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Delaying Gratification and Social Trust

1900 words

Tests of delayed gratification, such as the Marshmallow Experiment, show that those who can better delay their gratification have better life outcomes than those who cannot. The children who succumbed to eating the treat while the researcher was out of the room had worse life outcomes than the children who could wait. This was chalked up to cognitive processes by the originator of the test, while individual differences in these cognitive processes also were used as explanations for individual differences between children in the task. However, it doesn’t seem to be that simple. I did write an article back in December of 2015 on the Marshmallow Experiment and how it was a powerful predictor, but after extensive reading into the subject, my mind has changed. New research shows that social trust has a causal effect on whether or not one would wait for the reward—if the individual trusted the researcher he or she was more likely to wait for the other reward than if they did not trust the researcher, in which they were more likely to take what was offered in the first place.

The famous Marshmallow Experiment showed that children who could wait with a marshmallow or other treat in front of them while the researcher was out of the room, they would get an extra treat. The children who could not wait and ate the treat while the researcher was out of the room had worse life outcomes than the children who could wait for the other treat. These lead researchers to the conclusion that the ability to delay gratification depended on ‘hot’ and ‘cold’ cognitive processes. According to Walter Mischel, the originator of the study method, the ‘cool’ system is the thinking one, the cognitive system, which reminds you that you get a reward if you wait, while the ‘hot’ system is the impulsive system, the system that makes you want the treat now and not want to wait for the other treat (Metcalfe and Mischel, 1999).

Some of these participants were followed up on decades later, and those who could better delay their gratification had lower BMIs (Schlam et al, 2014); scored better on the SAT (Shoda, Mischel, and Peake, 1990) and other tests of educational attainment (Ayduk et al, 2000); along with other positive life outcomes. So it seems that placing a single treat—whether it be a marshmallow or another sweet treat—would predict one’s success, BMI, educational attainment and future prospects in life and that there are underlying cognitive processes, between individuals that lead to differences between them. But it’s not that simple.

After Mischel’s studies in the 50s, 60s and 70s on delayed gratification and positive and negative life outcomes (e.g., Mischel, 1958; Mischel, 1961Mischel, Ebbeson, and Zeiss, 1972) it was pretty much an accepted fact that delaying gratification somehow was related to these positive life outcomes, while the negative life outcomes were partly a result of the lack of ability to delay gratification. Though in 2014, a study was conducted showing that ability to delay gratification depends on social trust (Michaelson et al, 2013).

Using Amazon’s Mechanical Turk, (n = 78, 34 male, 39 female and 5 who preferred not to state their gender) completed online surveys and read three vignettes in order—trusty, untrustworthy and neutral—while using a scale of 1-7 to note how likeable, trustworthy, and how sharing their likelihood of sharing. Michaelson et al (2013) write:

Next, participants completed intertemporal choice questions (as in Kirby and Maraković, 1996), which varied in immediate reward values ($15–83), delayed reward values ($30–85), and length of delays (10–75 days). Each question was modified to mention an individual from one of the vignettes [e.g., “If (trustworthy individual) offered you $40 now or $65 in 70 days, which would you choose?”]. Participants completed 63 questions in total, with 21 different questions that occurred once with each vignette, interleaved in a single fixed but random order for all participants. The 21 choices were classified into 7 ranks (using the classification system from Kirby and Maraković, 1996), where higher ranks should yield higher likelihood of delaying, allowing a rough estimation of a subject’s willingness to delay using a small number of trials. Rewards were hypothetical, given that hypothetical and real rewards elicit equivalent behaviors (Madden et al., 2003) and brain activity (Bickel et al., 2009), and were preceded by instructions asking participants to consider each choice as if they would actually receive the option selected. Participants took as much time as they needed to complete the procedures.

When one’s trust was manipulated in the absence of a reward, within the group of subjects influenced their ability to delay gratification, along with how trustworthy one was perceived to be, influenced their ability to delay gratification. So this suggests that, in the absence of rewards, when social trust is reduced, ability to delay gratification would be lessened. Due to the issues of social trust manipulation due to the order of how the vignettes were read, they did a second experiment using the same model using 172 participants (65 males, 63 females, and 13 who chose not to state their gender). Though in this experiment, a computer-generated trustworthy, untrustworthy and neutral face was presented to the participants. They were only paid $.25 cents, though it has been shown that the compensation only affects turnout, not data quality (Burhmester, Kwang, and Gosling, 2011).

