The Music Industry as Counter-Example to the Technological Explanation for Shakeouts

May 21st, 2010 Comments off

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While papers such as Klepper (2002) and many others argue that technological innovations lead to shakeouts, Scherer (1965), Mansfield (1968, 1983), and Mueller (1967) suggest that market concentration and large firm size are only weakly associated with innovation. Alexander (1994) shows one case, the music industry, in which technological changes actually resulted in a de-concentration of firms (by spurring new entry).

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Evidence

The history of music industry concentration and the chronology of events provide general evidence against technology always being the direct cause of shakeouts. At the beginning of the industry’s life (1890-1900), there were three major firms producing the vast majority of audio products: Victor, Columbia, and Edison. This included both the machines—cylinder and record players—and the actual cylinders and records. Patents on these machines were a major barrier to entry, but major innovations from 1900-1910 and the expiration of important patents in 1914 resulted in industry deconcentration. Early record production required live-action recording to produce each record, requiring either multiple record writers present during a performance or multiple performances. From 1914 to 1919, the number of firms manufacturing records and record players grew on average by 44 percent annually. Demand was stimulated as a result of a new variety and quantity of available products on the market, and the period was characterized by heavy innovation in the music, particularly by small producers. However, from 1919 to 1925, the number of producers declined at an average annual rate of 14. 4 percent. Larger firms were able to capitalize on the small producers’ innovations, resulting in imitation as well as several horizontal mergers. The onset of the Great Depression and World War II finalized the reconcentration of the music industry. Prior to 1948, Columbia, Decca, RCA Victor, and Capitol were responsible for three-fourths of record sales in America.

Following the war, a new innovation reshaped the industry: magnetic tape recordings. Previously, records were produced in a very tedious and unforgiving fashion. Errors in the performance for a recording would require the artists to execute the piece perfectly—start to finish—in order for the recording to be successful, but magnetic tape

allowed a particular section with an error to be spliced out and replaced by a re-recorded part. Magnetic tape machines were also much cheaper. By reducing the amount of studio time required and also lowering the costs of starting up a recording business, magnetic tape technology was followed by an increase in the number of companies producing LP (long-play) records from eleven to two thousand between 1949 and 1954 (Gelatt 1954).

By 1956 independent firms held around 52 percent of the music recording industry’s total market share, increasing to the industry’s peak in 1962, at which time independent firms accounted for 75 percent. Afterward, major firms began to reacquire market share, primarily through horizontal mergers, and the number of firms in the industry began to shrink.

Analysis

This prompts us to seek an alternative explanation to technological changes for the causes of the most recent extended music industry shakeout (1962-). Several technological improvements turned out to be exogenous (allowing universal adaptation) rather than endogenous (proprietary and thus concentration-inducing). The nature of the technologies Alexander cites tended to be scale-reducing, thus reducing barriers to entry. Developments in musical technology over the past 50 years have been consistently scale-reducing, though the trend for a large portion of that period has been toward consolidation. Magnetic tape and compact disc players became commercial and low-cost home appliances, and their respective means of creation grew as common (tape recorders, CD-burners, etc. Computer-based music recording and playback has become more widespread. Still, the number of firms has been decreasing.

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Human Exposure and Risk Assessment for Naturally Occurring Asbestos (Part 3)

May 21st, 2010 Comments off

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Summary/Toxicological Review for Asbestos (CASRN 1332-21-4) viewed at Integrated Risk Information System (IRIS) website, USEPA, http://www. epa. gov/ncea/iris/subst/0371. htm, viewed February 1, 2008.

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Human Exposure and Risk Assessment for Naturally Occurring Asbestos (Part 2)

May 21st, 2010 Comments off

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There is not clear evidence of lower chrysotile toxicity in relationship to lung cancer and asbestosis, a debilitating scarring of the lung tissues. Evidence, such as that reviewed by Hardy in 1995, suggests that iron also plays a part in asbestos toxicity. Iron is present in all asbestos minerals. Iron ions on the surface of asbestos fibers may be catalytic sites for free radical and reactive oxygen species (ROS) generation, resulting in the initiation or promotion of cancer.

