Your OCD may stem from a false need for certainty. What can you do about it? There are two types of OCD : Moral and existential, both of which stem from a felt need for certainty expressed as a demand. The felt need not to do bad things is deceptive; human actions are never certain by any reasonable definition of the latter term. Overcoming this bogus felt need means (cognitively and behaviorally) embracing possibility, not certainty. OCD Thinking There are, in general, two types of obsessions that can occur in obsessive-compulsive disorder: Moral Existential In moral obsessions, the person imagines herself doing something she thinks would be extremely (morally) bad and ruminates about it. In existential obsessions, the person imagines something bad happening to himself or a loved one, for example, getting sick and dying, and ruminates about it (Cohen, 2021). While this post examines the thought process embedded in moral obsessions, the logic in existential obsessions is similar. In both cases, the genesis of the obsession is a demand for certainty. For example, suppose you think: I must be certain that I would not stab my partner with this steak knife. But I am imagining myself doing it and it almost feels like I’m going to really do it! It’s possible I’m going to really do it! But what kind of monster would do such a horrible thing! I can’t stop thinking about it until I can be certain I wouldn’t do it! The above set of premises displays the emotional reasoning involved in moral obsessions. This reasoning chain produces and sustains the intense anxiety experienced by the person with a moral obsession. Notice that the process is generated by a demand for certainty (Premise 1). Here, the term “must” express a felt need for certainty. The term “certain” entails both knowledge and impossibility (Chisholm, 1957, p. 19). That is, in Premise 1 you are demanding that you know that you would not do such a thing and that it is impossible for you to be mistaken. This is an extremely strong sense of knowledge that many contemporary philosophers would argue is vacuous and is satisfied only by truisms like “All triangles are three-sided.” In Premise 2, you imagine yourself doing this very act and even feeling an urge to do it. In Premise 3, from the very fact that you imagine yourself doing it and it feels so real, you conclude that there’s a real possibility you might stab your partner with the steak knife. Clearly, this premise conflicts with Premise 1, which demands that it is impossible that you would do such a thing. Given the latter possibility, in Premise 4, you then damn yourself by calling yourself a “monster.” Such damning language thus reinforces a lack of self-respect, which feeds a vicious cycle of rumination . Consequently, in Premise 5 you conclude that you can’t stop yourself from ruminating about this demoralizing thought until you can somehow be certain you wouldn’t do it. However, every time you imagine yourself doing it, you only reinforce your lack of certainty (if you can imagine it, then it’s not logically impossible). You torment yourself in a vicious ruminative cycle ad nauseam with no way out. There is indeed no way out so long as you hang on to inconsistent premises—1 and 3. On the one hand, in Premise I, you demand certainty. But in Premise 3 you make clear that you don’t have certainty. This is because you're performing the action in question is not impossible. The Meaning of Impossibility But let’s look even deeper at this curious logic. What does it mean to say that something is impossible? One sense of impossibility is physical impossibility. This means contrary to the laws of physics. For example, it appears to be physically impossible for life to exist without a water source. It is not impossible in this sense for you to stab your partner with a steak knife, however. This is because humans do not uncommonly do such regrettable things. That’s exactly why there are criminal laws that proscribe them. Another sense of impossibility is logical impossibility. This means logically contradictory or inconsistent. For example, it is impossible in this sense to draw a triangle that has four sides. You could not even imagine doing such a thing because triangles, by definition, only have three sides. However, stabbing your spouse with a steak knife is not impossible in this sense because you can easily imagine yourself doing it; and that’s exactly what you have done in the present scenario—imagine yourself doing it. As demonstrated here, you have painted yourself into the proverbial corner by demanding that something be impossible that is not so, in either the physical or logical sense. For each time you imagine doing this act, you reaffirm its possibility, which then contradicts the demand that you be certain you wouldn’t do it—that is, that it be impossible that you would do it. Your only rational way out is to give up your demand for certainty. It is plainly self-defeating to cling to a demand that you cannot possibly satisfy. What, then, does it take to give up this unrealistic demand? Getting Practical In Cognitive-Behavioral Intervention for Self-Defeating Thoughts (Cohen, 2021), I discuss the construction of a cognitive-behavioral plan to overcome this demand and gain freedom from self-oppression. You need to learn to accept possibility rather than certainty as a condition of living in the everyday world. If you wish, you could redefine the latter term as "certain for practical purposes." Indeed, humans make decisions every day by accepting conditions that are not certain, but we merely assume that they will stand the test of time. For example, it is not certain that the earth will support life in the near future (there is no contradiction in the earth ceasing to support life), but you still make future plans. With much less assurance that something won’t go awry, you drive or take public transportation, cross busy intersections, live in proximity to nuclear power plants, or other sources of potential harm. You assume that most people with whom you have social commerce (from your babysitter to your physician) are not rapists, murderers, or psychopaths even though, no matter how carefully you check them out, you cannot be certain of this. These are things, that for practical purposes, you simply assume are probable enough to act on. You don’t need certainty to live as though you have it; and once you live as though you have it (and here comes the behaviorally therapeutic upside of doing so), you won’t even feel the need to obsess about not having it. This means pushing yourself to go about your life without checking and rechecking your thinking ad nauseam. It means not locking up the knife or throwing it away but instead using it to cut steak. It means giving up any other meaningless ritual you have concocted to remediate your anxiety (for example, humming to drown out your thoughts). This means accepting that it is not impossible (logically or physically) for you to do bad things, even very bad things. You are flesh and blood and like all other contingent creatures in the universe are subject to an infinite range of possibilities—some bad and some very wonderful. This means embracing possibility, not certainty, as an inescapable part of life on earth. Elliot D. Cohen, Ph.D., - Website References Cohen, E.D. (2021). Cognitive behavioral interventions for self-defeating thoughts: Helping clients to overcome the tyranny of 'I Can't'. London: Routledge. Chisholm, R.M. (1957). Perceiving: A philosophical study. Ithaca: Cornell U. Press.