In this experiment, each participant read a vignette and there was a particular face attached to it (trustworthy, untrustworthy and neutral), which were used in previous studies on this matter. They found that when trust was manipulated in the absence of a reward between the subjects, this influenced the participants’ willingness and to delay gratification along with the perceived trustworthiness influencing it as well.

Michaelson et al (2013) conclude that the ability to delay gratification is predicated on social trust, and present an alternative hypothesis for all of these positive and negative life outcomes:

Social factors suggest intriguing alternative interpretations of prior findings on delay of gratification, and suggest new directions for intervention. For example, the struggles of certain populations, such as addicts, criminals, and youth, might reflect their reduced ability to trust that rewards will be delivered as promised. Such variations in trust might reflect experience (e.g., children have little control over whether parents will provide a promised toy) and predisposition (e.g., with genetic variations predicting trust; Krueger et al., 2012). Children show little change in their ability to delay gratification across the 2–5 years age range (Beck et al., 2011), despite dramatic improvements in self-control, indicating that other factors must be at work. The fact that delay of gratification at 4-years predicts successful outcomes years or decades later (Casey et al., 2011; Shoda et al., 1990) might reflect the importance of delaying gratification in other processes, or the importance of individual differences in trust from an early age (e.g., Kidd et al., 2012).

Another paper (small n, n = 28) showed that the children’s perception of the researchers’ reliability predicted delay of gratification (Kidd, Palmeri, and Aslin, 2012). They suggest that “children’s wait-times reflected reasoned beliefs about whether waiting would ultimately pay off.” So these tasks “may not only reflect differences in self-control abilities, but also beliefs about the stability of the world.” Children who had reliable interactions with the researcher waited about 4 times as long—12 minutes compared to 3 minutes—if they thought the researcher was trustworthy. Sean Last over at the Alternative Hypothesis uses these types of tasks (and other correlates) to show that blacks have lower self-control than whites, citing studies showing correlations with IQ and delay of gratification. Though, as can be seen, alternative explanations for these phenomena make just as much sense, and with the new experimental evidence on social trust and delaying gratification, this adds a new wrinkle to this debate. (He also shortly discusses ‘reasons’ why blacks have lower self-control, implicating the MAOA alleles. However, I have already discussed this and blaming ‘genes for’ violence/self-control doesn’t make sense.)

Michaelson and Munakata (2016) show more evidence for the relationship between social trust and delaying gratification. When children (age 4 years, 5 months, n = 34) observed an adult as trustworthy, they were able to wait for the reward, compared to when they observed the adult as untrustworthy they ate the treat thinking that, since they observed the adult as untrustworthy, they were not likely to get the second marshmallow than if they waited for the adult to return if they believed him to be untrustworthy. Ma et al (2018) also replicated these findings in a sample of 150 Chinese children aged 3 to 5 years old. They conclude that “there is more to delay of gratification than cognitive capacity, and they suggest that there are individual differences in whether children consider sacrificing for a future outcome to be worth the risk.” Those who had higher levels of generalized trust waited longer, even when age and level of executive functioning were controlled for.

Romer et al (2010) show that people who are more willing to take risks may be more likely to engage in risky behavior that provides insights to that specific individual on why delaying gratification and having patience leads to longer-term rewards. This is a case of social learning. However, people who are more willing to take risks have higher IQs than people who do not. Though SES was not controlled for, it is possible that the ability to delay gratification in this study came down to SES, with lower class people taking the money, while higher class people deferred. Raine et al (2002) showed a relationship between sensation seeking in 3-year-old children from Mauritius, which then was related to their ‘cognitive scores’ at age 11. As usual, parental occupation was used as a measure of ‘social class’, and since SES does not capture all aspects of social class then controlling for the variable does not seem to be too useful. Because a confound here could be that children from higher classes have more of a chance to sensation seek which may cause higher IQ scores due to cognitive enrichment. Either way, you can’t say that IQ ’causes’ delayed gratification since there are more robust predictors such as social trust.

