how the data collected would be used. The Consent Form also informed them of their right to withdraw from the study prior to the submission of their completed questionnaires. (Appendix A). When the questionnaire was submitted by each participant, their collected data and their consent forms were stored separately thus providing anonymity for each participantsâ&#x20AC;&#x2122; information. Access to consent forms was limited to the primary researcher and the research supervisor. Data was stored in a secure location in hardcopy and by password protected file and computer in softcopy. When transported, a password protected USB stick was used. Participants were later informed, through a debriefing sheet, of the purpose of the study and its examination of perceived warmth and competence levels toward

male and female parent political candidates (See Appendix F). Results Instruments Statistical analyses were performed using IBM SPSS statistics version 20 (windows) and Microsoft Excel 2010. The critical alpha level was set at .05 (Shaughnessy, Zechmeister and Zechmeister, 2012). All outliers of two or more standard deviations were examined. No outliers were removed. Due to the use of rank scoring to generate warmth and competence scales in this study, non-parametric testing was employed (Rust and Golombok, 1999). Assessment of research questions The influences of parental status on warmth and competence scores for females and subsequently males were assessed separately using T-tests. The independent variable used was parental status which contained two categories, parent and non-parent. The dependent variables included warmth and competence scores respectively for different analyses. Where assumptions of parametric data were violated, nonparametric, Wilcoxon Signed Ranks test, were used. The relationships between warmth and competence scores and voting intention were assessed using individual correlations. The voting intention measure was a 5-point Likert scale ranging from

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Strongly Disagree to Strongly Agree and was based on ranked data. The warmth and competence scores were also based on ranked data. Spearmanâ&#x20AC;&#x2122;s correlations were therefore completed in place of parametric tests. Reliability and independence of warmth and competence scales As described by John (2013), two scales were used in this study. These scales described the perceived warmth and competence scores of each participant toward each political candidate as outlined in the characteristic ranking chart. The warmth items on which the participants ranked each election candidate included: 1. irritating (reversed item), 2. good hearted, 3.friendly, 4. selfish (reversed item), 5. has a good sense of humour. The competence items on which the participants ranked each election candidate included: 6. has difficulties in understanding things (reversed item), 7. can help other people, 8. is successful in his/her tasks , 9. requires help of others (reversed item), 10. has good manual skills. Due to the fact that there were ten items in the ranking table, and four candidates on which the participants assigned rankings, the minimum and maximum scores for each candidate were 5 and 20 for each of the warmth and competence scales respectively. The reliability of the scales was assessed by finding correlations between items on the same and different scales. Pearson correlations (Cronbachâ&#x20AC;&#x2122;s alpha)

could not be used as the data were ranked. Hence, the rank order correlations as generated using Spearmanâ&#x20AC;&#x2122;s correlations are shown in Table 1. The correlations shown in Table 1 indicate reliability of the warmth and competence scales. All negative correlations can be explained as cases where reverse and non-reverse items are correlated together. Large negative correlations are expected between reverse and non-reverse items on the same scale. As shown in the table, there were significant correlations between all items within the warmth and competent scales, with the exception of the manual skills item which showed no significant correlations with other items. In keeping with the study completed by John (2013) from which this scale was originally derived, the manual skills item was included for consistency purposes. However, it is possible that this item was unreliable due to the relative un-relatedness of manual skills to the position as an electoral candidate. The correlations shown in Table 1 also suggest independence between the warmth and competence scales. By considering only the size and not the direction of correlations, between scale inter-item correlations were calculated. The average inter-item correlation within the warmth scale (rw = .325) was 54% larger than the correlation between items on the two different scales (rcw = .148). However, the average inter item correlation within the competent scale (rc = .159) was only 7% larger than the correlation between items on the two different scales. By excluding the manual skills item from

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A STUDY OF PARENTS IN POLITICS all analysis, these correlations changed to 46% for the warmth scale and to 29% for the competent scale. This suggests that the two scales measure different constructs. Due to the weakness for both the independence and the reliability of the manual skills item, this item was removed from the analyses of the collected data. The final competence scale was generated from four items 1. has difficulties in understanding things (reversed item), 2.

can help other people, 3. is successful in his/her tasks , 4. requires help of others (reversed item). This scale had a maximum score of 16. As all subsequent analyses examined the warmth and competence scales independently with no direct comparisons or joint analyses including both scales, changing the range of the competence scale from 5-20 to 4-16 did not significantly alter results with the exception of the reliability and independence of the competence scale.

Hypothesis testing Hypothesis one, which stated that female parents would elicit significantly higher perceived warmth scores than female non-parents was tested using a Wil-

coxon Signed Ranks Test. This hypothesis was supported. As shown in Figure 1, there was a significant difference between perceived warmth scores of female parent and female non-parent candidates, (Z = 1.905, N - Ties = 83, p = 0.028).

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Hypothesis two, which stated that female parents would elicit significantly lower perceived competence scores than female non-parents, was tested using a Wilcoxon Signed Ranks Test. This hypothesis was not supported. As shown in Figure 2, there was no significant difference between perceived competence scores of female parent and female non-parent candidates (Z = 1.137, N â&#x20AC;&#x201C; Ties = 79, p = .128).

Hypothesis three, which stated that there would be no statistically significant difference between male parent and male

Hypothesis four, which stated that there would be no statistically significant difference between male parent and male non-parent perceived competence scores, was supported, using a Wilcoxon Signed Ranks Test. As shown in Figure 4, there was no significant difference between perceived competence scores of male parent and male non-parent candidates, (Z = .722, N â&#x20AC;&#x201C; Ties = 75, p = .470).

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Hypothesis five, which stated that there would be a statistically significant correlation between perceived warmth scores and voting intention, was supported, using a Spearman’s correlation. As shown in Table 2 there was a statistically significant relationship between warmth scores and voting intention, rs= .297, p = .000. Hypothesis six, which stated that there would be a statistically significant correlation between perceived competence scores and voting intention, was supported, using a Spearman’s correlation. As shown in Table 2 there was a statistically significant relationship between competence scores and voting intention, rs= .346, p=.000.

Discussion The aim of this study was to examine the perceived warmth and competence of parents in politics and to examine the relationship of these perceptions to voting intention. As hypothesized, the study found a statistically significant positive difference between the perceived warmth scores of female candidates who were parents and females who were not. However, contrary to the study’s hypotheses, it did not find a statistically significant difference in perceived competence scores between female candidates who were parents and those who were not. In addition, male parent candidates measured significantly higher in perceived warmth scores than male non-parents. As hypothesised, there was no statistically significant difference found in perceived competence scores between parental and non-parental male candidates. The study found a positive correlation between perceived warmth and voting intention and between perceived competence and voting intention. Higher warmth scores were associated with a stronger likelihood of voting for the candidate and a similar positive correlation was observed for competence. The findings of this research contradict the findings of previous similar studies in this area. Cuddy, Fiske and Glick’s (2004) studies, utilising the Stereotype Content Model, found that perceptions of female parents elicited an increase in warmth scores and decrease in compe-

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tence scores, while perceptions of male parents elicited no changes in warmth and competence scores. The study described female parents as being perceived within a “paternalistic” prejudice category while male parents are perceived within an “admiration” or “prejudice” category. Janssens, Verkuyten and Khan’s (2015) studies also supported these theories of prejudice groups resulting from gender and parental groupings. This study found increased warmth scores in parents of both gender groups and no lowered competence scores for female parents, thus demonstrating no such prejudice groupings. Cuddy, Fiske and Glick’s (2004) study of warmth and competence within the workplace found that increases in warmth scores indicated less intention to hire, train or promote individuals professionally. The present study found no such association when voting intention was assessed. Perceived warmth was instead associated with higher levels of voting intention. The results generated in this study, differing significantly from those of other research, including that of Cuddy, Fiske and Glick (2004), have several implications. This study suggested that, in a political context, females who are parents do not decrease in their perceived competence, unlike the results generated in a workplace setting by Cuddy, Fiske and Glick (2004). In addition, this study suggested that unlike previous research by Cuddy, Fiske and Glick (2004), increases in perceived warmth scores are not singularly observed

for females who are parents. In a political context, this study shows that both male and female parents elicited higher warmth scores than non-parents. While Cuddy, Fiske and Glick (2004), indicated a disadvantage for individuals obtaining high warmth scores in relation to hiring, training and promoting in the workplace, no such disadvantage was observed in a political setting. While causation was not indicated in this study, a relationship was found between high warmth scores and high levels of voting intention. This study demonstrated both methodological strengths and weaknesses. Participants were provided with limited information regarding the aim of this study prior to their participation. This ensured that they were blind to the purpose of the study thus reducing the risk of potential preconceptions of participants regarding gender and parental status impacting on the collected results. As discussed by Intons-Peterson (1993) demand characteristics may arise if participants are made aware of the aims of the particular research in advance of completing it. Providing only essential information prior to participation reduced the risk of demand characteristics occurring. The conducting of a pilot study prior to the commencement of the research project was a valuable methodological approach (Thebane et al., 2010).This pilot study allowed for the identification of participants’ requirements, including the amendment of aspects of the survey to improve clarity and ease of usage for participants. As expressed by Thabane et al. (2010), the use

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A STUDY OF PARENTS IN POLITICS of pilot studies allows for the prevention of hindrances to the main study process and increases the potential for success. The participant group used in this study consisted of an approximately even ratio of males and females. As discussed by Furman and Buhrmester (1992), males and females often perceive relationships and social factors differently to each other. As this study was examining the factor of parental status it was essential to control for these differences. Unlike other studies in this area, such as that of Johns (2013) candidate profiles did not include pictures, to ensure participant decisions were not influenced by the appearance of the candidate. This study utilised fictitious candidate profiles devised to ensure each was consistent, had the same criteria and only differed on the variables of gender and parental status. As expressed by Shaughnessy, Zechmeister and Zechmeister (2012), research must adhere to particular ethical criteria in order to gain acknowledgement in its academic field. This study was given ethical approval from the UCD Ethics Committee and followed strong ethical procedures. Participants were firstly informed of the essential information regarding the study, the requirements of their participation, and were asked for their consent. They were informed that they could withdraw from the study at any stage prior to the submission of their completed questionnaires. Following their participation, participants were provided with debriefing sheets informing them of the aims of the research study.

This study also demonstrated several methodological weaknesses. The study examined the perceptions of parents, however the parental status of the participants was not noted. As discussed by Shaughnessy, Zechmeister and Zechmeister (2012), confounding variables such as this may impact on the views expressed throughout the study, and thus upon the generated results. The use of paper surveys increased the likelihood of human error and was also costly and time consuming. Ink and paper were required to create each survey and collected data from each participant had to be inputted into a computer manually. As discussed by Stanton (1998), internet-based surveys, when examined in comparison to paper-based surveys have shown to reduce the occurrence of human error, and collect a larger sample of more reliable data than that of paper-based surveys. The direct presence of the experimenter may also have had adverse effects on the data collection process. As discussed by Kintz, Delprato, Mettee, Persons and Schappe (1965), the presence of an experimenter can affect participantsâ&#x20AC;&#x2122; motivation to provide answers and results he/she believes to be desired by the experimenter. The use of computers in such research settings in the future could reduce cost and increase efficiency (Stanton, 1998). It may also reduce the occurrence of possible human error when completing the ranking chart and reduce experimenter effects on participants.

There are many implications aris-

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ing from this study. The results indicate a strong link between parental status and perceived warmth, and show a positive relationship between perceived warmth and voting intention. These related factors are therefore important to consider in the context of politics and for political candidates. It would be a valuable field of future inquiry to examine the advantages of perceived warmth and its association with parental status to determine whether particular political candidates have automatic advantages based on this status and on voters’ immediate perceptions of them. As discussed by, Miller, Taylor, and Buck (1991) the gender of voters has an immediate effect on patterns of voting. It is therefore advised that future researchers examine this relationship in view of the parental status of male and female candidates. Further research into perceived warmth and competence of parents in other social and employment contexts would also be of immense benefit to identify how perceptions might be different across these contexts. Much of the current research in this field today, emphasises the influence of gender on perceived warmth and competence levels. In this study both gender groups were observed to demonstrate an increase in warmth with parental status, however gender groups were not compared against one another. Future researchers are advised to examine the differences in warmth scores between male and female candidates. Studies such as that of Kahn

(1994) and Huddy and Terkildsen (1993) express the growing interest of gender differences regarding the perception of women in politics, therefore examining the link between gender and warmth and competence levels are encouraged in this field. Cuddy et al., (2004) discuss the concept of “ingroups” within societies, the members of which are perceived as warm and competent. They site examples such as middle class, Christian, white people in America and college graduates and married people in Hong Kong. Political candidates or politicians may represent such a societal “ingroup” in Ireland being perceived as both warm and competent whether they are parents or not. A study by Etaugh and Poertner (1991) found that ratings of competence were related to job prestige, with mothers with moderately prestigious jobs being rated as more competent than mothers with low prestige jobs. Politics, as a moderate to highly prestigious job, may therefore carry inherent competence values. The findings of this study may suggest changing perceptions of parents, particularly working mothers, within society. Future studies are advised to examine this potential changing concept. In conclusion, this study found that perceived competence levels of fictitious political candidates did not alter according to parental status in either male or female candidate groups. However, participants perceived parents in both male and female

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A STUDY OF PARENTS IN POLITICS categories as being warmer than their non-parent counterparts. In general, participants perceived parents to be more friendly, good-hearted, have a greater sense of humour and to be less selfish and irritating than non-parents of the same gender group. Significantly, these warmth scores were positively correlated with voting intention which may give parents in political campaigns an advantage in elections. Research studies to date have indicated that perceptions of parents, particularly mothers serve to disadvantage them, in the workplace. The findings of this study suggest parental status might confer some advantages on those seeking to hold public office. This finding is worth exploring in more depth given its possible implications.

Biernat, M., & Wortman, C. B. (1991). Sharing of home responsibilities between professionally employed women and their husbands. Journal of Personality and Social Psychology , 60, 844-860.

References

Cuddy, A. J., Fiske, S. T., & Glick, P. (2004). When professionals become mothers, warmth doesnâ&#x20AC;&#x2122;t cut the ice. Journal of Social Issues, 60(4), 701718.

Acker, J. (2006). Inequality regimes gender, class, and race in organizations. Gender & society, 20(4), 441-464. Ajzen, I. (1991) The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179211. Ajzen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behaviour. New Jersey: Prentice Hall. Armitage, C. J., & Conner, M. (2001). Efficacy of the Theory of Planned Behaviour: A meta-analytic review. British Journal of Social Psychology, 40(4), 471

Brescoll, V.L., & Uhlmann, E. L. (2005). Attitudes towards traditional and non-traditional parents. Psychology of Women Quarterly, 29, 436-445. Correll, S., Benard, S., & Paik, I. (2007). Getting a job: Is there a motherhood penalty? American Journal of Sociology, 112, 197-1338. Crosby, F. J. (1991). Juggling: The unexpected advantages of balancing career and home for women and their families. New York: The Free Press.

Cuddy, A. J., Fiske, S. T., & Glick, P. (2008). Warmth and competence as universal dimensions of social perception: The stereotype content model and the BIAS map. Advances in experimental social psychology, 40, 61-149. Cuddy, A.J. C., Fiske, S. T., Kwan, V. S., Glick. P.S., Demoulin, S., Leyens, J-Ph. et al. (2004). Is Stereotyping Culture-Bound? A Cross-cultural Comparison of Stereotyping Principles Reveals Systematic Similarities and Differences. Manuscript submitted for publication.

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Deutsch, F. M. (2001). Equally shared parenting. Current Directions in Psychological Science, 10, 25-28. Deutsch, F. M., & Saxon, S. E. (1998a). The double standard of praise and criticism for mothers and fathers. Psychology of Women Quarterly, 22, 665-683. Eagly, A. H., & Kite, M. E. (1987). Are stereotypes of nationalities applied to both women and men?. Journal of Personality and Social Psychology, 53(3), 451. Eagly, A. H., Ashmore, R. D., Makhijani, M. G., & Longo, L. C. (1991). What is beautiful is good, but…: A meta-analytic review of research on the physical attractiveness stereotype. Psychological Bulletin, 110, 109-128. Etaugh, C., & Poertner, P. (1992). Perceptions of women: Influence of performance, marital and parental variables. Sex Roles, 20, 59-70. Fishbein, M., & Ajzen, I. (1975). Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. Reading, MA: Addison-Wesley Furman, W., & Buhrmester, D. (1992). Age and sex differences in perceptions of networks of personal relationships. Child development, 63(1), 103-115. Giles, M., McClenahan, C., Cairns, E., & Mallet, J. (2004). An application of the theory of planned behaviour to blood donation: the importance of self-efficacy. Health Education Research, 19(4), 380-391.

Glick, P., & Fiske, S. T. (1996). The ambivalent sexism inventory: Differentiating hostile and benevolent sexism. Journal of Personality and Social Psychology, 70, 491-512. Glick, P., & Fiske, S. T. (2001). An ambivalent alliance: Hostile and benevolent sexism as complimentary justifications for gender inequality. American Psychologist, 56, 109-118. Glick, P., Lameiras, M., Fiske, S. T., Eckes, T., Masser, B., Volpato, C., & Wells, R. (2004). Bad but bold: Ambivalent attitudes toward men predict gender inequality in 16 nations. Journal of personality and social psychology, 86(5), 713. Goldberg, E (1968). Are women prejudiced against women? Transaction, 5(5), 28-30. Gonzalez, A. Q., & Koestner, R. (2005). Parental preference for sex of newborn as reflected in positive affect in birth announcements. Sex Roles, 52, 407-411. Haddock, G., & Zannam M. P. (1994). Preferring ‘housewives’ to ‘feminists.’ Psychology of Women Quarterly, 18, 25-52. Huddy, L., & Terkildsen, N. (1993). Gender stereotypes and the perception of male and female candidates. American Journal of Political Science, 119147. Intons-Peterson, M. J. (1993). Imagery’s role in creativity and discovery. In R. Roskos-Ewoldson, M. J. Intons-Pe-

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A STUDY OF PARENTS IN POLITICS terson & R. E Anderson (eds.), Imagery, Creativity, and Discovery: A cognitive Perspective. Elsevier. Jackman, J. W., & Senter, M. S. (1981). Beliefs about race, gender, and social class different, therefore unequal: Beliefs about trait differences between groups of unequal status. In D.J Treiman & R. V. Robinson (eds), Research in stratification and mobility. (Vol. 2). Greenwich, CT: JAI Press. Janssens, H., Verkuyten, M., & Khan, A. (2015). Perceived social structural relations and group stereotypes: A test of the Stereotype Content Model in Malaysia. Asian Journal of Social Psychology, 18(1), 52-61. John, B. (2013). Patterns of ageism in different age groups. Journal of European Psychology Students, 4(1), 16-36. Kahn, K. F. (1994). Does gender make a difference? An experimental examination of sex stereotypes and press patterns in statewide campaigns. American Journal of Political Science, 162-195. Kapp, J. M., Peters, C., & Oliver, D. P. (2013). Research recruitment using Facebook advertising: big potential, big challenges. Journal of Cancer Education, 28(1), 134-137. Kelley, H. K. (1979). Personal relationships. Hillsdale, NJ: Lawrence Erlbaum Associates. Kintz, B. L., Delprato, D. J., Mettee, D. R., Persons, C. E., & Schappe, R. H. (1965). The experimenter effect. Psychological Bulletin, 63(4), 223.

Lee, J., Cerreto, F. A., & Lee, J. (2010). Theory of Planned Behavior and Teachersâ&#x20AC;&#x2122; Decisions Regarding Use of Educational Technology. Educational Technology & Society, 13(1), 152-164. Likert, R. (1932). A technique for the measurement of attitudes. Archives of Psychology, 140 McKenna, E. (2012). Business Psychology and Organizational Behaviour. Sussex: Psychology Press. Miller, D. T., Taylor, B., & Buck, M. L. (1991). Gender gaps: Who needs to be explained?. Journal of Personality and Social Psychology, 61(1), 5. Moen, P. (2015). An Institutional/Organizational Turn Getting to Workâ&#x20AC;&#x201C;Life Quality and Gender Equality. Work and Occupations, 42(2), 174-182. Myers, D., Abell, J., Kolstad, A. & Sani, F. (2010) Social Psychology. London: McGraw Hill. Rust, J., & Golombok, S. (1999). Modern Psychometrics: The Science of Psychological Assessment. Routledge. Shaughnessy, J. J., Zechmeister, E. B., & Zechmeister, J. S. (2012). Research Methods in Psychology (9th ed.). New York: McGraw-Hill. Stanton, J. M. (1998). An empirical assessment of data collection using the Internet. Personnel Psychology, 51(3), 709-725.

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Swim, J. K. (1994). Perceived versus meta-analytic effect sizes: An assessment of the accuracy of gender stereotypes. Journal of Personality and Social Psychology, 50, 947-991. Thabane, L., Ma, J., Chu, R., Cheng, J., Ismaila, A., Rios, L. P., & Goldsmith, C. H. (2010). A tutorial on pilot studies: the what, why and how.BMC medical research methodology, 10(1), 1. Topa, G., & Moriano, J. A. (2010). Theory of planned behavior and smoking: Meta-analysis and SEM model. Substance Abuse and Rehabilitation, 1, 23. Williams, J. E., Satterwhite, R. C., & Best D. L. (1999). Pancultural gender stereotypes revisited: The Five Factor model. Sex Roles, 40, 513-525. Williams, J. E., Satterwhite, R. C., & Best, D. L. (2000). Five factor gender stereotypes in 27 countries. Paper presented at the XV Congress of the International Association for Cross-Cultural Psychology, Pultusk, Poland.

Student Psychology Journal of Ireland, 2015, 121-140

Response Inhibition Performance Correlates with Pragmatic Language Ability in Neurotypical Children Aged 10-12 Cal Ryan Mc Donagh Supervisor: Dr. Jean Quigley

Trinity College Dublin

Correspondence: mcdonac2@tcd.ie

abstract

Pragmatic language ability encompasses conversational skills such as turn-taking, topic-management and theory of mind judgements about conversational partners. In response to evidence that pragmatic deficits coincide with poor inhibitory control in clinical groups such as individuals with ASD, this correlational study investigates the relationship between these variables in neurotypical children aged 10 to 12 years (mean age of 10.977). Pragmatic language ability was measured using the Pragmatic Rating Scale for School-Age Children on unstructured interviews based on the Autism Diagnostic Observation Schedule, achieving high inter-rater agreement. Inhibitory control was operationalised as the number of commission errors on a Go/NoGo response-inhibition task, and nonverbal ability was controlled for using subtests from the Detroit Tests of Learning Aptitude. Results indicated a weak but statistically significant positive correlation between pragmatic language and inhibitory control. This relationship is discussed in reference to methodological limitations, with particular focus on subtypes of inhibitory control. No direct causal relationship between inhibitory control and pragmatics is inferred. Keywords: pragmatic language, communication, executive function, response inhibition, inhibitory control

Introduction Pragmatic language ability is implicated in the use of language, in specific contexts, for social and communicative purposes, including skills such as conversational turn-taking and topic-manage-

ment (Paul & Wilson, 2009). The development of measures, such as the Pragmatic Rating Scale (Landa et al., 1992), which assess pragmatics in naturalistic conversation has, in part, contributed to an operationalisation of pragmatics beyond mere social inference (Lam & Yeung, 2012;

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Paul, Orlovski, Marcinko, & Volkmar, 2009). These skills are theoretically distinct from language skills involved in form and content, such that pragmatic language impairment (PLI), now designated social communication disorder, is only identified in the absence of an underlying language deficit (American Psychiatric Association, 2013; Bishop, 2004). Pragmatic deficit is also implicated with the related diagnosis of autism spectrum disorder (ASD) in which pragmatic features such as irrelevant details, poor clarification and topic-preoccupation have been profiled (Lam & Yeung, 2012). Presupposition, the ability to make theory of mind (ToM) judgements about conversational partners and moderate speech accordingly, is particularly impaired in ASD (Paul et al., 2009). Subclinically, autism relatives with mild characteristics, qualitatively similar to ASD, may be discriminated from controls by comparison of pragmatic abilities (Landa et al., 1992; Losh & Piven, 2007; Ruser et al., 2007). The Role of Inhibitory Control There is modest evidence for executive functions, including inhibitory control, underlying pragmatic ability (Poletti, 2011). Lam and Yeung (2012) suggest inhibition of inappropriate speech and behaviour as a cognitive prerequisite for a number of pragmatic skills. Successful conversation may also rely on the suppression of an egocentric heuristic (Keysar,

Barr, Balin, & Brauner, 2000). Consistently, children with PLI show high levels of externalising behaviours, suggesting a role for disinhibition (Ketelaars, Cuperus, Jansonius, & Verhoeven, 2010; Poletti, 2011); children with attention deficit hyperactivity disorder, associated with executive dysfunction, also show a degree of pragmatic impairment (Green, Johnson, & Bretherton, 2014). Additionally, inhibitory control, measured using a Stroop task, and working memory both correlate positively with understanding and production of metaphoric language, indicative of pragmatic understanding, with more cognitively demanding tasks, such as the reverse digit-span, better predicting performance than less demanding tasks (Chiappe & Chiappe, 2007; Glucksberg, Newsome, & Goldvarg, 2001). Inhibition, then, may facilitate adaptive responding in reciprocal conversation (Agam, Joseph, Barton, & Manoach, 2011) and at least two discernible types of inhibition, therefore, may have discreet implications for pragmatics: control over competing cues, interference suppression, and control over competing responses (Martin-Rhee & Bialystok, 2008). Poletti (2011), accordingly, conceives a dual relationship between inhibitory control and pragmatics: a direct role inhibiting behaviour, and an indirect role through pragmatic understanding and systems in-

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RESPONSE INHIBITION CORRELATES WITH PRAGMATIC ABILITY cluding ToM. Inhibitory control has been found to significantly predict ToM (Beck, Riggs, & Gorniak, 2009; Dennis, Agostino, Roncadin, & Levin, 2009) but this effect is not always replicable with different ToM measures (Ahmed & Stephen Miller, 2011). There is conflicting evidence for executive dysfunction in ASD (Goldberg et al., 2005; Hill, 2004; Kenworthy, Yerys, Anthony, & Wallace, 2008) and different types of inhibitory control may be affected unevenly (Adams & Jarrold, 2012; Christ, Holt, White, & Green, 2006; Sanderson & Allen, 2013). Nonetheless, an overlap with poor executive function, including inhibitory control, may partly explain the pragmatic deficit in autistic symptomatology, including some pragmatic violations which may be classified as restricted, repetitive behaviours (Bishop & Norbury, 2005).

Distinction is made, however, between simple stop-signal tasks which require inhibition of a prepotent response, for example the Go/NoGo, and more complex resistance-to-distractor and conflict inhibition tasks which test interference suppression and which some studies have found are more likely to discriminate individuals with ASD from neurotypical controls (Adams & Jarrold, 2012; Sanderson & Allen, 2013). Similarly, conflict inhibition tasks have been found to be the most significant predictors of ToM in neurotypical children (Carlson, Moses, & Breton, 2002), with stop-signal task performance only predicting ToM inconsistently (Carlson, Moses, & Claxton, 2004). Conversely, â&#x20AC;&#x2DC;inhibitory reducersâ&#x20AC;&#x2122; which caused child participants to postpone a prepotent response, have been shown to benefit counterfactual thinking, and this may be generalisable to ToM (Beck, Carroll, Brunsdon, & Gryg, 2011).

Studies using fMRI indicate atypical, asynchronous activation of neural inhibition circuitry for high-functioning individuals with ASD during response-inhibition tasks, suggesting that inhibition is accomplished strategically, rather than automatically (Agam et al., 2011; Kana, Keller, Minshew, & Just, 2007). Poor performance at these tasks is associated with higher-order repetitive behaviours relevant to pragmatics such as topic preoccupations, but not with sensorimotor repetitive behaviours (Mosconi et al., 2009).