EPA’s carcinogenicity assessment dates back to 1986. The lung cancer model in that assessment (Nicholson, 1986) assumes a linear function of cumulative asbestos exposure in units of fibers-years/ml as measured with phase contrast microscopy, and can be expressed as follows: IL IE(1+KL*f*d), where: IL lung cancer incidence observed or projected in an exposed population IE lung cancer expected in the absence of exposure KL= proportionality constant measure of the carcinogenic potency of exposure f intensity of exposure (fibers/ml) d duration of exposure (years) The model assumes equal potency for all six regulated asbestos types and all asbestos fibers greater than 5 μm in length. The 1986 assessment document does point out that fiber size distribution varies with asbestos type and mineral processing, and accepts that length and width are important variables in fiber carcinogenicity in animal studies. Stanton et al (1981) developed the “Stanton Hypothesis,” which suggested that long thin fibers were the most toxic. Later studies, such as those reviewed by Dodson et al, suggested that all fiber sizes may contribute, to some extent, to asbestos toxicity. One source of uncertainty in asbestos exposure estimates is the uncertainty of conversions between analytical measurements performed with PCM and measurements performed with transmission electron microscopy (TEM).

Asbestos unit risk is based on fiber counts made with PCM because PCM is typically the method used for measurements in the occupational environment. Unfortunately, PCM is not fiber specific. All fibers are counted, regardless of identity. PCM also does not have the resolution necessary to image smaller fibers, generally resolving fibers longer than 5 μm and greater than 0. 4 μm in diameter. Transmission electron microscopy (TEM) resolves much shorter and thinner fibers and allows for identification of fibers based on chemical composition and selected area electron diffraction (SAED) of the mineral’s crystal structure. The correlation between PCM and TEM is highly uncertain. Asbestos measurement techniques and the level of understanding of asbestos toxicity have improved substantially since EPA’s 1986 assessment document.

A proposed updated methodology for conducting asbestos risk assessments (Berman and Krump, 2003) is under review at this time. The proposed methodology, which distinguishes between asbestos types and fiber sizes in assessing risk, is a topic of debate. The report on EPA’s peer consultation workshop to discuss the proposed methodology (Eastern Research Group, 2003) documents several discussion topics. Issues under discussion include fiber diameter and length (what size cut-off points to use in considering fibers), the use of different carcinogenic potency factors for different asbestos fiber types for lung cancer versus mesothelioma, how to address mineral cleavage fragments of equal dimension and biopersistence as fibers, the potency of unregulated asbestos minerals, statistical analysis methods, consideration of the synergistic impact of cigarette smoking, and localized exposures to naturally occurring asbestos such as that in California. The potential for health risks associated with exposure to asbestos minerals continues to be a public concern. Much of the epidemiological asbestos data studied over the past several decades has focused on occupational exposure. Since asbestos is a generic term used to identify a group of naturally-occurring minerals, however, there are areas of the United States in which geological deposits of asbestos minerals pose a potential environmental exposure risk. Unlike occupational asbestos exposures, which can be controlled with personal protective equipment and specialized work practices, exposure to naturally occurring asbestos may not be easily controlled and may impact susceptible subpopulations. Given the asbestos toxicity questions that remain and the vigorous research debate, it is obvious that asbestos is still a relevant exposure and risk assessment topic.

References

Berman, D. W. and Krump, K. (2003). “Technical Support Document for a Protocol to Assess Asbestos-Related Risk – Final Draft. ” Report No. EPA 935. 4-06600/8-84/003F, Prepared for U. S. EPA Office of Solid Waste and Emergency Response, Washington, DC.

Bernarde, M. (1990). Asbestos The Hazardous Fiber. CRC Press: Florida.

Dodson, R. Atkinson, M. and Levinson, J. (2003). “Asbestos Fiber Length as Related to Potential Pathogenicity: A Critical Review,” American Journal of Industrial Medicine, 44: 291-297.

Eastern Research Group, Inc. (2003). “Report on the Peer Consultation Workshop to Discuss a Proposed Protocol to Assess Asbestos-Related Risk. ” Contract No. 68-C-98-148, Prepared by Eastern Research Group, Inc. for U. S. EPA Office of Solid Waste and Emergency Response, Washington, DC.

Fubini, B. and Fenoglio, I. (2007). “Toxic Potential of Mineral Dusts,” Elements, 3: 407-414. Hardy, J. and

Aust, A. (1995). “Iron in Asbestos Chemistry and Carcinogenicity,” Chemical Reviews, 95(1): 97-118.

Ladd, K. (2005). “El Dorado Hills Naturally Occurring Asbestos Multimedia Exposure Assessment, Preliminary Assessment and Site Inspection Report Interim Final. ” Contract No. 68-W-01-012, Prepared by Ecology and Environment, Inc. Superfund Technical Assessment and Response Team (START) for U. S. EPA Region IX. Nicholson, W. J. (1986). “Airborne Asbestos Health Assessment Update. ” Report No. EPA/600/8-84/003F, Prepared for U. S. EPA Environmental Criteria and Assessment Office, Research Triangle Park, NC.

