Online degree, online education, part 25. APPLIED BEHAVIOR ANALYSIS

APPLIED BEHAVIOR ANALYSIS
Applied behavior analysis is a methodology for systematically applying the principles of learning theory to develop interventions that will improve socially significant behaviors to a meaningful degree, as well as demonstrate that the interventions employed are responsible for the improvement in behavior. Applied behavior analysis has been repeatedly demonstrated to be a highly effective approach across a wide range of problems and environments, including education, mental health and mental retardation, parent training, environmental management, and organizational management. Applied behavior analysis is a specialty used by various professions. It is not regulated by most states, except as part of psychology or other established professions, although there have been a few attempts to recognize trained and qualified behavior analysts over the years. Most recently the nonprofit Behavior Analyst Certification Board has promoted a national certification program to identify and credential qualified practitioners and trainers.

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Principles and Techniques
Several terms besides applied behavior analysis have been used to describe intervention methods based on behavioral learning theories, including behavior modification, behavior therapy, and others. Although sometimes used interchangeably, there are possible distinctions made. Applied behavior analysis is used most often for the orientation that derives predominantly from Skinnerian operant conditioning and follows a radical behavioral philosophy. Although other behavioral orientations often utilize operant principles to differing degrees, they typically place a greater emphasis on classical conditioning processes (the neo-behavioristic mediational model) or cognitions and perceptions as targets for change (social learning theory and cognitive behavior modification) than does applied behavior analysis.
Operant conditioning eschews hypothetical mental constructs as explanatory contracts. Behaviors are viewed as being selected by environmental consequences, much like adaptive changes are in Darwinian evolution, rather than being emitted to serve some future purpose. That is, a child does not cry in order to attract attention but cries because crying has resulted in reinforcing consequences in similar situations in the past (unless, of course, the crying is in response to actual physical discomfort).
The central precept of applied behavior analysis is that behaviors are under the control of environmental stimuli. Functional relationships are described by a three-term contingency that consists of antecedents, responses (behaviors), and consequences. At times these are referred to as the ABCs of behavior. Early uses of behavior analysis focused primarily on changing behaviors through manipulating consequences. All consequences are seen as directly influencing whether behaviors will recur in the future. Conse-quences can be grouped into three main types: reinforcing, punishing, or neutral stimuli.
The first class of consequences, reinforcers, consists of events that increase the future probability of a behavior they immediately follow. These include events that strengthen behaviors when they are presented following the behavior, such as food, attention, or social praise. This operation is referred to as positive reinforcement. For example, a child may learn to apologize because the apology consistently is followed by parental praise. Behaviors also can be strengthened through the removal of an aversive (negative) stimulus following a behavior. This operation is termed negative reinforcement. This would be the case if a child learns to apologize if the apology terminates (or avoids) being scolded by his or her parents.
Reinforcers can either be biologically preestablished (primary reinforcers), such as food or water, or can acquire reinforcing properties through careful pairing with primary reinforcers (conditioned reinforcers).

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Most reinforcers are differentially effective with different people rather than being universal. This is particularly true of conditioned reinforcers such as praise or tokens. The schedule of reinforcement used to deliver reinforcers also is important. Early in the process of strengthening a behavior, reinforcers are typically delivered on a continuous schedule, where a reinforcer is given each time the response occurs. Later in the process, various schedules are used that deliver reinforcers more intermittently and help increase resistance to extinction and/or produce specific types of responding patterns.
Punishment consists of two operations, but these weaken the likelihood of behaviors recurring. In positive punishment, the presentation of the consequence following the behavior results in weakening future occurrences of a behavior. An example might be a brief swat on the bottom when a young child chases a ball into the street. Removing a reinforcing stimulus contingent upon a behavior also can weaken it. This is negative punishment and includes, for example, taking away television-watching privileges for a short time to weaken a child's lying behavior. Applied behavior analysts typically advocate negative punishment as a more appropriate reductive method in most cases.
Behavior also may be decreased through the use of extinction, where the connection between a response and its maintaining consequences is discontinued, leading to a progressive decline in the rate of a previously reinforced response.
Antecedents, which are the front end of the three-term contingency, influence behaviors largely through a prior history of differential association with reinforcing or punishing consequences. When a child's behavior has been reinforced previously in a situation, the likelihood of that behavior is heightened under similar circumstances. It is lowered in situations in which reinforcement has been consistently withheld or punished. For example, a child whose father con-sistently buys him candy in a store when he whines is likely to exhibit similar behaviors in the future when shopping with his father. With his mother, who does not "give in," the child will learn not to whine.
Another type of antecedent stimulus used program-matically includes visual, verbal, or physical prompts given to increase the likelihood a child will respond appropriately to the given situation. For example, pictures of objects may be placed with letters to assist a child in learning letter sounds. These can then be removed either abruptly or through a gradual process called fading. Modeling can be seen as a special form of prompting in which someone demonstrates a desired behavior to increase its likelihood.
When a behavior is not present in the individual's repertoire, the procedure of shaping or successive approximations may be used. Shaping involves reinforcing progressively closer approximations of the desired behavior. For example, in teaching new words to a young child, the child is reinforced for vocalizations that are increasingly more like the desired word. As the sequence progresses, the word must be more and more like the target word for the child to receive reinforcement.
Particularly important behavioral concepts for instructional applications include discrimination, generalization, and concept formation. Behaviorally, concept formation occurs when the same response occurs to a group of discriminably different objects that have some aspect in common (as well as responding differently to other classes of stimuli). Concept formation involves both generalization and discrimination: generalization within classes and discrimination between classes. Thus, a child who responds "dog" to different examples of dog but not cats or other animals is exhibiting concept formation.
Many other effective techniques have evolved over time from this relatively small set of basic principles. In addition to those just mentioned, these include procedures such as overcorrection, token economies, time-out, response cost, self-monitoring, and task analysis.