In spite of the group differences described, it is unclear whether inhibitory control predicts pragmatic language ability within the neurotypical population. It is argued, by Martin and McDonald (2003), that pragmatic language ability is supported by interacting cognitive systems and heterogeneous functional deficits, and that the relationship between executive dysfunction and pragmatic impairment in ASD is not necessarily causal, nor necessarily generalisable to other populations. Responding to evidence that impaired

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pragmatic language ability and inhibitory control coincide in ASD, it would be beneficial to investigate the relationship between these two variables in neurotypical children, predicted to have a range of pragmatic abilities. The Role of Sex There is an established female advantage for inhibitory control tasks, including a greater benefit from effortful control (Yuan, He, Qinglin, Chen, & Li, 2008; Y端cel et al., 2012). However, this effect may be reversed in ASD groups where there is a female disadvantage for such tasks (Lemon, Gargaro, Enticott, & Rinehart, 2011). While pragmatic language in female autism has not been profiled (Klusek, Losh, & Martin, 2014), it would also be beneficial to compares the relationship between inhibitory control and pragmatic language ability for neurotypical males and females, in the light of the substantial sex bias in autism presentation. Current Study The present study sought to determine the relationship between pragmatic ability and inhibitory control, operationalised as response-inhibition task performance; a significant positive correlation was hypothesised. As the present study does not control for verbal intelligence, response inhibition was measured using the nonverbal Go/NoGo only. An additional two-tailed hypothesis predicted a sex difference in this relationship between inhibitory con-

trol and pragmatic ability. Method Design A cross-sectional correlational study of two natural variables, pragmatic language ability and inhibitory control, in neurotypical children aged 10-12, was undertaken along with and a between groups comparison of the relationship between these variables in males and females. Individual interviews, based on the ADOS (Lord, Rutter, DiLavore, & Risi, 2000) were video-recorded and rated using the Pragmatic Rating Scale for School-Age Children (PRS) (Landa, 2011) to produce a score for pragmatic ability (PRS total) comprising six subdomains and 34 individual items. Inhibitory control, was operationalised as the number of commission errors on a computerised response-inhibition task (Go/NoGo). Subtests from the Detroit Tests of Learning Aptitude: Fourth Edition (DTLA-4) (Hammill, 1998) were administered, producing a nonverbal quotient (NVQ) to control for variation in intelligence. Participants Sixty children (33 male) with a mean age of 10.955 (.544) were recruited by letter sent home to their parents through four mainstream primary schools. Children were tested in their schools with full parental written consent; children gave oral consent after hearing an explanation of

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RESPONSE INHIBITION CORRELATES WITH PRAGMATIC ABILITY the study and their right to withdraw at the beginning of the testing session, and were fully debriefed at the end. Teachers reported that all children were native, monolingual English speakers, without language or learning impairments, receiving no additional support for speech or reading. However, to avoid sampling bias, all eligible children in a given class-group were invited to participate before recruitment was opened to the next group, encompassing six groups in total. Five male participants did not successfully complete the Go/NoGo and were excluded from analysis (see Go/NoGo error analysis) leaving a mean age of 10.977 (.549), 10.966 (.569) among males and 10.990 (.540) among females. Apparatus PRS. The PRS was originally developed to detect non-clinical traits of ASD in adult autism relatives (Klusek et al., 2014; Landa et al., 1992; Losh, Childress, Lam, & Piven, 2008; Losh & Piven, 2007) but has also been used to profile pragmatic language in children and adolescents with ASD, and neurotypical controls (Freitag, Kleser, von Gontard, & von Gontardf, 2006; Lam & Yeung, 2012; Paul et al., 2009). It was designed to examine pragmatic difficulties, prevalent in ASD, in semi-social settings in the form of interviews adapted from the ADOS, eliciting speech acts sufficient for identifying atypical pragmatics (Lam & Yeung, 2012; Paul et al., 2009; Pickles et al., 2013). Trained

raters have achieved good reliability using entire interviews as the unit of analysis (Lam & Yeung, 2012), or by rating 3-minute interview-segments individually and calculating an average rating (Paul et al., 2009). The Pragmatic Rating Scale for School-Age Children (Landa, 2011) is a modified version of the scale, designed for children older than 4, speaking in full sentences with or without grammar errors. The scale comprises 34 items rated using a three-level scoring procedure. Ratings of 0 and 2 indicate absence and presence of pragmatic abnormality respectively; ratings of 1, indicating abnormality which is moderate or limited in quantity, are only available for 23 of the items, nonetheless making this an appropriate measure for high-functioning and neurotypical individuals (Paul et al., 2009). Each item is defined objectively (see Landa, 2011) and ratings of 1 or 2 must be evidenced with examples of pragmatic violations, constituting present or absent behaviours. Item ratings are summed, producing a total score and scores for six distinct subdomains, itemised here. 1. Speech Acts. Two items: Diversity of communicative intents; Social appropriateness of expression of communicative intents. 2. Presupposition/Theory of Mind (ToM). Eight items: Overly personal, candid, straightforward, or authoritative speech; Swearing; Overly talkative, ver-

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bose; Overly-detailed; Insufficient background information and linkage of information to the ongoing or prior discourse; Redundant; Fails to signal humour or teasing with appropriate tone of voice, facial expression, gesture, or language; Inadequate clarification upon examiner’s request. 3. Discourse Management. Eight items: Topic initiation, including small talk; Inappropriate topic shifts; Interrupting; Acknowledging examiner’s communications; Response elaboration on examiner’s utterances; Perseverates on a topic or seems preoccupied with a topic; Making vocal noises that are not relevant; Quality of reciprocal conversation. 4. Speech and Language Behaviours that may affect Pragmatics. Four items: Overly formal or informal speech or language for the context; Scripted, stereotyped sentences or discourse (for example: echolalia or highly repetitive language); Errors in grammar, use of vocabulary, and/ or expression of ideas; Speech is indistinct or words are difficult to understand. 5. Suprasegmental Speech Characteristics. Six items: Rate of speech too rapid or slow; Unusual intonation or pitch; Abnormal loudness level; Use of ‘character’ voice/speech pattern or ‘silly’ talk; Language formulation difficulty (for example: reformulations, frequent pauses, or unusual timing of responses); Stuttering. 6. Nonverbal Communicative Behaviours that affect Pragmatics. Six items: Mismanagement of interpersonal space;

Gestures; Mannerisms of posturing behaviour; Facial expression or inappropriate laughter; Inappropriate use of eye contact or eye gaze; Inappropriate vegetative sounds or inappropriate grooming/hygiene acts. The first three subdomains are somewhat aligned with factors which discriminate autism relatives from controls, identified by Landa and associates (1992): Inadequate expression and Disinhibited communication (Piven et al., 1997). The ToM subdomain, in particular, examines pragmatic features such as clarity and relevance of communication, and judgements of listener’s informational needs. Go/NoGo. The response-inhibition task was a modified version of the PEBL Go/NoGo Test (Mueller, 2012), adapted from Bezdjian, Baker, Lozano, & Raine (2009), presented using PEBL (Mueller, 2011) on a 13 in. laptop. Stimuli were presented alternately, in one of four squares, each otherwise containing a blue star, in a 2 x 2 array, for 500 milliseconds with an inter-stimuli interval of 1,500 milliseconds across ten practice and 160 test trials (contact author for testing protocol), taking approximately 6 minutes. Arrows were chosen as stimuli in the present study so that grapheme-recognition would not be required of participants. Participants were required to give a motor response to the target stimulus (↑), pressing a laptop key (labelled with a yellow sticker), and to in-

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RESPONSE INHIBITION CORRELATES WITH PRAGMATIC ABILITY hibit this response when a similar non-target stimulus (↓) was presented; the ratio of targets to non-targets was 80:20, presented in random order. Task performance has acceptable test-rest reliability and is relatively stable overtime (Kindlon, Mezzacappa, & Earls, 1995), with higher rates of commission errors – incorrect responses to the non-target stimuli – indicating poor inhibitory control (Bezdjian et al., 2009). Reaction times and rates of omission errors – failure to respond to the target stimuli – were measured to account for errors due to slow reaction speeds and to ensure that low commission error rates were not due to inattention. Another block of trials, requiring participants to only respond to non-target stimuli was removed from Bezdjian and associates’ version (2009) because these trials only measure attention. DTLA-4. Five subtests from the DTLA-4 were administered, taking approximately 45 minutes, to compute age-standardised subtest scores and NVQ. The DTLA-4, designed to measure mental ability in 6-17 year olds, is well correlated with the WISC-III and Kaufman Assessment Battery for Children (Smith, 2001) with subtests achieving .80 reliability for the age-group tested presently; NVQ theoretically corresponds to performance IQ on the WISC-III (Hammill, 1998). No special qualification is required to administer the test, but examiners received precurso-

ry training. Testing and scoring guidelines were adhered to closely (see Hammill, 1998 and DTLA-4 error analysis); the five subtests involved: writing aurally presented sequences of letters in reverse from memory (Reversed Letters); making sensible stories by putting captionless pictures in sequence (Story Sequences); reproducing sequences of non-meaningful symbols from memory; drawing non-meaningful geometric designs accurately from memory; indicating the missing pieces from pattern matrices. Procedure Interview and testing. The interview and all tests were administered by two examiners, one-on-one, in a quiet schoolroom, familiar to participants. Children were allowed to take breaks and, occasionally, testing was split across two shorter sessions to accommodate school routines. Language samples, approximately 15 minutes in length, were dyads of the examiner and child facing each other diagonally at the corner of a table, recorded using a Sony HDR-SR11 video-camera (1080p) and uploaded to a secure computer for rating; children typically remained in their seats during the interview, staying in clear view of the camera which was set upon a tripod. The interview protocol (available from the author) was adapted from Module 4 of the ADOS (items 3, 4, 5, 7, 12 and 14) (Lord et al., 2000) with the purpose of

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giving participants the opportunity to provide as rich a language sample as possible. The examiners avoided a directive question-and-answer approach and were only required to cover a few of the topics on the interview schedule, often requesting information, inviting questions or comment from the participant implicitly. Examiners used an informal, conversational tone, giving appropriate encouragement, and demonstrating enjoyment in the activities throughout the entire testing session. To generate a richer sample, the structured Go/NoGo and DTLA-4 tests were generally administered first, allowing time for participants to get used to the examiner and camera before the interview. The examiners were instructed to follow the participantsâ&#x20AC;&#x2122; leads however, and, in some cases, where conversation occurred spontaneously, or as a result of test activities, language samples were dispersed between tasks. Landa (2011) encourages such periods of natural conversation, even if integrated with other tasks. Conversation starters included questions about friends and hobbies but examiners were instructed to respond to participantsâ&#x20AC;&#x2122; interests while guiding conversations away from being about just one topic about which the participant especially liked to talk by: volunteering information, introducing topic shifts, and providing opportunities for the participant to change the subject. Examiners were also instructed to elicit questions from partici-

pants and remain silent for a few seconds, implicitly requiring participants to maintain the conversation, unassisted. PRS rating. Observational rating, in which the entire interview session recording was the entity rated, was performed by examiners using the ordinal ratings scale on 34 items with strict reference to the rating manual (Landa, 2011) which is calibrated specifically for language samples obtained during the ADOS. The boundaries of the largely social based items are defined and accompanied by examples and non-examples (see Yoder & Symons, 2010, pp. 39â&#x20AC;&#x201C;40) and the observers spent five hours training with a content expert before beginning rating. Paper and pencil were used, as is appropriate for untimed-event recording (Bakeman & Quera, 2011, p. 81), but the times of observations were noted for ease of reference during reliability checks. PRS inter-rater reliability. Initially, both observers rated 16.66% of interviews independently, and half of these pairs of ratings were selected randomly, achieving high total agreement (88.24%) but poor agreement above chance-level (k(170)=.192, p=.001) (Landis & Koch, 1977). This was overcome consensually through discrepancy discussion between the raters and a content expert. Initial total agreement was below 80% for only three items and more detailed guidelines were agreed for these items to overcome dis-

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RESPONSE INHIBITION CORRELATES WITH PRAGMATIC ABILITY agreement (see Additional coding instructions). Subsequently, this process was repeated with new interviews, maintaining high total agreement (84.71%) and fair agreement above chance-level (k(170)=.376, p<.001). To test agreement for item non-occurrence, ratings were collapsed into present (1 and 2) and absent (0) for the purpose of reliability analysis only, indicating high total agreement (86.47%) and, now, moderate agreement above chance-level (k(170)=.445, p<.001); this analysis was supported by the restricted range of available scores (0 or 2) for several PRS items (see Landa, 2011; Piven et al., 1997). It is noted that non-occurrence agreement is associated with an inflated estimation of chance agreement, making Cohen’s kappa coefficient a particularly conservative test for behaviours of interest which occur infrequently in a target population (Ruser et al., 2007; Yoder & Symons, 2010, pp. 167–70). Additional coding instructions. After the first round of inter-rater reliability checks, the PRS rating manual (Landa, 2011) was supplemented with more detailed guidelines to overcome disagreement on three items discussed here (contact author for further details). Topic initiations. Where two or fewer initiations were made, scoring was determined with emphasis on their spontaneity

and those encouraged or elicited by the examiner (for example: ‘Is soccer your only hobby?’) were not counted. Quality of reciprocal conversation. ‘Reciprocal conversation’ was operationalised as spontaneously engaging the other person with questions and showing signs of interest. To allow for initial shyness, this item was only coded when children were at their most comfortable during the interview, but not only during conversations about a child’s particular subject of interest, where the examiner’s other attempts to find a conversation topic had failed. Errors in grammar, use of vocabulary, and/or expression of ideas. Uncertainty about culturally acceptable errors and dialect variations was resolved through transcription and consensus coding of problematic occurrences. PRS subdomains. Scores for individual PRS items were summed to produce a total score and six subdomain scores. These PRS subdomains were developed partly through factor analysis on item scores from autism relatives, with additional theoretical groupings of suprasegmental speech and nonverbal behaviours (Landa, 2011; Landa et al., 1992; Paul et al., 2009). It was briefly noted that confirmatory factor analysis would be desirable in order to establish how well present data from the neurotypical population fit to this subdomain model. As the present dataset

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does not meet sampling criteria for such analysis, the present emphasis is on observed PRS items and total scores, rather than unobservable subdomains representing latent variables. Go/NoGo error analysis. Preliminary analyses, using MS Excel, were performed on the Go/NoGo data in order to improve the validity of commission and omission measurement, as recommended by Bezdjian and associates (2009). Commissions with reaction times below 120 milliseconds were marked as missing and taken to be late responses to the preceding trial, if that preceding trial had been recorded as an omission. Participants with omission error rates exceeding 25% were excluded from subsequent analysis to eliminate the effects of task misunderstanding, inattention, or failure to complete the task. DTLA-4 error analysis. An analysis of Reversed Letters test errors showed that, on items which required participants to write M or N, participants wrote N and M, respectively, on 5.5% of trials â&#x20AC;&#x201C; above the calculated chance level (3.7%), indicating that these were phonological, rather than memory or sequencing, errors â&#x20AC;&#x201C; so these responses were recorded as correct. Results All analyses were carried out using IBM SPSS. Across the sample (N=55), the mean PRS total was 4.58 (4.095) and the

modal scores were 1 and 2. The distribution of PRS totals was positively skewed, failing to meet parametric assumptions; one outlier was identified, 3.032 standard deviations from the mean, but, in light of the limited sample size, this was deemed close enough to 3.0 for the datapoint to be included at this stage in the analysis. For males (n=28) and females (n=27), the mean PRS totals were 4.68 (3.859) and 4.48 (4.397) respectively. A series of Mann-Whitney tests indicated no significant effects of sex (U(27,26)=355.5, z=-.382, p=.703, two-tailed), or the two experimenters (U(29,23)=332.0, z=-.491, p=.623, two-tailed) on PRS totals. The mean number of commission errors among participants was 19.491 (6.365); 21.679 (6.050) for males and 17.222 (5.970) for females. A significant Kolmogorov-Smirnov statistic indicated that the commission errors scores did not comply with a normal distribution, and thus a Mann-Whitney test indicated that males made significantly more commission errors than females (U(27,26)=210, z=-2.835, p=.003, one-tailed, r=-.382). NVQ data complied with assumptions of normality with a mean of 101.6 (1.549); one outlier, 3.012 standard deviations from the mean, was noted but included at this stage in the analysis. To address this lack of normality, the researchers approached both hypotheses

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RESPONSE INHIBITION CORRELATES WITH PRAGMATIC ABILITY using nonparametric Spearman’s rank correlations, which are also less sensitive to outliers. While subsequent partial correlations and regression analyses are interpreted cautiously with regards to the data’s non-parametricity, these tests are motivated by correlation coefficients generated by the initial nonparametric tests. Preliminary Spearman’s correlations also guided researchers to control for the effects of NVQ on PRS scores, as standardised scores for two DTLA-4 subtests had a significant negative relationship with PRS total scores – Reversed Letters (r=(55)=-.308, p=.011, one-tailed) and Story Sequences (r(55)=-.261, p=.027). However, NVQ was not significantly correlated with PRS totals or commission errors. Inhibitory Control and Pragmatic Ability Graphical depiction of PRS total and commission errors somewhat supported the hypothesis that these two variables would be positively correlated. A Spearman’s rank correlation, with an alpha level of .05, indicated a significant positive correlation, with a relatively small effect size, between PRS totals and commission errors, as hypothesised (r(55)=.294, p=.015, one-tailed). When a partial correlation was used to control for the effects of NVQ, this relationship remained significant (r(55)=.280, p=.020, one-tailed).

Regression and outlier analysis. Sim-

ple regression analysis was used to test whether commission errors significantly predicted PRS totals. Analyses of tolerance and VIF were within the normal range, rejecting the presence of multicollinearity. The results of the regression indicated that the predictor explained 8.7% of the variance (R2 =.087, F(1,54)=5.028, p=.029) with commission errors significantly predicting PRS totals (β=.294, t(54)=2.242, p=.029). One case had a standard residual of 3.455, when this outlier was removed, the predictor explained 15.4% of the variance R2 =.154, F(1,53)=9.431, p=.003) with commission errors significantly predicting PRS totals (β=.392, t(53)=3.071, p=.003). The outlier in the simple regression was 3.032 standard deviations above the mean PRS total and 3.012 below the mean NVQ. Outlier analysis, comprising two multiple regression analyses, one with, and one without, the outlier, determined that this case had an undue influence on the relationship between PRS total and NVQ, so the outlier was removed from all subsequent analyses. The multiple regression analyses included the two DTLA-4 subtests which were significantly correlated with PRS total in the model, along with commission errors. Analyses of tolerance and VIF were within the normal range, rejecting the presence of multicollinearity. The results of the regression indicated that, when the outlier was included, the three predictors explained 24% of the variance

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(R2 =.240, F(1,54)=5.358, p=.003) with Reversed Letters and Story Sequences, but not commission errors, significantly predicting PRS totals (see Table 1). However, when the outlier was excluded, the three predictors explained 21.3% of the

variance in PRS total scores (R2 =.213, F(1,53)=4.516, p=.007) with commission errors, but not Reversed Letters or Story Sequences, significantly predicting PRS totals (see Table 2).

After the outlier was excluded, Spearman’s correlations between PRS and the DTLA-4 subtests were repeated, and the relationship with Reversed Letters remained significant (r(54)=-.269, p=.024, one-tailed) but the relationship with Story Sequences did not. The correlation coefficient of PRS totals and commission errors increased, now indicating a significant weak correlation (r(54)=.340, p=.006, one-tailed), and this increase in effect size was also demonstrable when a partial correlation controlled for NVQ (r(54)=.384, p=.002, one-tailed).

ToM, achieving a significant weak correlation (r(54)=.360, p=.004, one-tailed), and Discourse Management (r(54)=.237, p=.043, one-tailed); partial correlations, controlling for NVQ, maintained the significant relationship between commission errors and ToM (r(54)=.373, p=.003, one-tailed) and Discourse Management (r(54)=.254, p=.033, one-tailed). Statistical significance was not reached by Spearman’s correlations between commission errors and the other PRS subdomains.

Further analyses. To investigate this relationship between commission errors and PRS scores, further analyses were carried out on the PRS subcomponents. Spearman’s correlations indicated that, commission errors had significant positive correlations with two PRS subdomains:

However, emphasis is placed on the relationship between commission errors and individual PRS items rather than subdomains. Five PRS items with no variance, because all participants scored 0, were excluded from correlational analysis: Redundant, Stereotyped sentences, Use of ‘Character’ Voice, Stuttering and Inappropriate Vegetative sounds. As 29

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RESPONSE INHIBITION CORRELATES WITH PRAGMATIC ABILITY correlations were performed at a PRS item-level, these results are interpreted using a Bonferroni correction which stipulated a new alpha level of .002 in order to reduce familywise error and the risk of a type 1 error. However, in light of this test’s limited statistical power, and the restricted sample size, particular attention is given to correlations with p-values exceeding .05, even though these do not meet more conservative criteria for statistical significance. Most PRS items positively correlated with commission errors beyond the .05 level were on the ToM and Discourse Management subdomains; all but one of these correlations were maintained using follow-up partial correlations controlling for NVQ: Insufficient Background (r(54)=.252, p=.035, one-tailed), Fails to Signal Humour (r(54)=.327, p=.008, one-tailed) and Interrupting (r(54)=.336, p=.007, one-tailed); however, Inadequate Clarification only correlated with commission errors beyond the .05 level when NVQ was not controlled for (r(54)=.250, p=.034). Controlling for NVQ, Response Elaboration also partially correlated, positively, with commission errors scores (r=(54).233, p=.047, one-tailed), exceeding the .05 level, despite only approaching this level in a nonparametric Spearman’s correlation. Another item, Mannerisms or posturing behaviour, from the Nonverbal Communicative Behaviours subdomain, was also correlated with commission er-

rors beyond the .05 level and this correlation was also maintained when controlling for NVQ (r(54)=.251, p=.035, one-tailed). Gender Differences Graphical depiction of PRS total and commission errors score did not fully support the null hypothesis that there would be no difference in strength of the correlation between PRS total and commission errors among males and females. Two Spearman’s rank correlation, with alpha levels of .05, indicated a significant – weak, approaching moderate – positive correlation between PRS totals and commission errors for females (r(25)=.453, p=.010, one-tailed), but not for males (r28)=., p=.010, one-tailed). When a partial correlation was used to control for the effects of NVQ, the relationship remained close to moderate for females (r(26)=.498, p=.006, one-tailed) and non-significant for males. Regression analysis. Regression analysis with mixed-effect was used to test whether an interaction between commission errors and sex significantly predicted PRS totals. Analyses of tolerance and VIF were within the normal range, rejecting the presence of multicollinearity. The results of the regression indicated that the predictors explained 16.6% of the variance (R2 =.116, F(1,53)=3.311, p=.027) with commission errors, but not sex, or an interaction between these variables, significantly predicting PRS total (see Table 2) – failing

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to reject the null hypothesis that there is no sex difference in the correlation between

Discussion Summary of Results This research hypothesised, firsly, a positive correlation between childrenâ&#x20AC;&#x2122;s pragmatic language ability and response-inhibition task performance, and, secondly, a gender difference in the relationship between these two variables. The results supported the first, but not the second hypothesis. Inhibitory Control and Pragmatic Ability The findings indicated a significant weak positive correlation between inhibitory control performance and pragmatic language ability across the neurotypical sample, with and without controlling for nonverbal ability; this supports evidence for executive dysfunction underlying pragmatic impairment in clinical populations (Lam and Yeung, 2012; Poletti, 2011). Although the null hypothesis was not accepted, this correlation should be interpreted in light of its modest effect size. Inhibitory control performance significantly predicted pragmatic ability, explaining 15.4% of the variance in PRS totals, whereas the two DTLA-4 subtests which correlated

commission errors and PRS total.

with pragmatic ability did not. Only two individual items, Fails to Signal Humour, and Interrupting, on the ToM and Discourse Management subdomains, achieved an effect size above .3. Most other significantly correlated items, with smaller effect sizes, were also on these subdomains, supporting the prediction that inhibition is a cognitive prerequisite for some pragmatic skills: inhibiting socially unacceptable behaviours, like interrupting, and facilitating presuppositions (Lam & Yeung, 2012). However, as neurotypical children, without a large pragmatic deficit are likely to be rated 0 on a majority of PRS items (Landa, 2011), larger item-level correlations may be unlikely in a sample of this size. The presence of item correlations on the ToM and Discourse Management subdomains supports Polettiâ&#x20AC;&#x2122;s (2011) model of a dual relationship between inhibitory control and pragmatics via pragmatic understanding and behavioural inhibition discretely and has implications for interventionists who may target both pathways separately.