Though the relationship is there, what to make of it? Since exploring more leads to, theoretically, more chances to get things wrong and take risks by being impulsive, those who are more open to experience will have had more chances to learn from their impulsivity, and so learn to delay gratification through social learning and being more open. ‘IQ’ correlating with it, in my opinion, doesn’t matter too much; it just shows that there is a social learning component to delaying gratification.

In conclusion, there are alternative ways to look at the results from Marshmallow Experiments, such as social trust and social learning (being impulsive and seeing what occurs when an impulsive act is carried out may have one learn, in the future, to wait for something). Though these experiments are new and the research is young, it’s very promising that there are other explanations for delayed gratification that don’t have to do with differences in ‘cognitive ability’, but depend on social trust—trust between the child and the researcher. If the child sees the researcher is trustworthy, then the child will wait for the reward, whereas if they see the researcher is not trustworthy, they ill take the marshmallow or whatnot, since they believe the researcher is not trustworthy and therefore won’t stick to their word. (I am also currently reading Mischel’s 2014 book Marshmallow Test: Mastering Self-Control and will have more thoughts on this in the future.)

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Transvestic Disorder and Gender Dysphoria Identification and Prevention

2150 words

Abstract

Transvestic Disorder comes about in early childhood and manifests itself in sexually deviant actions. Men suffering from TD who aren’t homosexual, more likely than not, show attraction to themselves dressed in women’s clothing. The signs of TD are noticed at an early age when the individual begins to cross dress. TD is also correlated highly with numerous sexually deviant actions. Fluoxetine and serotonin reuptake blockers may be able to lessen TD since it is an impulsive disorder. With TD being co-morbid with OCD, by treating OCD we can better treat TD itself and give a better quality of life to the patient suffering from the disease. Since autogynephilia and transgenderism are related, measures taken to alleviate TD and autogynephilia could be taken to alleviate symptoms of gender dysphoria, since autogynephilia leads to transgenderism.

 

Transvestic Disorder and Gender Dysphoria Identification and Prevention

            Transvestic disorder is a paraphilic disorder, classified by the American Psychological Association (2013), in which males dress up as women to gain sexual gratification. The individual suffering from TD suffers from compulsions to want to dress as a woman, which causes distress due to the individual not wanting their secret to come out. This then leads to the quality of life of the individual to decrease due to constantly being worried about his secret coming out. TD is diagnosed when a male has sexual feelings and gets sexual arousal from dressing in women’s clothing. It is only diagnosed when these activities are ongoing for at least six months. TD is also similar to another paraphilic disorder called ‘autogynephilia’ (Lawrence, 2011), in which the subject is aroused at the thought of himself being a female, so he, therefore, then begins to dress as a woman to fulfill his sexual desires. Blanchard (1989) proposed that most gender-dysphoric males who do not show sexual arousal to men, instead show sexual arousal to themselves dressed in the opposite sex’s clothing. He concludes that the hypothesis is supported that major types of those men who cross-dress are nonhomosexual, and do so because they become aroused at the thought of dressing as a woman. The DSM V says that autogynephilia is a specifier to transvestic disorder. This is because they are characterized by the same things (American Psychological Association, 2013).

The signs of TD are noticed at very early ages. Most notable are when children begin to cross-dress at or before puberty. This then continues into their adult lives where it begins to be a problem and cause dysfunction due to needing to keep their secret. Dr. Mark Griffiths (2012) states that all though children may engage in transvestic behavior, what differentiates it between an adult suffering from TD is that the child who cross-dresses does so for excitement and pleasure, not for sexual pleasure. Though some researchers say that the disorder is brought on through childhood trauma, i.e., accidental exposure to women’s clothing or exposure to a woman who is undressing. Numerous studies have also concluded that many men who suffer from TD have had to deal with parental separation during childhood.

The American Psychological Association (2013), reports that fewer than 3 percent of males are characterized as having transvestic disorder. TD is most always seen in males, though Moser (2009) noted that in his study using the Autogynephilia Scale for Women (ASW), that out of the 29 respondents that sent back questionnaires, 90 percent would be classified as having autogynephilia. Though, by using a more meticulous definition, only 28 percent were seen to be autogynephilic (Moser, 2009).