EDITOR Neil J. Salkind
Copyright © 2008 by SAGE Publications, Inc.

Online degree, online education, part 24. Anxiety Disorders.

Anxiety Disorders in Children and Adolescents in School
Many children and adolescents who either have been diagnosed with an anxiety disorder or have high levels of anxiety experience difficulty in the school setting. Students with anxiety disorders or high levels of anxiety have more difficulty learning new material, receive poorer grades, and do not perform as well on standardized and classroom tests. These students may struggle in core courses such as reading and math. They are also more likely to repeat a grade and drop out of school.
Besides experiencing academic difficulties, children and adolescents with anxiety disorders experience poor peer relationships. Because of cognitive distortions or maladaptive thinking patterns, these children and adolescents view their relationships with others more negatively. These negative perceptions of their relationships with others reduce the likelihood of interactions with peers. These individuals may feel socially isolated and experience depression and feelings of hopelessness.
Symptoms of anxiety can significantly interfere with children or adolescents' social-emotional and academic functioning. In light of these concerns, children and adolescents with an anxiety disorder may be eligible for special education and related services under the Individuals with Disabilities Education Improvement Act of 2004 (IDEA). Specifically, anxiety disorders are categorized under the emotional disturbance (ED) category of disabilities. To meet the criteria for an emotional disturbance, a student must exhibit one or more of the following conditions, and the condition(s) must have occurred over a long period of time and to a marked degree and must adversely affect the individual's educational performance:
1.An inability to learn that cannot be explained by intellectual, sensory, or health factors
2.An inability to build or maintain satisfactory interpersonal relationships with peers and teachers
3.Inappropriate types of behavior or feelings under normal circumstances
4.A general pervasive mood of unhappiness or depression
5.A tendency to develop physical symptoms or fears associated with personal or school problems