There also appeared to be a consid-

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RESPONSE INHIBITION CORRELATES WITH PRAGMATIC ABILITY erable floor effect on PRS total, or ceiling effect on pragmatic ability, and the modal score was close to 0 – the empirical minimum on the scale (Yoder & Symons, 2010, p. 210). It is unclear whether a more sensitive measure, for instance, sequential coding of pragmatic behaviours (Paul et al., 2009) would detect a similar relationship with inhibitory control for children with particularly good pragmatic ability. Although the present study controls for nonverbal ability, it might be hypothesised that this relationship plateaus, or even reverses, as other factors, such as verbal ability, increase. The role of inhibitory control in pragmatic impairment may be illuminated by an understanding of its involvement in very good pragmatics. Gender Differences As anticipated, females demonstrated significant greater inhibitory control (Yuan et al., 2008; Yücel et al., 2012). Response-inhibition performance was significantly correlated with pragmatic language for females – with an effect size approaching moderate – but there was no such relationship for males. Although this finding appears to support the hypothesis that inhibitory control is related to pragmatics differently in males and females, regression analysis indicated that the relationship between these variables was not significantly mediated by sex, supporting the null hypothesis. The risk of a type 2 error, due to the limited sample size, is noted and it is hoped that a larger investigation

into the mediation of inhibitory control by gender, motivated by this discernible, albeit insignificant, sex difference, will contribute to the limited literature on pragmatic ability in females (Klusek, Losh, & Martin, 2014). Research Limitations The researchers acknowledge methodological limitations – the potential for sample self-selection and issues with inter-rater reliability – in this research; a weighted kappa coefficient may have provided a fairer measure of reliability by treating disagreement between ordinal PRS codes farther apart (0 and 2) as more severe than between those closer together (0 and 1, 1 and 2) (Bakeman & Quera, 2011, p. 83). However, failures to account for verbal intelligence and working memory, and the choice of inhibitory control measure, are discussed. Although only nonverbal ability is controlled for in the present study, Lam and Yeung (2012) point out that verbal intelligence may also confound PRS performance. Analysis indicated that inhibitory control’s ability to predict pragmatics was compromised by one outlier with low nonverbal ability and that, among DLTA4 subtests, Story Sequences’ correlation with pragmatic ability was only significant when this outlier was included; although this is a nonverbal task, it may be proxy to crystallised intelligence, testing culturally acquired and school-taught abilities

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(Hammill, 1998), thus highlighting a need to control against verbal intelligence. Similarly, correlation between pragmatics and Reversed Letters, a test comparable to the reverse digit-span (Chiappe & Chiappe, 2007) also highlights a need to delineate the role of inhibition from that of working memory. Kenworthy and colleagues (2008) point out that inhibitory control is not a unitary construct; in the present study, a task measuring delay inhibition – of a prepotent response – was chosen over conflict inhibition and resistance-to-distractor tasks. The methodological impetus for this choice was to implement a widely available nonverbal measure which was unlikely to be affected by crystallised intelligence, however, in future research, selection of a conflict inhibition task would be more theoretically motivated because ASD populations show greater impairment in this task, which is also more clearly related to ToM (Adams & Jarrold, 2012; Carlson et al., 2002; Sanderson & Allen, 2013). While correlations between conflict inhibition, and PRS total and item scores might yield larger effect sizes, a comparison of the relationship between pragmatics and the different inhibitory control subtypes would be another useful extension of this study. Delineation of these subtypes’ influence could also provide useful comparison between sexes, levels of develop-

mental ability, and between neurotypical and pragmatically impaired populations. Conclusion Group differences in inhibitory control, between the neurotypical population and phenotypes with pragmatic language deficits, such as ASD, are supported by prior research (Lam & Yeung, 2012; Paul et al., 2009). Nonetheless, the relationship indicated here, between inhibitory control and pragmatics in neurotypical children, may be unlike that in autism (Martin & McDonald, 2003) and may be attributable to general executive functions, specific inhibitory control abilities, or a third variable such as verbal intelligence – not included in the present model. In spite of this, further understanding of the functions which assist, and dysfunctions which impair, pragmatics in neurotypical groups may have particular implications for our understanding of pragmatic deficits where they do so occur. In other populations, pragmatic language violations may be developed as reliable predictors for reduced inhibitory capacity. References Adams, N. C., & Jarrold, C. (2012). Inhibition in autism: Children with autism have difficulty inhibiting irrelevant distractors but not prepotent responses. Journal of Autism and Developmental Disorders, 42(6), 1052–1063. Agam, Y., Joseph, R. M., Barton, J. J. S., & Manoach, D. S. (2011). Reduced cog-

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RESPONSE INHIBITION CORRELATES WITH PRAGMATIC ABILITY nitive control of response inhibition by the anterior cingulate cortex in autism spectrum disorders. Neuroimage, 52(1), 336–347. Ahmed, F. S., & Stephen Miller, L. (2011). Executive function mechanisms of theory of mind. Journal of Autism and Developmental Disorders, 41(5), 667–678. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Bakeman, R., & Quera, V. (2011). Sequential analysis and observational methods for the behavioral sciences. Cambridge: Cambridge University Press. Beck, S. R., Carroll, D. J., Brunsdon, V. E., & Gryg, C. K. (2011). Supporting children’s counterfactual thinking with alternative modes of responding. Journal of Experimental Child Psychology, 108(1), 190–202. Beck, S. R., Riggs, K. J., & Gorniak, S. L. (2009). Relating developments in children’s counterfactual thinking and executive functions. Thinking & Reasoning, 15(4), 337–354. Bezdjian, S., Baker, L. A., Lozano, D. I., & Raine, A. (2009). Assessing inattention and impulsivity in children during the Go/NoGo task. British Journal of Developmental Psychology, 27(2), 365–383. Bishop, D. V. M. (2004). Pragmatic language impairment: A correlate of SLI, a distinct subgroup, or part of the au-

tistic continuum? In D. V. M. Bishop & L. B. Leonard (Eds.), Speech and language impairments in children: Causes, characteristics, intervention and outcome (pp. 99–113). Hove: Psychology Press. Bishop, D. V. M., & Norbury, C. F. (2005). Executive functions in children with communication impairments, in relation to autistic symptomatology: I: Generativity. Autism, 9(7), 7–27. Carlson, S. M., Moses, L. J., & Breton, C. (2002). How Specific is the relation between executive function and theory of mind ? Contributions of inhibitory control and working memory. Infant and Child Development, 11, 73–92. Carlson, S. M., Moses, L. J., & Claxton, L. J. (2004). Individual differences in executive functioning and theory of mind: An investigation of inhibitory control and planning ability. Journal of Experimental Child Psychology, 87(4), 299–319. Chiappe, D. L., & Chiappe, P. (2007). The role of working memory in metaphor production and comprehension. Journal of Memory and Language, 56(2), 172–188. Christ, S. E., Holt, D. D., White, D. A., & Green, L. (2006). Inhibitory control in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(6), 1155–1165.

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Dennis, M., Agostino, A., Roncadin, C., & Levin, H. (2009). Theory of mind depends on domain-general executive functions of working memory and cognitive inhibition in children with traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 31(7), 835–47. Freitag, C. M., Kleser, C., von Gontard, A., & von Gontardf, A. (2006). Imitation and language abilities in adolescents with Autism Spectrum Disorder without language delay. European Child & Adolescent Psychiatry, 15(5), 282–291. Glucksberg, S., Newsome, M., & Goldvarg, Y. (2001). Inhibition of the literal: Filtering metaphor-irrelevant information during metaphor comprehension. Metaphor and Symbol, 16(3), 277–293. Goldberg, M. C., Mostofsky, S. H., Cutting, L. E., Mahone, E. M., Astor, B. C., Denckla, M. B., & Landa, R. J. (2005). Subtle executive impairment in children with autism and children with ADHD. Journal of Autism and Developmental Disorders, 35(3), 279–293 Green, B. C., Johnson, K. A., & Bretherton, L. (2014). Pragmatic language difficulties in children with hyperactivity and attention problems: An integrated review. International Journal of Language & Communication Disorders, 49(1), 15–29. Hammill, D. D. (1998). Detroit Tests of Learning Aptitude: Fourth Edition. Austin, TX: Pro-ed.

Hill, E. L. (2004). Executive dysfunction in autism. Trends in Cognitive Sciences, 8(1), 26–32. Kana, R. K., Keller, T. A., Minshew, N. J., & Just, M. A. (2007). Inhibitory control in high-functioning autism: Decreased activation and underconnectivity in inhibition networks. Biological psychiatry, 62(3), 198–206. Kenworthy, L., Yerys, B. E., Anthony, L. G., & Wallace, G. L. (2008). Understanding executive control in autism spectrum disorder in the lab and in the real world. Neuropsychology Review, 18(4), 320–338. Ketelaars, M. P., Cuperus, J., Jansonius, K., & Verhoeven, L. (2010). Pragmatic language impairment and associated behavioural problems. International Journal of Language & Communication Disorders, 45(2), 204–214. Keysar, B., Barr, D. J., Balin, J. A., & Brauner, J. S. (2000). Taking perspective in conversation: The role of mutual knowledge in comprehension. Psychological Science, 11(1), 32–38. Kindlon, D., Mezzacappa, E., & Earls, F. (1995). Psychometric properties of impulsivity measures: Temporal stability, validity, and factor structure. Journal of Child Psychology and Psychiatry, 36(4), 645–661. Klusek, J., Losh, M., & Martin, (2014). Sex differences and in-family associations in the autism phenotype. Autism, 106–116.

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RESPONSE INHIBITION CORRELATES WITH PRAGMATIC ABILITY Lam, Y. G., & Yeung, S. S. (2012). Towards a convergent account of pragmatic language deficits in children with high-functioning autism: Depicting the phenotype using the Pragmatic Rating Scale. Research in Autism Spectrum Disorders, 6(2), 792–797. Landa, R. J. (2011). Pragmatic Rating Scale for School-Age Children. Unpublished manuscript, Johns Hopkins University. Landa, R. J., Piven, J., Wzorek, M. M., Gayle, J. O., Chase, G. A., & Folstein, S. E. (1992). Social language use in parents of autistic individuals. Psychological Medicine, 22(1), 245–254. Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159–174. Lemon, J. M., Gargaro, B., Enticott, P. G., & Rinehart, N. J. (2011). Executive functioning in autism spectrum disorders: A gender comparison of response inhibition. Journal of Autism and Developmental Disorders2, 41(3), 352–356. Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (2000). Autism Diagnostic Observation Schedule. Torrance, CA: Western Psychological Services. Losh, M., Childress, D., Lam, K., & Piven, J. (2008). Defining key features of the broad autism phenotype: A comparison across parents of multipleand single-incidence autism families. American journal of medical genetics, 147b(4), 424–433.

Losh, M., & Piven, J. (2007). Social-cognition and the broad autism phenotype: identifying genetically meaningful phenotypes. Journal of child psychology and psychiatry, and allied disciplines, 48(1), 105–12. (should the journal titles be capitalised, some are and some aren’t) Martin, I., & McDonald, S. (2003). Weak coherence, no theory of mind, or executive dysfunction? Solving the puzzle of pragmatic language disorders. Brain and Language, 85(3), 451–466. Martin-Rhee, M. M., & Bialystok, E. (2008). The development of two types of inhibitory control in monolingual and bilingual children. Bilingualism: Language and Cognition, 11(1), 81– 93. Mosconi, M. W., Kay, M., D’Cruz, A.-M., Seidenfeld, A., Guter, S., Stanford, L. D., & Sweeney, J. a. (2009). Impaired inhibitory control is associated with higher-order repetitive behaviors in autism spectrum disorders. Psychological medicine, 39(9), 1559–1566. Mueller, S. T. (2011). The PEBL Go/ NoGo test [Software]. Mueller, S. T. (2012). PEBL: The psychology experiment building language (Version 0.13) [Software]. Paul, R., Orlovski, S. M., Marcinko, H. C., & Volkmar, F. (2009). Conversational behaviors in youth with high-functioning ASD and Asperger Syndrome. Journal of Autism and Developmental Disorders, 39(1), 115–125.

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Paul, R., & Wilson, K. P. (2009). Assessing speech, language, and communication in autism spectrum disorders. In S. Goldstein, J. A. Naglieri, & S. Ozonoff (Eds.), Assessment of autism spectrum disorders (pp. 171–208). New York: Guilford Press. Pickles, A., Parr, J. R., Rutter, M. L., De Jonge, M. V, Wallace, S., Le Couteur, S., … Bailey, J. (2013). New interview and observation measures of the broader autism phenotype: Impressions of interviewee measure. Journal of Autism and Developmental Disorders, 43(9), 2082–2089. Piven, J., Palmer, P., Landa, R., Santangelo, S., Jacobi, D., & Childress, D. (1997). Personality and language characteristics in parents from multiple-incidence autism families. American journal of medical genetics, 74(4), 398–411. Poletti, M. (2011). A neuropsychological approach to the etiology of pragmatic language impairment. Clinical Neuropsychiatry, 8(5), 287–294. Ruser, T. F., Arin, D., Dowd, M., Putnam, S., Winklosky, B., Rosen-Sheidley, B., … Folstein, S. (2007). Communicative competence in parents of children with autism and parents of children with specific language impairment. Journal of autism and developmental disorders, 37(7), 1323–1336. Sanderson, C., & Allen, M. L. (2013). The specificity of inhibitory impairments in autism and their relation to ADHDtype symptoms. Journal of Autism and Developmental Disorders, 43(5), 1065–1079.

Smith, J. K. (2001). Detroit Tests of Learning Aptitude, Fourth Edition. In B. S. Plake & J. C. Impara (Eds.), Mental Measurements Yearbook and Tests in Print (14th ed., Vol. 14, p. 113). Lincoln, NE: Buros. Yoder, P., & Symons, F. (2010). Observational measurement of behavior. New York: Springer. Yuan, J., He, Y., Qinglin, Z., Chen, A., & Li, H. (2008). Gender differences in behavioral inhibitory control: ERP evidence from a two-choice oddball task. Psychophysiology, 45(6), 986– 993. Yücel, M., Fornito, A., Youssef, G., Dwyer, D., Whittle, S., Wood, S. J., … Allen, N. B. (2012). Inhibitory control in young adolescents: the role of sex, intelligence, and temperament. Neuropsychology, 26(3), 347–356.

Review Articles

Student Psychology Journal of Ireland, 2015, 142-150

Discourse and Diagnosis: A Comparison between the Medical Model and Lacanian Approach to Diagnosis using a Clinical Example of Anorexia Nervosa Jennifer Barry Trinity College Dublin abstract

Correspondence: jebarry@tcd.ie

In the Western world the predominant method of mental health diagnosis is based on the medicalization of symptoms using the Diagnostic and Statistical Manual (DSM) currently in its fifth edition. This widely used system of diagnosis has largely informed the way in which mental illness is perceived and treated. Being diagnosed with a mental illness can have significant consequences for individuals in the way they understand themselves, their suffering and how others relate to them. This model of diagnosis offers one particular way in which mental health is understood and has consequently overshadowed how mental health is perceived within and across a variety of discourses. Using a clinical example of anorexia nervosa this paper compared the medical model’s approach to diagnosis with the Lacanian approach to diagnosis, which aims to identify the psychical structure of an individual rather than focus on a particular set of symptoms. Fundamental to this method of diagnosis is the understanding that an individual cannot be completely or wholly defined through language and as such this hole in knowledge elicits a desire within the individual to know something of his or her own subjectivity. The desire to know is the cornerstone of analytic treatment, a desire which is nullified by the medical model’s approach to diagnosis. Keywords: Mental Health, Diagnosis, Medical Model, Anorexia Nervosa, Psychoanalysis, Discourse, Jacques Lacan

‘What labels me negates me’ (Soren Kierkegaard). According to Michel Foucault it is through language, a system of meaning, that individuals are constituted as subjects (Howitt, 2010). The medical

model’s approach to mental illness exemplifies the way in which individuals are constituted as either ‘normal’ or ‘abnormal’ depending on the category to which their symptoms fit (Pilecki, Clegg &

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DISCOURSE AND DIAGNOSIS McKay, 2011). This approach to diagnosis is based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) currently in its fifth edition (American Psychiatric Association, 2013). The question is what type of effect does labelling an individual as ‘normal’ or ‘abnormal’ and by default ‘mentally healthy’ or ‘mentally ill’ have on the individual? Does it help or hinder their experience of distress or does it negate their subjectivity to such an extent that they are left feeling alienated from themselves and others?

is negated (Malson, Finn, Treasure, Clarke & Anderson, 2004). The medical and Lacanian approaches differ in a significant way, specifically, in the questions that they ask when formulating a diagnosis and in turn the therapeutic treatment that is undertaken (Verhaeghe, 2008). This discussion will draw on qualitative research and a psychoanalytic case study to illustrate the effect of naming individuals as disorders, specifically the clinical diagnosis of ‘anorexia’ and the subsequent effect this diagnosis has on the individual.

‘Go and name things’ is an axiom borrowed from Verhaeghe (2008), which alludes to the medical model’s approach to diagnostics, that is, to make a diagnosis based on symptoms in order to assign a name to an individual in the form of a particular mental health disorder. The command ‘go and name things’ is argued to be fundamental to the medical model’s discourse on mental health (Verhaeghe, 2008). Therefore the central question throughout this paper will focus on the effect on the individual of the command ‘go and name things’ (Verhaeghe, 2008). Specifically, a comparison between the medical approach to diagnosis and the Lacanian approach to diagnosis will be central to this discussion, in order to illuminate the effect produced by both disciplines on the individual through naming. It will be argued that the discourse in which the individual is diagnosed and therefore constituted will determine the extent to which the subject

The emergence of the Diagnostic and Statistical Manual of mental health disorders (DSM) arose out of a need to establish a common language of psychiatric diagnosis and to formulate a standardized classification system which enabled professionals to communicate with each other, unlike previously heterogeneous classifications of mental illness, which prevented coherent modes of communication between researchers and practitioners (Sanders, 2011). The current edition of the DSM is atheoretical, reflecting the multiplicity of theories that have evolved and continue to do so within the field of psychiatry and psychology (Pilecki, Clegg & McKay, 2011). A highly contested aspect of the evolution of the DSM is the way in which diagnostic categories emerge, that is, through consensus of committee members rather than an established set of empirical findings or any particular theory (Pilecki, Clegg & McKay, 2011). Inter-

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estingly, a major shift towards a medical model approach to mental illness occurred in the third edition of the DSM, which marked a move away from vague and untested psychoanalytic concepts towards a classification system, that operationalized symptoms hence improving the reliability of diagnosis (Pilecki, Clegg & McKay, 2011). The central question underpinning this paradigm is whether the individual is ‘normal’ or ‘abnormal’ (Verhaeghe, 2008). The DSM is the yardstick against which mental health professionals determine what is ‘normal’ and ‘abnormal’ behaviour based on the presenting symptoms of the patient (Horwitz, 2011). Implicit within the conceptualisation of the DSM is the construction of mental illness based on a medical paradigm, in which there is a ‘norm’, a ‘standard’ or ‘ideal’ against which behaviour is measured and the extent to which individuals behaviour, thoughts and feelings deviate from this ‘norm’ determines the extent to which their behaviour is pathologized (Verhaeghe, 2008).

state (Verhaeghe, 2008). In essence, this approach circumvents the individual as a subject within a particular socio-cultural context (Malson, Bailey, Clarke, Treasure, Anderson & Kohn, 2011). The implication of such a diagnostic approach is evidenced in accounts of individuals’ experience of being diagnosed with a mental illness and the subsequent success or failure of treatment. For example, individuals diagnosed with eating disorders are generally perceived to be difficult to treat often resulting in reports of poor treatment outcomes (Bergh, Brodin, lindberg & Sodersten, 2002). The difficulty in treating these ‘disordered patients’ is attributed to obstacles within the patient, that is, eating disordered patients are constituted as ‘oppositional’, ‘impervious to treatment’ and ‘ambivalent to change’ (Kaplan & Garfinkel, 1999). A diagnosis of ‘anorexia’ or ‘bulimia’ within a medical discourse thus prescribes a presupposed ready-made eating disordered identity, a host of characteristics that may or may not be the lived experience of the individual.

There is an assumption within this specific discourse that symptoms are the manifestations of an underlying disorder similar to that of a disease, thus identifying and naming the symptom allows professionals to diagnose the underlying disease. Accordingly the cure lies in the treatment of symptoms located within the individual in an effort to eradicate the symptoms and return the individual to their original

The effect of being diagnosed with an eating disorder within this specific discourse is illustrated in a qualitative study conducted by Malson, Finn, Treasure, Clarke and Anderson, (2004). Participants in the study expressed how their diagnosis of an eating disorder subsequently affected the way in which mental health professionals treated them, that is, as symptoms rather than individuals who were not solely a

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DISCOURSE AND DIAGNOSIS disease. One participant from the Malson et al, (2004) study explained ‘everything you say is part of the disease… everything you do is analyzed as anorexic’ (Malson, et al, 2004, p481). Inherent in the diagnosis of eating disorders is prescription with the potential effect being an expectation of how these patients will behave and respond to treatment. Thus professionals are themselves informed by the very constructions they create and as a result approach patients with pre-established expectations, which immediately limit what can be known about the subjective experience of the individual (Parker, 1999). The effect of this approach of ‘go and name things’ is exemplified in reports of studies which have found that 30% of those diagnosed as anorexic and 20% diagnosed as bulimic are reported to never recover (Richard, Baldwin, Frost, Clark-Sly, Berrett & Hardman, 2000) with high rates of chronic relapse (Deter & Herzog, 1994). ‘I am the anorexia, this is my identity… that’s my name… if I give up that name, what else is there?’ (Malson, 1999, p.147) Here we have an example of the problem of naming a subject, of diagnosing an individual as a particular disorder. The exclamation ‘I am the anorexia’ creates an association between the symptoms one produces and a particular identity, as such, in order to maintain this identity, the anorexic must continue to produce symptoms of that which he/she has been named, otherwise ‘what else is there’? (Malson,

1999) Implicit within the anorexic identity is the absence of an identity and so the severity of the problem becomes evident, to name and therefore constitute an individual as a particular disorder covers up an experience of loss, a loss of subjectivity (Malson, 1999). So the question arises: how can one approach the diagnosis and treatment of these patients while creating enough space for something that is uniquely subjective to emerge? A Lacanian approach to diagnosis and treatment takes a different form to that of the medical model, in that Lacanian analysts are guided by different questions (Verhaeghe, 2008). Rather than question what disease or disorder an individual has the questions Lacanian analysts ask are: to what do the symptoms refer, what is the meaning of these symptoms and to who do they relate? (Verhaeghe, 2008) Unlike the medical model which assumes the locus of disorder is characteristic of the individual, fundamental to a Lacanian approach is the impact of the Other. The Lacanian Other refers to an ambiguous impersonal entity; the symbolic totality of law and language exemplified in Lacan’s adage ‘the unconscious is the discourse of the Other’ (Lacan, 1966/2006). From a Lacanian perspective the approach of ‘go and name things’ is problematic because the very act of naming further negates and alienates the subject from their own particularity. A comparison between the medical model and Lacanian

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approach to diagnosis demonstrates that the medical model begins with the particular (symptoms) and moves towards the general (disorder). Whereas psychoanalysts, rather than constructing symptoms as signs that point to an underlying disorder, focus on signifiers which have the potential to convey an endless chain of meaning in the interaction between an individual and the Other (Rodriguez, 2004). Thus the Lacanian approach to diagnosis begins with symptoms, which may have a general appearance at a descriptive level, but gradually moves towards the particularity of the subject, based on his/her specific use of signifiers and the particular meaning they have for the subject in terms of his/her relationship with the Other (Verhaeghe, 2008). It was the shift from the psychoanalytical approach to the medical model’s approach to diagnosis that led to the establishment of the DSM III in an effort to make particular that which Freud had made vague (Pilecki, Clegg & McKay, 2011). However, the psychoanalytic theory of the human psyche has remained vague to ensure that a gap is created such that, the ‘absent identity’ which is covered up or masked through naming can emerge, that is, the particularity of the subject (Verhaeghe, 2008). Unlike Foucault who placed emphasis on the content of language and in an effort not to succumb to the disadvantage of Freud’s theory, which left itself open to being psychologized, Lacan went a step further to the structure of language (Verhaeghe, 2008).

The underlying structures are central to diagnosis in that they enable the analyst to make predictions and formulate explanations that guide the direction of the treatment (Rodriguez, 2004). The three structural categories are neurosis, psychosis and perversion which are founded upon three fundamental mechanisms: repression, which characterizes neurosis; foreclosure, which characterizes psychosis; and disavowal, which is the determining characteristic of perversion (Fink, 1997). In short the three fundamental mechanisms determine ‘the way in which the patient negates something’ (Fink, 1997, p 76). As these mechanisms cannot be directly observed the analyst uses the material that arises within the therapy to infer the patients underlining mechanism (Fink, 1997). The analyst can then formulate a hypothesis regarding the position of the patient in relation to the Other (Hill, 2002). Once a diagnosis has been made the analyst can correctly position him/herself in the therapeutic relationship and begin to make specific interventions (Fink, 1997). This process of diagnosis takes place throughout the treatment and often remains a hypothesis on the part of the analyst, rather than something that is definitively assigned or communicated to the patient (Verhaeghe, 2008). The act of diagnosing within Lacanian psychoanalysis does not aim to cover up or mask the absent identity of the individual; rather it is left uncovered so that throughout the treatment the patient through language comes

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DISCOURSE AND DIAGNOSIS to fill in the gap and thereby constitutes him or herself as a speaking being (Fink, 1997). The effect of this process, that is, the way the patient experiences him/herself and his/her relation to the Other is then analyzed. In Lacanian terms, this process of diagnosis is not based on a medical approach to symptomology rather it takes place at a structural level (Fink, 1997). The way in which an individual negates something has been outlined as a fundamental characteristic in determining their psychical structure (Fink, 1997). It is this structure that determines the subjects social bond, a relation conceptualized through Lacan’s four discourses. For the purposes of this discussion it is necessary only to elaborate on the discourse of the master, in which the agent (in this case the medical diagnostician) attempts to name the Other (the patient) (Verhaeghe, 2008). In this relation the agent produces knowledge of the Other and in doing so ascribes meaning to the patient’s subjective experience of their presenting symptoms (Verhaeghe, 2008). However there is an inevitability of impossibility in the agent’s act of naming, as it is not possible to signify the entirety of an other’s experience through language (Verhaeghe, 2008). Lacanian theory acknowledges that there is always a partial failure in communication but a necessary one because communication as failure is the reason why we continue to speak, a continued attempt to communicate that

which is impossible to say (Verhaeghe, 1995). This failure makes clear the difficulty in naming, as there will always be a partial failure, a negation of the thing being named (Verhaeghe, 1995). This failure inherent in language is key to the Lacanian approach to diagnosis and differs from the medical model’s approach, which attempts to name and categorize an individual in their totality. How then does the Lacanian approach to diagnosis affect the patient and in what way does the opportunity afforded the patient through analysis, that is, the opportunity to speak, create an opportunity for something of their subjectivity to be known? According to a Lacanian perspective in the clinic of anorexia, the anorexic symptom constructed as a refusal is both a demand and an invitation ‘highlighting a paradox – the sign of a wish to make something known but by disguising it’ (Phillips, 1995, p. 33-34 as cited in Failler, 2006). By ascribing meaning to the anorexic symptom as a refusal the analyst is able to question what it is that is being refused. The function of the analyst in interpreting the symptom and the effect that has on the patient is exemplified in a clinical case of a 14-year-old girl with anorexia (Silva, Pereira & Celeri, 2010). This young girl refused all demands by her parents to eat, rather she insisted that she be left in isolation with a further insistence that her parents were to ‘go away’. Her parents, worried about their daughter’s

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health sought out a psychoanalyst. The analyst after listening to the clients wish for isolation advised her parents to ‘go away’ and leave their daughter in isolation. After a short time the young girl began to eat. The hypothesis formulated by the analyst as to why the young girl began to eat, was that the young girl’s refusal was a refusal of being smothered by her parents and by refusing the demands of her parents to eat, she was making an attempt at separation. The analysts intervention which allowed the young girl to realize this separation through isolation, promised the opportunity for this separation to be established, and therefore something of this young girl’s own subjective desire to be realized (Silva, Pereira & Celeri, 2010). The paradox of the anorexic refusal as both a demand and invitation lies in the need for separation from the Other, which is at the same time reliant on the Other to facilitate and make possible this separation (Failler, 2006). To what extent does the practice of naming negate the subjective experience of the individual? According to Lacanian theory communication always amounts to a partial failure, in that what one wants to communicate is never fully or wholly expressed through language. Based on this assumption this paper questioned the medical model’s approach to diagnosis and the Lacanian analysts structural diagnosis, as a method of directing the treatment and making appropriate interventions in an effort to ascertain the effect of discourse on

the individuals’ experience of themselves and the world in which they live. The clinical case of anorexia illustrated the extent to which naming can have an effect on one’s experiences as ‘anorexic’, and the anxiety that surfaces in these individuals of the potential loss if such a name were to be given up. It is at this juncture that psychoanalysis finds its foothold. Rather than begin treatment with a diagnosis or a name, psychoanalysts aim to listen to the patient speak in order for the loss of this name to be experienced and subsequently filled with the patient’s own subjective identity, a subjective desiring that is uniquely theirs rather than a desire belonging to the Other, as illustrated in the clinical case of the 14-year-old girl. It is the Lacanian paradigm of diagnosis and treatment that this paper ultimately sides with. Lacanian discourse does not aim to perfect communication, unlike that of the medical discourse implicit within the DSM, in which general categories of symptoms were established in an attempt to perfect communication across mental health and medical disciplines. Rather Lacanian discourse recognizes this failure in language and as such, failure is constructed as something necessary in order for the speaking being to emerge and have a desire to do so. References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.