Langstrom and Zucker (2005) observed in a sample of 2,450 18 to 60-year-olds in Sweden that transvestic disorder was correlated significantly with being separated from their parents, homosexual relations, higher masturbatory frequency, being easily aroused sexually and pornography use. Also noticed, was a positive attitude in regards to sexual arousal from pain, exposing oneself to a stranger and voyeurism were all positively correlated with TD. Langstrom and Zucker observed how TD is co-morbid with many other paraphilic disorders as well as other deviant behavior. By attempting to treat what TD is correlated with, symptoms of TD can be lessened.

Men suffering from TD and autogynephilia are told that women are the standard of beauty. They then look at themselves in the mirror and see a male and not the standard of beauty they were told of growing up. They then turn to cross-dressing to finally see their “beauty standard” in the mirror but keep it a secret. This strong want to keep their disorder a secret then leads to dysfunction. Men suffering from TD will go to any lengths to hide their secret. This then causes extreme dysfunction in their lives, which leads to a lessened quality of life.

Less than three percent of males suffer from TD in the American population, as such, it is classified as a deviant lifestyle as it deviates from the norm of the population. It causes distress due to them not wanting their secret to be discovered. This, in turn, leads to dysfunction where the individual cannot live their daily lives to the fullest due to their abnormal disorder. It finally leads to danger due to their secret beginning to consume their lives so that they’re not discovered.

There are ways to treat TD. Usmani et al (2012) follow a case study in which a 17-year-old Indian male who had occurring desires to wear his mother’s clothes. He then would masturbate in his mother’s clothes to alleviate himself. This continued on for two years so he could pleasure himself. He was caught by his parents wearing his mother’s clothes and was beaten by them for it. He then said that it is a compulsive behavior and cannot be helped. This case also shows the obsessive compulsive side to TD. They have an urge so strong they cannot help but to do it compulsively to alleviate their sexual desires. He also said that the occurring thoughts then affected his schoolwork as he was so preoccupied with the thought of wearing women’s clothes. All of his brain scans were found to be normal, so what brought on this case in the individual in the case study? He was then diagnosed with TD and prescribed fluoxetine, an antidepressant SSRI. The dose was started at 20 mg and increased by 40 mg once a day for two weeks. In his six-month follow-up, he reported lessened desire to masturbate with women’s clothes (Usmani et al, 2012).

Paraphilias and other related disorders have been thought of as sexual addictions. Though it has been argued that they are not sexual addictions, but are sexual compulsions (Stein et al, S 1992). The researchers reviewed 13 patients who showed signs of TD and were administered serotonin reuptake blockers.  The symptoms of those individuals were then divided into paraphilias, non-paraphilic sexual addictions, and sexual addictions. Stein et al discovered that paraphilias had the least improvement with the reuptake blockers whereas sexual compulsions showed the best improvement. They end up concluding that paraphilias and other related disorders are on the impulsive end of the spectrum compared to the compulsive end. These impulsions, then, have those men suffering from TD have the urge to dress in women’s clothes to fulfill their sexual impulsion.

TD is co-morbid with obsessive compulsive disorder (Abdo, Hounie, de Tubino Scanavino, and Miguel, 2001). They used longitudinal case studies in which they assessed two individuals who had OCD as well as TD. They conclude that some cases of TD may be OCD related and not always be caused by gender dysphoria. Since OCD and TD are co-morbid, by treating symptoms of OCD, the want to cross-dress will lessen, which will then lessen the symptoms of TD. Treatments could include SSRI and fluoxetine, as previously stated in the paper. Other treatment for TD should be looked at, such as treatment for OCD due to the co-morbidity between the two. By doing so, feelings of wanting to cross-dress may lessen due to one of the underlying causes (OCD) of TD being treated.

Autogynephlia could also explain transgenderism.Transvestism can be called both a paraphila and a sexual orientation. Lawrence (2004) says that it can explain mid-life MtF transitions, progression from transvestism to transgenderism, the prevalence of other paraphilias among MtF transsexuals and the late development of male intrest in MtF transsexuals. However, when Lawrence says that “Hormone therapy and sex reassignment surgery can be effective treatments in autogynephilic transsexualism”, that is incorrect. The prevalence of suicide attempts among transgenders is 41 percent according to the Williams Institute, UCLA School of Law, in comparison to 4.6 percent for the average population. That’s almost ten times higher than the national average. Clearly, surgery doesn’t do anything to alleviate the feelings of gender dysphoria, and as shown in this paper, therapy and drugs like Prozac can better help to alleviate feelings of gender dysphora in transsexuals due to them being extremely similar to eachother. These two disorders greatly mirror each other. Since Lawrence (2004) observed that there is a progression from transvestism to transgenderism, using similar techniques that work on those with TD may also work on those with gender dysphoria.