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Assessment of individuals With an Anxiety Disorder
To detect an anxiety disorder or high levels of anxiety in individuals of different ages, a multimethod approach to the assessment of anxiety is recommended. A multi-method approach involves the use of different types of measures completed by multiple informants across multiple settings to detect anxiety and comorbid conditions. A variety of assessment techniques, including clinical interviews, rating scales, direct observations, self-report, and psychophysiological measures, are available to assess anxiety in individuals of different ages. Many of these measures are completed by multiple informants (self, parent, spouse, and/or teacher) across multiple settings (home, school, and/or work).
Treatment of Anxiety
Once an assessment or evaluation is completed and high levels of anxiety are detected or an anxiety disorder is diagnosed, assessment results are linked to interventions to ameliorate anxiety and its negative effects. Different treatment strategies are available to address anxiety, including pharmacotherapy, behavioral strategies, and cognitive-behavioral interventions. Additional strategies may also be used to address comorbid issues. Thus, a multimodal approach, consisting of two or more interventions, is often used to alleviate an individual's anxiety and its negative effects.
Pharmacological treatment is one means of alleviating anxiety in individuals. Medications that have been used to treat anxiety include benzodiazepines, selective serotonin reuptake inhibitors, tricyclic antidepressants, and buspirone. Medication is often used in combina-tion with other treatments such as cognitive-behavior therapy because although the medication may reduce anxiety symptoms, it does not help individuals learn to cope effectively with their anxiety.
Behavioral interventions are another means of reducing anxiety in individuals. Relaxation training, systematic desensitization (graduated exposure), and modeling are some of the behavioral strategies used to treat anxiety. These strategies have been shown to be effective. Relaxation training may include deep breathing exercises or progressive muscle relaxation. Progressive muscle relaxation involves individuals learning to relax and tense different muscle groups in order to become more relaxed. Relaxation training may also be found in systematic desensitization. In systematic desensitization, a fear hierarchy is created, consisting typically of 10 to 15 steps evenly spaced. For example, if an individual had a fear of large dogs, the first step in the fear hierarchy may consist of a discussion about dogs. The second step may involve looking at a picture of dogs. The third step of the fear hierarchy may involve driving past a pet shop and so on until the last step, when the individual pets a real-life dog. The purpose of creating a fear hierarchy is to gradually expose the individual, step by step, to the feared stimulus. The graduated exposure can be conducted using imagery or real-life experiences. Relaxation or another incompatible response to anxiety is induced along the way to calm the individual as graduated exposure of the feared stimulus occurs. Modeling is another behavioral strategy used to reduce fears and anxieties. Modeling is based on social learning theory in which an individual observes, either live or on film, a person who interacts successfully with the feared stimulus or situation. The model is typically of the same age and gender as the individual. After watching the model interact successfully with the feared stimulus or situation, the individual is more likely to perform the same behavior, and the fear and anxiety associated with the feared stimulus or situation are reduced.
Cognitive-behavioral strategies, such as self-instruction, self-control training, and rational-emotive therapy, have also been used to alleviate individuals' anxieties. Self-instruction involves the use of positive self-talk to handle anxiety-provoking situations. In self-control training, individuals learn to modify and restructure maladaptive thoughts, resulting in less anxiety in the presence of anxiety-provoking stimuli or situations. Less anxiety experienced then leads to positive changes in behavior because these individuals are more likely to approach the feared stimuli or situations. Replacement of false, irrational beliefs that underlie an anxiety problem with rational beliefs is the focus of rational-emotive therapy.

Prevention of Anxiety
Because anxiety is a common mental health concern facing many Americans today, efforts should be directed toward the prevention of anxiety disorders. The emotional, social, and economic costs associated with anxiety disorders are astronomical. Economic costs alone are estimated to be more than $40 billion per year. Yet, few prevention programs exist. Although prevention programs are costly up front, universal (primary), selective (secondary), and indicated (advanced) prevention programs are needed. Future efforts should be directed toward the development and implementation of these programs, as there will never be enough mental health professionals to provide adequate treatment of anxiety and other disorders.

Patricia A. Lowe and Jennifer M. Raad

EDITOR Neil J. Salkind
Copyright © 2008 by SAGE Publications, Inc.