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DISCOURSE AND DIAGNOSIS Bergh, C., Brodin, U., Lindberg, G., & Södersten, P. (2002). Randomized controlled trial of a treatment for anorexia and bulimia nervosa. Proceedings of the National Academy of Sciences, 99(14), 9486-9491. Deter, H. C., & Herzog, W. (1994). Anorexia nervosa in a long-term perspective: results of the Heidelberg-Mannheim Study. Psychosomatic Medicine, 56(1), 20-27. Failler, A. (2006). Appetizing loss: Anorexia as an experiment in living. Eating disorders, 14(2), 99-107. Fink, B. (1995). The Lacanian subject: between language and jouissance. Princeton University Press Fink, B. (1997). A clinical introduction to Lacanian psychoanalysis: Theory and technique. Harvard University Press Hill, P. (2002). Using Lacanian clinical technique: An introduction. Press for the Habilitation of Psychoanalysis. Horwitz, A. V. (2011). Naming the problem that has no name: creating targets for standardized drugs. Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences, 42(4), 427-433. Howitt, D. (2010). Introduction to qualitative methods in psychology. New Jersey NJ: Prentice Hall. Kaplan, A. S., & Garfinkel, P. E. (1999). Difficulties in treating patients with

eating disorders: a review of patient and clinician variables. Canadian journal of psychiatry. Revue canadienne de psychiatrie, (44), 665-70. Lacan, J. (2006). Écrits: The First Complete Edition in English. (B. Fink, Trans). New York. WW Norton & Company. (Original work published 1966). Malson, H. (1999). Womæn under erasure: Anorexic bodies in postmodern context. Journal of community & applied social psychology, 9(2), 137-153. Malson, H., Finn, D. M., Treasure, J., Clarke, S., & Anderson, G. (2004). Constructing ‘The Eating Disordered Patient’1: a discourse analysis of accounts of treatment experiences. Journal of community & applied social psychology, 14(6), 473-489. Malson, H., Bailey, L., Clarke, S., Treasure, J., Anderson, G., & Kohn, M. (2011). Un/imaginable future selves: A discourse analysis of inpatients’ talk about recovery from an ‘eating disorder’. European Eating Disorders Review, 19(1), 25-36. Parker, I. (1999) Deconstructing diagnosis: psychopathological practice, in Feltham, C. (Ed.). (1999). Controversies in psychotherapy and counselling. Sage Pilecki, B. C., Clegg, J. W., & McKay, D. (2011). The influence of corporate and political interests on models of illness in the evolution of the DSM. European Psychiatry, 26(3), 194-200.

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Richards, P. S., Baldwin, B. M., Frost, H. A., Clark-sly, J. B., Berrett, M. E., & Hardman, R. K. (2000). What works for treating eating disorders? Conclusions of 28 outcome reviews. Eating Disorders, 8(3), 189-206. Rodriguez, S.L (2004, January) Diagnosis in Psychoanalysis. Paper presented at the Centre for Freudian Analysis and Research (London). Sanders, J. L. (2011). A distinct language and a historic pendulum: The evolution of the diagnostic and statistical manual of mental disorders. Archives of psychiatric nursing, 25(6), 394403. Silva, M. B. P. D., Pereira, M. E. C., & Celeri, E. H. V. (2010). The analyst’s desire in the clinic of anorexia. Revista Latinoamericana de Psicopatologia Fundamental, 13(2), 207-223. Verhaeghe, P. (1995). From impossibility to inability: Lacan’s theory on the four discourses’. The Letter: Lacanian Perspectives on Psychoanalysis, 3, 91-108. Verhaeghe, P. (2008). On being normal and other disorders: A manual for clinical psychodiagnostics. Karnac Books., 248-259.

Student Psychology Journal, 2015, 151-161

The interaction between control beliefs and cognitive function Niamh Doyle Trinity College, Dublin Correspondence: niamhdoyle100@gmail.com

abstract

Control beliefs and cognitive control efficacy represent important components to everyday functioning and well-being. The current review discusses how these constructs influence each other. Control beliefs likely develop in part as a result of experience and an awareness of oneâ&#x20AC;&#x2122;s cognitive control ability. This is supported by research consistently demonstrating low perceived control among individuals with impairments in cognitive control functioning such as those with drug dependence and ADHD. Motivation seems to play a mediating role, such that high internal cognitive control beliefs promote cognitive control by increasing motivation and expended effort on related tasks. Anxiety and stress are also discussed as potential mediators between control beliefs and cognitive control. Typically, low perceived control predicts anxiety in stressful situations, which is turn decreases cognitive control performance. Nevertheless, if anxiety is interpreted as a challenge, the individual can be aroused sufficiently to facilitate attentional control processes. Implications for fields such as addiction treatment and sports psychology are addressed, emphasising the importance of studying cognitive control beliefs, and cognitive control efficacy together, rather than as independent variables. Keywords: control beliefs, cognitive control, attentional control, drug dependence, sports psychology

Control beliefs and cognitive control efficacy represent important components to everyday functioning and well-being. The latter refers to the ability to concentrate, to focus attention and inhibit prepotent responses. These represent

skills integral to daily tasks such as driving, studying and the ability to stop the impulse to have one glass of wine too many. Control beliefs surround the ability to control external events These beliefs have been investigated under a variety

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of different labels, such as ‘perceived control’, ‘locus of control’ (LOC) and ‘self-efficacy’ (Wegner, 2002); however each measures a similar concept. High perceived control refers to the belief that one has the ability to act and achieve desired outcomes. Similarly, an internal locus of control is the generalised belief that environmental events are contingent upon one’s own behaviour, rather than external forces such as luck, chance or powerful others (Rotter, 1966). Adaptive control beliefs have consistently been associated with cognitive processes such as better memory and reasoning skills (e.g., Lachman & Andreoletti, 2006; Soederberg Miller, & Lachman, 2000). What is less clear is specifically how control beliefs and cognitive control performance may influence each other. Control beliefs may be a consequence of, antecedent to, or mere correlates of the ability to exert cognitive control. These two constructs are all too often studied separately, as independent predictors of outcomes such as drug dependence (Sheffer et al., 2012) and depression (Struijs, Groeneworld, Oude, & de Jonge, 2013). Yet they are consistently correlated, such that those with severe impairments in cognitive control functioning (e.g., Drug addicts, ADHD) also demonstrate low perceived control. Understanding precisely how beliefs are integrated into core executive control functions, such as inhibitory and atten-

tional control, is thus essential to understanding the development of pathologies such as addiction and ADHD and may help identify multi-component treatments, targeting both beliefs about being in control and cognitive control. Accordingly, the purpose of this essay is to show how these two concepts may be related to one another. Several possibilities will be addressed in turn, with a particular emphasis on their associated implications in various fields such as sports psychology and addiction research. Development of beliefs as a result of experience The traditional view of the development of control beliefs was informed by Social Learning Theory (Rotter, 1954), assuming that if one consistently has the opportunity to exert influence over the environment, the generalised belief of being in control will subsequently develop. Chorpita and Barlow (1998) added to this theory, pointing specifically towards a child’s ability to use their executive control in controlling their attention away from distressing and towards comforting stimuli from a very young age. Declerck, Boone, and de Brabander (2006) further this idea, proposing that control beliefs develop as a result of previous experience in controlling outcomes through executive function.

Ideally, properly controlled longitu-

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CONTROL BELIEFS AND COGNITVE FUNCTION dinal designs would inform on the relationship between early cognitive control abilities, experience and the development of control beliefs. However, to date, this kind of study has not been carried out and so evidence must instead be taken indirectly. If control beliefs are reinforced by the ability to delay responding or use attentional resources to achieve our goals, it follows that those with deficits in cognitive control would be more likely to learn that they have little control over the environment and accordingly, exhibit an external locus of control. ADHD is one such disorder characterised by chronic deficits in aspects of cognitive control such as poor response inhibition (Epstein, Johnson, Varia, & Conners, 2001) and attentional control (Banich et al., 2009). As expected, researchers have found that children (Lufi & Parishplass, 1995), adolescents (Niederhofer, 2008) and adults (Rucklidge, Brown, Crawford, & Kaplan, 2007) with ADHD, have more external locus of control than their healthy peers. Similarly, schizophrenic patients with characteristic impairments in executive functioning (Chey, Lee, Kim, Kwon, & Shin, 2002) also tend to have a more externally oriented sense of control (Chadwick, 2001; Pinto, Grapentine, Francis, & Picariello, 1996). Further evidence come from addiction research which has found addicts to be much more external in their belief about their control of drug-taking behaviour (Ersche, Turton, Croudace, & Stochl, 2012) as well as having an over-

all external orientation of control (Poikolainen, 1997). This is highly relevant considering that the very definition of dependence implicates a loss of control (4th ed., text rev; DSM-IV-TR; American Psychiatric Association, 2000). In particular, they have great difficulty inhibiting inappropriate responses and switching attention between items held in working memory (Fillmore & Rush, 2002; Kübler, Murphy, & Garavan, 2005), making it difficult to control their attention away from drug-related thoughts. Unsurprisingly, alcoholics who are more successful in reducing their drinking habits and maintaining abstinence are more internal in their control beliefs in comparison to their counterparts (Collins, Koutsky, & Izzo, 2000). As mentioned, these findings can only be taken as indirect evidence for the role of executive function in influencing control beliefs. Particularly for research on addiction, it is equally plausible that those with low perceived control are less motivated to ‘fight’ developing addictions and are thus more susceptible to becoming addicted than those with high control. The Role of Motivation Control beliefs may affect cognitive control performance by influencing motivation and expended effort. It is likely that individuals who believe they have the capacity to influence outcomes will expend more effort on tasks of cognitive

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control (Bandura, 1977). Indeed, an internal control orientation has been shown to predict motivation in rewarding situations (Patrick, Skinner & Connell, 1993). Additionally, motivation can be induced by manipulating control perception. Eitam, Kennedy and Higgins (2013) gave varied feedback to participants during a simple reaction time task and found that when the participantsâ&#x20AC;&#x2122; actions had an explicit perceivable effect, participants were more motivated to devote effort in the tasks. Motivation also appears to be crucial in tasks of cognitive control. For instance, Locke and Braver (2008) found that inducing motivation through reward incentives activated brain regions associated with sustained attention, a finding which has been repeated by several other fMRI studies (Rothermund, Wentura, & Bak, 2001; Small et al., 2003). This implies that motivation promotes improved cognitive control processes, particularly boosting mechanisms involved in focusing our attention. Interestingly, researchers have found that motivation is particularly crucial to enhancing selective attention networks during adolescents, while these networks are maturing (Smith, Halari, Giampetro, Brammer, & Rubia, 2011). Combining these findings, it certainly seems plausible that the belief that one has control over the environment induces a motivation in people to put effort into tasks which consequently activates

brain regions associated with cognitive control. Confidence in this relationship can of course be strengthened by studies demonstrating the influence of low control beliefs of motivation and consequent cognitive control performance. Reed and Antova (2007) exposed 36 participants to either controllable or uncontrollable outcomes in the form of solvable or unsolvable problems. After being primed to believe that their actions either did or did not lead to outcome success, participants were required to engage in a simple attentional reaction time task wherein they had to decide whether a stimulus presented centrally on the screen was a square or a circle. Those exposed to uncontrollable outcomes were more vulnerable to distraction from incongruent stimuli, suggesting that their motivation to use their attentional control resources was impaired. These findings have important implications for disorders of cognitive control impairment and future research should investigate whether control beliefs are amenable to treatment. For instance, if addicts can be given confidence in their ability to control their behaviour and achieve their goals, they may be more motivated in treatment interventions. This forms the basis for the theory of planned behaviour. In this model, greater perceived behavioural control is proposed to be related to a stronger intention to perform the behaviour in question

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CONTROL BELIEFS AND COGNITVE FUNCTION (Ajzen, 2012). Unsurprisingly, there is evidence that belief of being in control plays a crucial role in determining engagement in treatment and effort in maintaining abstinence (Murphy & Bentall, 1992). Moreover, preliminary evidence suggests that addiction interventions are more successful when generalised control beliefs are taken into account (Blagojevic, Frencl, Perekovic, Cavajda, & Kovacek, 2012; Sheffer et al., 2012). Sheffer and colleagues (2012) found that among individuals enrolled in intensive cognitive-behavioural treatment for tobacco dependence, an external locus of control predicted relapse. Similarly, Blagojevic et al (2012) demonstrated that men with chronic alcoholism who also had an internal locus of control managed to remain abstinent for longer than those with an externally orientation The mediating role of anxiety and stress In contrast to the facilitating motivational consequences that high perceived control can induce, it appears that low perceived control has negative affective and physiological consequences which in turn impairs cognitive control performance (Bandura, 1997). Specifically, control beliefs have been consistently related to anxiety, such that low perceived control predicts anxiety in stressful situations (Cheng, Hardy, & Markland, 2009; Cohen, Sade, Benarroch, Pollak,

& Gross-Tsur, 2008; Soederberg Miller & Lachman, 2000). For example, Agrigoroaei, Neupert, and Lachman (2013) found that adults with unstable control beliefs were more anxious and distracted during tasks of working memory. Along the same lines, Endler, Macrodimitris, and Kocovski (2000) demonstrated that participants with low perceived control solved fewer anagrams and were more anxious than those with low perceived control beliefs. Interestingly, anxiety does not always lead to impaired performance. This is all too evident in high pressure sports requiring superior sustained attention skills, when competitive anxiety can sometimes produce optimal performances and at other times, lead players to â&#x20AC;&#x153;chokeâ&#x20AC;? under pressure (see Wilson, 2012 for a review). Vine, Freeman, Moore, Chandra-Ramanan, and Wilson (2013) recently addressed this issue and demonstrated that it is how a person appraises the situation that is important. For example, they found that evaluating stress as a challenge actually facilitated superior visual attentional control, whereas appraising stress as a threat impaired attentional processes. Others have also found that the threat of a shock impairs attentional control (Choi, Padmala, & Pessoa, 2012; Pallak, Pittman, Heller, & Munson, 1975). One reason for this concerns the adaptive value of anxiety. From an evolutionary perspective, anxiety evolved in order to signal danger and

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prepare an individual to respond effectively to perceived threat (Ohman, 2000). Thus, anxiety can improve the ability to focus attention to threat-related stimuli. Yet, this also increases distraction in the presence of task-irrelevant threatening information (Weierich, Treat, & Hollingworth, 2008). If the anxiety is interpreted as a challenge that can be overcome rather than an external threat, an individual will be aroused enough to facilitate attentional control. In light of this, Wood and Wilson (2011) tested the ‘Quiet Eye’, an intervention that has received support for increasing sports players’ attention under stress (Vickers, 2007). The training program is designed to direct attention to relevant thoughts and cues in the environment with the aim of improving sports performance; however the specific mechanisms underlying its effectiveness have previously been unclear. The researchers examined the processes by which the programme exerted its effects on ten experienced soccer penalty takers. It was found that by coaching players how to optimise their visual control, participants developed greater beliefs in their ability to control the outcome of penalties. This subsequently reduced anxiety when they were under pressure and enhanced their likelihood of scoring. These are interesting results and provide just one example of the opportunity to take advantage of the seemingly reciprocal relationship

between control beliefs and control function. The researchers managed to optimise control beliefs by coaching players where to focus their attention, which in turn increased cognitive control effectiveness by reducing the debilitating effects of anxiety in stressful performance situations. This approach represents a major break-away from traditional strategies in sports aimed at reducing anxiety through relaxation and positive-self talk (Wilson, 2012). Rather, it recognises the influence that positive control beliefs can have on the relationship between anxiety and cognitive control and exploits this fact to enhance performance. Conclusion The purpose of this essay was to explore the ways in which beliefs about the ability to influence interactions with the environment and cognitive control efficacy might influence one another. It has been demonstrated that these two constructs are likely mutually reciprocal. Control beliefs may stem from an awareness of one’s cognitive control abilities and how constructs such as response inhibition and attentional control can help us achieve one’s goals. Additionally, beliefs about control influence how effectively we exert cognitive control in various performance settings. These findings have important implications for fields such as Sports Psychology, Addiction treatment and indeed, our daily functioning.

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CONTROL BELIEFS AND COGNITVE FUNCTION If control beliefs are rendered amenable to treatment, constructs such as locus of control and perceived control should be considered for intervention in disorders of impaired cognitive control. Taking drug addiction as an example, although treatment often focuses on improving cognitive control mechanisms, there is evidence that beliefs of being in control play an even more important role in determining engagement in treatment and effort in maintaining abstinence (Murphy & Bentall, 1992). Furthermore, the relationship between beliefs, anxiety and control has been shown to be of use in sports performance training. The â&#x20AC;&#x2DC;Quiet Eyeâ&#x20AC;&#x2122; is such an example of how manipulating control beliefs can help sports players keep calm in the face of stressful penalty shots and focus their attention on the task at hand. As regards our daily functioning, our belief that we have the capacity to succeed activates brain regions associated with sustained attention which can, in everyday life, help us to carry out tasks without being distracted by irrelevant stimuli. Given these implications, it is perhaps surprising that these two concepts of control are so often studied in isolation. This review demonstrates the need for both components to be studied together and perhaps, a greater understanding of how they relate to each other will follow.

Agrigoroaei, S., Neupert, S. D., & Lachman, M. E. (2013). Maintaining a sense of control in the context of cognitive challenge: Greater stability in control beliefs benefits working memory.Geropsych: The Journal Of Gerontopsychology And Geriatric Psychiatry, 26(1), 49-59. doi:10.1024/1662-9647/a000078

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formance anxiety: Rationale and initial measurement development. Psychology Of Sport And Exercise, 10(2), 271-278. doi:10.1016/j. psychsport.2008.08.001 Chey, J., Lee, J., Kim, Y., Kwon, S., & Shin, Y. (2002). Spatial working memory span, delayed response and executive function in schizophrenia. Psychiatry Research, 110(3), 259-271. doi:10.1016/S0165-1781(02)00105-1 Choi, J., Padmala, S., & Pessoa, L. (2012). Impact of state anxiety on the interaction between threat monitoring and cognition. Neuroimage, 59(2), 1912-1923. doi:10.1016/j.neuroimage.2011.08.102 Chorpita, B. F., & Barlow, D. H. (1998). The development of anxiety: The role of control in the early environment. Psychological Bulletin, 124(1), 3-21. doi:10.1037/0033-2909.124.1.3 Cohen, E., Sade, M., Benarroch, F., Pollak, Y., & Gross-Tsur, V. (2008). Locus of control, perceived parenting style, and symptoms of anxiety and depression in children with Touretteâ&#x20AC;&#x2122;s syndrome. European Child & Adolescent Psychiatry, 17(5), 299-305. doi:10.1007/ s00787-007-0671-7 Cohen, S., & Lichtenstein, E. (1990). Perceived stress, quitting smoking, and smoking relapse. Health Psychology, 9(4), 466-478. doi:10.1037/02786133.9.4.466 Collins, R., Koutsky, J. R., & Izzo, C. V. (2000). Temptation, restriction, and the regulation of alcohol intake: Va-

lidity and utility of the Temptation and Restraint Inventory. Journal Of Studies On Alcohol, 61(5), 766-773 Declerck, C. H., Boone, C., & De Brabander, B. (2006). On feeling in control: A biological theory for individual differences in control perception. Brain And Cognition, 62(2), 143-176. doi:10.1016/j.bandc.2006.04.004 Eitam, B., Kennedy, P. M., & Higgins, E. (2013). Motivation from control. Experimental Brain Research, 229(3), 475-484. doi:10.1007/s00221-0123370-7 Endler, N. S., Macrodimitris, S. D., & Kocovski, N. L. (2000). Controllability in cognitive and interpersonal tasks: Is control good for you?. Personality And Individual Differences, 29(5), 951-962. doi:10.1016/S01918869(99)00246-9 Epstein, J. N., Johnson, D. E., Varia, I. M., & Conners, C. (2001). Neuropsychological assessment of response inhibition in adults with ADHD. Journal Of Clinical And Experimental Neuropsychology, 23(3), 362-371. doi:10.1076/ jcen.23.3.362.1186 Ersche, K. D., Turton, A. J., Croudace, T., & Stochl, J. (2012). Who do you think is in control in addiction? A pilot study on drug-related locus of control beliefs. Addictive Disorders & Their Treatment, 11(4), 195-205. doi:10.1097/ADT.0b013e31823da151

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CONTROL BELIEFS AND COGNITVE FUNCTION Fillmore, M. T., & Rush, C. R. (2002). Impaired inhibitory control of behavior in chronic cocaine users. Drug And Alcohol Dependence, 66(3), 265-273. doi:10.1016/S03768716(01)00206-X KĂźbler, A. A., Murphy, K. K., & Garavan, H. H. (2005). Cocaine dependence and attention switching within and between verbal and visuospatial working memory. European Journal Of Neuroscience, 21(7), 1984-1992. doi:10.1111/j.14609568.2005.04027.x Lachman, M. E., & Andreoletti, C. (2006). Strategy Use Mediates the Relationship Between Control Beliefs and Memory Performance for Middle-Aged and Older Adults. The Journals Of Gerontology: Series B: Psychological Sciences And Social Sciences, 61B(2), P88-P94. doi:10.1093/geronb/61.2.P88 Locke, H. S., & Braver, T. S. (2008). Motivational influences on cognitive control: Behavior, brain activation, and individual differences. Cognitive, Affective & Behavioral Neuroscience, 8(1), 99-112. doi:10.3758/ CABN.8.1.99 Lufi, D., & ParishPlass, J., (1995). Personality assessment of children with attention deficit hyperactive disorder. Journal of clinical Psychiatry, 50, 565-576. Murphy, P. N., & Bentall, R. P. (1992). Motivation to withdraw from heroin: A factor-analytic study. British Journal Of Addiction, 87(2), 245250. doi:10.1111/j.1360-0443.1992. tb02698.x

Niederhofer, H. (2008). Attributions for school success and failure by adolescent students with and without attention deficit hyperactivity disorder. Psychological Reports, 102(2), 616620. doi:10.2466/PR0.102.2.616-620 Ohman, A. (2000). Fear and anxiety: Evolutionary, cognitive and clinical perspectives. In M. Lewis, & J. M. Haviland-Jones (Eds.), Handbook of emotions (2nd ed., pp. 573-593). New York: Guilford Press. Pallak, M. S., Pittman, T. S., Heller, J. F., & Munson, P., (1975). The effect of arousal on Stroop color-word task performance. Bulletin of the Psychonomic Society, 8(3), 248-250. Patrick, B. C., Skinner, E. A., & Connell, J. P. (1993). What motivates childrenâ&#x20AC;&#x2122;s behavior and emotion? Joint effects of perceived control and autonomy in the academic domain. Journal Of Personality And Social Psychology, 65(4), 781-791. doi:10.1037/00223514.65.4.781 Pinto, A., Grapentine, W., Francis, G., & Picariello, C. M. (1996). Borderline personality disorder in adolescents: Affective and cognitive features. Journal Of The American Academy Of Child & Adolescent Psychiatry, 35(10), 1338-1343. doi:10.1097/00004583-19961000000021 Poikolainen, K. (1997). Risk factors for alcohol dependence: A questionnaire survey. Alcoholism: Clinical And Experimental Research, 21(6), 957-961.

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Reed, P., & Antonova, M. (2007). Interference with judgments of control and attentional shift as a result of prior exposure to controllable and uncontrollable feedback. Learning And Motivation, 38(3), 229-241. doi:10.1016/j. lmot.2006.08.005 Rothermund, K., Wentura, D., & Bak, P. M. (2001). Automatic attention to stimuli signalling chances and dangers: Moderating effects of positive and negative goal and action contexts. Cognition And Emotion, 15(2), 231248. doi:10.1080/0269993004200079 Rotter, J. B. (1954). Social Learning and Clinical Psychology, Englewood Cliffs, NJ, US: Prentice-Hall Rotter, J. B. (1966). Generalized expectancies for internal versus external control of reinforcement. Psychological Monographs: General And Applied, 80(1), 1-28. doi:10.1037/h0092976 Rucklidge, J., Brown, D., Crawford, S., & Kaplan, B. (2007). Attributional styles and psychosocial functioning of adults with ADHD: practice issues and gender differences. Journal of Attention Disorder, 10(3), 288-298. doi:10.1177/1087054706289942 Sheffer, C., MacKillop, J., McGeary, J., Landes, R., Carter, L., Yi, R., & ... Bickel, W. (2012). Delay discounting, locus of control, and cognitive impulsiveness independently predict tobacco dependence treatment outcomes in a highly dependent, lower socioeconomic group of smokers. The American Journal On Addictions, 21(3), 221-232. doi:10.1111/j.15210391.2012.00224.x

Small, D. M., Gitelman, D., Simmons, K., Bloise, S. M., Parrish, T., & Mesulam, M. M., (2003). The posterior cingulated and medial prefrontal cortex mediate the anticipatory allocation of spatial attention. Neuroimage, 18(3), 633-641. doi: 10.1016/S10538119(02)00012-5 Smith, A. B., Halari, R., Giampetro, V., Brammer, M., & Rubia, K. (2011). Developmental effects of reward on sustained attention networks. Neuroimage, 56(3), 1693-1704. doi:10.1016/j. neuroimage.2011.01.072 Soederberg Miller, L. M., & Lachman, M. E. (2000). Cognitive performance and the role of control beliefs in midlife. Aging, Neuropsychology, And Cognition, 7(2), 69-85. doi:10.1076/13825585(200006)7:2;1-U;FT069 Struijs, S. Y., Groenewold, N. A., Oude Voshaar, R. C., & de Jonge, P. (2013). Cognitive vulnerability differentially predicts symptom dimensions of depression. Journal Of Affective Disorders, 151(1), 92-99. doi:10.1016/j. jad.2013.05.057 Vickers, J. N. (2007). Perception, Cognition and Decision Making: The Quiet Eye in Action. Champaign, IL: Human Kinetics. Vine, S. J., Freeman, P., Moore, L. J., Chandra-Ramanan, R., & Wilson, M. R. (2013). Evaluating stress as a challenge is associated with superior attentional control and motor skill performance: Testing the predictions of the biopsychosocial model of challenge and threat. Journal Of Experimental Psychology: Applied, 19(3), 185-194. doi:10.1037/a0034106

Review Articles CONTROL BELIEFS AND COGNITVE FUNCTION Wegner, D. M., (2002). The Illusion of conscious will. Bradford Books. Weierich, M. R., Treat, T. A., & Hollingworth, A. (2008). Theories and measurement of visual attentional processing in anxiety. Cognition And Emotion, 22(6), 985-1018. doi:10.1080/02699930701597601 Wilson, M. R. (2012). Anxiety: Attention, the brain, the body and performance. In S. Murphy (Ed.), The Oxford handbook of sport and performance psychology (pp. 173-190). New York, NY: Oxford University Press. Wood, G., & Wilson, M. R. (2011). Quiet-eye training for soccer penalty kicks. Cognitive Processing, 12(3), 257-266. doi:10.1007/s10339-0110393-0

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Student Psychology Journal, 2015, 162-170

A critical evaluation of the essentialist debate: Do fathers make a unique contribution to child development? Maedbh King Trinity College Dublin Correspondence: mking86@uwo.ca

abstract

The essentialist debate, which is advocated by neoconservative researchers, argues for the uniqueness of father-child engagement for positive child development (Blankenhorn, 1995). However, this neoconservative debate of fathering has been heavily criticised for failing to control for mitigating factors such as socioeconomic status, maternal support and samesex parenting that modulate the importance of father presence for positive child development (Lamb, 2010). The aim of this literature review is to critically analyse the assertion that fathers make a unique contribution to child development. This is done by focussing on two key tenets of the essentialist debate, the first of which assesses the contention that biological differences construct gender differences in parenting, and the second, which investigates whether fathers-as-role-models are uniquely important for normative child development (Silverstein & Auerbach, 1999). It is concluded that consistent and supportive parenting is the common denominator for successful child development and that fathers, as male role models, do not make a unique contribution to development. Keywords: Child Development; Essentialist Debate; Father-Child Engagement; Single Mother Families; Lesbian Families.