Stanton M. F. Layard M. Tegeris E. Miller E. May M. Morgan E. and Smith A. (1981). “Relation of Particle Dimension to Carcinogenicity in Amphibole Asbestoses and Other Fibrous Minerals. ” Journal of the National Cancer Institute, 67: 965-975.

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Human Exposure and Risk Assessment for Naturally Occurring Asbestos

May 21st, 2010 Comments off

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Asbestos is a general name given to a group of naturally occurring silicate minerals with a tendency to separate into fibers or fiber bundles. The fibers have high tensile strength, low heat transfer, chemical resistance, and heat resistance. These properties make asbestos useful for a number of industrial applications, including thermal insulations and fireproofing, friction materials such as automotive brake pads, and fiber reinforcement in cementitious materials…

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Although asbestos is a versatile material with many commercial applications, it also a known human carcinogen. Epidemiological data consistently indicate an increased incidence of cancer in occupationally exposed individuals. Asbestos exposure occurs primarily through inhalation of fibers in asbestos dust. Animal inhalation studies show consistently similar findings for lung cancer and mesothelioma. Animal and epidemiological ingestion study data are insufficient to judge carcinogenicity due to ingestion. Asbestos regulation has been based on a linear dose-response relationship between exposure and adverse health effects (risk increases as total dose increases) and on the lack of a known exposure threshold below which no asbestos-related health effects have been observed. Much of the available epidemiological data cover occupational exposures, which are frequently higher than environmental exposures.

Since asbestos is a naturally-occurring mineral, however, there are areas of the United States in which geological deposits of asbestos minerals pose a potential environmental exposure risk. Asbestos also occurs as a contaminant in some commercially mined minerals, such as vermiculite. The most well-known case of exposure to naturally-occurring asbestos may be the case of Libby, Montana. Asbestos-contaminated vermiculite was mined in Libby from 1919 until the mine was closed in 1990. In response to local concerns and media coverage of the local population’s exposure to the asbestos-contaminated vermiculite, EPA sent an emergency response team to Libby in 1999 to collect air, soil, dust, and insulation samples from businesses and homes. Libby was added to EPA’s Superfund National Priorities List in 2002. Asbestos-related lung diseases have been observed in the Libby population. Exposure scenarios in this case include occupational exposures in the mining process, exposure of family members through “take-home” dust, environmental exposures due to ambient airborne asbestos concentrations, and exposure of residents due to vermiculite-containing insulations and soil conditioners used in and around their homes.

Although the Libby, Montana, situation may be the best known case of exposure to naturally occurring asbestos in the United States, there are other areas of the country in which asbestos deposits result in potential exposure. The presence of naturally occurring asbestos in exposed soils in El Dorado Hills, California, has been well documented by State and Federal agencies. In response to a citizen’s petition to evaluate asbestos-related health risks in the community, EPA contracted to conduct a multimedia assessment of the area in 2003 to evaluate the potential for inhalation exposure to naturally occurring asbestos in disturbed soils. That assessment concluded through activity-based sampling that airborne asbestos concentrations were elevated in the breathing zone for both children and adults when soils were disturbed (Ladd, 2005).

Unlike occupational asbestos exposures, which may be controlled with personal protective equipment and specialized work practices, exposure to naturally occurring asbestos in native soils is not easily controlled. Exposed individuals may not even realize they have been exposed during outdoor activities. While occupational exposures generally affect adults of working age, exposure to naturally occurring asbestos minerals may also affect children and the elderly. Adverse health effects resulting from exposure to asbestos have been anecdotally documented as far back as ancient Rome, where slaves weaving asbestos fibers into textile products became weakened due to breathing problems and suffered premature death. More recent awareness of escalating asbestos-related respiratory disorders in the 1960s and early 1970s led EPA to add asbestos in 1971 to the list of materials regulated by the National Emissions Standard for Hazardous Air Pollutants (NESHAP), and to promulgate regulation under the Asbestos Hazard Emergency Response Act (AHERA) in 1986 to address asbestos in schools. AHERA covers asbestos-containing materials inside school buildings and, therefore, works to protect a susceptible subpopulation (children).