Rules for ensuring success when combining households. A blended family is a unit that includes parents and their stepchildren. Joining family members enhances the social support network. Despite the benefits, navigating the creation of a blended family can sometimes present a challenge. A blended family is a unit that includes parents and their stepchildren. Joining members of more than one family can increase the number of people available in members’ social support networks and lead to expanded opportunities to form strong and loving connections. However, navigating the creation of a blended family can sometimes present a challenge. For example, psychologist, Anne Malec, who authored Marriage in Modern Life: Why It Works, When It Works, notes that stepchildren may often experience tension between wanting their parents to be happy but feeling upset or disloyal to their other parent. No matter what the growing pains may be, there is likely to be an adjustment period . Take for example hypothetical couple Shawna and Ray, who recently got married. Shawna has two sons, aged 20 and 17 from a previous marriage, and Ray has a 7-year-old-son and 5-year-old daughter from his previous relationship. They purchased a house big enough for them and the kids but are encountering many challenges. Shawna’s sons are adults and view themselves as such. As a result, they don’t want to join the rest of the family for dinners or game nights, and they feel that since they are in college, they don’t have anything in common with Ray’s children. Ray’s children had been living in another state with their biological mother until recently, so even though they have known about Shawna for a long time, they are adapting to being around her for extended periods of time and living with her. They often ignore her requests and rules, not viewing her as a parental authority figure. Shawna and Ray, in trying to get their family to come together as one, are feeling exhausted and overwhelmed, which has resulted in them getting angry with one another over small things that never used to come between them. Below are some helpful suggestions for blending families: 1. Move Slowly and at Your Own Pace While Shawna and Ray have been together for a while, their four children are just getting used to living together under one roof. They are also just getting accustomed to having another parental figure as a part of their daily lives. Shawna and Ray, because of their desire to create a happy and cohesive family, may have instituted too many rules and changes too quickly. While they were well-intentioned, trying to have a family dinner, family game night, etc., as well as giving the children new house rules, roles, and responsibilities, may have been too much all at once. Instead, allow the children to get acclimated to the new family and family environment, slowly introducing new things one by one. 2. Be Present and Be Active Remember to show your partner’s children that you care about them and understand how big of an adjustment blending your families is. Be sure that you are there, answer any questions they have, and address their fears/ anxiety . Don’t make any assumptions; let them know that you are available and that you are able and willing to talk to them and engage with them. Opening the lines of communication between you and your stepchildren will establish trust between you and ensure that you are all on the same team. To do this, Shawna and Ray could each have a separate conversation with their stepchildren to let them know that they are there for them, without going in with a specific agenda. 3. Be Open and Honest with Your Partner It is important for you and your partner to discuss parenting roles and responsibilities, as well as your parenting styles. While you may have had these discussions when dating, now that you are all under one roof, responsibilities and stressors have changed. So, it is imperative to have another conversation/series of conversations. For example, what role do each of you want/feel comfortable with in terms of creating and implementing rules for your partner’s children? How important is it for your children and your partner’s children to be friends? Having a clear understanding about where each of you stand on parenting issues is important. A united front will communicate to your children the importance of creating a new blended family unit. By following these steps, you not only ease the stress on the family members, but on yourself. This is a big transition, so remember to practice self-compassion, as change can be slow, but rewarding. Marisa T. Cohen, Ph.D - Website - Book References Malec, A. B. (2015). Marriage in modern life: Why it works, when it works. Advantage Media Group.

A partner's low emotional intelligence can impact your sense of self. A robustly and rigidly defensive partner may lack the emotional capacity to relate in healthy ways. Narcissistic partners rarely say things like "What I did was insensitive, and I apologize," or "I would be mad too." The constant absence of six sentiments may indicate a partner has narcissistic tendencies. Their lack of empathy, insight, and ability to self-reflect, be accountable, and partner with you instead of taking control may be evidence of low emotional intelligence. An explanation of how these deficiencies impact you may help you evaluate the emotional safety of the relationship. 1. "I hurt your feelings, and that is not okay." Often, a narcissist is annoyed and indignant when their partner communicates a feeling that they do not appreciate. This may be most evident when the partner attempts to address an issue with the narcissist, which involves the narcissist doing or saying something hurtful. Instead of conveying empathy, as in the statement above, they tend to dodge accountability and either shame the partner, dismiss the partner or withdraw their affection to punish the partner passively aggressively. Owning a hurtful action in the moment is rare for narcissists because they are typically robustly defensive and resist “looking in the mirror.” However, after several days or weeks pass, the narcissist may try to take responsibility for their selfish act but eventually minimize or subtly justify the transgression. In place of authentic and heartfelt introspection during the course of the interaction, it can take days and weeks for the narcissist to grasp an understanding of their emotional mistreatment, and even then, they may not grasp the negative impact their actions had on you. 2. "You have every right to be upset." In a relationship, a narcissist often has difficulties honoring your feelings when they feel differently than you; thus, they lack empathy. Empathy requires a person to access the deep and uncomfortable emotions that allow them to momentarily resonate with a partner’s emotional discomfort in order to truly understand. This allows the partner to feel less alone in their predicament and connected to a loved one who gets it. Feeling understood and close to someone in emotional distress is usually comforting and can speed up the healing process. A narcissist may be too fragile to put themselves in another person’s shoes because it is difficult and taxes a waning sense of self. Providing empathy requires a person have “broad emotional shoulders.” A narcissist usually has low emotional intelligence and thus prefers to be sympathetic because they escape the brief hardship empathy requires. Instead, they would rather to be the hero. Sympathizing allows them to emotionally distance themselves from the pain by pitying you. Next, they usually take a position of authority and tell you how to fix the problem or offer to swoop in and “save the day.” Either way, they use your most painful moments as an opportunity to fluff up their ego. 3. "I’m glad you told me that bothered you–I’ll try to be more considerate." Addressing an issue with a narcissist frequently leads to an epic battle. Their refusal to consider your perspective if it differs can be maddening. Frustrated and agitated, you may waste a lot of time and energy attempting to get the narcissist to understand where you are coming from. Unfortunately, their inability to perspective-take in the context of an interpersonal relationship often prevents them from owning even small missteps in the relationship. In addition, the narcissist may unfairly frame your attempt to address an issue with them as “aggressive” or “antagonistic.” They may immediately position themselves as the victim in the interaction and you as the “abusive party.” They often convince you and many others that you are unfairly persecuting them. In addition, a narcissist may take this as an opportunity to project their tendencies onto you. Using deflection and then projection, they ignore your viewpoint and accuse you of doing what they actually did. For example, when you confront them about a lie they told you, they twist the narrative and call you a “liar.” Due to their extreme defensiveness, they are typically unable to self-reflect, so it is unlikely that they will graciously accept the feedback and use it for permanent growth and change. 