Introduction The essentialist debate of fathering advocates for the unique and essential contribution that fathers make to positive child development, coupled with the as-

sumption that children whose fathers are uninvolved in their upbringing are likely to suffer from deficits in their developmental outcomes (Silverstein & Auerbach, 1999). Neoconservatives, who strongly support the essentialist debate of father-

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CONTRIBUTION OF FATHERS TO CHILD DEVELOPMENT ing, firmly believe that the epidemic of fatherless children is “a major force behind many of the most disturbing problems that plague American society: crime and juvenile delinquency; premature sexuality and out-of-wedlock births…” (Popenoe, 1997, p. 1). The Three Pillars of the Essentialist Debate There are three distinctive tenets associated with the essentialist debate. The first argument focuses on the biological differences between mothers and fathers, which facilitate unique contributions to child development; the second tenet contends that marriage civilizes men into becoming responsible and caring fathers, and that this institution combats a man’s promiscuous nature, while the third tenet posits that fathers are essential male role models for young children, in particular for gender role development in young boys (Silverstein & Auerbach, 1999). However, the crux of the essentialist debate, which emphasises the merits of father involvement on the basis of their unique reproductive functions, has been heavily criticized in the literature as being over-simplistic while misrepresenting the findings from empirical research (Silverstein & Auerbach, 1999). Gender Differences in Parenting

One of the important premises that

has been outlined by the essentialist debate is that gender differences in parental behaviours are the result of biological differences between fathers and mothers (Doucet, 2006). The neoconservative perspective borrows from Trivers (1972) sexual-conflict-of-interest hypothesis to demonstrate how biologically driven reproductive functions have designed an instinctual drive that compels women to nurture and care for their offspring while fathers are primed to provide resources to ensure the family’s survival (Cabrera & Tamis-LeMonda, 2013). However, this evolutionary perspective on gender roles has been criticised in the literature, with research reporting that men and women both have the same abilities to nurture, suggesting that the neoconservative is misguided in placing such an emphasis on biological differences (Lamb, 1987 as cited by Silverstein & Auerbach, 1999). The essentialist position has yielded lively debates concerning the unique impact that father-child play has on positive developmental outcomes (Lamb, 2010; Paquette, 2004). Neoconservatives suggest that fathers make a unique contribution to self-regulation and socialisation through rough-and-tumble play (Paquette, 2004), while the mother acts as a secure base for the child (Ainsworth, 1979). A study by Flanders, Leo, Paquette, Pihl and Seguin (2009) found that paternal dominance exhibited through rough-and-tumble play resulted in diminished aggressive

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tendencies in childhood, whereas absence of rough-and-tumble play was associated with higher levels of aggression. Neoconservatives are steadfast in their argument that because of the biological differences between men and women, the instrumental roles associated with masculinity uniquely contribute to child development through dominance in rough-and-tumble play (Paquette, 2004). However, it is consistently reported in the literature (e.g. Craig, 2006; Pleck, 1997) that fathers spend less time on average engaging with their children in contrast with mothers, with father-child interaction calculated as 43% of total mother-child engagement (Pleck, 1997). Although this does not have direct implications for the essentialist debate, it could be suggested that the benefits of intensive father-child rough-and-tumble play are greater in a context where overall engagement is lower (Lamb, 2010). Of course, the important question to address with regards to the essentialist debate is whether this paternal contribution to child development is fundamental to child development (Cabrera et al., 2013). Paternal and Maternal Involvement in Child Development If the neoconservatives were correct in assuming that biological differences in parenting result in unique contributions to child development, it must be questioned

whether the effects of paternal involvement significantly differ from the effects of maternal involvement. Lamb (2010) has stated that in order for the essentialist debate to be accepted, the influence of paternal involvement must yield a strong effect size separate from maternal involvement. Specifically, maternal and paternal roles must not be interchangeable to the extent that if a father was not present, the mother would not be able to provide the same benefits as the absent father. However, contradictory results have been published in the literature, with one study reporting positive paternal involvement in child rearing to be predictive of 7% of the unique variance on the Bayleyâ&#x20AC;&#x2122;s Mental Development Index compared with 13% predicted by positive mothering (Pan, Rowe, Spier and Tamis-LeMonda, 2004). A similar study by Ryan, Martin and Brooks-Gunn (2006) assessed whether paternal and maternal roles were interchangeable, reporting that a paternal and maternal model of supportive parenting yielded the same effects as positive mother-child interactions. Similar results have been found with regards to the effects of rough-and-tumble play on child development, with Roggman (2004) stating that although gender differences may exist in parenting styles (with fathers being more physical), the theory that father-child rough-and-tumble uniquely contributes to development is not fully supported by the literature (Lamb, 2010).

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CONTRIBUTION OF FATHERS TO CHILD DEVELOPMENT Overall, the research does not support the assertion that biological differences construct gender differences in parenting, with many researchers suggesting that the gender of a supportive parent is irrelevant to the development of a child, arguing instead that parenting roles are interchangeable and malleable to social and environmental influences (Ryan et al., 2006). Male Role Models and Child Development Another important tenet of the essentialist debate, which has been heavily criticised in the literature, concerns the importance of a heterosexual male role model for positive child development (Stevens, Golombok & Beveridge, 2002; Silverstein & Auerbach, 1999; Lamb, 2010). The neoconservative argument articulates that masculine fathers are essential role models for young boys, as well as providing the script for future relationships for young girls (Popenoe, 1997). One of the pivotal arguments of the essentialist debate proposes that the absence of paternal involvement results in atypical gender role development (Silverstein & Auerbach, 1999), with a high expression of masculinity associated with positive well being (Pleck, 1981). This deficit in development has been emphasized in relation to young boys more so than young girls. An early study by Sears (1951) investigated 3-5 year old

boys as they played with dolls; they reported that the boys whose fathers were uninvolved in their upbringing displayed less aggressive tendencies than the boys whose fathers were present and involved. However, a large body of empirical research has contradicted this argument, stating that the presence of a masculine role model is not necessary for gender role development (Silverstein & Auerbach, 1999). One such example is a study conducted by Stevens et al., (2002), which found that maternal and paternal influences on the development of gender identity did not differ in preschool children from father-present and father-absent households. These findings were corroborated by Lytton and Romney (1991) who conducted a meta-analysis on 172 studies and reported few significant differences between maternal and paternal socialization according to gender roles, while a later study corroborated these results, reporting a strong correlation between the attitudes of mothers and fathers towards gender-typed behaviours (Crouter, Whiteman, McHale and Osgood, 2007). The idea that a male father figure is essential for the positive development of gender-typed behaviours as well as identifying as heterosexual is completely misrepresented by the extensive empirical research, which has found that although gender-typed behaviours are incorporated into a childâ&#x20AC;&#x2122;s identity through observational learning, the effects of gender social-

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isation are not contingent on the unique masculinity of a father but derive from both mothering and fathering (Cabrera et al., 2013). In conclusion, the available research fails to support the essentialist argument that masculinity uniquely contributes to gender-role development (Silverstein & Auerbach, 1999). Single Mother Families Empirical evidence supporting the tenets of the essentialist debate is derived from studies, which compare the developmental outcomes of children raised by both a mother and a father with children raised by single mothers (Lamb, 2010). Neoconservatives argue that children who are primarily reared by single mothers experience deficits in cognitive and emotional capacities as a result of inconsistent or nonexistent paternal care-giving (Popenoe, 1997). The general consensus arising from the essentialist debate is that children who receive consistent and responsive care-giving from both a mother and a father are more likely to benefit from positive developmental outcomes than children whose fathers are absent from their upbringing (McLanahan, 1999). There are a number of issues with this consensus. Firstly, research often fails to account for mediating factors such as divorce, separation, frequency of visitation and parental status (biological versus step-father) when discussing the effects

of paternal absence on child development (Lamb, 2010). Many research studies have emphasised the importance of paternal involvement for positive child development in terms of single mother families. However, what is noteworthy about these studies is that paternal involvement is only seen as essential when the supportive role of the mother is compromised (Martin, Ryan & Brooke-Gunn, 2010). Empirical work conducted by De Wolff and Van Ijzendoorn (1997) found that in the absence of consistent mothering, the sensitive and caring nature of the father resulted in positive social-emotional development. Therefore, what this suggests is that fathers are capable of successfully adopting roles that are typically attributed to mothers. In contrast to the essentialist debate, which argues that parenting roles are gender-specific (Silverstein & Auerbach, 1999), this finding supports the idea that parental roles are interchangeable. Scaffolding and Buffering in Single Mother Families Martin et al., (2010) referred to the concept of scaffolding in the case of low maternal support, corroborating the findings of De Wolff et al., (1997) in reporting that fathers act as a â&#x20AC;&#x2DC;bufferâ&#x20AC;&#x2122; with regards to imparting transferable skills to their children when the maternal role is compromised. In this study, positive father-child interactions as well as increased paternal support were found to effect school readi-

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CONTRIBUTION OF FATHERS TO CHILD DEVELOPMENT ness and academic performance in young children when the mother was incapacitated in her role (Martin et al., 2010). However, when assessing the father’s role as a ‘buffer’, there are many moderating variables, which must be taken into consideration that potentially contradict the findings of the essentialist debate (MacCallum & Golombok, 2004). Research has found that low socioeconomic status, strife in parental relationships and lack of support systems operate as predictor variables of negative developmental outcomes for children, regardless of whether fathers are absent or present in their upbringing (Amato, 1993; Lamb, 2010). In the Martin et al., (2010) study, paternal involvement was only considered to be necessary for positive child development in the case where the care-giving ability of low-income single mothers was compromised. A study by Amato (1993) also reported that when divorce or separation were considered alongside father absence, it was more often that disaccord and strife, which were by-products of the separation or divorce proceedings, negatively impacted the child’s emotional development, rather than the absence of the father from the household. When these factors are taken into account, the relationship between child outcomes and paternal presence becomes statistically non-significant (Sigle-Rushton & McLanahan, 2004). Upon controlling

for socioeconomic status, children of divorced single mothers were more likely to suffer negative outcomes, and this was significant in comparison with children of never married single mothers (Carlson, 2006). Although these findings were only marginally significant, there is merit in suggesting that divorce-related conflict, rather than paternal absence, is the operative factor in determining negative developmental outcomes for children of single mothers. Therefore, when contrasting and comparing single mother families with two-parent heterosexual families, it is important to be cognizant that negative developmental outcomes are most likely the result of deficits in responsive and supportive care-giving due to low socioeconomic status, parental conflict and even the stigma associated with single parenting (MacCallum et al., 2004). Although fathers may make important contributions to child development when maternal care-giving is compromised, it is important to determine whether the positive benefits associated with father presence are the result of biologically driven masculinity or the result of being raised by two parents rather than one (Lamb, 2010). Lesbian Families and Child Development Much research investigating this particular question has focussed on chil-

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dren of lesbian parents (Golombok, Perry, Burston, Murray, Mooney-Somers et al., 2003) in order to assess whether the absence of a masculine role model disadvantages children in two-mother families. Many studies have found little to no support that children of lesbian parents suffer from negative developmental outcomes compared with children from two-parent heterosexual families (Golombok et al., 2003). A revealing study was conducted by Wainright, Russell and Patterson (2004) who examined a sample of 44 heterosexual families and a sample of 44 lesbian families, both with adolescent children; the adolescents from both samples were tested on measures of self-esteem, depression, grade point average and anxiety, and no significant differences were reported. Another interesting study was conducted by Patterson (1995) who reported that children with same-sex parents were as likely as children of heterosexual parents to develop a heterosexual orientation, contradicting the essentialist position that heterosexual fathers are essential role models for ‘normal’ gender identity development (Popenoe, 1997). Conclusion In conclusion, the view that biological differences construct gender differences in parenting has not been supported by empirical research, which has largely found maternal and paternal roles to be interchangeable (Ryan et al., 2006), while

the importance of masculine role models for gender role development has not been found to be dependent on the unique masculinity of the father (Cabrera et al., 2013). The most striking evidence opposing the essentialist debate pertains to the moderating variables that influence the quality of parenting, in particular a second supportive caregiver, conflict deriving from divorce and/or separation and socioeconomic status. When these variables are controlled, in the context of both single-mother (Lamb, 2010) and lesbian families (Golombok et al., 2004) respectively, there is no evidence to suggest that fathers do in fact make unique contributions to positive child development. Instead, it is suggested that positive developmental outcomes are associated with supportive and consistent parenting rather than the influence of traditional gender roles in parenting styles (Silverstein & Auerbach, 1999). References Ainsworth, M. S. (1979). Infant–mother attachment. American psychologist, 34(10), 932. Amato, P. R. (1993). Children’s adjustment to divorce: Theories, hypotheses, and empirical support. Journal of Marriage and the Family, 23-38. Blankenhorn, D. (1995). State of the Family and the Family Policy Debate, The.Santa Clara L. Rev., 36, 431.

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CONTRIBUTION OF FATHERS TO CHILD DEVELOPMENT Cabrera, N.J & Tamis-LeMonda, C.S. (2013). Handbook of Father Involvement: Multidisciplinary Perspectives, Second Edition, NY: Routledge. Carlson, M. J. (2006). Family structure, father involvement, and adolescent behavioral outcomes. Journal of Marriage and Family, 68(1), 137-154. Craig, L. (2006). Does father care mean fathers share? A comparison of how mothers and fathers in intact families spend time with children. Gender & Society, 20(2), 259-281. De Wolff, M.S., & van Ijzendoorn, M.H. (1997). Sensitivity and Attachment: a meta-analysis on parental antecedents of infant attachment. Child Development, 68(4): 571-91. Crouter, A. C., Whiteman, S. D., McHale, S. M., & Osgood, D. W. (2007). Development of gender attitude traditionality across middle childhood and adolescence. Child Development, 78(3), 911-926. Doucet, A. (2006). Do Men Mother? University of Toronto Press Incorporated. Flanders, J.L., Leo, V., Paquette, D., Pihl, R.O., & Séguin, J.R. (2009). Roughand-tumble play and the regulation of aggression: an observational study of father-child play dyads. Aggression and Violent Behaviour, 35(4): 285-95. Golombok, S., Perry B., Burston, A., Murray, C., Mooney-Somers, J., Stevens, M., & Golding, J. (2003). Children with lesbian parents: a community study. Developmental Psychology, 39(1), 20-33.

Lamb, M.E. (2010). The Role of the Father in Child Development, 5th Edition. Wiley Publishers. Lytton, H., & Romney, D. M. (1991). Parents’ differential socialization of boys and girls: A meta-analysis. Psychological Bulletin, 109(2), 267. MacCallum, F., & Golombok, S. (2004). Children raised in fatherless families from infancy: a follow-up of children of lesbian and single heterosexual mothers at early adolescence. Journal of Child Psychology and Psychiatry, 45(8), 1407-1419. Martin, A., Ryan, R. M., & Brooks-Gunn, J. (2010). When fathers’ supportiveness matters most: maternal and paternal parenting and children’s school readiness. Journal of Family Psychology, 24(2), 145-155. McLanahan, S. (1999). Father absence and the welfare of children. Coping with divorce, single parenting, and remarriage, 117-145. Pan, A., Rowe, M. L., Spier, E., & Tamis-Lemonda, C. (2004). Measuring productive vocabulary of toddlers in low-income families: Concurrent and predictive validity of three sources of data. Journal of Child Language, 31(03), 587-608. Paquette, D. (2004). Theorizing the Father-Child Relationship: Mechanisms and Developmental Outcomes. Human Development, 47(4), 193-219.

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Patterson, C.J. (1995). Sexual Orientation and Human Development: An Overview. Developmental Psychology, 31(1), 3-11.

Silverstein, L.B., & Auerbach, C.F (1999). Deconstructing the essential father. American Psychologist, 54(6), 397407.

Pleck, J. (1997). Paternal involvement. The role of the father in child development, 66-104.

Stevens,M., Golombok, S., & Beveridge, M. (2002). Does father absence influence childrenâ&#x20AC;&#x2122;s gender development? Findings from a general population study of preschool children. Parenting science and practice, 2(1), 47-60.

Pleck, J. H. (1981). The myth of masculinity. MIT Press (MA). Popenoe, D. (1997). Life without father. Paper presented at the Annual Conference of the NCFR Fatherhood and Motherhood in a Diverse and Changing World. Roggman, L. A. (2004). Do fathers just want to have fun? Commentary on theorizing about father-child relationships. Human Development, 47, 235248. Ryan, R. M, Martin, A., & Brooks-Gunn, J. (2006). Is one good parent good enough? Mothering, fathering and child cognitive outcomes in the Early Head Start Research and Evaluation Project. Science and Practice, 6, 211228. Sears, R.R. (1951). A theoretical framework for personality and social behavior. American Psychologist, 6(9), 476-482. Sigle-Rushton, W., & McLanahan, S. (2004). Father absence and child wellbeing: A critical review, 116-55. Russell Sage Foundation.

Trivers, R. (1972). Parental investment and sexual selection. Aldine Publishing Company. Wainright, J.L, Russell, S.T., & Patterson, C.J. (2004). Psychosocial Adjustment, School Outcomes, and Romantic Relationships of Adolescents With Same-Sex Parents. Child Development, 75(6), 1886-1898.

Student Psychology Journal, 2015, 171-179

Cesare Lombroso’s Biological Explanations of Crime: How relevant are they to modern criminal psychology? James Larkin Trinity College, Dublin Correspondence: larkinja@tcd.ie

abstract

Criminologist Cesare Lombroso was seen as a visionary in the late 1800s but for much of the 1900s his work was reviled. This essay will re-evaluate the work of Lombroso, in particular his biological explanations of crime and whether they are applicable to modern criminal psychology. Upon examining Lombroso’s work on atavism, phrenology, epilepsy, temperature, age, and several other areas, the author deduced that the theories themselves may be valid and investigable, and as such relevant to modern criminal psychology. These insights may rule out modern social factors as causes of certain criminological phenomena. Due to the time in which Lombroso conducted his work, his methodologies have several shortcomings. However, several of these shortcomings can be seen in the work of modern criminologists demonstrating that Lombroso’s work was somewhat robust given the time period it was conducted in. Keywords: Lombroso, biology, crime, atavism, epilepsy, phrenology Cesare Lombroso is thought of by many as the founding father of criminal psychology (Assael & Avanzini, 1997; Granieri & Fazio, 2011; Kushner 2011). When Lombroso was alive his theories on the biological explanations of crime were seen as being in the vanguard of criminology (Kurella & Paul, 1911) but after his death his theories were ridiculed and denigrated (Gatti & Verde, 2012)

with Abraham Verghese referring to them as “pseudoscience, utter rubbish” (Verghese, 2009, p. 239). Despite much criticism this author believes that a reappraisal of Lombroso’s work is necessary in order to conclude how relevant his biological explanations of crime are to modern criminal psychology.

In 1897 Lombroso sought out Tolstoy

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for study. He wanted to meet Tolstoy in order to test this hypothesis that there is a relationship between genius and madness, Lombroso chose Tolstoy to test this theory on because he believed that Tolstoy was the greatest writer (Mazarello, 2005). Lombroso believed that Tolstoy would be of “cretinous or degenerate appearance” (Lombroso, 1895, p. 9). Upon meeting Tolstoy he began to observe him naturalistically in order to confirm his hypothesis. Lombroso found that Tolstoy had an “epileptoid psychosis” (Gatti & Verde, 2012, p. 20) which Lombroso believed was a hereditary mental illness. Lombroso felt that from this result he could confirm his theory that there is a relationship between genius and madness (Gatti & Verde, 2012, p. 20). This anecdote epitomises why aspects of Lombroso’s biological explanations of crime are both relevant and irrelevant to modern criminal psychology; he finds interesting and relevant results but he does this by using unsound methodologies and poor empirical analysis such as lack of research and inferring causality without adequate background information. These unsound methodological methods make it so that many of his biological explanations of crime are not directly applicable to modern criminal psychology. However, given the temporal context Lombroso’s work should be given credit, and at times can be used to demonstrate that modern theories have been consistent over time. Also, his methodological and deductive

ineptitudes are relevant because they are sometimes repeated in the work of modern criminologists. As well as this, his explanations provide bases for possible hypotheses in modern criminal psychology, some of which are currently unexplained and his research on the matter may allow modern research to control for modern social factors because this phenomenon was present in the late 1800s. Through a series of examples of his works this essay will show that these themes among others continually emerge from Lombroso’s work and this will hence show that some aspects of his work have relevance to modern criminal psychology while other aspects do not. One of Lombroso’s primary biological explanations of crime was atavism (Lombroso-Ferrero, 1911): the idea that one can be a born criminal and that these born criminals are a reversion to a human subtype such as savages or even animals such as apes. Lombroso’s daughter Gina Lombroso-Ferrero provides an account of how Lombroso first came upon his theory of atavism. When Lombroso was a young doctor it was requested of him to perform an autopsy on a criminal named Viella who was an “Italian Jack the Ripper” (Lombroso-Ferrero, 1911, p. 6), upon performing the autopsy he noticed a hollow in the occiput of the skull, he named this the median occipital fossa. He also noticed hypertrophy of the vermis which he had found in apes and forty

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LOMBROSO’S BIOLOGICAL EXPLANATION OF CRIME percent of members of the Aymaras tribe in Bolivia and Peru. This was the first appearance of his theory of atavism; he declared that “At the sight of the skull… I seemed to see all at once… the problem of the nature of the criminal” (Lombroso-Ferrero, 1911, p. 7). Following this discovery Lombroso felt that the presence of physical anomalies such as enormous jaws and strong canines in criminals was explained by atavism however this jaw size can be more likely linked to an excess of testosterone (Burriss, Little, & Nelson, 2007). Lombroso lists a litany of physical characteristics he had found in criminals that he believed to be atavistic (Lombroso, 1911). Many of these characteristics are contentious and baseless such as a wrinkled face, Lombroso speaks of how the “wrinkled face takes us back to the apes” (Lombroso, 1911, p. 373). His conclusions here are not directly applicable to modern criminal psychology because he has found a correlation and inferred causation with insufficient background knowledge. Robins and Wasserman (1999) outline that causation cannot be inferred in an observational environment without “substantive subject-matter-specific background knowledge” (Robins and Wasserman 1999, p. 305). As outlined above, Lombroso does not provide this background knowledge. However, modern theorists are consistently making the same mistakes as Lombroso; Robins and Wasserman (1999) cite numerous modern authors who have in-

ferred causality in an observational study with insufficient background knowledge, Spirtes, Glymour, and Scheines (1993) and Pearl (1995) are just some examples. Therefore, given the temporal context of Lombroso’s work his theories should be given much credibility. Upon further study of atavism, Lombroso came to the conclusion that epilepsy was a manifestation of born criminality. When studying cases of “moral insanity” (Lombroso, 1911, p.369) Lombroso found that “not one of the atavistic phenomena shown by criminals is lacking in epilepsy” (Lombroso, 1911, p. 369). Lombroso claimed that born criminals were epileptics but that their fits were latent and that alcohol and anger can cause a fit in a born criminal (Lombroso, 1911), he fails to give any research to support this claim. This is another example of inferring causality with insufficient background information leaving this biological explanation as a theory rather than a scientific explanation that can be deemed relevant to modern criminal psychology. One of the primary facets of Lombroso’s theory of atavism is phrenology; linking the size and shape of a human skull to one’s mental abilities and character (Fodor, 1983). Examples in his work include the aforementioned median occipital fossa as well as implying that a large cerebral frontal cortex is linked to females committing rape and infanti-

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cide (Lombroso & Ferrero, 1959). Gatti and Verde, (2012) and Renneville (2000) claim that Lombroso’s study of phrenology was what established cerebral localisation as a psychological tool. Lombroso’s work in phrenology is a cautionary tale for modern criminal psychologists. Blair (2003) posited the idea that there is a neurological basis to psychopathy and Dolan (1999) links the orbitofrontal cortex to psychopathy. Benning (2003) points out that when one considers these theories with regard to Lombroso’s theories of phrenology then they begin to have far reaching consequences. Benning (2003) believes that if modern criminality begins to be explained by human biology then Lombroso’s ideas of preventative criminality may begin to re-emerge. Benning envisages a possible future where a brain scan diagnosis of psychopathy may legitimise a preventative incarceration. Benning also questions whether it could lead to defendants resorting to a deterministic argument when defending themselves in court with a view to a pardon from their offense. Here, themes from Lombroso’s work or reemerging in modern criminology, Lombroso’s work can potentially influence modern discourse on the topic of preventative incarceration based on neurology. In Lombroso’s work: Crime: It’s Causes and Remedies (1911) one of the primary biological explanations of crime is temperature. Lombroso begins

by claiming that “a relatively moderate degree of heat” (Lombroso, 1911, p. 3) causes crime. He supports this point up by referencing two novels which are by definition fictitious. Lombroso explains this correlation by claiming that “this is doubtless because heat excites the nervous centres” (Lombroso, 1911, p. 3). He has no physiological evidence to support this claim and Anderson (1987) has found that this conclusion was indeed erroneous. The basis for scientific progress is the modern epistemological approach first posited by Peirce (Peirce, Hartshorne, & Weiss, 1935) and subsequently elaborated upon by Hanson (1958). According to this approach in order to make scientific progress three successive steps must be followed; abduction, deduction and induction. Deduction is the logical derivation of empirically verifiable statements and induction is the empirical confirmation of those statements. Lombroso continually failed to provide empirical confirmation of his statements with this explanation of crime being a prime example. Lombroso goes on to point out correlations between several different crimes and heat. This correlation is still prevalent in the modern era (Anderson, 1987). So while Lombroso’s physiological explanations of why heat causes crime is lacking proof, the question of whether heat does cause crime is still highly relevant as it has not been explained definitively yet. Unpleasant odours (Rotton, Frey, Barry, Milligan, & Fitzpatrick, 1979) and the

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LOMBROSO’S BIOLOGICAL EXPLANATION OF CRIME concentration of negative and positive ions in the air (Baron, Russel, & Arms, 1985) are offered as possible modern explanations. Bell, Granand and Heath (1984) offer the explanation of crowding as a cause of the correlation between crime and heat, Lombroso makes a similar claim when referencing carnivals (Lombroso, 1911) but he once again fails to offer any background information to support this implication of causality. Lombroso’s explanation that heat has a physiological effect that causes crime is also relevant because it allows modern social factors to be controlled for when considering heat as a determinant of crime. One of Lombroso’s biological explanations for crime is “moral insanity” which he describes as being caused by “pathological mental characteristics, congenital or acquired” (Lombroso, 1911, p. xxii). Moral insanity seems analogous to psychopathy which is evident in his description of the disease. He describes a “complete absence of moral feeling and of moral ideas” (Lombroso, 1911, p. xxi) which could account for “lack of empathy” and “shallow affect” respectively in the Psychopathy Checklist – Revised (PCL-R; Hare, 1999). He goes on to say that “all his impulses and desires, to which he yields without check”, this may account for “impulsiveness” in the PCL-R. He continually repeats phrases such as “immoral motives” and “moral

insensibility” which emphasised how immoral a person with this pathology has, also one of the key parts of the PCL-R. Lombroso mentions “acute intelligence” which seems incongruous with the general pathology of a psychopath which is that a psychopath is on average of low intelligence (Heilbrun, 1982) however this may have been him misjudging intelligence due to the psychopath’s “conning and manipulativeness”, and “grandiose sense of self worth”, both of which appear in the PCL-R. Lombroso then describes “an extraordinary ingenuity in explaining, excusing or justifying their behaviour” (Lombroso, 1911, p. xxi) which would account for the PCL-R’s “failure to accept responsibility for own actions”, “pathological lying”, “conning and manipulativeness”, and “irresponsibility”. He fails to mention anything related to the other symptoms such as “early behavioural problems” or “promiscuous sexual relationships” amongst others but it is possible that if they were investigated they would have held true to Hare’s PCL-R, however this is unverifiable. If it is the case that this is psychopathy then it is highly relevant to modern criminal psychology because it creates the possibility of controlling for modern social factors when studying the epidemiology of psychopathy and it reinforces aforementioned modern biological explanations. However, Lombroso fails to give anything more than anecdotal evidence to back up his explanation so once again it is

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unlikely that this can be directly applied to modern criminal psychology due to these methodological shortcomings. Another modern theory which Lombroso uses to explain crime is that of the relationship between crime and age. Modern theories such as Levitt’s (1999) claim that a rise in crime appears around the age of ten and continues to rise until it peaks between the ages of fifteen and eighteen followed by a decline from eighteen to twenty five and a sharp decline from twenty five to thirty nine and after thirty nine crime comes close to ceasing. Similarly to psychopathy, Lombroso seems to identify a similar correlation between age and crime. He claims that the “the maximum of criminality is found at ages ranging from fifteen to twenty five years” (Lombroso, 1911, p. 175). Here he quotes statistics from a reliable source; the Italian prison system but he then goes on to back up his point that crime rates drop after twenty five by quoting from a novel which as mentioned before is fictitious by nature. Evidence supporting the modern age-crime correlation theory appears in the 1800s, therefore the theory is consistent over time, demonstrating, in part, Lombroso’s relevance to modern criminology. The preceding paragraphs illustrate explanations of Lombroso’s that can be interpreted as both irrelevant and relevant to modern criminal psychology however,

this may be due to a “throw enough mud at a wall” effect. Much of what Lombroso has done has little or no relevance to modern criminal psychology. He posits that women do not commit as many crimes as men due to a lack of “intellectual force” (Lombroso, 1911, p. 185). He emphasises that he does not mean education when he says intellectual force, he means hereditary intelligence. He then explains this lack of “intellectual force” by saying that a woman has a smaller “Orbital capacity” (Lombroso & Ferrero, 1959, p. 5). Both of these explanations have been proven to be erroneous and thus irrelevant as Lynn and Kanazawa (2011) have found no significant sex differences in intelligence and Roth and Dicke (2005) have found that within- human encephalization quotient does not correlate to intelligence. Lombroso also posits that women suffer less from epilepsy than men; he then offers this as another explanation for low crime rates amongst women (Lombroso and Ferrero, 1959). No robust evidence is used to substantiate this theory. Instead, anecdotal research is used. Modern research has found no sex differences among epileptics (Smith, Elliott, & Naguiat, 2009). Another example is his explanation of some crime in prisons being caused by “storms approaching” (Lombroso, 1911, p. 12) and the moon. This is offered as an explanation with anecdotal evidence from superintendents of prisons offered as adequate proof. Upon review of the literature there is no further

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LOMBROSO’S BIOLOGICAL EXPLANATION OF CRIME study on the matter but loose anecdotal evidence from the late 1800s doesn’t offer grounds for a sound hypothesis and as such this explanation can be deemed irrelevant to modern criminal psychology.