Online Education And Degree. Part 23. Common Features of Anxiety Disorders

Although different types of anxiety disorders exist, according to Michael Telch, Jasper Smits, Matt Brown, and Victoria Beckner, there are some common features across these different disorders. Common features include escape and avoidance behaviors, chronic worry, attentional hypervigilance, faulty threat perception, and sympathetic activation. Individuals with an anxiety disorder try to avoid or escape from stimuli or situations that make them anxious, and they constantly worry about current and future events. These individuals attend excessively to cues that they perceive as threatening. The excessive attention given to these cues is referred to as attentional hypervigilance. Faulty threat perception is another common feature found among individuals with an anxiety disorder. These individuals erroneously perceive situations as threatening. Sympathetic activation is also a core feature found among individuals with an anxiety disorder. Activation of the sympathetic nervous system producing physiological changes in the body occurs in individuals with an anxiety disorder when there is no real or potential threat. Physiological changes experienced by these individuals in the absence of a real or potential threat may include accelerated heart rate, muscle tension, and increased perspiration and respiration.
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Types of Anxiety Disorders
The Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) (DSM-IV-TR) has identified 15 types of anxiety disorders, including generalized anxiety disorder, separation anxiety disorder, specific phobia, social anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, panic attack, panic disorder with and without agoraphobia, agoraphobia without a history of panic disorder, anxiety disorder not otherwise specified, anxiety disorder due to a general medical condition, and substance-induced anxiety disorder. Generalized anxiety disorders, phobias, obsessive-compulsive disorders, panic disorders, and posttraumatic stress disorders are the most common types of anxiety disorders.
Although there are several types of anxiety disorders, each involves an excessive degree of worry or fear about certain stimuli, situations, or events, which significantly interferes with an individual's normal state of functioning. Generalized anxiety disorder is characterized by a chronic, excessive, and uncontrollable degree of worry about a variety of events or situations, such as friends, family, school, work, or the future. Symptoms of generalized anxiety disorder include fatigue, irritability, restlessness, muscle tension, and difficulties with concentration and sleep. Another common anxiety disorder, specific phobia, is characterized by an extreme and irrational fear in response to a specific stimulus, such as animals or insects (e.g., dogs), aspects of the natural environment (e.g., storms), blood (e.g., viewing blood or receiving an injection), situations (e.g., being in small spaces), or other stimuli (e.g., loud sounds or costumed characters). This worry must be present for at least 6 months and may lead to symptoms in children such as crying, clinging, tantrumming, dizziness, shortness of breath, and fainting.
Like a specific phobia, social phobia is associated with particular circumstances and must involve symptoms present for at least 6 months. An individual with a social phobia experiences extreme worry regarding social situations. The individual may worry over or fear the possibility of ridicule, humiliation, or embarrassment in social situations, such as speaking in class or conversing with peers. Individuals with a social anxiety disorder may attempt to avoid or escape social behaviors, and they often have poor social skills. These individuals may also experience symptoms such as trembling hands or voice, perspiration, muscle tension, and blushing.
Obsessive-compulsive disorder involves obsessions (recurrent or persistent thoughts or worries that intrude on, and interfere with, an individual's normal functioning) and compulsions (repetitive behaviors, rituals, or practices in which the individual engages to provide relief from, or comply with, the obsessive thoughts or worries). Common obsessions and compulsions in children include contamination (hand washing), safety (checking), preoccupations with orderliness and symmetry (ordering, aligning), and counting or touching rituals. Individuals with an obsessive-compulsive disorder may feel embarrassed by their compulsions and may experience difficulties related to concentration, preoccupations, and perfectionist tendencies.
Posttraumatic stress disorder refers to stress or worry experienced by an individual following a traumatic event (such as a serious injury, death, or catastrophic event). The individual reexperiences the event (via flashbacks, nightmares, or images), as well as the accompanying physiological arousal, and may attempt to avoid stimuli associated with the event. Following the event, the individual may feel helpless, fearful, agitated, or disorganized and may experience hypervigilance, irritability, and difficulties with concentration or sleep. These symptoms must be present for at least 1 month following the traumatic event. If symptoms are present for less than 1 month, then an acute stress disorder may be present. Similar to posttraumatic stress disorder, acute stress disorder also results from witnessing or experiencing a traumatic event. Symptoms include reexperiencing the event and the accompanying physiological arousal; however, these symptoms are present for no more than 1 month.
A panic disorder refers to recurrent and unexpected panic attacks that are followed for at least 1 month by concern about, or consequences of, having another attack and/or a change of behavior related to the attack. Panic attacks develop abruptly, often last for approximately 10 minutes, and involve symptoms such as heart palpitations, sweating, chest pain, dizziness, fear of dying, feelings of detaching from one's body, and feelings of losing control. If the attacks become more frequent, the individual may come to fear experiencing a panic attack in public places, and develop agoraphobia (fear of public places) as well. However, agoraphobia may also develop in the absence of, and without resulting from, a panic disorder. In these cases, individuals may avoid public situations, such as being in a crowd or traveling in a train, and may experience symptoms of panic in these situations.
Separation anxiety disorder is an anxiety disorder commonly found in children. Separation anxiety disorder refers to excessive and unrealistic worry in response to separation from home or a caregiver. Children with separation anxiety disorder may experience nightmares with separation themes, headaches, stomachaches, or nausea. These symptoms must be present for at least 4 weeks. Separation anxiety disorders tend to decrease with an increase in age. That is, this type of anxiety disorder is common during the childhood years but declines during the adolescent and adulthood years.
Anxiety disorders may also result from external factors, such as a general medical condition or substance use. Finally, for individuals who experience symptoms of anxiety, but whose symptoms, duration, or impairment do not meet the criteria for a specific disorder, a diagnosis of anxiety disorder not otherwise specified (NOS) may be appropriate.
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EDITOR Neil J. Salkind
Copyright © 2008 by SAGE Publications, Inc.

Online degree, part 22. Prevalence of Anxiety and Comorbid Conditions.