4. "What I did was insensitive–I apologize." Narcissists usually have a distorted self-image. They see themselves as innocent, at all times, and thus are rarely able to take responsibility for an insensitive or inconsiderate action or comment. Instead, they accuse you of being “picky, harsh, overly critical, or impossible to please.” They tend to excuse their selfish or disrespectful behavior as justified in response to your “unfair criticisms.” The unwavering denial that they have done something wrong prevents them from authentically admitting fault in a relationship . The exception, of course, is when you are fed up and ready to end things. At this point the narcissist may issue a general apology for past behaviors, however, they often minimize and justify their wrongdoings. The evidence of their insincerity is the continual repetition of hurtful behavior in the future. They lack genuine empathy, remorse, and insight, so the apology is simply lip service in order to get out of “hot water.” This type of partner rarely apologizes when it matters the most. 5. "I would be mad too." One of the telltale signs of narcissism is a lack of empathy. A narcissist shames and dismisses you for identifying a feeling that they do not care to hear. The expectation is that you feel the same way about the relationship as they do. If you are mad, they react angrily in response to your anger. If you dare to express a feeling that is incongruent with how they feel, they may passive-aggressively punish you by withdrawing their love and affection. In order to avoid being emotionally abandoned, you may find yourself censoring your feelings because you are afraid that you will be rejected. A series of these micro-abandonments may cause you to shut down essential aspects of who you are. Moreover, when a loved one strips you of your basic human right to feel what you feel, it can be dehumanizing. When you are treated as less than human, it may induce anger and pain. These experiences can be traumatizing. Desperate to be heard, respected, and understood, and deeply disappointed when you are not, may result in feelings of loneliness and shame. 6. "How can I help?" More often than not, a narcissist truly believes they know best. Unable to perspective take, they firmly believe there is one right way, and it is their way. Because of this unilateral and egocentric viewpoint, they tend to tell their partner what to do–a lot. Because the narcissist believes they know everything, they demand that you follow their advice. Also, narcissists tend to enjoy being the hero, so they like to save and rescue. In place of following your lead about how they can best support you, they may take over and grab control. You may be grateful for the help, but it may also strip you of your own self-efficacy and create dependence on the narcissist. A loss of confidence in your own competence may follow. Alternatively, a partner who asks for guidance on how to support you best may be someone who has faith in your ability to solve problems. Taking responsibility for hurtful behavior in the moment is rare for a narcissist because they lack the ability to introspect. Offering empathy is also uncommon for them, as they prefer to use your hardship as an opportunity to fuel their ego by either being the “expert” or by playing the “hero.” In addition, considering your feedback is almost impossible for a narcissist due to their immediate and hefty defensiveness. An apology may only be issued when their back is against the wall, and taking over in place of asking you what you need may also be a sign. For these reasons, a narcissistic partner may fail to respond in ways that preserve the closeness in a relationship. Erin Leonard, Ph.D. - website

Discovering a spouse’s porn use can be a challenge and an emotional opportunity. The discovery of porn in a committed relationship can be a crisis of exposure and trust. Using certain guidelines, a couple can address the meaning of porn use in terms of mutual trust and desire. If the porn use is excessive, professional help can be a valuable asset for repair. Porn is defined as the depiction of erotic behavior intended to cause sexual excitement and accessed through adult and sexually oriented online sites, DVDs, chat rooms, etc. The use of porn may be a passing curiosity, a source of sexual stimulation, or excessive and problematic to many aspects of a person's life. For partners who are married or in committed relationships , the secret continual use of pornography is complicated, as it can ultimately impact both partners and pose a risk to their relationship. Discovering Your Partner’s Secret Use When a partner walks in on the other viewing porn that is quickly shut off or discovers charges for porn on a credit card, there is often an initial shock followed by a mix of feelings including anger, distrust, rejection, and betrayal. Some partners feel hit in the gut. “How could he do this?" Some become frightened, “Who is she talking to?” Some are afraid to say anything and collude with the silence that surrounds the secret. For others, the feelings spill out in anger. “If you want that, you don’t want me.” “Is this why you act like I am invisible?” Whether or not there is protest, many partners take the other’s secret use of porn as an indictment of their inadequacy—a feeling that disqualifies their desire and in a vicious cycle often results in less intimacy and often the partner’s continued use of porn. Whether they are comfortable or not with porn, many partners experience the “cover-up” of porn use as a rupture of trust and an assault to mutual desire. Sometimes the preface to learning about a male partner’s use of porn is his avoidance of sex because of difficulty with arousal or sustaining an erection with a real partner. Having the Secret Exposed Given the denial that fuels the secret use of pornography, it is not surprising that many partners will at first negate the other’s confrontation of their secret—even in the face of the evidence. “How dare you check my computer!” “I knew you would be too uptight to understand.” “ I am having problems—that’s the reason.” Whether or not initially denied, many partners who value their relationship, feel guilt, shame, and lowered self-esteem when their secret is exposed. Essentially, both partners are in crisis. What Do You Do in the Face of the Discovery of Porn Use? Like any challenge, a couple that believes they have a relationship worth saving or improving can repair the breach of sexual secrets. To do so, both partners need the courage to address the meaning, use, and impact of porn with openness and mutual consideration of their sexual connection. It happens, for example, that a period in which one partner stops being interested in sex or both lose sight of their sexual bond, may be the impetus for one of the partners (usually the male) to turn to porn as a sexual outlet. The real issue was not discussed or resolved. Couple Guidelines 1. Talking so the other will listen—listening so the other will talk. Whether your partner is very upset and apologetic about their porn use or quiet and avoidant, try to calmly talk and listen together. Rather than judging or condemning, try to be curious. The expectation that partners who feel betrayed, judged, and angry can just talk this out in one sitting is unrealistic, but you can start anywhere. Consider reflecting on the state of your relationship: Was it intimate and fulfilling? Consider sharing (even writing) your answers to questions like: Do we both want a sexual relationship? What do we each think about porn? Why is it being used? How does using it affect our sexual and intimate relating? 