Baron, R. A., Russell, G. W., & Arms, R. L. (1985). Negative ions and behavior: Impact on mood, memory, and aggression among Type A and Type B persons. Journal of Personality and Social Psychology, 48(3), 746.

It is clear from the present review of Lombroso’s work that his biological explanations of crime are both relevant and irrelevant to modern criminal psychology. This is despite the fact that for the most part of the last century his conclusions have been deemed erroneous. It has been shown that his methodological methods and deductions are not up to modern scientific standards which leave much of his work not directly applicable to modern criminal psychology, but given the temporal context credit should be given to his work as breaking ground for modern research. And Lombroso’s work at times can contribute to modern research by demonstrating that certain theories such as the age-crime correlation have been consistent over time.

Bell, P. A., Garnand, D. B., & Heath, D. (1984). Effects of ambient temperature and seating arrangement on personal and environmental evaluations. The Journal of general psychology, 110(2), 197-200.

References Anderson, C. A. (1987). Temperature and aggression: effects on quarterly, yearly, and city rates of violent and nonviolent crime. Journal of personality and social psychology, 52(6), 1161. Assael, B. M., & Avanzini, G. (1997). Il male dell’anima: l’epilessia fra’800 e’900. Laterza.

Benning, T. B. (2003). Neuroimaging psychopathy: lessons from Lombroso. The British Journal of Psychiatry, 183(6), 563-564. Blair, R. J. R. (2003). Neurobiological basis of psychopathy. The British Journal of Psychiatry, 182(1), 5-7. Burriss, R. P., Little, A. C., & Nelson, E. C. (2007). 2D: 4D and sexually dimorphic facial characteristics. Archives of sexual behavior, 36(3), 377-384. Dolan, R. J. (1999). On the neurology of morals. Nature neuroscience, 2(11),927 -929. Fodor F. (1983) Modularity of Mind: An Essay on Faculty Psychology. Cambridge, Mass.: MIT Press. p.1 Gatti, U., & Verde, A. (2012). Cesare Lombroso: Methodological ambiguities and brilliant intuitions. International journal of law and psychiatry, 35(1), 19-26.

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Gould, S. J. (1980) Ever Since Darwin: Reflections in Natural History. Harmondsworth: Penguin. Granieri, E., & Fazio, P. (2012). The Lombrosian prejudice in medicine. The case of Epilepsy. Epileptic psychosis. Epilepsy and aggressiveness.Neurological Sciences, 33(1), 173-192. Hanson, N. R. (1965). Patterns of discovery: an inquiry into the conceptual foundations of science... CUP Archive. Hare, R. D. (1999). The Hare Psychopathy Checklist-Revised: PLC-R. MHS, Multi-Health Systems. Heilbrun, A. B. (1982). Cognitive models of criminal violence based upon intelligence and psychopathy levels. Journal of Consulting and Clinical Psychology, 50(4), 546.

Lombroso, C. (1911). Crime, its causes and remedies (Vol. 3). Little, Brown,. Lombroso, G. (1911). Criminal man: According to the classification of Cesare Lombroso. New York: Putnam. Lynn R, Kanazawa S. (2011) A longitudinal study of sex differences in intelligence at ages 7, 11 and 16 years; Personality and Individual Differences, 51(3), 321-324. Mazzarello, P. (2001). Lombroso and Tolstoy. Nature, 409(6823), 983-983. Mazzarello, P. (2005). Il genio e l’alienista: la strana visita di Lombroso a Tolstoj. Bollati Boringhieri. Pearl, J. (1995). Causal diagrams for empirical research. Biometrika, 82(4), 669-688.

Kurella, H., & Paul, E. (1911). Cesare Lombroso: A modern man of science. Rebman limited.

Peirce, C. S., Hartshorne, C., & Weiss, P. (Eds.). (1935). Collected papers of charles sanders peirce (Vol. 2). Harvard University Press.

Kushner, H. I. (2011). Cesare Lombroso and the pathology of left-handedness. The Lancet, 377(9760), 118-119.

Renneville M. (2000) Le langage des crânes: une histoire de la phrénologie. Seuil, Paris

Levitt, S. D. (1999). The Limited Role of Changing Age Structure in Explaining Aggregate Crime Rates. Criminology, 37(3), 581-598.

Robins, J. M., & Wasserman, L. (1999). On the impossibility of inferring causation from association without background knowledge. Computation, causation, and discovery, 305321.

Lombroso C, Ferrero W. (1959) The Female Offender (Vol. 3). Peter Owen Ltd. Lombroso, C. (1895). Gli anarchici. Fratelli Bocca.

Roth, G., & Dicke, U. (2005). Evolution of the brain and intelligence. Trends in cognitive sciences, 9(5), 250-257.

Review Articles LOMBROSOâ&#x20AC;&#x2122;S BIOLOGICAL EXPLANATION OF CRIME Rotton, J., Frey, J., Barry, T., Milligan, M., & Fitzpatrick, M. (1979). The Air Pollution Experience and Physical Aggression1. Journal of Applied Social Psychology, 9(5), 397-412. Smith, M. L., Elliott, I., & Naguiat, A. (2009). Sex differences in episodic memory among children with intractable epilepsy. Epilepsy & Behavior, 14(1), 247-249. Spirtes, P., Glymour, C. N., & Scheines, R. (2000). Causation, prediction, and search (Vol. 81). MIT press. Verghese, A. (2009). Cutting for Stone: a novel. Random House LLC.

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The role of the Irish Psychologist in responding to cases of Child Sexual Abuse Jennifer Lennon Trinity College, Dublin Correspondence: lennonj3@tcd.ie

abstract

Investigations into the years of concealed Irish clerical sexual abuse have highlighted the state’s intolerable failure to protect its children and highlighted the need for legislation, services and practice that can effectively prevent future abuse and support the victims of past abuse in their recovery. Psychological expertise may be an indispensable supplement to such endeavours insofar as clinical, forensic, developmental and criminological insights may address incidences of abuse from all angles. At a victimological level, psychologists draw upon various models of psychotherapy in formulating the individual’s experience of abuse, so as to ameliorate the present impact of past trauma and to re-align developmental trajectories. Furthermore, the psychologist may work alongside legal bodies in a forensic setting, providing an insight into the complex nature of how experiences of child abuse are disclosed, for the purposes of identifying and removing victims from abusive environments and assisting the decisions of prosecutors in child sexual abuse criminal trials. Finally, psychological skills and knowledge may inform the development of policy and practice regarding the punishment and rehabilitation of perpetrators of child sexual abuse. This review explores the role of psychology in responding to child sexual abuse, drawing upon general theory and research and the specific application of such knowledge within Ireland. Keywords: Child Sexual Abuse, Psychotherapy, Judicial System, Criminal Rehabilitation

Introduction In 2009, the publication of the Ryan Report cataloguing forty years’ worth of Irish child abuse reified what is perhaps

one of the gravest violations of human rights in Irish history (Cunneen, 2006). The public outrage generated by the belated airing of Catholic sexual crimes has drawn issues such as paedophilia and

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IRISH PSYCHOLOGISTS RESPONDING TO CASES OF CHILD SEXUAL ABUSE the implications of child abuse into Irish consciousness (McAvoy, 2012). Furthermore, this exposé has served to reiterate a zero tolerance policy for child abuse and emphasised a need for criminal legislation that can provide justice for victims and help prevent future incidences of abuse (McAlinden, 2013). Ireland’s response to clerical child abuse provides an example of the interface between psychology and the Irish criminal justice system- where psychology helps to inform retributory and victimological proceedings in a legal context. Child abuse is a criminal issue that spans across many psychological domains and requires various aspects of the psychologist’s professional skillset. In this regard, psychological engagement with the output of The Catholic Church Scandal, be it on a forensic, therapeutic or rehabilitative level, demonstrates the psychologist responding to an extremely pertinent issue within the Irish criminal justice system. Conceptualising Child Sexual Abuse for Intervention Purposes The term child sexual abuse has been used as an umbrella term in the psychological literature to encompass all sexual interactions between children and older persons and same-age children or adolescents when coercion is involved (Loh, 1979). However according to Kilpatrick (1987) this ‘grouping’ and the indiscriminate use of terminology in the sexual

abuse literature presents an obstacle to understanding the long-term effects of premature or non-consensual sexual activity in minors. Kilpatrick points out that abuse, as the violation of societal sexual norms, is often presumed to imply that harm has been inflicted, with the media and indeed some of the professional literature depicting experiences of child sexual abuse as a “special destroyer of adult mental health’’ (Seligman, 1994, p. 232). However departures from sexual convention may not necessarily always entail harm and this sensationalized portrayal of childhood sexual experiences may not always be justified. For instance, despite violating societal sexual norms and laws, sexual relations between an already sexually active (but technically underage) adolescent and an adult do not parallel the experience of an abused child who is not equipped to understand or consent to such activity (Browne & Finklehor, 1986). While associations between sexual abuse and compromised developmental outcomes have been extensively documented in the literature (Paolucci, Genuis, & Violato, 2001) individuals have also been found to demonstrate various degrees of resilience in response to such traumatic experiences (Himelein, & McElrath, 1996). For instance, Finkelhor (1990) estimated that between 25% and 30% of abused children have the emotional and social resources that enable them to cope with the experience of sex-

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ual abuse without adverse effects. Placing this phenomenon in an Irish context, Flanagan et al. (2009) observed that in a sample of Irish adult survivors of institutional abuse, 18% had no current or history of psychological disorders. The point is that an individualâ&#x20AC;&#x2122;s experience of abuse is a highly individualised phenomenon and variations in the frequency, duration, age at onset, and the relationship of the victim to the perpetrator all combine to yield a unique response or reaction to abuse (Courtois, 1999). In this respect it is imperative that individuals such as psychologists who work with such populations are trained to respect and recognise all possible variations in experiences and consequences of abuse (Walsh & Liddy, 1993). Child Sexual Abuse and Psychotherapy Psychologists engage with cases of child abuse at various stages of the abuse process with psychological intervention occurring most commonly in a therapeutic context following the occurrence and discovery of abuse (Blanchard & Tabachnick, 2002). Often child sexual abuse entails overwhelming levels of trauma during a formative life period and so child sexual abuse has an astronomical ability to adversely influence developmental outcomes and to yield a wide range of psychological, social and somatic symptomology (Lynskey & Ferguson,

1997). For instance in a study commissioned by the Catholic Church, Goode, McGee and Boyle (2003) reported an array of psychological issues in adult victims of Irish clerical sexual abuse such as depression, anxiety, suicidal ideation and feelings of isolation and stigma. Similarly in a more recent Irish study, Carr et al. (2010) observed psychological disorders in over 80% of a sample of adult institutional abuse victims, citing anxiety, mood and substance use disorders as the most prevalent diagnoses. Abuse victims may present in therapy with issues that reflect both the trauma of the abuse and maladaptive mechanisms of coping with abuse (e.g. substance abuse), hence there are a variety of therapies that may be suitable for a given victim depending on their symptomology (Paolucci et al., 2001). According to Faller (1993) dealing with the effects of abuse and decreasing the risk of future victimization constitute the two main goals of sexual abuse treatment. In this respect, merely treating the abused individualâ&#x20AC;&#x2122;s symptoms with a given therapy may not be sufficient. It is important to consider that victims of abuse have often experienced not only sexual abuse but also emotional and even physical abuse (this is particularly true of Irish survivors of institutional abuse) (Fitzpatrick et al., 2010) so intervention design is often integrative, utilizing elements from several psychotherapeutic orientations. Indeed,

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IRISH PSYCHOLOGISTS RESPONDING TO CASES OF CHILD SEXUAL ABUSE according to Nolan et al. (2002), an integrative approach drawing upon principles from both individual and group therapy practices within the major traditions of psychodynamic, client-centred and cognitive-behaviour therapy represents the majority of clinical practice in present day Ireland. In Ireland, psychological support for victims of child sexual abuse is provided by a number of statutory services within the Health Service Executive and the Child and Family Agency, in addition to several state funded and charitable organisations that act as referral systems or offer therapeutic services to victims of child sexual abuse (Barnardos, n.d.). Specific therapeutic services for children who have been sexually abused are available in the two children’s hospitals (St. Clare’s Unit in Temple Street Hospital & St. Louise’s Unit in Crumlin Hospital) (O’ Shea & McElvaney, 2001) and with the CARI foundation, which provides child-centered therapy in addition to a parental support and child protection advocacy programme (The Cari Foundation, n.d). The National Counselling Service represents a primary care counselling service specifically for victims of child sexual abuse. Established in 2000 in response to the rising numbers of individuals requiring help for child sexual abuse related issues following the instigation of Child Abuse Commission, this service

now employs over 70 counsellors and therapists who are specialised in developmental trauma (Health Service Executive, 2013). The National Counselling Service was established by the ten Health Boards in Ireland as part of an initiative to ensure free and direct access to counselling and psychotherapy for victims of abuse. In 2004, a counselling helpline service was established under the name NOVA (National Office for the Victims of Abuse) as an adjunct to the National Counselling Service, to be later re-named Connect (Connect, n.d.) The objective of Connect is to provide an out of hours telephone counselling and support service for adults who experienced abuse or neglect during childhood, encompassing physical, emotional and sexual abuse. Connect also provides support to the relatives or partners of those who have suffered abuse (Merrigan, 2015). The Catholic Church funded ‘Towards Healing’ programme provides a further exemplar of psychologists responding to the aftermath of clerical criminal activity. Towards Healing is a referral service that arranges free counselling and support services for survivors of Institutional, Clerical and Religious abuse, providing such individuals with qualified and accredited therapists (Towards Healing, n.d.). Over the past thirty years particularly, the restorative skills of Irish psychologists within such services have been heavily availed of insofar as discourse

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and legal inquiries into the Catholic Church sexual abuse scandal seems to have ignited a pattern of adult survivors of child sexual abuse coming forward and seeking counsel for abuse related difficulties (McElvaney, 2013). Given the outpour of victims seeking help for issues related to childhood sexual abuse over the past three decades, a recurring issue within supportive services is long psychotherapy waiting lists. For instance in 2014, the statutory funding of the Dublin Rape Crisis Centre was cut for the seventh year in a row, meaning that the more immediate victims of sexual violence were prioritised and survivors of childhood abuse have had to wait for longer periods before being seen by a therapist (O’Malley-Dunlop, 2014, p. 3). Indeed, in the One in Four 2015-2018 strategic plan (a charitable agency that provides therapeutic services for victims of child sexual abuse and runs both advocacy and sex offender intervention programmes) it is acknowledged that the employment of additional psychotherapists is a high priority, given that current staff are working at capacity and yet still incapable of meeting service demands (One in Four, 2015). In this respect, it is likely that supporting victims of both past and present child sexual abuse will remain a pressing duty of Irish psychologists for the foreseeable future. The Psychologist’s Forensic Role

Traditionally, psychologists’ involvement in cases of child abuse has been predominantly in the assessment and implementation of services for abused children (Melton & Limber, 1989). However the mental health professional or psychologist often plays an important role when applying their forensic expertise for the purposes of establishing whether or not a child has been abused in suspected cases, or providing expert testimony to the courts regarding the nature of child abuse disclosure. The establishment of the Child Abuse Commission saw a significant rise in individuals going before the Irish courts with complaints of sexual abuse during childhood (McElvaney, 2013). However, these delayed accusations present a number of issues for the court, including difficulties in preparing a defense for the accused and subsequent issues in prosecuting such cases, hence the Director of Public Prosecutions has traditionally been reluctant to prosecute such cases given the lack of evidence and unfair prejudice to the accused (McElvaney & O’Shea, 2001). Psychological expert testimony has been used in assisting the courts when deliberating whether delayed reporting is permissible in a given case, juxtaposing what the empirical literature has taught us regarding the processes and patterns by which experiences of abuse are disclosed, with the accused’s right to a speedy trial (see McElvaney, 2002).

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IRISH PSYCHOLOGISTS RESPONDING TO CASES OF CHILD SEXUAL ABUSE According to Lalor and McElvaney (2010) there is now consensus within the literature that the majority of victims of childhood sexual abuse do not disclose this abuse until later in adulthood, and when disclosure does occur in childhood, substantial delays are not uncommon. Indeed the Sexual Abuse and Violence In Ireland (SAVI) study (McGee et al., 2002) detailed that 47% of respondents who had experienced some form of sexual assault before the age of 17 had not told anyone prior to participation in the study. Empirical research has also identified certain patterns to the way that children and adults have historically disclosed their experiences of abuse, suggesting that disclosure of sexual abuse is sometimes a process as opposed to a single conclusive disclosure. For instance Sorenson and Snow (1991) reported that in a number of cases of abuse confirmed by corroborative evidence, a significant proportion of victims denied the abuse in their initial interview. The authors reported that in some cases children’s initial disclosures were tentative and unconvincing, and that subsequent sessions of questioning were necessary to draw out a credible account of the abuse. Incidences in which children recant their accusations, only to later reaffirm the accuracy of the initial disclosure have also been frequently documented (see Lyon, 1995) as have interviews in which children admit to their abuse yet downplay the severity or extent of their abuse (Sjöberg & Lindblad, 2002).

Such patterns of disclosure are arguably symptomatic of the internal conflict endured by victims of child sexual abuse. For instance in a qualitative study with 22 Irish young people who had been sexually abused, McElvaney, Greene and Hogan (2012) discuss a ‘pressure cooker effect’, representing the conflict between wanting to tell and not wanting to tell. The authors describe the numerous difficulties endured by the young people when first verbalising their abuse, describing inhibitive and incomplete disclosures in which information was withheld in addition to the enormous distress experienced when confiding in someone for the first time. While it is predominantly accepted that such patterns of disclosure are characteristic of sexually abused individuals, the fact remains that delayed and fragmented disclosures are not conducive to the operations of legal investigation and prosecution systems (McElvaney, 2013). For such reasons, psychological expert testimony pertaining to the disclosure of child sexual abuse has provided an invaluable opportunity to educate those in legal professions regarding the complexities of child sexual abuse disclosure and to depict both delayed and partial/inaccurate disclosures in an understandable light (Shannon, 2001). In a similar vein, the child interview and the psychologist’s assessment of it are also becoming increasingly important to

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court proceedings, with the psychologist often being called to proffer an opinion on the credibility of the child’s disclosure or allegations (Ceci & Bruck, 1994). Psychologists may act as the go between in child sexual abuse trials, drawing on their clinical experience or knowledge of the scientific literature in order to facilitate jurors in judging the veracity of a child’s forensic interview or courtroom testimony. Studies have suggested that the nature of the child’s disclosure during the forensic interview may influence prosecutors’ judgments of veracity or truthfulness. Castelli and Goodman (2014) reported that when children exhibited greater degrees of emotional withdrawal during disclosure in forensic interviews, prosecutors found their reports less credible relative to more emotionally charged recollections of abuse. Similarly, the prosecutors used emotional affect to evaluate whether the child could be used as a witness, which contributed to judgments of whether the case warranted prosecution. This study is demonstrative of certain unjustified expectations that a courtroom may project onto a child’s testimonial. For instance Wood, Orsak, Murphy and Cross (1996), observed the emotional displays of children during forensic interviews in suspected sexual abuse cases finding that the children predominantly demonstrated relatively neutral or stable levels of affect. Similarly, the previously mentioned study of Sjöberg and colleagues (2002) found that children tended to minimise

or downplay their experience. Such evidence is demonstrative of ways in which psychological expertise are both relevant and useful in child sex abuse court cases in that their professional opinion may sometimes help to undermine certain courtroom biases. Psychologists working to prevent incidences of Child Sexual Abuse When discussing the role of psychology in instances of child sexual abuse, the psychologist’s restorative duty to the victim is what perhaps seems most obvious. However there is also a role for the psychologist working in a preventative or rehabilitative context with those who have already abused a child or are at risk of doing so (Farrenkopf, 1992). Indeed, recent years have seen the emergence of preventative programs that target individuals who are at risk of abusing a child or engaging in other forms of child sexual exploitation such as such as child pornography use (Beier et al., 2009). At present there are two Irish programmes that have diverged from the punitive model and implement preventative interventions for the purpose of child sexual abuse prevention. The horror of Ireland’s history of child sexual abuse has understandably evoked an emotive response in the Irish public, instilling a desire for punishment and prison sentences that reflect the severity of such a

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IRISH PSYCHOLOGISTS RESPONDING TO CASES OF CHILD SEXUAL ABUSE heinous offence (Kilkelly, 2012). While it is natural for society to demand justice for those who have been victims of childhood assault, from a child protection perspective, there are a number of issues that arise when relying solely on punitive measures. Most sex-offenders will remain in prison for only a few years, (Murphy, 1998) so without concurrent preventative treatment there is no mechanism to disable established patterns of thought and behavior that lead to sexual offences (Walsh, 1998). While the mandatory treatment of offenders in prison represents a starting point in terms of child protection and indeed is in place in certain Irish correctional institutions such as Arbour Hill (Irish Prison Service, 2009), the fact remains that a significant portion of sex- offenders go undetected or do not receive prison sentences (Travers, 1998). In this regard, a punitive approach is not an entirely effective long-term approach to child protection. Acknowledging the limitations of punitive solutions, the 1980s saw the establishment of a pioneering community based treatment programme for adult male sex offenders in Letterkenny, Co. Donegal (Travers, 1998). The North Western Health Board’s community based programme for sexual offenders is comprised of a multidisciplinary a team consisting of a Consultant Psychiatrist, Psychologist, Behaviour Therapist, Social Worker and two Probation and Wel-

fare Officers, thereby providing a holistic and integrative approach to offender rehabilitation. The programme includes initial assessment, intervention and relapse prevention work in both individual and group contexts. Travers provides anecdotal evidence of the programme’s success, citing encouraging voluntary attendance levels and team members’ appraisals of client’s willingness to participate, reduced risk of reoffending and progression towards establishing a life and identity beyond their history or fear of committing sexual assault. Travers contends that for the sake of effective child protection, we need to cast aside our abhorrence for sexual offenders and to acknowledge abusers as fellow human beings. It is widely acknowledged that sexual offenders have often experienced childhood abuse themselves (Sobsey & Doe, 1991) suggesting that a proclivity to abuse may not always represent a sexual disorder or ‘immorality’ but rather a manifestation of psychological trauma. Accordingly, she advocates for the widespread integration of preventative community based sex offender treatment into Child Protection practice so as to break the vicious cycle of the abused going on to abuse. Since the establishment of the North Western programme, Ireland has only seen the development of a single additional preventative programme. Based in Dublin, One in Four runs the only other Irish therapeutic programmes

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for non- convicted sexual offenders (One in Four, 2011). One in Four’s Phoenix Programme operates on both self, family, Gardaí, Tusla, and Court referrals and works to enable offenders to confront the harm they have caused to their victims, families, etc. and to facilitate them in living lives devoid of sexually harmful behavior. Offenders work alongside a psychotherapist in a group setting over 18 months, which are divided into three distinct modules that focus on life history, offending behavior and relapse prevention. Following treatment cessation, programme participants attend maintenance groups, which provide support and try to prevent recidivism. When speaking at the launch of the organisation’s 2013 annual report, Maeve Lewis, the executive director of One in Four, claimed that since the programme’s inception in 2008 only 4 out of 114 sex offenders who underwent treatment have re-offended (O’Keefe, 2014). Experiences of sexual abuse have been shown to exert a corrosive influence on many aspects of child psychosocial functioning and in this respect the absence of a widespread Irish effort to detect or help potential offenders prior to offence constitutes a major shortcoming in the child protection constitution and legislation and practice. Irish society’s heightened awareness of sexual abuse brings with it a renewed intolerance for those who victimised Irish children and

for those who may do so in the future (McAvoy, 2012). In this regard, psychological engagement with both victims and perpetrators of abuse demonstrates Irish psychologists responding to the needs of not just the criminal justice system, but also of a society in need of reparation for past injustices. While the psychologist cannot compensate for past exploitation, if their work helps mitigate the damage of abuse or prevent future incidences, then it represents a viable means for Irish society to progress with a strengthened sense of how and why we must protect our children from sexual abuse. References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Barnardos. (n.d.). Directory of Services. Retrieved from http://www.barnardos.ie/resources-advice/were-here-tohelp/directory-of-services.html Beier, K. M., Neutze, J., Mundt, I. A., Ahlers, C. J., Goecker, D., Konrad, A., & Schaefer, G. A. (2009). Encouraging self-identified pedophiles and hebephiles to seek professional help: first results of the Prevention Project Dunkelfeld (PPD). Child abuse & neglect, 33(8), 545-549. Blanchard, G., & Tabachnick, J. (2002). The prevention of sexual abuse: Psychological and public health perspec-

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IRISH PSYCHOLOGISTS RESPONDING TO CASES OF CHILD SEXUAL ABUSE tives. Sexual Addiction &Compulsivity: The Journal of Treatment and Prevention, 9(1), 1-13. Briere, J. N., & Elliott, D. M. (1994). Immediate and long-term impacts of child sexual abuse. The future of children, 4(2), 54-69. Browne, A., & Finkelhor, D. (1986). Impact of child sexual abuse: A review of the research. Psychological bulletin, 99(1), 66. Carr, A., Dooley, B., Fitzpatrick, M, Flanagan, E., Flanagan-Howard, R., Tierney, K., White, M., Daly, M. & Egan, J. (2010). Adult adjustment of survivors of institutional child abuse in Ireland. Child Abuse and Neglect, 34, 477-489. Castelli, P., & Goodman, G. S. (2014). Children’s perceived emotional behavior at disclosure and prosecutors’ evaluations. Child abuse & neglect. 38(9), 1521-1532. Ceci, S. J., & Bruck, M. (1995). Jeopardy in the courtroom: A scientific analysis of children’s testimony. American Psychological Association. Connect. (n.d.). Connect: Professional Telephone Counselling & Support. Courtois, C.A. (1999). Recollections of Sexual Abuse: Treatment Principles and Guidelines. New York: Norton. Cunneen, C. (2006). Exploring the relationship between reparations, the gross violation of human rights, and restorative justice. Handbook of re-

storative justice: a global perspective, 355-368. Faller, K. C. (1993). Child sexual abuse: Intervention and treatment issues. Diane Publishing. Farrenkopf, T. (1992). What happens to therapists who work with sex offenders?. Journal of Offender Rehabilitation, 18(3-4), 217-224. Fitzpatrick, M., Carr, A., Dooley, B., Flanagan, Howard, R., Flanagan, E., Tierney, K., ... & Egan, J. (2010). Profiles of adult survivors of severe sexual, physical and emotional institutional abuse in Ireland. Child Abuse Review, 19(6), 387-404. Flanagan, E., Carr, A., Dooley, B., Fitzpatrick, M. Flanagan-Howard, R., Shevlin, M., Tierney, K., & White, M., Daly, M. & Egan, J. (2009). Profiles of resilient survivors of institutional abuse in Ireland. International Journal of Child & Family Welfare, 2-3, 56-73. Finkelhor, D. (1990). Early and long-term effects of child sexual abuse: An update. Professional Psychology: Research and Practice, 21(5), 325. Giarretto, H. (1982). A comprehensive child sexual abuse treatment program. Child abuse & neglect, 6(3), 263-278. Goode, H., McGee, H. M., & OB̓ oyle, C. A. (2003). Time to listen: Confronting child sexual abuse by Catholic clergy in Ireland. Dublin, Ireland: Liffey Press.