Prevalence rates of anxiety in community samples are difficult to estimate, especially given the fact that internalizing disorders, such as anxiety, are often difficult to observe and identify. Prevalence estimates for clinical levels of anxiety in children, young and middle-age adults, and older adults range from 5% to 19%, 6% to 8%, and 9% to 11%, respectively. In general, the prevalence of anxiety disorders has been found to increase with age in the child and adolescent population, decline during the young and middle-age adult years, and slightly increase in the older adult years. Gender differences have also been found in the literature. Specifically, females typically report more anxiety symptoms than do males. However, it remains unknown at the present time whether this gender difference is due to females actually experiencing more anxiety symptoms than males or whether females are simply better able to recognize and report their symptoms of anxiety than are males. On the other hand, overall, more females than males are believed to suffer from an anxiety disorder. However, the gender ratios differ based on the type of anxiety disorder diagnosed and the age of the individual. Despite this variability and the need for further research with regard to prevalence rates among different ages and genders, it is clear that anxiety continues to be a major problem for individuals of all ages and one that can potentially lead to significant difficulties within multiple domains of functioning.
Anxiety disorders have high rates of comorbidity with other disorders. The rate of comorbidity between anxiety and depressive disorders may be as high as 55% to 65%. Speculation as to why these rates are so high is that both anxiety and depression share a similar trait known as negative affectivity, or emotional distress. Negative affectivity includes such affective states as worry, self-dissatisfaction, and sadness. High comorbidity rates may also be due to a sequential link between anxiety and depression, with anxiety serving as an early precursor to a depressive disorder. Comorbidity rates are also high between different types of anxiety disorders. It is not uncommon for an individual who has one anxiety disorder to be diagnosed with another anxiety disorder. Other common comorbid conditions include substance use disorders and disruptive behavior disorders, such as attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder.

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From a trait model perspective, anxiety is viewed as a stable personality characteristic. Without treatment, anxiety disorders may persist. Approximately 45% to 65% of individuals diagnosed with an anxiety disorder do not show remission of symptoms. However, approximately 35% to 55% of individuals do show remission, but many who show remission develop other disorders, especially other anxiety disorders. Anxiety disorders interfere with the social and emotional well-being of individuals. If individuals are still in school, academic development may be impaired. For adults, work productivity may decline and unemployment may increase.
Developmental Precursors or Etiological Factors
Different theories exist about the development of an anxiety disorder. The three most popular models used to explain the development of an anxiety disorder are the biological, behavioral, and cognitive models. Biological explanations of anxiety focus on genetics, neurotransmitters, differences in structural regions of the brain, abnormalities in the immune system, and behavioral inhibition. Genetics is believed to play a role in the development of an anxiety disorder. Genetic influences account for approximately 30% to 35% of the variance in anxiety in most cases, suggesting that anxiety is moderately inheritable. The neuro-transmitter gamma aminobutyric acid (GABA) has received some attention as a possible risk factor in the-development of an anxiety disorder. GABA may increase excitatory responses to real or perceived threats, or it may fail to send messages to inhibit these responses. Perturbations in the hypothalamic-pituitary-adrenal axis indicate structural brain differences in individuals with an anxiety disorder. Behavioral inhibition may be another possible etiological factor. Behavioral inhibition characterizes a child's temperament. Children with this type of temperament are shy and exhibit inhibited behaviors in response to novel stimuli. These individuals are also highly physiologically reactive to such stimuli.

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Behavioral explanations for the development of an anxiety disorder focus on learned behaviors. According to behaviorists, anxiety is a learned behavior that is acquired and maintained through a combination of classical and operant conditioning, operant conditioning alone, or modeling. From a classical and operant conditioning perspective, anxiety problems result when a neutral stimulus, such as a large dog, is paired repeatedly with an aversive stimulus (i.e., an unconditioned stimulus), such as a loud noise, to produce an unconditioned response, such as a startled reaction. Through repeated pairings with the unconditioned stimulus, the neutral stimulus becomes a conditioned stimulus, and this conditioned stimulus will produce a conditioned response. In other words, the presence of a large dog will result in a startled response without the loud noise being present on a regular basis. The conditioned stimulus (i.e., a large dog) will then be avoided, and by avoiding the conditioned stimulus, an individual's anxiety is reduced. The avoidance behavior demonstrated by the individual in response to the large dog is an example of operant conditioning. In operant conditioning, the stimulus, task, or situation feared is maintained by a negative reinforcement con-tingency. The feared stimulus, task, or situation is avoided, and the avoidant behavior is maintained because it reduces the individual's anxiety. In modeling, the individual observes the behavior of significant others in response to aversive stimuli, tasks, or situations. When significant others exhibit avoidance behavior and anxiety in response to aversive stimuli, the individual learns to model these behaviors. Exposure to similar aversive stimuli, tasks, or situations will produce similar behaviors.
The cognitive approach to anxiety disorders assumes that distorted cognitions are responsible for symptom manifestation. According to cognitive psychologists, individuals who have an anxiety disorder or experience high levels of anxiety exhibit threat-related attentional and interpretative biases. These individuals attend to threat-related stimuli, and they interpret ambiguous or neutral stimuli as threatening.