2. Access Information Information often helps move people from a state of helplessness and confusion to a feeling of control. Understanding more about the reason for, the types, and the use of pornography may offer a blueprint for collaboration and repair. It’s worth knowing that: The American Psychological Association considers the compelling use of porn that disrupts a person’s functioning and relationships to be in the category of sexual pathology or maladaptive sexual behaviors. Not everyone viewing porn uses it to excess or has a problem with it. Research does show that when men regularly used porn, they tended to report lower levels of sexual intimacy in their real-life relationships. When women used porn, intimacy increased. Consistent with this, in a study of newlyweds followed for three years, there was a negative reciprocal relationship for men between relationship adjustment, sexual satisfaction, and porn use. For men, the more porn use, the more negative relationship adjustment and more sexual dissatisfaction. Women’s porn use did not result in negative relationship adjustment or decreased sexual satisfaction. Researchers hypothesize that the male’s porn use is more disruptive to the relationship than the female’s use because his use is driven by solitary stimulation. Her use is more often with the expectation of viewing porn that involves couples and is related back to sex with her partner. In his book, Your Brain on Porn, Gary Wilson addresses the physical difficulty many men eventually face when the use of porn has become so linked to arousal that it interferes with the ability to be aroused by a partner. He underscores that what makes porn so compelling is that It offers the brain and body nonstop novelty and taps into the dopamine reward system. Over time, it can make the ability to be aroused or to sustain an erection with a partner very difficult. In clinical work, I have found that when a man can share this problem with a spouse, she feels less rejected and more eager to work together to rekindle the bond. Often partners can seek information individually and as a couple for overall help with their sexual relating. There is also information and online help for the impact of excessive porn use. 3. Develop and Try Couple Solutions For something to change in the life of an individual and the relationship he/she shares, there has to be a plan. For many partners, healing from the rupture of discovering porn use may invite seeing and desiring each other in a new way. Mutuality is key. No one wants to dread having sex with their partner, or feel they are competing with a computer screen. Checking in with each other on what is working can be a wonderful insider connection. Talking and texting more, being affectionate, adding humor, dropping expectations, finding paths of unexpected reconnection are valuable steps to romantic renewal. For some couples, the joint agreement to occasionally use porn alone or together might be possible and enjoyable. For other couples reigniting their relationship may be all that they need and want. Change happens in steps—a commitment to reconnect with love rather than a magical expectation of bliss is a first step. When a relationship has been disrupted, the way back to each other is a new way forward. Suzanne B. Phillips, Psy.D., ABPP - website - book

Addressing both biomedical and social psychological factors can help. Masculine norms and stigma may play a role in both the occurrence of concussions and their undertreatment. On some college campuses, concussions are more common among women and nonathletes than among men or athletes. Knowledge and preparedness can help prevent concussions and ensure prompt medical attention when they occur. When you think about the major problems affecting college students, what comes to mind? You may think of physical health hazards associated with alcohol, other drugs, and sex. And there are threats to psychological health including academic stress, interpersonal conflict, and being away from family and home. These are without doubt important dimensions of college life. If you have come across mild traumatic brain injuries , or mTBIs—commonly known as concussions—as a problem on campuses, it was most likely in connection with college sports, pranks, or rough-housing among male students. You would not be alone in placing mTBIs low on your list, though, especially for nonathletes and women. Underreported, Undertreated, and Understudied An mTBI is a form of brain injury resulting from a sudden blow that causes damage to the brain. A person with an mTBI may lose consciousness briefly and experience symptoms including headache; dizziness; blurred vision; ringing in the ears; changes in sleep, behavior, or mood; and difficulty with memory, concentration, or thinking. More severe TBIs have the potential to cause more severe and longer-lasting symptoms, but mTBIs are both more common and more likely to go undetected and untreated. Psychological approaches to the problem of mTBIs are informed by health behavior theories. These can guide the design of psychoeducational programs aimed at preventing TBIs and promoting treatment-seeking when they occur. Barriers to prevention and prompt treatment include beliefs about vulnerability to TBIs, their perceived severity, and the cost-benefit analysis of health-care seeking. Vulnerability, severity, and treatment-related beliefs are relevant to a wide range of health threats. Unlike most of those, TBI prevention and treatment-seeking also may be influenced by masculinity beliefs and stigma. These factors play a role in health problems like TBI that have features that involve social identity. There are no definitive national data on TBIs in the general college population, but studies of individual institutions suggest they represent a large and growing problem. Although athletics play a role, some studies find that most TBIs are not sports-related. Other major causes are bicycle and automobile accidents, falls, self-harm, and assault. Some data suggest a higher incidence among women compared with men, whether or not they are athletes. Women also may be more likely to experience long-lasting effects of TBI as a result of several biomedical factors. There is evidence that college students who express greater conformity to norms placing a higher value on self-reliance and winning indicate that they would be less willing to report symptoms of a possible TBI. This has been observed both among athletes and nonathletes, and among both male and female students. These are sometimes referred to as masculine norms because they involve a desire to manifest agency, a trait-like behavior pattern emphasizing a sense of control and independence. Masculine norms are a salient feature of male gender-role expectations but are present in women as well as men. Stigma Among athletes, the operation of masculinity norms may be augmented by the threat of being stigmatized—that is, experiencing diminished positive regard in the eyes of teammates and coaches. For college students in general, fear of potential academic consequences may also play a role. A TBI also may be stigmatizing if attributed to carelessness or lack of impulse control. Just as TBI is not high on the lists of major health hazards on college campuses, it does not rise to the top when it comes to health conditions that are stigmatizing. Mental health and behavioral problems such as depression and alcohol and other substance use disorders, are more often discussed as stigmatizing conditions, as are physical health problems that are sexually transmitted or involve bodily systems and functions that can be a source of embarrassment. Processes involved in stigmatization are complex and variable. In the case of TBI, they may involve attributions of the injury to psychological attributes such as personality, the view that the person was responsible for its occurrence, and the belief that symptoms reports represent malingering or at least exaggeration of their severity. Prevention, Recognition, and Timely Treatment Campus resources for preventing TBIs and identifying them when they occur include coaches, campus safety personnel and police, disability services, psychological services, health centers, and academic assistance centers. Additional resources may be present nearby in the community and university-affiliated clinics. Staff members should be familiarized with the signs and symptoms of TBI, including indicators such as pain, nausea, and dizziness, as well as more subtle cues such as evidence of impaired executive functioning. Medical treatment should be sought for anyone who loses consciousness, even just for moments, for any reason, especially if they suffered a blow to the head and experienced the symptoms of TBI outlined above. Horses and Zebras There is an expression used in medical school saying that, when you hear hoof beats, think horses, not zebras, an admonition to consider the most likely diagnosis. Clearly, there are other possible causes of apparent TBI symptoms that may be more likely than a TBI depending on the circumstances. Nonetheless, a TBI might be responsible and should be among the causes that are considered. And this is true regardless of the affected person's gender or sports participation. Richard Contrada, Ph.D., References Barnwell, P. V., Ingate, M. R., Sagar, A., & Contrada, R. J. (2023). College students’ perceptions of concussion: Illness beliefs and masculinity norms predict stigma and willingness to seek treatment. Journal of American College Health, 1–16. Breck J, Bohr A, Poddar S, McQueen MB, Casault T. Characteristics and incidence of concussion among a US collegiate undergraduate population. JAMA Netw Open. 2019;2(12):e1 917626–e1917626. doi:10.1001/jamanetworkopen.2019.17626. Tanabe KO, Hayden ME, Rege S, Simmons J, Holstege CP. Risk factors associated with concussions in a college student population. Ann Epidemiol. 2021;62:77–83. doi:10.1016/j.annepidem.2021.06.009. Kroshus E, Baugh CM, Stein CJ, Austin SB, Calzo JP. Concussion reporting, sex, and conformity to traditional gender norms in young adults. J Adolesc. 2017;54:110–119. doi:10.1016/j.adolescence.2016.11.002.