 

Discussion

TD can be helped with the correct therapy as well as right medication. With those, impulsions to wear women’s clothes, as well as impulsions to commit abnormal acts will be greatly lessened and quality of life will be restored to a somewhat normal level. Due to co-morbidity between TD and OCD, treating OCD will, in turn, better help the patient suffering from TD. When more studies are carried out on those suffering from TD, we can see whether or not SSRI drugs and fluoxetine will have the desired effect in alleviation of the symptoms of TD. The individual in the Usmani study reported lessened symptoms and impulsions of cross-dressing, so by identifying which parts of the brain are and were activated during the fluoxetine therapy, we can then better give better care and treatment to those suffering from TD. We can also use some data from TD cases for transgenders, as TD and transgenders have a lot of things in common. With therapy as well as, maybe even fluoxetine (which is just Prozac), and high doses of testosterone/estrogen, this could possibly help to alleviate ‘gender dysphoria’. It could also lower the suicide rate as it’s completely possible that these interventions could fix them mentally.

 

Conclusion

There is little current literature in treating TD, due to it being a shameful disorder and many men not speaking about what they suffer from. One major way in which to help those with TD is to administer SSRI drugs, in which compulsion to cross-dress, and other attitudes associated with TD lessened. Blanchard (1989) proposed the autogynephilia theory for those transgenders who are not attracted to men. With the obseration by Lawrence (2004) on how autogynephilia and transgenderism are related, this can better help those with transgenderism, as they can get correct help and the right hormones they need, instead of the opposite hormones. SSRI therapy is a good candidate in treating TD, as drastic changes in deviant behavior are seen while the patient is taking the SSRI drug. Seeing as most cases of TD begin in childhood before puberty, by better identifying warning signs of these disorder, we can better treat those children who are at risk of developing these disorders before they become a big problem later in life. As more men come out and say that they suffer from these disorders, more studies can be carried out that corroborate the findings in the studies laid out here. It is extremely promising that these disorders can be treated with common drugs already on the market. In those individuals suffering from TD as well as OCD, by treating the OCD first (which may be an underlying cause) the symptoms of TD may be lessened and the individual may eventually have the ability to lead a life without TD. In using these measures on those with transgenderism, this could possibly alleviate suicide rates and other negative variables associated with these paraphilic disorders and sexual orientations.

 

References

Abdo, C.H.N., Hounie, A., de Tubino Scanavino, M., & Miguel, E.C. (2001). OCD and transvestism: Is there a relationship?. ACTA Psychiatrica Scandinavica, 103(6

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Blanchard, R. (1989). The Concept of Autogynephilia and the Typology of Male Gender Dysphoria. The Journal of Nervous and Mental Disease, 177(10), 616-623. doi:10.1097/00005053-198910000-00004

Griffiths, M. (2012, February 28) Dressed to thrill? A brief overview of transvestic fetishism. Retrieved from https://drmarkgriffiths.wordpress.com/2012/02/28/dressed-to-thrill-a-brief-overview-of-transvestic-fetishism/

Lawrence AA . Autogynephilia: An Underappreciated Paraphilia . In: Balon R, Hrsg . Sexual Dysfunction: Beyond the Brain-Body Connection. Adv Psychosom Med 2011 ; 135 – 148

Långström, N., & Zucker, K. J. (2005). Transvestic fetishism in the general population: Prevalence and correlates. Journal of Sex and Marital Therapy, 31, 87–95

Moser, C. (2009). Autogynephilia in Women. Journal of Homosexuality, 56(5), 539-547. doi:10.1080/00918360903005212

Stein DJ, Hollander E, Anthony DT, Schneier FR, Fallon BA, Liebowitz MR, Klein DF: Serotonergic medications for sexual obsessions, sexual addictions, and paraphilias. J Clin Psychiatry 1992; 53:267–271

Usmani et al, (2012) Treatment of Transvestic Fetishism With Fluoxetine: A Case Report. Iran J Psychiatry Behav Sci. 2012 Autumn-Winter; 6(2): 100–101