Abstract
Twelve persistent exposers underwent three different psychological treatments in a balanced Latin-square design. The treatments were aversion, self-regulation, and muscular relaxation, the last chosen as a control method unlikely to have a specific effect on the target problem. Each patient received every treatment, one treatment per week. The treatments were given over 3 consecutive weeks, with eight therapist sessions per week. The same amount of therapist time was devoted to each treatment. Measures of change were necessarily based mainly on self-report. The order of efficacy of the three treatments was aversion first and self-regulation second, with relaxation being last and ineffective. Aversion produced significant improvement on four measures, self-regulation on two measures, and relaxation on none. Aversion was significantly superior to relaxation on two measures and to self-regulation on two measures. Self-regulation was significantly superior to relaxation on one measure. Aversion was most effective when given as the first treatment, while self-regulation was potentiated when preceded by aversion. During followup to 1 year, there were some reexposures and reconvictions, but significant improvement continued despite the pretreatment chronicity and severity of the disorder.
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References
Abel, G. G., Leavis, D. J., and Clancy, J. (1970). Aversion therapy applied to taped sequences of deviant behaviour in exhibitionism and other sexual deviations.J. Behav. Therap. Exptl. Psychiat. 1: 59–66.
Bancroft, J. H. J. (1970). A comparative study of two forms of behaviour therapy in the modification of homosexual interest. Unpublished M.D. thesis, Cambridge.
Bancroft, J. H. J., and Mathews, A. (1967). Penis plethysmography: Its physiological basis and clinical application. Proceedings of the 7th European Conference on Psychosomatic Research.
Bergin, A. E. (1969). A self-regulation technique for impulse control.Psychotherapy: Theory, Research and Practice 6: 113–118.
Birk, L., Huddleston, W., Miller, E., and Cobler, B. (1971). Avoidance conditioning for homosexuality.Arch. Gen. Psychiat. 25: 314–323.
Bond, I. C., and Hutchison, H. C. (1960). Application of reciprocal inhibition therapy to exhibitionism.Can. Med. Ass. J. 83: 23–25.
Cabanis, D. (1966). Medizinisch-Kriminologische Untersuchung uber Exhibitionismus. Unpublished habilitationsschrift, Berlin University.
Evans, D. R. (1967). An exploratory study into the treatment of exhibitionism by means of emotive imagery and aversive conditioning.Can. Psychol. 8: 162.
Evans, D. R. (1968). Masturbatory fantasy and sexual deviation.Behav. Res. Therap. 6: 17–19.
Evans, D. R. (1970). Subjective variables and treatment effects in aversion therapy.Behav. Res. Therap. 8: 147–152.
Feldman, M. P., and McCulloch, M. J. (1965). The application of anticipatory-avoidance learning to the treatment of homosexuality. I. Theory, technique and preliminary results.Behav. Res. Therap. 2: 165–183.
Feldman, M. P., and McCulloch, M. J. (1971).Homosexual Behaviour: Therapy and Assessment Pergamon Press, Oxford.
Floch, M. (1956). The treatment of a chronic case of exhibitionism by means of the autobiographic method of analysis.J. Crim. Law Criminol. 37: 316–317.
Gebhart, P. H.,et al. (1965).Sex Offenders Harper and Row, New York.
Gelder, M. G., and Marks, I. M. (1970). Aversion treatment in transvestism and transsexualism. In Green, R., and Money, J. (eds.),Transsexualism and Sex Reassignment Johns Hopkins Press, Baltimore.
Glover, M. (1971). Covert sensitisation: A review. Unpublished M.Sc. study, London University.
Grassberger, R. (1964). Der Exhibitionismus.Kriminalistik 18: 557–562.
Jacobson, E. (1938).Progressive Relaxation University of Chicago Press, Chicago. Quoted by Wolpe, J. (1958), pp. 135–137 inPsychotherapy by Reciprocal Inhibition, Stanford University Press.
Kanfer, F. H. (1971). The maintenance of behaviour by self-generated stimuli and reinforcement. In Jacobs, A., and Sachs, L. G. (eds.),Psychology of Private Events Academic Press, New York and London.
Kushner, M., and Sandler, J. (1966). Aversion therapy and the concept of punishment.Behav. Res. Therap. 4: 179–186.
Marks, I. M., and Sartorius, W. H. (1968). A contribution to the measurement of sexual attitude.J. Nerv. Ment. Dis. 145: 441–451.
Marks, I. M., Gelder, M. G., and Bancroft, J. H. J. (1970). Sexual deviants two years after electric aversion.Brit. J. Psychiat. 117: 173–185.
Marks, I. M., Boulougouris, J., and Marset, P. (1971). Flooding vs. desensitisation in the treatment of phobic patients: A crossover study.Brit. J. Psychiat. 119: 353–375.
Mathis, J. L., and Collins, M. (1970). Mandatory group therapy for exhibitionists.Am. J. Psychiat. 126: 1162–1166.
McConaghy, N. (1970). Subjective and penile plethysmograph responses in aversion therapy for homosexuality: A follow-up study.Brit. J. Psychiat. 117: 555–560.
McCulloch, M. J., Williams, C., and Birtles, C. J. (1971). The successful application of aversion therapy to an adolescent exhibitionist.J. Behav. Therap. Exptl. Psychiat. 2: 61–66.
Mohr, J. W., and Turner, R. E. (1960).Exhibitionism and Pedophilia University of Toronto Press, Toronto.
Mohr, J. W., Turner, R. E., and Ball, R. B. (1962). Exhibitionism and pedophilia. Paper presented at the Annual General Meeting of the Americal Psychiatric Association, Toronto. Quoted by Gebhart, p. 717.
Radzinowicz, L. (ed.) (1957).Sexual Offences Macmillan, London.
Rognant, J. (1965). Exhibitionnisme et deconditionnement.Ann. Med. Psychol. 123: 169–204.
Roper, P. (1966). The use of hypnosis in the treatment of exhibitionism.Can. Med. Ass. J. 94: 72–77.
Rosen, I. (1964). Exhibitionism, scopophilia and voyeurism. In Rosen, I. (ed.),The Pathology and Treatment of Sexual Deviation Oxford University Press, London.
Schultz, J. H., and Luthe, W. (1959).Autogenic Training—A Psychophysiologic Approach in Psychotherapy Grune and Stratton, New York and London.
Stern, R. S., and Marks, I. M. (1973). A comparison of brief and prolonged flooding.Arch. Gen. Psychiat. 28: 270–276.
Turner, R. E. (1961). The group treatment of sexual deviations.Can. J. Correct. 3: 485–491.
Watson, J. P., and Marks, I. M. (1971). Relevant and irrelevant fear in flooding—A crossover study of phobic patients.Behav. Therap. 2: 275–293.
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The research was supported by the Bethlem-Maudsley Research Fund.
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Rooth, F.G., Marks, I.M. Persistent exhibitionism: Short-term response to aversion, self-regulation, and relaxation treatments. Arch Sex Behav 3, 227–248 (1974). https://doi.org/10.1007/BF01541487
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DOI: https://doi.org/10.1007/BF01541487