Comparing yourself to others rarely makes your life better. Social comparison is a normal part of being human. The effect of social comparison is mediated by self-esteem and perceived control. The internet has arguably made social comparison more extreme and toxic. There are steps you can take to reduce how much you compare yourself with others. We humans are comparison creatures. We are constantly measuring ourselves against other people. This attribute may have evolved as a means of helping us fit into the social hierarchy of the cultures we inhabited. Regardless of the reasons, social comparison plays a significant role in how we view and evaluate ourselves, and how we interact with our world. What is Social Comparison? The noted psychologist Leon Festinger defined social comparison as “the processes by which individuals evaluate their own abilities, opinions, attitudes, feelings, physical features, accomplishments, or any other self-aspects in relation to other individuals and/or groups.” Other researchers propose that the impact of social comparison depends on two factors: 1) how closely the comparison is connected to people’s self-esteem, and 2) how much perceived control people feel they have related to their status in relation to the person or people they are comparing themselves to. For those with high self-esteem or high perceived control, downward comparison, namely, comparing yourself to those less fortunate, tends to bolster self-esteem and improve mood states, while for those with low self-esteem or low perceived control, downward comparison reduced their self-evaluations and produced diminished mood states. Conversely, for those with high self-esteem or high perceived control, upward comparison—that is, comparing yourself to those more fortunate—provided encouragement and hope. For those with low self-esteem or low perceived control, upward comparison decreased subjective well-being and lead to more negative mood states. Then and Now It used to be that our primary reference of comparison was our local communities, primarily neighbors and co-workers. Because we tend to congregate around those similar to ourselves in terms of educational level, work income, and shared interests, the range of differences when we compared ourselves to others was fairly small. Yes, through magazines, newspapers, television, movies, radio, and other media, we experienced glimpses of other potential comparison groups, but they tended to be viewed at a distance, as separate from us, so they were less impressionable on us. As such, the impact that those comparisons had on our self-identities, self-esteem, and place in our above-mentioned social hierarchies was relatively minimal. Unfortunately, with the emergence of the internet, our points of comparison have expanded exponentially because we can now compare ourselves to literally anyone in the world. Thus, we are now exposed to groups that are drastically different from us in terms of wealth, status, power, celebrity, and physical appearance. What had in previous generations been a small gap in our comparisons has become a yawning chasm of differences, in which those differences feel so large and unattainable. Comparison is Often Toxic This new level of comparison has immense implications for many aspects of our psychological and emotional lives. Before the internet, there seemed to be far fewer people to compare ourselves to because there were, in fact, far fewer in our immediate vicinities and in our visual fields. But when so many people that are easily discoverable on the internet seem to be so successful, famous, influential, and beautiful, given our proclivities to compare, it is difficult to not have it influence how we view ourselves. Sadly, these stark comparisons usually result in our feeling inadequate and “less than.” Even if we compare downward (to those less fortunate than we are), it usually only provides a temporary salve to low self-esteem and feelings of inadequacy. These toxic comparisons also erode our emotional lives. When we feel lacking, we experience an array of unpleasant and unhealthy emotions that make happiness and contentment difficult to experience. We feel jealousy and envy for what others have and what we lack. We feel frustration and helplessness for our inability to have what they have. We can even feel bitterness, resentment, and anger at others (but really at ourselves) for the unfairness of it all. We can feel shame, guilt, and humiliation for believing that there is something wrong with us compared to others. And we can feel hurt, sadness, and even despair in realizing that we will never have all of those wonderful things that we think so many people in the world have (in reality, “those people” are a very small number). Again, even if we compare downward, the schadenfreude that we might experience and feelings of superiority from measuring ourselves to those less fortunate can’t easily be considered a healthy emotion. Stop Comparing It’s one thing to realize that you compare yourself to others. It’s another thing to recognize that social comparison is often corrosive to you in so many ways psychologically and emotionally. It’s an entirely other thing to stop yourself from comparing yourself to others. Yet it is possible, and it is worth the effort for your mental health and well-being. Here are some steps you can take to reduce the amount of comparing you do to others. Accept that social comparison is a normal part of being human (but that doesn’t mean you should keep doing it). Recognize when you are comparing (“Here I go again!”). Acknowledge why you are comparing (you may feel threatened by some aspect of another person, for example, accomplishments, relationships, intelligence, appearance). Understand how comparing makes you feel (probably bad!). Acknowledge that continuing to compare will only hurt you. Ask yourself whether you have high or low self-esteem and perceived control to better understand how social comparison affects you. Realize that we tend to compare our lesser qualities with others’ best qualities (not apples to apples), so you put yourself in a no-win situation. Put your comparisons in context, meaning put those lesser perceptions you have of yourself and those more admirable perceptions of others into a broader picture of who you and they really are in toto. Recognize that you only see the outside of a person and have little knowledge of who they are inside (they may appear happy on the outside but may be miserable on the inside). Accept your humanity (we are all imperfect beings, who still deserve love, respect, and appreciation). Focus on your strengths (you may be “lesser” than others in some ways, yet “more” than others in other ways). Focus on your goals and how to achieve them (remind yourself who you want to be). Limit social media (it tends to make comparison more noxious). If you do compare, use comparison as motivation (“If they can be that way, so can I!”). Shift your focus onto who you want to be and what you want to accomplish. Jim Taylor, Ph.D. - Website - Book -

The call for a more gender-sensitive understanding of autism. During Thanksgiving dinner, Beth's aunt asked her how she was enjoying college. This seemingly innocent question triggered Beth's discomfort and prompted her to abruptly exit the room. Beth is frequently misunderstood by her family, who have labeled her as "difficult," "angry," and “aloof." Her relatives have gossiped that Beth’s parents should have taught her to be more socially appropriate. No one, including Beth’s parents, ever asked the question: “Might Beth be on the spectrum?” Why? Well, she never looked like her cis-gender male cousin who, at 6 years old, was throwing temper tantrums, getting in trouble at school, and knew the number of floors in every major skyscraper in the world. Diagnostic Criteria for Autism: Gender Specificity The diagnostic criteria for autism spectrum disorder (ASD) were initially based largely on male presentations. Women like Beth may have non-male-specific manifestations of ASD. For instance, women may demonstrate fewer stereotypical behaviors and have strengths in social motivation, executive function, and intelligence. These variations complicate timely diagnosis, leaving individuals without essential support and interventions vital to their well-being. In response to this disparity, the Autism Center of Excellence (ACE) Network is actively working on a gender-sensitive tool for ASD assessment, aiming to bridge the diagnostic gap and ensure timely and appropriate support. Autism Spectrum Disorder (ASD) can present differently in men and women, though it’s crucial to recognize that these are general trends and may not apply to every individual. 1. Social Differences Men: Often display more noticeable social difficulties, such as challenges in forming friendships, understanding social cues, and engaging in reciprocal social interactions. Women: May develop coping mechanisms that allow them to camouflage or mask their social difficulties. They might mimic social behaviors, which can make it less apparent that they are experiencing challenges in social situations. 2. Communication Differences Men: May exhibit more pronounced language and communication difficulties. For example, they may have delayed language development or struggle with maintaining conversations. Women: Can be more verbally fluent and may develop compensatory strategies, such as memorizing social scripts, to navigate social interactions. This might make their communication difficulties less noticeable. 3. Interests and Activities Men: Often show intense and narrow interests, focusing on specific topics or activities to the exclusion of others. Women: May have more varied interests and may be able to blend in more easily with neurotypical peers by adopting interests that are more socially acceptable. 4. Sensory Sensitivities Men and Women: Both genders may experience sensory sensitivities, such as hypersensitivity or hyposensitivity to sensory stimuli like lights, sounds, or textures. 5. Diagnosis and Recognition Men: Tend to be diagnosed with ASD more frequently, possibly because their symptoms are often more overt and align with traditional diagnostic criteria. Women: May be underdiagnosed or diagnosed later in life due to differences in the manifestation of symptoms and a greater ability to mask difficulties. The Impact of Undiagnosed ASD: A Link to Depression The silent epidemic of undiagnosed women with ASD exposes them to a heightened risk of depression. Without a timely diagnosis, individuals like Beth may struggle to understand and navigate the challenges they face, leading to persistent feelings of isolation, anxiety, and frustration. The absence of appropriate interventions and support further exacerbates these struggles, compounding the emotional toll on undiagnosed individuals. Psychologists have a responsibility beyond awareness: to challenge stereotypes and advocate for gender-sensitive diagnostic tools. Understanding the intricacies of ASD in women contributes to a more inclusive environment, paving the way for a brighter future for those navigating the intricate landscape of neurodiversity. Cara Gardenswartz, Ph.D. - Website -