While there is strong evidence of a causal link between inhalation of asbestos particles and the development of debilitating respiratory disease and cancers, the specific mechanisms by which asbestos minerals cause disease are still not fully understood. The roles that morphology, fiber length, chemistry, and solubility in biological fluids (biopersistence) play in asbestos toxicity are still an area of vigorous debate. As noted by Fubini and Fenoglio (2007), particle toxicology is a distinct study area. Particle toxicants, in which surface chemistry and surface topography play a significant role in interaction with living tissues, behave differently than molecular toxicants. A particle’s surface structure and surface chemistry are affected by factors such as the mechanical processes that generate the particle, weathering processes, and adsorption of chemical contaminants onto the particle surface. For this reason, two particles with the same general chemical composition may have different surface chemistry.

In the case of mineral particles, properties relevant to toxicity include fibrous morphology, surface features such as sharp edges or fracture faces, surface reactivity related to covalent and ionic bonds, the presence of surface contaminants, and biopersistence. Asbestos particles have some toxicity characteristics that are different from other mineral dusts. Although fibrous morphology plays a part in toxicity, not all mineral fibers are equally toxic. There is some evidence that carcinogenic potency varies with asbestos mineral type and the geographic area from which the asbestos originates (EPA IRIS). It is generally agreed that chrysotile asbestos is less toxic than the other regulated asbestos minerals in relationship to mesothelioma, a cancer of the lining of the lungs and abdominal cavity.

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The Epidemiology, Manifestations, Consequences, Treatment Options, and Diagnostic Controversy of Sexual Addiction (Part 5)

May 20th, 2010 Comments off

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References

Carnes PJ. Don’t call it love: recovery from sexual addiction. New York: Bantam Books, 1991 42-4

Carnes P. Out of the shadows: understanding sexual addiction. Minneapolis: CompCare Publishers, 1983

Mayo Clinic staff (September 29, 2005). Compulsive sexual behavior. Mental Health Center. Mayo Clinic. Retrieved on 2007-03-11.

Book, Praeger. (1997). Sex & Love Addiction, Treatment & Recovery. New York: Lucerne Publishing.

Bird. M Sexual Addiction And Marriage And Family Therapy: Facilitating Individual And Relationship Healing Through Couple Therapy,. Journal of Marital and Family Therapy. Upland: Jul 2006. Vol. 32, Iss. 3; pg. 297, 13 pgs

Coleman E. The obsessive-compulsive model for describing compulsive sexual behavior. Am J Prev Psychiatr Neurol 1990;2(3):9-14

Vukadinovic Z. Sexual Addiction, Sexual Compulsivity, Sexual Impulsivity, or What? Toward a Theoretical Model The Journal of Sex Research. New York: Aug 2004. Vol. 41, Iss. 3; pg. 225, 10 pgs

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The Epidemiology, Manifestations, Consequences, Treatment Options, and Diagnostic Controversy of Sexual Addiction (Part 4)

May 20th, 2010 Comments off

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Many people and professional associations do not recognize SA as a legitimate form of addiction. One argument is based on whether the expression has any accurate connotation for describing human sexual behavior.

Some others see sexual addiction as an excuse for wanton behavior. Other characteristics or symptoms of this supposed condition are not easy to diagnose in a scientific manner, for example the primary difference between promiscuity and sexual addiction is essentially the motivation behind the act.

Other scientists interpret of sexual addiction ‘as a compulsion, an impulse control disorder, a sexual desire disorder, a lack of morals and willpower, or a form of obsessive compulsive disorder. ’ Proponents of the sexual addiction concept frequently liken it to food or gambling addiction, “where an outside substance isn’t used to create the high. ”

The American Psychiatric Association (APA) has not yet identified SA as a mental illness, but, the APA has classifications that are useful for grasping sexual behavior disorders. These disorders are called paraphilias. And include: “pedophilia, exhibitionism, voyeurism, sexual etc. ” All of these are typified by “recurrent, intense, sexually arousing fantasies, sexual urges or behaviors” which involve:- non-human objects; the suffering or humiliation of oneself or one’s partner, children or other nonconsenting persons; and clinically significant distress in social, occupational or other important areas of functioning caused by the behavior, sexual urges or fantasies.

It is vital to keep in mind that just because a person takes part in certain sexual behaviors, it does not mean they need to be labeled a sexual addict. The main feature in figuring out if a person is an addict is if that person’s behavior is compulsive. Case in point, a person sporadically looking at pornography is not automatically a sexual addict. However, a person who spends 13 hours a day, and gets fired because of extreme pornography use is most likely a sex addict. Another issue in determining sexual addiction is if the behaviors are used to ‘self-medicate’ and ‘escape reality’.