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Himelein, M. J., & McElrath, J. A. V. (1996). Resilient child sexual abuse survivors: Cognitive coping and illusion. Child abuse & neglect, 20(8), 747-758. Health Service Executive. (2013). HSE National Counselling Service prepared for publication of the Dublin Diocesan Report. Hogan, L. (2011). Clerical and Religious Child Abuse: Ireland and Beyond. Theological Studies, 72(1), 170-186. Irish Prison Service. (2009). Sex Offender Management Policy: Reducing Re-offending, Enhancing Public Safety. Kilkelly, U. (2012). Learning lessons from the past: Legal issues arising from Irelandâ&#x20AC;&#x2122;s child abuse reports. Irish Journal of Applied Social Studies, 12(1), 2. Kilpatrick, A. C. (1987). Childhood sexual experiences: Problems and issues in studying long range effects. Journal of Sex Research, 23(2), 173-196. Lalor, K., & McElvaney, R. (2010). Child sexual abuse, links to later sexual exploitation/high-risk sexual behavior, and prevention/treatment programs. Trauma, Violence, & Abuse, 11(4), 159-177. Loh, W. D. (1979). Impact of Common Law and Reform Rape Statutes on Prosecution: An Empirical Study, The. Wash. L. Rev., 55, 543. Lynskey, M. T., & Fergusson, D. M. (1997). Factors protecting against the development of adjustment dif-

ficulties in young adults exposed to childhood sexual abuse. Child Abuse & Neglect, 21(12), 1177-1190. Lyon, T. D. (1995). False allegations and false denials in child sexual abuse. Psychology, Public Policy, And Law, 1(2), 429-437. McAlinden, A. M. (2013). An inconvenient truth: barriers to truth recovery in the aftermath of institutional child abuse in Ireland. Legal Studies, 33(2), 189-214. McAvoy, J. (2012). Birds of a Feather? Irish Public Attitudes towards Sex Crime and Sex Offender Reintegration. Is there a Publically Perceived Scale of Sexual Deviance? (Unpublished Doctoral dissertation). DIT, Dublin. McElvaney R. 2002. Delays in reporting childhood sexual abuse and implications for legal proceedings. In Sex and Violence: The Psychology of Crime and Risk Assessment, Farrington DP, Hollin CR, McMurran M (eds). Routledge: London; 138â&#x20AC;&#x201C;153. McElvaney, R. (2013). Disclosure of Child Sexual Abuse: Delays, Non-disclosure and Partial Disclosure. What the Research Tells Us and Implications for Practice. Child Abuse Review. McElvaney, R., Greene, S., & Hogan, D. (2012). How children tell: Containing the secret of child sexual abuse. JOURNAL OF INTERPERSONAL VIOLENCE, 27 (6), 1155-1175.

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IRISH PSYCHOLOGISTS RESPONDING TO CASES OF CHILD SEXUAL ABUSE McElvaney, R., & O’Shea, D. (2001). Current Issues in Therapy for Adults Sexually Abused in Childhood. In K. Lalor (Eds,), The End of Innocence (pp. 89-108). Dublin: Oak Tree Press. McGee, H., Garavan, R., deBarra, M., Byrne, J., & Conroy, R. (2002). The SAVI report: Sexual abuse and violence in Ireland. Dublin, Ireland: Liffey Press. Melton, G.B., & Limber, S. (1989). Psychologists’ involvement in cases of child maltreatment. American Psychologist, 44, 1225-1233. Merrigan, T. (2015). Connect Service Report 2011-2014. Murphy, P. (1998). A therapeutic programme for imprisoned sex offenders: Progress to date and issues for the future. Irish Journal of Psychology, 19,190-207. Nolan, M., Carr, A., Fitzpatrick, C., O’Flaherty, A., Keary, K., Turner, R., ... & Tobin, G. (2002). A comparison of two programmes for victims of child sexual abuse: a treatment outcome study. Child Abuse Review, 11(2), 103-123. O’Keefe, C. (2014, October 2). Success of sex abuse treatment highlighted. The Irish Examiner.

One in Four. (2011). One in Four Annual Report 2011. O’ Shea, D., & McElvaney, R. (2001). Therapy with Sexually Abused Children. In K. Lalor (Eds,), The End of Innocence (pp. 59-88). Dublin: Oak Tree Press. Paolucci, E. O., Genuis, M. L., & Violato, C. (2001). A meta-analysis of the published research on the effects of child sexual abuse. The Journal of psychology, 135(1), 17-36. Seligman, M. E. P. (1994). What you can change and what you can’t. NY: Alfred A. Knopf. Shannon, G. (2001). Child Sexual Abuse Victims and the Legal Process. In . Lalor (Eds,), The End of Innocence (pp. 155-1988). Dublin: Oak Tree Press. Sjöberg, R.L.,& Lindblad, F. (2002). Limited disclosure of sexual abuse in children whose experiences were documented by videotape. American Journal of Psychiatry, 159(2), 312314. Sobsey, D., & Doe, T. (1991). Patterns of sexual abuse and assault. Sexuality and Disability, 9(3), 243-259.

O’Malley-Dunlop, E. (2014). The Dublin Rape Crisis Centre Annual Report 2014.

Sorensen, T., & Snow, B. (1991). How children tell: the process of disclosure in child sexual abuse. Child Welfare: Journal of Policy, Practice, and Program 70(1), 3-15.

One in Four. (2015). One in Four Strategic Plan 2015-2018.

The CARI Foundation. (n.d.). CARI’s Role.

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The National Counselling Service. (2001). The National Counselling Service for adults who have experienced childhood abuse: First Report. The Dublin Rape Crisis Centre. (2009). Annual Report and Annual Statistics 2009. Towards Healing (n.d.). Retrieved from http://www.towardshealing.ie/site/ Travers, O. (1998). Treatment v. punishment: A case for treating sex offenders in the community. The Irish Journal of Psychology, 19(1), 226-233. Walsh, P. (1998). Child sex-offenders: The case for treatment. Irish Journal of Psychology, 19,93-101. Walsh, D. & Liddy, R. (1993). Surviving sexual abuse. Dublin: Attic Press. Wolfe, D. A. (1999). Child abuse: Implications for child development and psychopathology (Vol. 10). Sage. Wood, B., Orsak, C., Murphy, M., & Cross, H. J. (1996). Semi-structured child sexual abuse interviews: Interview and child characteristics related to credibility of disclosure. Child Abuse & Neglect, 20(1), 81-92.

Student Psychology Journal, 2015, 193-201

The Effect of Early Institutional Care on Cognitive and Social-emotional development: A Critical Review Rachel Potterton Trinity College Dublin Correspondence: pottertr@tcd.ie

abstract

Institutional care for children remains prevalent worldwide, including in Central and Eastern European countries. In light of this, this paper seeks to review research into the impact of institutional care on the cognitive and social-emotional development of children. In doing so, it focuses particularly on the body of research regarding children adopted from Romanian institutions following the fall of the Ceausescu regime in 1989. The reviewed literature suggests much indirect evidence for the role of institutionalisation in producing deficits in both cognitive and social-emotional functioning. It appears, however, that significant developmental catch-up is possible following adoption and fostering, and that the shorter the period of time spent within the institutional environment, the better the outcomes. It is therefore suggested that policy should focus on the eradication of this form of care in favour of family environments. Keywords: Early institutional care; cognitive development; social-emotional development

Institutional care (IC) for children may be defined as “a group living arrangement for more than ten children, without parents or surrogate parents, in which care is provided by a much smaller number of paid adult carers” (Browne, 2009, pg. 1). IC implies “an organised, routine and impersonal structure to the living arrangements and a professional re-

lationship, rather than a parental relationship, between the adults and the children” (Browne, 2009, pg. 1). The UN estimates that up to 8 million children around the world live in IC (Pinheiro, 2006). This practice is not limited to non-Western countries and indeed remains prevalent in Central and Eastern European countries; in Romania, for example, there remained

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9,000 children living in institutions in 2012 (ARK, 2012). In light of the prevalent nature of IC, it is clearly imperative that the implications of this type of environment for child development are fully explored. The fall of the Ceausescu regime in Romania in 1989, and the subsequent large-scale release of children from institutions and their adoption into the United Kingdon (UK), Ireland and North America, inadvertently provided a unique opportunity for such exploration, and a vast body of research now exists regarding the effects of early IC within this particular population. Research has identified correlates between such conditions of early care and physical development, development of motor skills, and cognitive and socio-emotional development. This review will focus exclusively on the latter two domains, discussing and evaluating the research conducted on the impact of the Romanian institutional environment on cognitive and social-emotional development. Impact on Cognitive Development The English Romanian Adoptees (ERA) study team, headed up by Michael Rutter, examined cognitive development in 165 children who had lived in Romanian institutions before being adopted to the UK whilst under two years of age. Children were assessed at 4, 6, 11 and 15 years of age. According to parental retrospective scoring on the Denver Develop-

mental Scales, all children, irrespective of age at time of adoption, demonstrated severe developmental delay upon entry to the UK. However, at four and six years of age (Rutter, 1998; Castle et al., 1999), the scores of those children who had been adopted before the age of six months were closely comparable to those of a sample of within-UK adoptees. Those who had been adopted later, between 6 and 24 months, meanwhile, scored significantly lower than the within-UK adoptee group. Such results suggest a dose-response trend between the institutional environment and cognitive deficit, with longer time spent in the institution associated with greater cognitive deficit. Impairment remained evident at 11 years and 15 years, although the dose-response trend had disappeared (Beckett et al., 2006). Beckett et al., 2010). However, it must be noted that the ERA study failed to control for the possible effect of pre-institutional experience. Children sent to institutions may have a significantly different genetic make-up and perinatal and prenatal experiences than those children who remain within the family environment, which may in turn effect cognitive functioning. Additionally, the unspecified nature of the independent variable of institutionalisation (beyond presence and absence) and the retrospective scoring used to assess developmental progress are further criticisms that might be directed at ERAâ&#x20AC;&#x2122;s

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EARLY INSTITUTIONAL CARE work. A smaller scale study by Morison and Elwood (2000), of 35 children adopted from Romanian orphanages into Canada, addressed some of these methodological flaws. This study controlled for pre-institutional experience by including a sample of 24 Romanian children who would have gone into institutions, had they not been adopted before four months, as a comparison group. These children presumably have a similar genetic, prenatal and perinatal background to the institutionalised children, given that they are likely to have come from the same type of parents. Morison and Ellwood also attempted to specify the independent variable, and measure empirically the nature of deprivation experienced by individual children within their respective institutions, by asking parents questions about their child’s institutional experience (e.g. whether their child had toys to play with). Despite these methodological improvements, Morison and Ellwood’s results were in line with Rutter’s, reporting that, at four and a half years, of the three groups, Canadian-born children performed best, institutionalised children performed worst and the children adopted before four months were in the middle. Within an Irish context, there are no directly comparable studies of children adopted from Romanian institutions. However, one study by Greene et al. (2006) followed up 180 children, 70% of whom had been in institutions, adopted

into Ireland from 15 different jurisdictions including Romania. In line with the ERA study team and Morison and Elwood’s results, analysis indicated that the adopted children’s cognitive performance was lower than that of non-adopted Irishborn children matched for socio-economic background. Correlation does not equal causation, however, and alternative interpretations of the observed dose-response might be suggested. For example, length of time in the institution is confounded with length of time spent within the adoptive family in these studies. It could therefore be suggested that cognitive abilities post-institutionalisation are not related to duration of time spent in the institution, but how long the child has lived within the adoptive home environment. Indeed, Morison and Ellwood’s study utilised the Home Observation for Measurement of the Environment (HOME) questionnaire, which is designed to assess the level of support and stimulation available to the child within the family home. The results reported that, having controlled for the amount of time spent in the institution and developmental delay upon adoption, HOME scores accounted for a significant amount of variance in the Romanian children’s scores. This suggests that the adoptive home, and the stimulation it provides, may have an important role in cognitive development. However, the direction of this relationship might be

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questioned, as it could be suggested that children experiencing cognitive deficits will demand less and be less responsive to stimulation, which could in turn lead to less stimulation on the part of the parents, as reflected in low HOME scores. Length of exposure to the institutional environment is also frequently confounded with the age of the child, and it might be suggested that deficit is not produced by length of exposure to the environment, but exposure within a key time-frame, a sensitive period. Such a theory is supported, as McCall (2011) notes, by the observation that, beyond a certain age, length of time in the institution does not increase the risk of later deficits. McCall concludes for a combination of both the dose-response and sensitive period theories, suggesting that it is length of exposure within a particular window of age (e.g. one to two years) that determines developmental outcomes. In summary, although causation has not been proven, studies suggest that IC is associated with poorer cognitive outcomes, and the degree of cognitive deficit is linked with the amount of time spent within the institutional environment. However, scant information about the nature of deprivation experienced means that what exactly it is that impedes cognitive development, and the mechanism by which this exerts its influence, is a matter that needs further research. Both poor nutrition (Politt, Gorman, Engle, Martorell & Rivera, 1993) and psychosocial depri-

vation (MacPhee, Ramey &Yeates, 1984) have been found to predict cognitive development in non-institutionalised samples. However, Rutter (1998) suggests that, among this sample, psychological privation may be more influential than nutritional privation. Such a proposition is supported by the observation, by both Rutter and Morison and Elwood that weight at time of adoption was not a significant predictor of later cognitive development.

Impact on social-emotional development

The ERA study reported no significant difference between the Romanian adoptees and the control group on an overall measure of emotional and conduct disturbance (Rutter et al., 2001). However, internalising problems were more common in adoptees than in the control group at 11 years. Marcovitch and colleagues (1997) examined social-emotional development using the Child Behaviour Checklist (Achenbach & Rescorla, 2000), which is a scale designed to identify both internalising behavioural problems and internalising emotional problems, and found that this group scored significantly higher on the checklist than comparison groups. The literature is therefore somewhat inconclusive regarding the effects of IC on rates of internalising and externalising behaviour.

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EARLY INSTITUTIONAL CARE More clear are a number of patterns of behaviour which appear to be unique consequences of institutionalisation, one such pattern being quasi-autistic behaviour. The ERA study found quasi-autistic behaviours, present in a dose-response manner, in adoptees at both 4 and 6 years (Rutter et al., 2003). At age 4, the behaviours were indistinguishable from “ordinary” autism but by age six they were present to a less apparent degree than in those with a traditional autism diagnosis. Interestingly, the dose-response trend was no longer present at 11 years, and only a minority of children retained quasi-autistic behaviours (Rutter et al., 2007); the reasons for this are not readily apparent. Quasi-autistic behaviour was also reported by Greene and colleagues (2006), with poor eye contact, oversensitivity to sound and dislike of physical contact present in a small minority of children. Additionally, several researchers have noted indiscriminate friendliness, characterised by disinhibited social approach behaviours, in these populations. The ERA study noted indiscriminate friendliness, and a dose-response trend, at 4, 6 and 11 years (O’Connor, Bredenkamp, Rutter, & the ERA Team, 1999; O’Connor, Rutter, & the ERA Team, 2000, Rutter et al., 2007). Meanwhile, Chisholm et al. (1998) reported, in the Canadian sample mentioned above in relation to cognitive development, that almost three-quarters of the adoptive parents of institutionalised

children describing their children as “overly friendly”. In Greene and colleagues’ (2006) Irish study approximately 20% of the children were described by their parents as having persistent problems with indiscriminate friendliness. Interestingly, the relationship between indiscriminate friendliness and attachment behaviour remains unclear. Rutter (2007) suggests that the two are separate, and indiscriminate friendliness is not a manifestation of attachment insecurity, as secure attachment to the mother may be present in conjunction with atypical responses to strangers. Chisholm and colleagues (1998) investigated whether institutionalisation effects the capacity of children to form secure attachments to adoptive parents. The study utilised a behavioural measure of attachment, a separation-reunion procedure, and found that the Romanian group displayed significantly more insecure attachment behaviours than both the Canadian group and the early-adopted group. These results were corroborated by Marcovitch and colleagues (1997) in another distinct sample of Romanian children adopted into Canada, who measured attachment behaviour using the Strange Situation paradigm among a sample of three and a half year olds who had spent more than six months in IC. The study reported significantly lower levels of secure attachment among the previously institutionalised children than among an early adopted group. These results therefore appear to

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suggest that formerly-institutionalised children are more likely to form insecure attachments. Attentional difficulties and over-activity are another recurring theme within the literature. In the ERA study, a dose-response trend was evident up to 11 years (Kreppner, Oâ&#x20AC;&#x2122;Connor, Rutter, & the ERA Team, 2001; Stevens et al., 2007). In Ireland, Greene and colleagues (2006) reported that one quarter of the children were deemed to have ongoing problems with distractibility and sustaining attention, with those who had been adopted after the age of 18 months judged to have particularly severe problems with hyperactivity. It must be noted that these studies are subject to the same limitations described earlier in relation to research into cognitive development; namely, the length of time in IC is frequently confounded with length of time spent in adoptive families and length of exposure to the institutional environment is often confounded with the age of the child. However, the research clearly suggests that early IC is at least associated with a range of adverse social-emotional outcomes, including quasi-autistic behaviour, indiscriminate friendliness, insecure attachment and hyperactivity. Conclusion The literature suggests much indirect evidence for the role of institutionalisa-

tion in producing deficits in both cognitive and social-emotional functioning. Within an international context, such findings have important implications for both policy-makers and those practicing within the child welfare sector, suggesting that efforts should be focused towards the eradication, or at the very least improvement, of this form of care in favour of family environments. To achieve this, policy and practice should focus on preventative measures; developing interventions, for instance, which challenge the barriers that prevent parents from keeping children within the family environment. Research suggests that significant developmental catch-up is possible following adoption and fostering, and that the shorter the period of time spent within the institutional environment, the better the outcomes. It is apparent that, with regard to those children already exposed to early IC, policy should focus on moving these children towards alternative family-based forms of care as soon as possible. Encouragingly, this research appears to have been disseminated quite effectively with many countries pledging to move away from IC; the Romanian government, for instance, recently committed to ending IC for those under three years (ARK, 2012). While care within a family environment is seen as the ideal, it is unlikely that it will be possible to end the institutionalisation of children immediately. Keeping this in mind, it is important to note that practices within institutions may be improved to

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EARLY INSTITUTIONAL CARE reduce detrimental impact. While research into what exactly within the institutional environment produces deficits is limited, it is still possible to improve institutions. As McCall (2011) notes, the first requirement for the successful implementation of intervention is to communicate to those in charge and those working in institutions the consequences of traditional IC, and then develop programmes which train caregivers on how to interact with the children in order to optimise developmental outcomes. The structural environment within the institution may also need to be changed with, for example, the reduction of child to caregiver ratios and staff turnover levels. Indeed, an intervention study by Smyke, Dumitrescu and Zeanah (2002) demonstrates the difference structural changes within the orphanage environment can make to developmental outcomes. Smyke and colleaguesâ&#x20AC;&#x2122; pilot unit reduced the caregiver to child ratio in a Romanian institution from 16:1 to 4:1, and caregivers subsequently reported fewer signs of aggression, stereotyped behaviour and attachment disorder in the children. Within an Irish context, the research into the impact of IC on child development suggests that post-institutionalisation is far from a walk in the park, and parents need to be aware of the challenges associated with adopting a child from an institution, even as compared to other adoption pathways. Policy and practice within international adoption therefore needs to focus on the

education of parents as to the special needs of their children. Given the research evidence that suggests the important role of the adoptive environment in developmental catch-up, parents must be educated as to how to provide the highest quality home environments for their children, in order to maximise their developmental potential and overcome their difficult start to life. References Achenbach, T. M., & Rescorla, L. (2000). ASEBA Preschool Forms & Profiles: An Integrated System of Multi-informant Assessment. Aseba. ARK (2012). Annual Report. Beckett, C., Maughan, B., Rutter, M., Castle, J., Colvert, E.Groothues, C. 2006. Do the effects of early severe deprivation on cognition persist into early adolescence? Findings from the English and Romanian Adoptees study. Child Development, 77: 696â&#x20AC;&#x201C;711. Beckett, C., Maughan, B., Rutter, M., Castle, J., Colvert, E.Groothues, C. (2010). Scholastic attainment following severe early institutional deprivation: A study of children adopted from Romania. Journal of Abnormal Child Psychology. Browne, K.D. (2009). The Risk of Harm to Young Children in Institutional Care. Chisholm, K. (1998). A Three Year Follow- up of Attachment and Indiscriminate Friendliness in Children Adopt-

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ed from Romanian Orphanages. Child Development, 69(4), 1092-1106. Chisholm, K., Carter, M. C., Ames, E. W., & Morison, S. J. (1995). Attachment security and indiscriminately friendly behavior in children adopted from Romanian orphanages. Development and Psychopathology, 7 (2), 283-283. Greene, S., Kelly, R., Nixon, E., Kelly, G., Borska, Z., Murphy, S., ... & Murphy, C. (2006). A study of intercountry adoption outcomes in Ireland main and summary report. Adoption Authority of Ireland. Kreppner, J., O’Connor, T. G., Rutter, M. and the English and Romanian Adoptees Study Team. 2001. Can inattention/overactivity be an institutional deprivation syndrome? Journal of Abnormal Child Psychology, 29: 513–528. MacPhee, D., Ramey, C. T., & Yeates, K. O. (1984). Home environment and early cognitive development: Implications for intervention. In A.W Gottfried (Ed.), Home environment and early cognitive development: Longitudinal Research, 343-369. New York: Academic. Marcovitch, S., Goldberg, S., Gold, A., Washington, J., Wasson, C., Krekewich, K., & Handley-Derry, M. (1997). Determinants of behavioural problems in Romanian children adopted in Ontario. International Journal of Behavioral Development, 20(1), 17-31.

McCall, R. B. (2011). IX. Research, practice, and policy perspectives on issues of children without permanent parental care. Monographs of the Society for Research in Child Development, 76(4), 223-272. Morison, S. J., & Ellwood, A. L. (2000). Resiliency in the aftermath of deprivation: A second look at the development of Romanian orphanage children. Merrill-Palmer Quarterly 46 (4), 717-737. O’Connor, T. G., Rutter, M., Beckett, C., Keaveney, L., & Kreppner, J. M. (2000). The Effects of Global Severe Privation on Cognitive Competence: Extension and Longitudinal Follow-up. Child development, 71(2), 376-390. O’Connor, T. G., Bredenkamp, D., Rutter, M. and the English and Romanian Adoptees Study Team. 1999. Attachment disturbances and disorders in children exposed to early severe deprivation. Infant Mental Health Journal, 20: 10–29. Pinheiro, P.S. (2006). World Report on Violence against Children. New York: UNICEF. Pollitt, E., Gorman, K. S., Engle, P. L., Martorell, R., Rivera, J., Wachs, T. D., & Scrimshaw, N. S. (1993). Early supplementary feeding and cognition: effects over two decades. Monographs of the Society for Research in Child Development, 58 (7), i-118. Rutter, M. (1998). Developmental Catchup, and Deficit, Following Adoption

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EARLY INSTITUTIONAL CARE after Severe Global Early Privation. Journal of Child Psychology and Psychiatry, 39(4), 465-476. Rutter, M. L., Kreppner, J. M., & O’Connor, T. G. (2001). Specificity and heterogeneity in children’s responses to profound institutional privation. The British Journal of Psychiatry, 179(2), 97-103. Rutter, M., Andersen-Wood, L., Beckett, C., Bredenkamp, D., Castle, J., Groothues, C., ... & O’Connor, T. G. (1999). Quasi-autistic Patterns Following Severe Early Global Privation. Journal of Child Psychology and Psychiatry, 40(4), 537-549. Rutter, M., Beckett, C., Castle, J., Colvert, E., Kreppner, J., Mehta, M., ... & Sonuga-Barke, E. (2007). Effects of profound early institutional deprivation: An overview of findings from a UK longitudinal study of Romanian adoptees. European Journal of Developmental Psychology, 4(3), 332-350. Rutter, M., Colvert, E., Kreppner, J., Beckett, C., Castle, J., Groothues, C., ... & Sonuga-Barke, E. J. (2007). Early adolescent outcomes for institutionally-deprived and non-deprived adoptees. I: Disinhibited attachment. Journal of Child Psychology and Psychiatry, 48(1), 17-30. Smyke, A. T., Dumitrescu, A., & Zeanah, C. H. (2002). Attachment disturbances in young children. I: The continuum of caretaking casualty. Journal of the American Academy of Child & Adolescent Psychiatry, 41(8), 972982.

Stevens, S. E., Sonuga-Barke, E. J., Kreppner, J. M., Beckett, C., Castle, J., Colvert, E., ... & Rutter, M. (2008). Inattention/overactivity following early severe institutional deprivation: presentation and associations in early adolescence. Journal of Abnormal Child Psychology, 36(3), 385-398.