Letting go of your work-life is formidable. Take time to let it sink in. Retirement can pack an emotional and existential wallop. Take a break before redirecting yourself. Letting go of a lifetime of work is a great opportunity to practice what the Sufis call “sacred drift.” Retirement may be the end of work, but not of evolving. Ask, “In how many ways can I continue to evolve?” Whenever I visited my father at the factory he owned in New York, he would usher me into the back office—which was his fathers before him—and motion toward a green vinyl couch in the corner. He would then position himself across the room, in a high-backed leather chair beneath a shield and two crossed swords, at a mahogany desk big enough to play a couple of rounds of golf on. He would lean his elbows on the desk, fist in palm, and look at me over his bifocals—a posture I took to be one of intimidation, or, perhaps, camouflage. On one particular visit, I invited him to come out from behind the desk and sit with me on the green vinyl couch. Long pause. Then he rose and walked slowly around the desk, keeping his fingers on it the whole time, breaking contact only at the last possible moment, before crossing that moat between us. When he finally sat next to me, I thought I saw on his face a look of pride mixed with sheepishness. This is one of the memories that came to me recently as I began deliberating about retirement, or rewirement, or call it what you will. A desk is emblematic of work-life, and stepping out from behind it—whether momentarily or permanently—is an act of vulnerability. And courage. It’s re-positioning yourself in relation to the world, to others, and to your own sense of power. In fact, any role you inhabit is, in part, motivated by the desire for power, and we don’t generally like letting go of power, as human history demonstrates with brutal and protracted eloquence. The readiness or willingness to even consider letting it go by relinquishing our work-life is sometimes fueled by nothing more than a hunch that there are other involvements equally worthy of our energies as the contributions we’ve made through our work, equally compelling and valuable, if not moreso: the building (or re-building) of relationships and community, the enjoyment of the natural world, the exploration of the spiritual life, the calls of elderhood, or the making of some peace with yourself that has so far eluded you. At the end of his life, psychologist Abraham Maslow changed his famous hierarchy of needs pyramid, at the bottom of which was always food-clothing-and-shelter and at the top of which was “self-actualization”—which he replaced with “self-transcendence.” He realized that self-actualization is still about the self-seeking its own potential, still about tinkering with the ego, whereas transcendence is a decentralizing of self, an extending of awareness and frame of reference beyond your own borders. Self-actualization isn't the be-all and end-all, but a transitional goal, and retiring its agendas isn’t just about pocketing a gold watch, moving to Florida, and playing golf, not that there’s anything inherently wrong with any of those things. But retirement may confront you in the most profound and often rattling ways with who you are, how you operate in the world , and how attached you are to your mental models. Or more to the point, who you are now, and what parts of you want airtime in the time remaining. And this won’t unfold at the flick of a switch. A lifetime of working—certainly of striving to attain the mythic summit of your potential—generates a tremendous momentum that doesn’t end just because work ends. It’s a bit like a head-on collision. The car stops, but the passenger doesn’t. The books I’ve been reading lately about retirement certainly speak of the challenges of losing a sense of identity, purpose, and power, but they instruct me to get busy again as soon as possible, filling up my calendar with new sources of these commodities, filling up the presumed holes in my sense of meaning and contribution left by the cessation of my work-life. Short shrift is given to the hard human work of making peace with the emotional and existential wallop of it (at least for many people) and the need to unabashedly face ourselves inside that vacuum. Because there is the backside of ambition, the downside of upward mobility, the brute existential fact of getting old and fading from view, and the imperative of learning to manage losses and endings. There is the truth that if your sense of value is pegged to visible achievement and external validation, you’ll be freaked out at the prospect of retirement. To say nothing of the anxiety about whether you can even afford to retire. But it’s critical to understand that even if you identify hugely with your work, have loved it, and will miss its benedictions, it isn’t your identity any more than the tip of an iceberg is an iceberg. Letting go of a career isn’t letting go of your true work in the world, not if you have what people call "a mission statement for your life." Let’s say your deepest calling, your soul’s work, if you will, is to model and educate (literally draw out) passion and self-expression in yourself and others—say as a teacher, life-coach, or performer. This isn’t something you retire from any more than you can retire from your personality. Such a mission is big enough to encompass a lifetime’s worth of activity in a multitude of arenas, not just a career, and certainly not just a job. (A good primer on crafting a mission statement is a book called The Path, by Laurie Beth Jones.) Early in the conversation with myself about retirement, while still stoned on self-actualization, I signed up for a weekend retreat on “designing your life.” But months later, on the morning it began, I woke up feeling deflated. “I don’t want to design my life. I want to listen to it.” The word retirement comes from the old French retirer, meaning "to go off into seclusion"—which is precisely what makes the prospect of retirement unnerving, but precisely what I sense needs to happen before I start scripting my retirement and spread-sheeting my future. That is, I need a break, a pitstop. Time to reflect and engage in what the Sufis call “sacred drift.” Time to let my soul catch up with my new circumstances, to celebrate my contributions, perhaps even do some griefwork around letting them go. “What is your karmic assignment right now?” the author John Kabat-Zinn asked the audience at a conference I recently attended called Wisdom 2.0. “And if it’s not-knowing, that may be the most powerful assignment of all.” Indeed, my impulse at this juncture is to not be impulsive, not just hop from one train to another, but step off the track altogether for a little while. Motion isn’t necessarily progressing any more than noise is necessarily music, and before I jump to problem-solving, I want to consider that retirement isn’t a problem to solve but a passage to navigate, and that I’m certainly not going to retire from evolving, or continuing the work of becoming myself, if not transcending myself. In fact, rather than focusing on what my next iteration is going to look like, what new roles I can invent for myself, perhaps the better question is, “In how many ways can I practice evolving?” Or, “In how many ways can I express my mission statement?” During this not-knowing period that I’ve been allowing myself for the past six months or so, this eddying-out from the current, I’ve been feeling the hunger to create a retirement ritual for myself, a rite of passage to commemorate the relinquishment of the work-life I’ve known for almost 50 years. And then, a few weeks ago—the universe and its mysterious ways being what they are—a ritual found me. An unplanned and perfectly fitting retirement ritual. My desk—and what’s more iconic of work-life than a desk? —broke apart in attempting to move it. The desk on which I’d written all of my books, hundreds of articles and blog posts, and from which I’d orchestrated my entire freelance and speaking careers. It was a most literal break with tradition, and a more appropriate observance I can’t imagine. Gregg Levoy - Website -

What happens when we procrastinate and how we can stop. Procrastination, often a habitual choice, provides temporary relief by lowering anxiety in the moment. Procrastination negatively impacts our performance and leaves us physically and mentally exhausted. Through awareness and practical strategies, we can break harmful patterns of procrastination. Most of us have done it at some point. For many of us, it’s an ongoing, persistent, and highly problematic habit we would love to break. We put off a dreaded task until the time comes when we can no longer ignore it. Procrastination is a choice—and a bad one that can become an entrenched habitual way of approaching work that we find challenging, overwhelming, or uninteresting. Temporary benefits As any habitual procrastinator will tell you, procrastination is a major problem that causes them nothing but grief and harm. Rather than ride out these uncomfortable emotions—which subside as we get down to the task at hand—we procrastinate, and temporarily relieve and avoid uncomfortable symptoms of anxiety. When we struggle with mood, anxiety, and high-stress symptoms, procrastination can feel like a healthy choice in the moment. But since it is a choice that inevitably leads to even greater states of anxiety, a far better choice is to focus on managing symptoms to make healthier choices. Longer-term problems Eventually, delaying a task is no longer an option. Here, procrastinators find themselves working long, unreasonable hours to complete assignments or tasks, while experiencing overwhelming symptoms of anxiety. With symptoms of anxiety and dread raging and little time to complete a project, we are forced to push through and complete the task at hand. We are trapped and forced to push ourselves beyond the point of exhaustion to complete a task on