Even without the consensus within the field of the mental health community, Sexual addiction manifests in addicts as they attempt to ‘medicate their feelings’ and/or ‘cope with their stresses’ so that their sexual behavior becomes the most important coping mechanism in their life.

 

Sexual addiction screening test *

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  1. Were you sexually abused as a child or adolescent?
  2. Have you subscribed to or regularly purchased sexually explicit magazines?
  3. Did your parents have trouble with sexual behavior?
  4. Do you often find yourself preoccupied with sexual thoughts?
  5. Do you feel that your sexual behavior is not normal?
  6. Does your spouse (or significant other) ever worry or complain about your sexual behavior?
  7. Do you have trouble stopping your sexual behavior when you know it is inappropriate?
  8. Do you ever feel bad about your sexual behavior?
  9. Has your sexual behavior ever created problems for you or your family?
  10. Have you ever sought help for sexual behavior that you did not like?
  11. Have you ever worried about people finding out about Your sexual activities?
  12. Has anyone been hurt emotionally because of your sexual behavior?
  13. Are any of your sexual activities against the law?

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  1. Have you made promises to yourself to quit some aspect of your sexual behavior?
  2. Have you made efforts to quit a type of sexual behavior and failed?
  3. Do you have to hide some aspects of your sexual behavior from others?
  4. Have you attempted to stop some parts of your sexual activities?
  5. Have you ever felt degraded by your sexual behavior?
  6. Has sex been a way for you to escape your Problems?
  7. When you have sex, do you feel depressed afterward?
  8. Have you felt the need to discontinue a certain form of sexual activity?
  9. Has your sexual activity interfered with your family life?
  10. Have you been sexual with minors?
  11. Do you feel controlled by yoursexual desire?
  12. Do you ever-think that your sexual desire is stronger than you are?
 

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* Affirmative answers to 13 questions strongly suggest addiction.

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The Epidemiology, Manifestations, Consequences, Treatment Options, and Diagnostic Controversy of Sexual Addiction (Part 3)

May 20th, 2010 Comments off

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The sexual addict who is in a marriage or committed relationship will find that his/her behavior and activities outside the primary relationship can result in loss of self-esteem to himself/herself as well as their partner. Besides severe stress to the relationship, parenting and bonds with children may also be detrimentally affected.

With increased high risk activities, Sex addicts may place themselves in situations of potential harm, which may even result in death. Many diseases may occur due to sexual addiction; these include but are not limited to genital injury, cervical cancer, HIV/AIDS, herpes, genital warts and other sexually transmitted diseases.

Sexual addiction can result in violation of the law, in cases such as sexual harassment, obscene phone calls, voyeurism, prostitution, rape, obscene phone calls, exhibitionism, incest and child molestation. There is also a related chance of loss of professional status and professional licensure, they may go to jail, get sued, or incur other financial and legal consequences because of their behavior.

There are also financial consequences, as debts may arise from the cost of prostitutes, cyber/phone sex and multiple affairs. Moreover, there are indirect costs associated with legal fees, the cost of divorce or separation, and decreased productivity or job loss.

Assessment and treatment

An assortment of surveys and examinations have been created in an effort to assess sexual addiction, but a small number of, if any have been officially evaluated, or verified to be correct. Advocators of the concept of the sexual addiction consider the cycle and the associated beliefs clearly exemplify the sexual addict.

Patrick Carnes PhD puts forward a fundamental test in order to deduce if a specific sexual behavior has become addictive:

  1. It is a secret.
  2. It is abusive or degrading to self or others.
  3. It is used to avoid (or is a source of) painful feelings.
  4. It is empty of a caring, committed relationship.

A copy of an actual test designed by Patrick Carnes is included towards the end of this report (figure 1)

In contrast with the aims in treatment of other forms of dependency (such as drug or alcohol), the therapeutic objective in sexual addiction is abstinence only from compulsive behavior with the goal and adaptation of a healthy sexuality. Most SA treatment programs recommend that patients refrain from all sexual activities (including masturbation) for 30 to 90 days to make it clear that life without sex is possible. It has been noted that when some sexual addicts stop all sexual activity, they report withdrawal symptoms akin to those encountered by cocaine addicts.

It is crucial that the Addict’s partner (if he/she has a significant other) be involved with the treatment program. In fact, the Mental Health Report by the Mayo Clinic categorically states that the most important predictor of relapse after treatment of sexual addiction is failure of the spouse to be involved in the treatment program.