Student Psychology Journal, 2015, 202-214

A Critical Account of Key Neurological Features of Parkinson’s Disease Katie Ryan University College Dublin Correspondence: katie.ryan.3@ucdconnect.ie

abstract

Parkinson’s disease is a progressive neurodegenerative condition. It is diagnosed by motor and non-motor symptoms. There is no known cause for Parkinson’s, but genetic (misfolding of the a-synuclein protein of Lewy bodies) and environmental (exposure to iron and copper) risk factors are associated with the disease. Ageing is the most common risk factor. Cognitive deficits such as working memory problems, verbal fluency issues, difficulty with spatial processing, and attention difficulties are critical features of Parkinson’s. Structural abnormalities are present at a mesencephalic level, cortical level and in the basal ganglia. Recent studies have also shown changes in the brainstem of patients with Parkinson’s. Functional Magnetic Resonance Imaging and Positron Emission Tomography are often employed to investigate neural mechanisms responsible for cognitive and functional symptoms. Treatment includes subsidising lost dopamine with Levodopa; which alleviates symptoms but does not cure the disease. Further research using structural and functional methodology to examine the biological markers of Parkinson’s Disease is critical. Keywords: ageing, muscular rigidity, working memory, mitochondrial dysfunction, dopamine, substantia nigra pars compacta

Parkinson’s Disease is a progressive neurodegenerative condition (MacPhee & Stewart, 2012). It is one of the most common neurodegenerative disorders, following Alzheimers Disease (Barone, 2010). There is no diagnostic test for Parkinson’s Disease, rather it is defined

and diagnosed by its symptoms (Barone, 2010). Parkinson’s can be characterised by both motor and non-motor symptoms. Motor symptoms include muscular rigidity, slowness of movement, tremors, imbalance and difficulty walking (Mazzoni, Shabbott & Cortes, 2012). Non-motor

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NEUROLOGICAL FEATURES OF PARKINSON’S DISEASE symptoms include fatigue, pain in limbs, difficulty sleeping, taste and smell disservices, neuropsychiatric symptoms and autonomic dysregulation (Barone, 2010). Parkinson’s Disease is significantly more prevalent among the older population, and the condition also worsens after onset with ageing (MacPhee et al., 2012). Early onset Parkinson’s Disease is thought to occur as a result of mutations in genes that cause mitochondrial dysfunction (Reeve, Simcox & Turnbull, 2014). Cells in the substantia nigra are especially susceptible to mitochondrial dysfunction, which accumulates within these cells with age (Reeve et al., 2014). This mechanism is also a risk factor for ‘normal’ Parkinson’s disease, but it occurs more rapidly in early onset Parkinson’s. Aetiology & Risk Factors There is no known cause for Parkinson’s disease, but extensive research has shown that there are certain risk factors associated with the onset of the disorder. Both genetics and environmental factors may play a role (Nuti et al., 2004). As a result of recent research, there has been a growth in knowledge of genetic factors that contribute to Parkinson’s Disease (Lewis & Cookson, 2012). Research has shown that the a-synuclein protein is the main component of Lewy bodies, and mis-folding of this protein is a genetic risk factor for the disorder (Bonifati, 2014). Lewy bodies are neuronal inclusions found in the substantia nigra, and they

are present in most cases of Parkinson’s disease (Gibb & Lees, 1988). Lewy bodies deplete dopamine, which cause motor deficits in Parkinsosn’s disease (Lee & Gibbs, 1988). In addition, mutations of the LRRK2 gene are commonly found in brains of patient’s with Parkinson’s Disease (Doggett et al., 2012). However, it is difficult to reach conclusive results with regards to genetic risk factors as there are very few known biological markers for the condition (MacPhee et al., 2012). Three blood biomarkers that appear to be associated with Parkinson’s have been identified and replicated (Chahine, Stern, Chen-Plotkin, 2014). Lower uric acid levels may be a risk factor for severity of motor symptoms in Parkinson’s, lower Plasma ApoaA1 levels are a risk factor, and lower plasma EGF levels may be a risk factor for cognitive deficits in Parkinson’s (Chahine et al., 2014). Further identification of biological markers that could predict the onset of Parkinson’s disease would be a breakthrough to diagnose preclinical Parkinson’s pathology (Stern, Lang, Poewe, 2012; Miller & O’Callaghan, 2014). Environmental factors such as exposure to iron, copper and agricultural chemicals are also substantial risk factors (Nuti et al., 2004). The toxin MPTP is a risk factor that causes very similar symptoms to Parkinson’s disease (Katagiri et al., 2010). MPTP destroys dopamine neurons, which causes motor deficits as seen in Parkinson’s disease (Verhave et al.,

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2012). Investigation into functional impairments caused by MPTP is critical for research into the possible treatments for Parkinson’s, as symptoms for both result from loss of dopaminergic function. Ageing is the largest risk factor for developing Parkinson’s Disease (Hindle, 2013). With age a number of physiological processes, which are necessary for the functioning of the substantia nigra, deteriorate (Reeve et al., 2014). For example, dopamine metabolism declines with age (Reeve et al., 2014). A number of studies have investigated the relationship between diet and ageing, as a possible preventative factor to delay the onset of the disease (Hipkiss, 2014). It has been found that certain dietary components may be risk factors for the onset of Parkinson’s disease (Hipkiss, 2014). Research has indicated that excessive intake of carbohydrates can cause mitochondrial dysfunction (Hipkiss, 2014). As mitochondria are involved in the regulation of calcium homeostasis, cellular quality and cell death pathways; mitochondrial dysfunction leaves dopaminergic neurons vulnerable to the degeneration seen in Parkinson’s disease (Winklhofer & Haass, 2010). Structural & Biochemical Brain Effects

There are a vast amount of structural abnormalities associated with Parkinson’s. Magnetic Resonance Imaging is one of the most commonly used methods

to investigate structural abnormalities in this disorder (Ibarretxe-Bilbao, Junque, Marti & Tolosa, 2011). In particular, Voxel Based Morphometry (VBM) and Region of Interest (ROI) imaging are frequently employed methods of analysis (Ibarretxe-Bilbao et al., 2011). The main anatomical changes that occur in the brain of a Parkinson’s patient can be seen on a mesencephalic level, cortical level and in the basal ganglia (Peran et al., 2010). Parkinson’s Disease occurs due to the degeneration of melanin-containing cells in the substantia nigra pars compacta, which are involved in the production of dopamine (Mazzoni, et al., 2012). Within the substantia nigra pars compacta of a healthy brain, dopamine producing cells project to the putamen and caudate (Martinu & Monchi, 2013). As they make contact with the putamen and the caudate, dopamine is utilized and discharged as a transmitter (Martinu & Monchi, 2013). In the brain of a Parkinson’s patient this process does not occur due to the reduced volume of dopamine producing cells (Martinu & Monchi, 2013). The substantia nigra plays an important role in motor function, thus the dysfunction of this system causes motor impairments associated with Parkinson’s disease (MacPhee et al., 2012). Bunzeck et al. (2013) completed a study using MRI to investigate the structural changes within a Parkinson’s brain. They

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NEUROLOGICAL FEATURES OF PARKINSON’S DISEASE employed a whole head MRI T1 scan to investigate abnormalities in the basal ganglia. This study found that patients with Parkinson’s Disease illustrated reduced volume in the substantia nigra, along with larger putamen volumes than the healthy controls (Bunzeck et al., 2013). They also concluded that increased iron levels were present in the caudate, putamen and the thalamus. These increased iron levels were associated more with patients suffering from tremor symptoms rather than rigidity (Bunzeck et al., 2013). Patients with Parkinson’s exhibited a reduced level of dopamine in the internal globus pallidus (Bunzeck et al., 2013). However, this study found no difference in the volume of the caudate, palladium or the thalamus. Parkinson’s Disease also exhibits changes at a cortical level. Melzer et al.’s (2012) study used structural T1 MRI scans to investigate grey matter deterioration in the brain due to Parkinson’s. An evaluation of brain scans was carried out using Voxel Based Morphometry (VBM). This study found that there was a reduction in grey matter volume for Parkinson’s patients with mild cognitive impairments, and much more severe grey matter atrophy for Parkinson’s patients with dementia. They concluded that there was no grey matter reduction for patients with Parkinson’s disease that did not possess cognitive deficits (Melzer et al., 2012). This indicates that structural

brain changes differ across patients with Parkinson’s disease, depending on the severity of symptoms they possess. In comparison, Agosta et al. (2014) found that grey matter atrophy was not associated with mild cognitive impairments. However, this study used Diffusion Tensor Imaging (DTI), which is more efficient at detecting white matter abnormalities than grey matter (Assaf & Pasternak, 2008). Agosta et al.’s (2014) study did find that there was reduced white matter volume in patients with Parkinson’s disease than the controls, and most of the damage was in the frontal cortex. Recent MRI VBM and DTI studies have also illustrated changes in the brainstem of patients with Parkinson’s disease (Tuite, Mangia, Tyan, Lee, Garwood & Michaeli, 2012). Brain stem abnormalities are difficult to detect using MRI, therefore there has been little research carried out to investigate this structural deficit (Tuite et al., 2012). Tuite et al. (2012) employed a new rotating frame adiabatic MRI technique, and found a difference in the midbrain and medullary brain stem between healthy controls and Parkinson’s patients. Further research into structural abnormalities in the brain stem is critical, as Tuite et al. (2012) suggest that they may underlie both non-motor and motor symptoms of Parkinson’s disease.

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Cognitive Deficits Mild cognitive deficits are present in most cases of Parkinson’s Disease, although the degree of cognitive impairment varies across individuals (Baggio et al., 2014). Common cognitive deficits of Parkinson’s are working memory problems, verbal fluency issues, slowed thinking, difficulty with imagery and spatial processing, problems with learning, and attention difficulties (McKinlay, Grace, Dalrymple-Alford, Roger, 2010). Cognitive symptoms of Parkinson’s can begin to emerge at early stages of the disease (Davidson et al., 2013). Dementia is commonly developed with age among Parkinson’s patients, but the cognitive deficits associated with Dementia are much more severe (Hindle, 2013). As a result, much of the literature on this disorder distinguishes between Parkinsons patients with dementia and without. The nature of cognitive deficits in Parkinson’s are not fully understood, and require further research to come to conclusions about the structural abnormalities that underpin them (MacDonald et al., 2013). Three cognitive deficits that have been recently researched are working memory, verbal fluency and attention. Working memory problems are common cognitive deficits in Parkinson’s (Foster, Yung, Drago, Cruciam & Heilman, 2013). Impairment in the frontostiatal circuitry causes working memory

problems, as the basal ganglia and prefrontal cortex play a central role in this function (Foster et al., 2013). Source memory is also impaired in Parkinson’s patients (Drag, Bieliauskas, Kaszniak, Bohnen & Glisky, 2009). This includes memory for perceptual, spatial and temporal contexts that the stimulus was present in (Davidson et al., 2013). Source memory relies on the prefrontal cortex which is affected by the loss of dopaminergic cells in Parkinson’s (Drag, et al., 2009). Drag and associate’s (2009) study indicates that Parkinson’s patients had impaired source memory, compared to healthy adults. However, source memory deficits have only been researched in recent years, and some studies have also shown that source memory is not impaired in Parkinson’s patients. Davidson and co-workers (2013) investigated source memory in Parkinson’s patients who had intact item memory, using neuropsychological and memory tasks. They used a memory laboratory task, where participant were required to remember voice, temporal and spatial source memory lists. It was found that there was no greater cognitive deficit in source memory for Parkinson’s patients than healthy age-matched controls (Davidson et al., 2013). However, this may be because their sample size was too small to detect significant impairments, but minor source memory problems may still be present (Davidson et al., 2013). As source memory has only recently been investigated

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NEUROLOGICAL FEATURES OF PARKINSON’S DISEASE in Parkinson’s literature, further investigation is needed based on its association with the prefrontal cortex, which relies heavily on dopaminergic functioning (Drag et al., 2009). Dopamine plays a critical role in the prefrontal cortex, as it controls access to consciousness (Botha & Carr, 2012). Therefore, many people suffering from Parkinson’s experience problems with attention as a result of degeneration of dopamine producing-cells (Botha et al., 2012). However, attention deficits in Parkinson’s Disease patients have been infrequently researched using laboratory tasks (Dujardin, Tard, Duhamel, Delval, Moreau, Devos & Defebvre, 2013). A recent study by Dujardin and associates (2013) used a computer task to assess attention in patients with non-demented Parkinson’s Disease. This study found that participants with Parkinson’s Disease had greater reaction times on the tasks than controls, illustrating that their cognitive skills were lower than healthy adults (Dujardin et al., 2013). While reduced attention is a significant symptom of Parkinson’s disease, attentional deficits increase in severity in Parkinson’s disease with dementia (Peralta et al., 2007) Difficulty with verbal fluency is another cognitive deficit associated with Parkinson’s Disease. Verbal fluency tasks are often used to measure this deficit (Ko-

erts, Meijer, Colman, Tucha, Lang & Tucha, 2013). A recent study using the FAS task demonstrated that patients with Parkinson’s disease are impaired in generating verbal responses and switching strategies on verbal tasks (Jaywant, Musto, Neargarder, Gilbert & Cronin-Golomb, 2014). In addition, they note that verbal fluency deficits may vary across individuals, depending on the severity of the disease (Jaywant et al., 2014). Functional Brain Abnormalities A great amount of research has also been done to investigate functional abnormalities in Parkinson’s disease. Functional Magnetic Resonance Imaging (FMRI) and Positron Emission Tomography (PET) are common methods employed to investigate the neural mechanisms responsible for cognitive and functional symptoms of Parkinsons Disease. One area that has received a large amount of investigation is executive functioning, particularly implicit learning (Schendan, Tinaz, Maher & Stern, 2013). Implicit learning, along with working memory, is associated with the basal ganglia. Schendan et al. (2013) used FMRI combined with sequence memory tasks to investigate the changes that occur in the frontostriatal and mediotemporal lobe with age, that affect learning. T1 scans were used as they provided high resolution images (Schendan et al., 2013). The FMRI images of Parkinson’s affected

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brains were mapped onto saggital, axial and coronal templates of healthy brains to compare activation in each area (Schendan et al., 2013). Results exhibited greater activation in the frontostriatal and mediotemporal lobes with sequencing tasks for younger, control participants than for Parkinson’s patients. Parkinson’s patients demonstrated a reversed pattern, which was greater activation of these areas for random tasks. This study revealed that the frontostriatal and the mediotemporal lobes are affected by Parkinson’s disease, which in turn causes impaired implicit sequence learning. A reduction in efficacy of sequence learning occurs with normal ageing, but the changes were amplified in a Parkinson’s brain (Schendan et al., 2013). FMRI scans have been used to assess brain areas involved in olfaction. One of the first symptoms to occur in Parkinson’s disease is olfactory loss (Haehner, Hummel, Hummel, Sommer, Junghanns & Reichmann, 2007). A recent FMRI study showed that different brain areas are activated for olfactory processing in Parkinson’s patients than healthy controls (Hummel, Fleissbach, Abele, Okulla, Reden, Reichmann, Wullner & Haehner, 2010). Hummel et al.’s (2010) study presented Parkinson’s patients and controls with pleasant and unpleasant olfactory stimuli during FMRI, and found that different brain areas are activated in the Parkinson’s brain compared to the control.

When presented with pleasant olfactory stimuli, both groups illustrated activation of typical olfactory processes, such as the amygdala, thalamus and hippocampus (Hummel et al., 2010). However, when presented with unpleasant smells, there was reduced activation in Parkinson’s patient’s amygdala and thalamus (Hummel et al., 2010). This finding supports structural research findings that the degeneration of dopamine producing cells in the basal ganglia impairs other brain structures, causing functional deficits. However this study did not include Parkinson’s patients suffering from dementia (Hummel et al., 2010), but this exclusion should not weaken the findings as dementia is usually developed at the latest stages of the disease. Olfaction is one of the first processes to deteriorate with Parkinson’s disorder. In addition, it did not include any smokers (Hummel et al., 2010). Smoking is thought to be a protective factor for Parkinson’s disease, as it may prevent degeneration of dopaminergic cells (Moccia et al., 2014). Therefore, the exclusion of smokers from Hummel et al.’s (2010) study increases the validity of results demonstrating that olfactory ability diminishes with Parkinson’s disease. Motor Deficits

While cognitive deficits associated with Parkinson’s disease have been most frequently studied in recent years,

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NEUROLOGICAL FEATURES OF PARKINSON’S DISEASE Parkinson’s remains commonly classified as a ‘motor disease’ (Louis, 2015). Resting tremor, rigidity of movement and gait disturbances are all symptoms of the disease that have a significant impact on Parkinson’s patients’ quality of life (Louis & Machado, 2015). Recent research has revealed that tremors can have a huge impact on both the patient’s physical and psychological well-being (Louis & Machado, 2015). This is an important finding with regards to treatment, as the efficacy of medication often does not take into account psychological well-being (Louis & Machado, 2015). Future research should take into consideration the broader impact tremors can have on the lives of patient’s with Parkinson’s disease (Louis & Machado, 2015). Gait disturbances are also a common feature of Parkinson’s that have a severe impact on daily life (Forsaa, Larsen, Wentzel-Larsen & Alves, 2015). The pathophysiology of gait disturbances in Parkinson’s is complex, thus recent research has focused on uncovering the brain regions and neurobiological mechanisms involved (Forsaa et al., 2015). Electroencephalography has been used to measure brain activity during gait disturbances in Parkinson’s (Rochester, Yarnall, Baker, David, Lord, Galna & Burn, 2012). Rochester et al. (2012) used an instrumented walkway to examine the gait of Parkinson’s patients while monitoring brain activity using motor evoked poten-

tials (Rochester et al., 2012). There is evidence that cholinergic dysfunction causes gait disturbances in Parkinson’s patients, thus a Short Latency Afferent Inhibition (SAI) test was employed to examine the sensorimotor cortex. The sensorimotor cortex depends on cholinergic systems (Rochester et al., 2012). Results of this study exhibited that reduced SAI correlated with poor gait functioning (Rochester et al., 2012). This indicates that cholinergic dysfunction in Parkinson’s brain does cause gait disturbances (Rochester et al., 2012). However, this study did not exclude patients that were on medication to relieve motor symptoms. As dopaminergic medication is often prescribed to patients with Parkinson’s, it is possible that these extraneous variables may have improved gait performance and had an impact on the results. An older study done by Karachi et al. (2010) did also find that cholinergic dysfunction caused gait deficits in monkeys that were injected with MPTP. This provides support for Rochester and associate’s (2012) findings, but further investigation on non-medicated human brains is needed to come to a valid conclusion about the role of cholinergic dysfunction in gait disturbances for Parkinson’s. Treatment for Parkinson’s Disease & Suggestions for Future Research Parkinson’s Disease is a pressing neurodegenerative condition in the field of Psy-

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chology, that has received a huge amount of research. It is clear from empirical evidence that there are many underlying structural and functional deficits associated with Parkinson’s Disease, but no cure has yet been found (Martinu & Monchi, 2013). Most research in the last three years has focused on cognitive symptoms rather than motor symptoms, as there is less general consensus about the cognitive features of this disease. Treatment for Parkinson’s includes subsidising lost dopamine with the drug Levodopa (Martinu et al., 2013). This alleviates symptoms, but does not cure the disease. It also may cause unpleasant side-effects, such as dyskinesia (Heumann et al., 2014). Stem cell research has suggested that the implementation of fetal cells that can produce dopamine would be a more effective treatment (Svendsen, 2007). Deep brain stimulation has also been used to alleviate motor symptoms in Parkinson’s disease (Cilia et al., 2007). Research has illustrated that subthalmic nucleus-deep brain stimulation improves motor symptoms in Parkinson’s patients, and reduces the level of medication needed (Cilia et al., 2007). However, deep brain stimulation as a method of treatment must be used with caution, as patients often experience reduced cognitive functioning and verbal fluency as a result (Gaspari et al., 2006).

While there is a variety of treatment

available to alleviate Parkinson’s disease symptoms, present research remains focused on curing the disease. Further research using structural and functional methodology to uncover biological markers of Parkinson’s Disease would be crucial for developing a cure. References Agosta, F., Canu, E., Stefanova, E., Sarro, L., Tomic, A., Spica, V., Comi, G., Kostic, V.S., Filippi, M. (2014). Mild Cognitive Impairment in Parkinson’s Disease Is Associated With a Distributed Pattern of White Matter Damage. Human Brain Mapping, 35 (5), 1921 – 1929. Assaf, Y., Pasternak, O. (2008). Diffusion Tensor Imaging (DTI)- Based White Matter Mapping in Brain Research: A Review. Journal of Molecular Neuroscience, 34 (1), 51 – 61. Baggio, H.C., Llonch, R.S., Segura, B., Marti, M.J., Valldeoriola, F., Compta, Y., Tolosa, E., Junque, C. (2014). Functional Brain Networks and Cognitive Deficits in Parkinson’s Disease. Human Brain Mapping, 35 (9), 4620 – 4634. Barone, P. (2010). Neurotransmission in Parkinson’s Disease: Beyond Dopamine. European Journal of Neurology, 17 (3), 364 – 376. Bonifati, V. (2014). Genetics of Parkinson’s Disease – State of the Art, 2013. Parkinsonism and Related Disorders, 20 (51), 523 – 528.

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NEUROLOGICAL FEATURES OF PARKINSON’S DISEASE Botha, H., Carr, J. (2012) Attention and Visual Dysfunction in Parkinson’s Disease. Parkinsonism and Related Disorders, 18 (6), 742-747. Bunzeck, N., Singh-Curry, V., Eckart, C., Weiskopf, N., Perry, R.J., Bain, P.G., Duzel, E., Husain, M. (2013). Motor Phenotype and Magnetic Resonance Measures of Basal Ganglia Iron Levels in Parkinson’s Disease. Parkinsonism and Related Disorders, 19 (12), 1136 – 1142. Chahine, L.M., Stern, M.B., Chen-Plotkin, A. (2014). Blood-based biomarkers for Pakinson’s disease. Parkinsonism and Related Disorders, 20, 99 – 103. Cilia, R., Siri, C., Marotta, G., Gaspari, D.D., Landi, A., Mariani, C.B., Benti, R., Isaias, I.U., Vergani, F., Pezzoli, G., Antonini, A. (2007). Parkinsonism & Related Disorders, 13 (5), 290 – 294. Davidson, P.S.R., Cook, S.P., McGhan, L., Bouchard, T., Camicioli,R. (2013). Source Memory in Normal Aging and Parkinson’s Disease. Journal of Neuropsychology, 7 (2), 179 – 192. Doggett, E.A., Zhao, J., Mork, C.N., Hu, D., Nichols, R.J. (2012). Phosphorylation of LRRK2 serines 955 and 973 is disrupted by parkinson’s disease mutations and LRRK2 Pharmacological Inhibition. Journal of Neurochemistry, 120 (1), 37-45. Drag, L.L., Bieliauskas, L.A., Kaszniak, A.W., Bohnen, N.I., Glisky, E.L. (2009). Source Memory and Frontal Functioning in Parkinson’s Disease. Journal of International Neuropsy-

chological Society, 15 (3), 399 – 406. Dujardin, K., Tard, C., Duhamel, A., Delval, A., Moreau, C., Devos, D., Defebvre, L. (2013). The Pattern of Attentional Deficits in Parkinson’s Disease. Parkinsonism and Related Disorders, 19 (3), 300 – 305. Forsaa, E.B., Larsen, J.P., Wentzel-Larsen, T., Alves, G. (2015). A 12-year population-based study of freezing of gait in Parkinson’s disease. Parkinsonism and Related Disorders, 21, 254 – 258. Foster, P.S., Yung, R.C., Drago, V., Crucian, G.P., Heilman, K.M. (2013). Working Memory in Parkinson’s Disease: The Effects of Depression and Side of Onset of Motor Symptoms. Neuropsychology, 27 (3), 303 – 313. Gaspari, D.D., Siri, C., Di Gioia, M., Antonini, A., Isella, V., Pizzolato, A., Landi, A., Vergani, F., Gaini, S.M., Appollonio, I.M., Pezzoli, G. (2006). Clinical correlates and cognitive underpinnings of verbal fluency impairment after chronic subthalamic stimulation in Parkinson’s disease. Parkinsonism and Related Disorders, 12, 289 – 295. Gibb, W.R.G., Lees, A.J. (1988). The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease. Journal of Neurology, and Psychiatry, 51, 745 – 752. Haehner, A., Hummel, T., Hummel, C., Sommer, U., Junghanns, S., Reichmann, H. (2007). Olfactory Loss May be a First Sign of Idiopathic Parkinson’s Disease. Movement Disorders, 22 (6), 839 – 842.

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Heumann, R., Moratalla, R., Herrero, M.T., Chakrabarty, K., Drucker-Colin, R., Garcia-Montes, J.R., Simola, N., Morelli, M. (2014). Dyskinesia in Parkinson’s Disease: Mechanisms and Current Non-Pharmacological Interventions. Journal of Neurochemistry, 130 (4), 472 – 489. Hindle, J.V. (2013). The Practical Management of Cognitive Impairment and Psychosis in the Older Parkinson’s Disease Patient. Journal of Neural Transmission, 120 (4), 649 – 653. Hipkiss, A.R. (2014). Aging Risk Factors and Parkinson’s Disease: Contrasting Roles of Common Dietary Constituents. Neurobiology of Aging, 35 (6), 1469 – 1472. Hummel, T., Fleissbach, K., Abele, M., Okulla, T., Reden, J., Reichmann, H., Wullner, U., Haehner, A. (2010). Olfactory FMRI in Patients with Parkinson’s Disease. Frontiers in Integrative Neuroscience, 4 (125), 1- 7. Ibarretxe-Bilbao, N., Junque, C., Marti, M., Tolosa, E. (2011). Brain Structural MRI Correlates of Cognitive Dysfunctions in Parkinson’s Disease. Journal of Neurological Sciences, 310, 70 - 74. Jaywant, A., Musto, G., Neargarder, S., Gilbert, K.S., Cronin-Golomb, A. (2014). The Effect of Parkinson’s Disease Subgroups on Verbal and Non-Verbal Fluency. Journal of Clinical and Experimental Neuropsychology, 36 (3), 278 – 289.

Karachi, C., Grabli, D., Bernard, F.A., Tande, D., Wattiez, N., Belaid, H., Bardinet, E., Prigent, A., Nithacker, H-P., Hunot, S., Hartmann, A., Lehericy, S., Hirsch, E.C., Francois, C. (2010). Cholinergic Mesencephalic Neurons are Involved in Gait and Postural Disorders in Parkinson Disease. Journal of Clinical Investigation, 120 (8), 2745 – 2754. Katagiri, N., Chida, S., Abe, K., Nojima, H., Kitabatake, M., Hoshi, K., Horiguchi, Y., Taguchi, K. (2010). Preventative Effects of 1,3-Dimethyl- and 1,3-dimethyl-N-Propargyl-1,2,3,4-Terahydroisoquinoline on MPTP-Induced Parkinson’s Disease-Like Symptoms. Brain Research, 13 (21), 133 – 142. Koerts, J., Meijer, H.A., Colman, K.S.F., Tucha, L., Lange, K.W., Tucha, O. (2013). What is Measured with Verbal Fluency tests in Parkinson’s Disease Patients at Different Stages of the Disease? Journal of Neural Transmission, 120 (3), 403 – 411. Lewis, P.A., Cookson, M.R. (2012). Gene Expression in the Parkinson’s Disease Brain. Brain Research Bulletin, 88 (4), 302 – 312. Louis, E.D. (2015). Non-motor symptoms in essential tremor: A review of the current data and state of the field. Parkinsonism and Related Disorders, 1 – 4. Louis, E.D., Machado, D.G. (2015). Tremor-related quality of life: A comparison of essential tremor vs. Parkinson’s disease patients. Parkinsonism and Related Disorders, 21, 729 – 735.

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NEUROLOGICAL FEATURES OF PARKINSON’S DISEASE MacDonald, A.A., Seergobin, K.N., Owen, A.M., Tamjeedi, R., Monchi, O., Ganjavi, H., MacDonald, P.A. (2013). Differential Effects of Parkinson’s Disease and Dopamine Replacement on Memory Encoding and Retrieval. Plos One, 8 (9), 1 – 9. MacPhee, G.J.A., Stewart, D.A. (2012). Parkinson’s Disease – Pathology, Aetiology and Diagnosis. Reviews in Clinical Gerontology, 22 (3), 165 – 178. Martinu, K., Monchi, O. (2013). Cortico-Basal Ganglia and Cortico-Cerebellar Circuits in Parkinson’s Disease: Pathophysiology or Compensation? Behavioral Neuroscience, 127 (2), 222 – 236. Mazzoni, P., Shabbott, B., Cortes, J.C. (2012). Motor Control Abnormalities in Parkinson’s Disease. Cold Spring Harbour Perspectives in Medicine, 2 (6), 1 – 17. McKinlay, A., Grace, R.C., Dalrymple-Alford, J.C., Roger, D. (2010). Characteristics of Executive Function Impairment in Parkinson’s Disease Patients without Dememtia. Journal of the International Neuropsychological Society, 16 (2), 268 – 277. M elzer, T.R., Watts, R., MacAskill, M.R., Pitcher, T.L., Livingston, L., Keenan, R.J., Dalrymple-Alford, J.C., Anderson, T.J. (2012). Grey Matter Atrophy in Cognitively Impaired Parkinson’s Disease. Journal of Neurology, Neurosurgery & Psychiatry, 83 (2), 188 – 194.

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