time. Procrastination negatively impacts our performance, leads to burnout , and leaves us emotionally, physically, and mentally exhausted. It compromises our immune systems and makes us susceptible to illness. The stories we tell ourselves Procrastination is an avoidance behavior. We tell ourselves a lot of stories to justify such behaviors, but such stories do us more harm than good. Some of the most common false narratives about procrastination include the following: I don’t want to start a task when I’m tired . Putting off tasks while feigning self-care concerns is a slippery slope, considering the lost sleep, skipped meals, and other unhealthy choices we make to complete a project at the last minute, I work best under pressure . Even if you do pretty well when rushing to complete your work, when you procrastinate, you sell yourself short. When you allow yourself sufficient time and energy to complete a task in the allotted time, you have time to review and rework areas where you see room for improvement, to reflect, contemplate, revise, and polish your work. Imagine how well I would have done with more time . If we have managed to complete a task fairly well—even though it falls short of what are capable of—we tell ourselves how brilliant we must be and feel good about how capable we must be and how well we would do if we had the luxury of the time allowed to complete the task. This final narrative, a false sense of accomplishment, leads to repeating patterns of procrastination. And each time we procrastinate, the habit and choice of procrastination sets in and grows stronger and less manageable. 6 steps to breaking the bad habit of procrastination Here’s the good news. Through awareness and practical strategies, you can break harmful patterns of procrastination. Realize that procrastination is an unhealthy choice that does not serve you. Accept the fact that procrastination is never a good choice. Reflect on how procrastination has affected your performance, your health, your relationships, and your life. Remember the many times you’ve promised to change your ways but find yourself trapped in habits of procrastination. Challenge the stories you tell yourself about procrastination. Identify practical strategies to help eliminate procrastination. Seek the help Monica Vermani, C. Psych., - Website - Book - References Charlotte Lieberman. Why You Procrastinate (It Has Nothing to Do With Self-Control). March 25, 2019. New York Times.

Toxic masculinity may hinge on devaluing femininity. There have been many attempts to define or describe toxic masculinity. Many of these attempts are too complicated or insufficient. One condition common to all definitions of toxic masculinity is the devaluing of femininity. The concept of toxic masculinity has received considerable attention in the past few years following the #Me-Too movement and various exposés of bro cultures, notably in the tech industry. But what exactly is toxic masculinity? The concept seems challenging to define, but much like the Supreme Court definition of hard-core pornography, you probably know it when you see it. There are many attempts at definitions, but they are typically overcomplicated or fall short of grasping the essence of toxic masculinity. When identifying the existence of a concept such as toxic masculinity, there are both necessary and sufficient conditions for its occurrence. A necessary condition, such as the expression of masculinity, must be present in all instances of toxic masculinity. However, masculinity is not sufficient by itself to be considered toxic. Masculinity can be positive when it is expressed by either men or women in the form of strength, ambition, courage, leadership, and self-reliance. There needs to be something more to the mix to make it toxic. A sufficient condition of toxic masculinity, such as hazing or sexual harassment, is enough to classify masculinity as toxic. However, these conditions are not necessary. A culture can have toxic masculinity without hazing or sexual harassment, such as a workplace that expects you to put your job above everything else in your life. It still leaves open the question of what puts the toxic in toxic masculinity. Others have offered more complicated definitions that really just enumerate its symptoms. For example, social scientists have characterized toxic masculinity cultures in the workplace – which they call “masculinity contest cultures” – as having four qualities. Employees are expected to (1) show no weakness or vulnerability, (2) display strength and stamina, (3) prioritize work over personal interests and family obligations, and (4) accept a “dog eat dog” competitive environment of winners and losers. Another article in the New York Times identifies toxic masculinity through “suppressing emotions or masking distress,” “maintaining an appearance of hardness,” and “violence as an indicator of power.” These descriptions are helpful, but the definition of toxic masculinity can be much simpler. My definition identifies a necessary and sufficient condition for a culture of toxic masculinity, and that is simply any context that devalues the positive aspects of femininity. Toxic masculinity and bro cultures exist where people – mostly men, but not exclusively so – dismiss or punish feminine qualities of care, warmth, empathy, diplomacy, sensitivity, mutual respect, etc. I challenge anyone to find a culture of toxic masculinity that embraces these feminine characteristics. Further, I challenge anyone to find a group of men or women who reject positive aspects of femininity who would not also be considered toxic by most. Nailing down a clear and simple definition of toxic masculinity is important for making sure we’re all talking about the same thing when addressing the problem, but it also helps identify ways to address toxic masculinity where it occurs. For example, interventions can include injecting reminders of the importance of care, inclusion, and empathy. A workplace can still be competitive and avoid toxicity by cultivating more feminine qualities such as a sense of teamwork and the promotion of mental health. The great challenge then will be encouraging men who are sources of toxic masculinity to embrace those positive aspects of femininity described above. It’s resistance to this femininity, and not masculinity by itself, that should be the focus of concern in changing cultures of toxic masculinity. PJ Henry, Ph.D., - Website -

Creating a path to a less lonely world. Loneliness is a global health issue that can profoundly impair mental and physical health. Combating loneliness requires solutions at all levels, from individual to international. Just as our culture has embraced mental health, we should have honest conversations about loneliness. On Kill Bill, SZA sang that she’d “rather be in jail than alone.” As an emotional alarm signal motivating us to focus on connection , loneliness is core to our human psychology and biology. In small doses, loneliness is a valuable reminder that our relationships are our greatest sources of joy, support, and meaning. But when it becomes severe and chronic, loneliness can feel all-consuming. Beyond a personal struggle, loneliness is now recognized as a global health issue capable of profoundly impairing mental and physical health across the lifespan . With leaders in science and politics calling for a society-wide fight against loneliness, efforts to support connection are gaining traction amid growing scientific evidence. U.S. Surgeon General Vivek Murthy recently released an advisory on loneliness in the United States, advocating for a comprehensive restructuring of American life to prioritize connection and belonging. In the New York Times, Murthy said, "If we truly want to be healthy, happy and fulfilled as a society, we have to restructure our lives around people. Right now, our lives are centered around work." Combating loneliness will require solutions from the individual level to the international. As awareness of loneliness’ societal costs grows, government policymakers are beginning to reconsider how social policies across the realms of housing, employment, welfare benefits, and infrastructure could support social relationships and community-building. More and more workplaces are looking to foster company cultures that prize kindness, generosity, and sharing among employees. And popular media creators are exploring their role in shifting cultural conversations about loneliness. Moving Past Stigma The first step in addressing loneliness is challenging its pervasive stigma—the idea that loneliness is not only a feeling but an immutable mark of communal rejection. When lonely people come to believe their loneliness reflects a personal inadequacy, they may give up on working to overcome it. Likewise, when others believe that lonely people could be social burdens whose ostracism is deserved and even contagious, they might hesitate to lend a helping hand. Just as our culture has grown more accepting of mental health struggles in recent decades, we can shift our preconceptions about loneliness for the better. The first step is to break down the taboo of talking about loneliness. By rejecting stigmatizing narratives, we gain breathing room to explore more productive solutions. Speaking up about personal struggles with loneliness takes bravery, but saying nothing only reinforces its stigma. When SZA expressed her feelings in Kill Bill, she risked judgment to open up an honest discussion. Our cultural silence about loneliness belies the fact that we can do so much about it. What can we do to help ourselves and those around us deal with loneliness? The current movement to address global loneliness has exciting potential to improve lives, yet these systemic changes are just one part of overcoming loneliness. Loneliness is still in many ways a highly personal challenge, so overcoming it often requires individual effort. Fortunately, as I discuss in part 2 of this piece, a wide range of effective approaches exist, each with distinct benefits. Benji Kaveladze, Ph.D., References Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of behavioral medicine , 40 (2), 218-227. Hickin, N., Käll, A., Shafran, R., Sutcliffe, S., Manzotti, G., & Langan, D. (2021). The effectiveness of psychological interventions for loneliness: A systematic review and meta-analysis. Clinical Psychology Review , 88 , 102066. Murthy, & The Office of the Surgeon General. (2023). Our epidemic of loneliness and isolation: The US Surgeon General’s advisory on the healing effects of social connection and community.