The conduct of sex addicts has intense effects on partners, children and other family. The addict is typically ‘partially or totally unaware’ that they have affected those close to them. Families in turn cultivate detrimental coping skills as they make every effort to acclimatize to the addict’s irregular moods behavior. Hence, friends and families will often need to be involved in the recovery process.

Recovery is a course that works when there is:

  1. Acceptance of the disease and its consequences.
  2. Commitment to change.
  3. Surrender of the need to control the compulsion.
  4. Willingness to learn from others in recovery in sexual addiction Twelve Step support groups, and from trained therapists.

Due to the fact that most sex addicts were often sexually abused as children, they may have distorted ideas about sex and they usually require information about healthy sexuality. Therapists may need to work with early trauma and provide reassurance during treatment. Shame, a chief concern for sex addicts, is best addressed in group therapy; moreover, other recovering addicts can provide both support and confrontation. Group support can be an influential tool for overcoming the shame that most sex addicts feel.

The 12 steps of Alcoholics Anonymous have been adapted for use in many programs which deal with addictions. A program designed for sexual addiction can be particularly helpful in the recovery process. It is also noted that by the time sex addicts seek help, ‘their marriage or relationship is often in great distress’. The lack of communication, growing distrust, resentment and anger are common in such situations. A therapist can be of great help during recovery. Nevertheless SA, as with other addictions, cannot be "cured" and there might be the risk of a relapse. To overcome this, sex addicts must be trained to stay away from certain people and situations that can ‘trigger old urges and behaviors’.

Though, not empirically proven, some mental health providers say that some patients benefit from specific drugs, such as fluoxetine hydrochloride (Prozac) and domipramine hydrochloride (Anafranil).

Controversy over Diagnosis and Diagnostic Criteria

Those in the mental health field specializing in sexual behavior normally have the same opinion on what represents ‘out-of-control sexual behavior’, but they disagree over whether it is correctly identify as an ‘addiction’ or as an indicator of an essential obsessive-compulsive disorder, which can result in sexual obsessions.

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The Epidemiology, Manifestations, Consequences, Treatment Options, and Diagnostic Controversy of Sexual Addiction (Part 2)

May 20th, 2010 Comments off

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Addicts can squander an astonishing sum of money and time on their inclinations, completely deficient in the capability to control it. They habitually undergo a nearly ‘trance-like’ state during which their actions can go on for many hours.

Similar to other addictions, some addicts go through ‘episodic binges’ (between these binges they may well believe they are completely normal), some others may endure more of a continuous level of the crisis. There are some sexual addicts who move back and forth in opposite end of the continuum, engaging in sexual anorexia, where they repress their tendencies in a manner so that they have absolutely no sexual experiences.

This is in no way a cure for the basic compulsion nor is it an effective manner of control, but, like food addictions is plainly one more symptom of the addiction. Some sexual addicts operate in more intrusive ways or advance to them as they go through diminishing "highs" for their unusual activities. Patrick Carnes PhD. maintains that explicit activities do not identify addiction, “it is the compulsive nature of the behaviors that demonstrates addiction”. Addicts often attempt to stop, but fail. Their behavior generally conforms to a cycle:

1. Preoccupation

2. Ritualization

3. Compulsive sexual behavior

4. Despair

In order to get rid of negative feelings the addict almost immediately happens to become engrossed with sexual thoughts again, resuming the ‘addictive cycle’. Patrick Carnes theorizes that the cycle begins with the "Core Beliefs" which addicts ‘knows’ to be true. Such as; "I am basically a bad, unworthy person. " "No one would love me as I am. " "My needs are never going to be met if I have to depend on others. " "Sex is my most important need. " These attitudes impel the obsession in its advancement and eventual destructive course.

First a “pain agent” activates emotional discomfort (e. g. shame, unresolved conflict) the sex addict is incapable of dealing with the pain agent in an emotionally healthy manner. Before resorting to sexually behavior, the sex addict goes through a phase of mental obsession/preoccupation. They disassociate (moving away from his/her feelings). Thus a division starts between the mind and the emotional self. Once this ‘disconnect’ takes hold, the addict becomes pre-occupied with acting out behaviors. The reality of the situation becomes blocked out and distorted.