New evidence shows reward and punishment learning differs across adolescence. Adolescence is typically linked to greater risk-taking and sensitivity to rewards. Learning from punishment increases from childhood to adolescence whereas learning from reward remains stable. These findings could be important for understanding antisocial behavior and improving learning. Adolescence, the transitional phase from childhood dependency to adulthood, is a complex period marked by significant changes in behavior. Many of these are positive, developing adolescents’ independence, but young people are also more likely to take risks and seek rewarding experiences even if they are dangerous, such as substance use. Theoretical frameworks propose that this heightened risk-taking, impulsivity, and reward-seeking are linked to changes in the brain. Moreover, adolescence is identified as a high-risk period for mental disorders, particularly disruptive behavior disorders associated with impulsivity. New research suggests that there are also important differences in learning from reward and punishment as we transition from childhood to adolescence, and these may be crucial for understanding this critical life stage. Challenges in Understanding Adolescent Behavior The complexity of adolescent behavior poses challenges for researchers. Traditional analysis techniques used in psychology often fall short of capturing underlying psychological processes. In addition, while taking risks, being impulsive, and seeking positive experiences are related behaviors, there is evidence linking them to different brain systems and distinct psychological processes. Previous research also often relied on questionnaires. In other areas of psychology, researchers have begun to use data science techniques that look at adolescents’ choices in simple games. Researchers can use these choices to decode how much adolescents learn from receiving rewards, such as small amounts of money or seeing smiling faces on the screen, and how much they learn from punishments or bad outcomes, like losing small amounts of money or seeing unhappy faces. Another challenge is that there is already some evidence that adolescents have a preference to act rather than resist making an action. For example, in an arcade game, it might be that pressing buttons gives you points, but at other times in the game, you score more points if you do nothing. In experiments, if children press buttons more than older adolescents, it can be hard to disentangle whether they just prefer doing something over waiting passively or whether they are actually more motivated to get the points or rewards. We wanted to design an experiment that could distinguish between these two possibilities. Computational Modeling: A New Frontier To try to overcome these challenges, we turned to a data science method, computational modeling, and, specifically, reinforcement learning models. These models assume that actions and outcomes become linked through experience, and this experience influences future behavior. For example, if you try a new tactic in a game and you unexpectedly win lots more points, you are much more likely to make the same action again. At the start, you learn a lot of new information about the consequences of what you did, but then if you keep repeating it, it becomes more predictable and less surprising each time. Now imagine you try a new tactic in a game and lose all of your points; you are very unlikely to try that again next time. The difference between these winning and losing examples shows the difference between learning from rewards compared to punishments. While previous studies have hinted at differences from childhood to adolescence in how people learn from rewards and punishments, there were still inconsistencies. Some of these inconsistencies might be explained by the tendency to test relatively small groups of adolescents from similar backgrounds. Often in psychology studies, the sample might only be from one university in one country, and it might be quite small, with fewer than 50 people. This is often necessary, but it might help us to draw stronger conclusions if we see the same thing over many young people. We also wanted to be able to compare lots of adolescents across multiple countries so that our research findings might be more representative of all adolescents. Separating Learning From Reward, Punishment, and Action Initiation Bias To try to overcome some of these challenges, we tested a sample of 742 young people aged 9 to 18 years from multiple countries in Europe. The young people played a trial-and-error task involving abstract 3-D objects, in which they had to learn when to act (press a button) to win points and when to withhold responding (do nothing) to avoid losing points. We used data science models of reinforcement learning models to measure how participants learned from reward compared to punishment. We also calculated each person’s tendency to always act known as their “action initiation bias.” Our findings challenged previous assumptions about adolescent reward and punishment learning. We found that adolescents, compared to children, did not learn better from rewards. From childhood to adolescence (ages 9-18 years), the ability to learn from reward remained the same. However, there were also important differences. The ability to learn from punishment (losing points) increased from childhood to late adolescence. At the same time, the tendency to perform actions regardless of whether they won points or not decreased. If we had not also measured this tendency to perform actions "impulsively" (i.e., regardless of winning points), we might have concluded that adolescents also got better at learning from rewards, but adolescents just became better at withholding actions when it helped their performance. Implications for Adolescent Learning We know that the transition from childhood to adolescence is one of the most common times for the start of mental health problems and, particularly, disruptive behaviors. In our next study, we will compare reward, punishment, and action learning in young people who struggle with disruptive behavior. Our findings also underscore the complexity of adolescent behavior, and the challenges researchers face in understanding it. The use of data science offers a promising avenue for unraveling the intricacies of reward learning, punishment learning, and action initiation biases during adolescence. As we continue to navigate the complexities of adolescence, these findings help contribute to more nuanced approaches to studying and supporting young individuals during this crucial developmental phase. Patricia Lockwood, Ph.D., and Jo Cutler, Ph.D. References Blakemore, S. J. (2018). Avoiding social risk in adolescence. Current Directions in Psychological Science, 27(2), 116–122. Hartley, C. A., & Somerville, L. H. (2015). The neuroscience of adolescent decision-making. Current Opinion in Behavioral Sciences, 5, 108–115. Konovalov, A., & Krajbich, I. (2019). Over a decade of neuroeconomics: What have we learned?. Organizational Research Methods, 22(1), 148–173. Nussenbaum, K., & Hartley, C. A. (2019). Reinforcement learning across development: What insights can we draw from a decade of research? Developmental Cognitive Neuroscience, 40, 100733. Pauli, R., Brazil, I. A., Kohls, G., Klein-Flügge, M. C., Rogers, J. C., Dikeos, D., ... & Lockwood, P. L. (2023). Action initiation and punishment learning differ from childhood to adolescence while reward learning remains stable. Nature Communications, 14(1), 5689.