Preoccupation, or in other words "sexual pressure" means that the addict is consumed about being sexual or romantic. Consequently ‘fantasy’ turns into a fixation that serves to avoid life. ‘Thinking about sex and planning out’ how to reach orgasm can continue for minutes or hours before moving into the next stage of the cycle. These fixations are strengthen and reinforced through ‘ritualization’ or acting out. A sex addict may for example, go to a strip show to heighten arousal until he/she is ‘beyond the point of saying no’. This helps detach reality from sexual obsession. Once the addict is in the midst of the ritual, there is very little hope of stopping that cycle.

The subsequent stage of the cycle is sexual compulsivity or "sex act". Tensions felt by addict diminished and for the short term they feel better, due to the release that occurs. Compulsivity merely signifies that addict regularly gets a pint where sex becomes unavoidable, no matter what the consequence.

After the compulsive act there may be realization and acknowledgement that the addict has become nothing more than ‘a slave to the addiction’. And the addict launches into feelings of shame and despair. ‘The last time the Addict was at this low point, they probably promised to never do it again’.

Etiology of the condition

Although there is no singular causation of sexual addiction, studies have shown that a high percentage of sexual addicts were abused by someone during their childhood. According to Sex & Love Addiction, Treatment & Recovery 60% of sexual addicts were the victims of child abuse. Additionally, neurochemistry of an individual may predetermine the condition.

There is also a relationship between depression, anxiety, OCD, and Attention Disorders to Sexual Addiction. The progression of a SA theoretically begins early in life through adolescent experimentation and self-stimulation, or premature introduction to pornography and other sexual stimulants. Social conditioning, imprinting and developmental impairments may also be factors.

Sex becomes a dominant, exhilarating fascination very early on and the addiction increases. Others may start later in life—during graduate school, divorce, or when anxiety and nervous tension become so acute that an escape is needed. It turns into an effective form of self-medication, and another way to cope with the demands of life.

Consequences of Sexual Addiction

There are many consequences which result from sexual addiction. This includes the ‘social cost’; sexual preoccupation can lead to loss of friendship and family relationships. Anxiety and stress are a general theme in the lives of sex addicts, as they live with the ‘constant fear of discovery’.

Guilt and shame are also commonplace, as the addict’s lifestyle is mostly at odds with personal values and beliefs. Compulsive sexual thoughts and/or behavior leads to ‘severe depression, often with suicidal ideation, low self-esteem, shame, self-hatred, hopelessness, despair, helplessness, intense anxiety, loneliness, resentment, self pity, self blame ,moral conflict, fear of abandonment, spiritual bankruptcy, distorted thinking, remorse, and self-deceit’.

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The Epidemiology, Manifestations, Consequences, Treatment Options, and Diagnostic Controversy of Sexual Addiction

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Sexual addiction is a pattern of sexual actions and mannerisms that are acted out even though it is detrimental to the effected individual and/or to others. Interestingly, the medical community has no consensus that sexual addiction actually exists. And it is not presently included in the Diagnostic and Statistical Manual of Mental Disorders (D. S. M. Instead, Sexual Addiction’s diagnostic criteria are parallel to those the D. S. M. provides for other addictions. This paper will define and investigate Sexual Addiction (SA), its epidemiology, manifestations and discuss the consequences of Sexual Addiction. Additionally, the Sexual Addiction cycle will be examined and the etiology and treatment options for this condition will be reviewed. Lastly, the controversy over diagnosis and diagnostic criteria will be scrutinized.

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Sexual Addiction

The term ‘compulsive sexual behavior’ has been used to describe sexual addiction; the Mayo Clinic in its Mental Health Report further explains as those suffering from condition have "an overwhelming need for sex and are so intensely preoccupied with this need that it interferes with [careers and relationships]. [One] may spend inordinate amounts of time in sexually related activities and neglect important aspects of …day-to-day life in social, occupational and recreational areas. [One] may find [him/herself] failing repeatedly at attempts to reduce or control …sexual activities or desires. "

The occurrence of sexual addiction is quite difficult to ascertain, essentially for the reason that addicts are guarded and secretive. Those in the mental health field who are proponents of including the condition in the DSM propose that it is usually seen in connection with other addictions, in addition to stress and mood disorders. On occasion, when several addictions are present (alcohol, drugs, gambling, etc. SA is considered the "core" addiction.

Sexual addiction is speculated to be (but is not always) linked with Narcissistic personality disorder, manic-depression and Obsessive-compulsive disorder (OCD). In the past this condition had been thought of as an exclusively male dilemma, but current research has suggested it may also be widespread among women.

Patrick Carnes PhD. a prolific researcher on this subject outlines the following signs of sexual addiction:

1. A pattern of out-of-control sexual behavior

2. Severe consequences due to sexual behavior

3. Inability to stop despite adverse consequences

4. Persistent pursuit of self-destructive or high-risk behavior

5. Ongoing desire or effort to limit sexual behavior

6. Sexual obsession and fantasy as a primary coping strategy

7. Increasing amounts of sexual experience because the current level of activity is no longer sufficient

8. Severe mood changes around sexual activity

9. Inordinate amounts of time spent in obtaining sex, being sexual, or recovering from sexual experience

10. Neglect of important social, occupational, or recreational activities because of sexual behavior

The supporters of the sexual addiction concept believe that sexual addicts may derive enjoyment in frequent sexual intercourse and other sexual activities, although the primary incentive of this addiction is “more the enjoyment of the journey rather than the destination. ” This means that sexual addicts do not need “an orgasmic event” to feel that their addiction has been satisfied. Hence, they are also known as "chemical addicts". While they pursue sexually (and even romantically) stimulating activities, they basically crave the chemicals released in the brain. An example of such a brain chemical is the "feel good" neurotransmitter dopamine. These heightened levels provide them with feelings of euphoria. An orgasm (may) boost this level even higher. This chemical reaction can be compared to the use of certain illegal drugs. Methamphetamines or cocaine, for example, can also assist in the same release.

Those individuals who cope with mood issues may learn of the calming effects derived through these brain chemicals, and quickly recognize which behaviors can successfully replicate the experience. Subsequently, a “cascading effect” commences. Already susceptible with respect to ‘compulsive or obsessive behavior’, the sexual addict begins duplicating ‘rewarding’ actions that swiftly establishes a “conditioned response”. As time goes by, the regular release of these mood elevating brain chemicals into the body causes them to lose their effectiveness. This means that the addict will need to increase or intensify the compulsive behavior for the same effects to be achieved.

Another point to be noted is that the addict’s inclinations can also be observed by the rate that masturbation is used for satisfaction. Frequently, masturbation will be used to the point of personal injury or to where it notably gets in the way of everyday life. In some cases masturbatory activities can very well replace the desire for sexual interactions with others.

There are times when some sexual addicts do not feel comfortable enough to be involved with people they know, (which actually happen quite often). They then look for strangers for anonymous sex or search for ‘new love’ through infidelity. Prostitutes may be employed, both because of the anonymity and the seemingly non-judgmental readiness to engage in the unusual sexual requests that some sex addicts have.

As noted earlier, a decisive attribute of sexual addiction is it’s evidently ‘compulsive & unmanageable’ makeup. A normal person may look at an attractive person as they drive past, a sexual addict might drive around the block a number of times to stare again. In order to repeat the experience over and over they may even arrange and organize methods so they can spot attractive people.

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The Adolescent Psychopathology Scale – Short Form (Part 3)

May 20th, 2010 Comments off

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As well as routine assessments of adolescents referred for health related and general adjustment difficulties. Moreover, The APS-SF can be utilized as a means to gauge treatment outcomes, and determine the effectiveness of treatment plans.

Personal Assessment of the Adolescent Psychopathology Scale- Short form

Though, the APS-SF is not a full proof method to diagnose psychopathology in adolescents, it’s design, reliability and validity make it a powerful tool in the hands of the mental health professional. Large groups can be screened together, and the extensive subject matter covered can ensure those who may need mental health services are identified.

Through the course of counseling and therapy the subject the APS-SF can measure the effectiveness of treatment and also provide the professional with an assessment tool to be employed during client intake as a method of discovery.

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References

Bickel, R. & Campbell, A. (2002). Mental health of adolescents in custody: the use of the Adolescent Psychopathology Scale. Australian & New Zealand Journal of Psychiatry, 5, 603-609.

DuBois, D. L. Parra, G. R. & Sher, K. J. (2006). Investigation of Profiles of Risk Factors for Adolescent Psychopathology: A Person-Centered Approach. Journal of Clinical Child & Adolescent Psychology, 35, 386-402

Reynolds, W. M. (1994). Assessment of depression in children and adolescents by self-report questionnaires. In Reynolds, W. M. & Johnston, H. F. , Handbook of depression in children and adolescents. (pp. 209-234). New York, NY: Plenum Press

Reynolds, W. M. (1998) Adolescent Psychopathology Scale. Odessa, FL: Psychological Assessment Resourses.

Reynolds, W. M. (2000) Adolescent Psychopathology Scale- Short form: Professional Manual. Odessa, FL: Psychological Assessment Resourses.

 

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