EDITOR Neil J. Salkind
Copyright © 2008 by SAGE Publications, Inc.

Online Education, College Degree, Part 21. ANXIETY.

Anxiety is a common mental health concern facing many Americans today. In 1997 Thomas Huberty defined anxiety as a unique emotional state characterized by feelings of distress and tension about real or anticipated threats that may manifest in cognitive, behavioral, or physiological patterns. Anxiety can have devastating effects on individuals, as it can interfere with their learning and social and emotional development. In this entry, general information about anxiety is presented. Common features found among the anxiety disorders, types of anxiety disorders, and etiologi-cal factors underlying anxiety disorders are discussed. Prevention and intervention strategies are covered.
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Components of Anxiety
Anxiety is a complex emotional state and may involve and influence multiple domains of an individual's functioning. Specifically, an individual may experience cognitive, behavioral, and physiological effects. Common cognitive symptoms of anxiety include excessive worries, concentration difficulties, and memory and attention problems. Anxiety may also be manifested through such behavioral symptoms as motor restlessness, difficulty sitting still, and attempts to escape or avoid anxiety-provoking stimuli or situations. Finally, anxiety also includes physiological symptoms, such as muscle tension, increased perspiration, rapid heartbeat, headaches, and stomachaches.
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Anxiety as a Unique Emotion
Anxiety is a unique emotion as it can be viewed in both a positive or negative light. A slight amount of anxiety can be helpful and facilitate an individual's performance, whereas too much anxiety can be debilitating and hinder one's performance. In small amounts, anxiety can serve as a motivator and lead to optimal performance in school, work, sports, or other areas in an individual's life. For example, a student can become slightly anxious before a major exam. The slight anxiety felt can motivate the student to study for the exam and do better because of the time spent preparing for the exam. In contrast, high levels of anxiety may interfere with the student's ability to concentrate, process information, or retrieve information from long-term memory. Under these circumstances, the student is less likely to perform his or her best on the exam.
Anxiety can also alert an individual to a potential danger. The fight-or-flight response, also referred to as the acute stress response, involves the activation of the sympathetic nervous system in an emergency situation. The individual will respond to a threatening or dangerous situation by fighting or fleeing. Thus, many believe that anxiety serves as a survival mechanism and protects the individual from harm.
Besides its positive and negative aspects, anxiety can be viewed as a normal indicator of development. During the normal course of development, individuals experience fears and anxieties, but the specific fears and anxieties experienced vary as a function of age. Moreover, there is some evidence to suggest that the number of specific fears and anxieties decrease with age, whereas others suggest that the number of specific fears and anxieties remain the same across the life span. Sources of anxiety for infants include loud noises, strangers, and novel stimuli, and for toddlers, separation from major attachment figures and imaginary creatures. Children fear large animals, darkness, and natural events, and adolescents fear social alienation. Sources of anxiety for adults include natural events, injury, and financial issues. Most individuals experience these age-specific anxieties and fears, which are mild and transient in nature.
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EDITOR Neil J. Salkind
Copyright © 2008 by SAGE Publications, Inc.

Online Education And Degree. Part 20. ANDROGYNY.

Androgyny is a term derived from the Greek andras (avSpaq—man) and gyne {yovx\—woman) referring to either the absence of any distinguishing masculine or feminine traits, as in the Hijras of India, or the combination of both masculine and feminine characteristics, whether spiritual, psychological, or physiological.
Most Western cultures presume a binary opposition between male and female. In the 1950s, June Singer revived a mystical interest in androgyny, reconciling the "masculine" and "feminine" aspects of a single human, restoring the balance between what Jung called animus and anima. Like Mircea Eliade and Carl Jung, Singer treated androgyny as archetypal, in which the divided self yearned for the complete reunion of male and female. This understanding of androgyny as a metaphysical ideal was implicit in shamans or deities like Buddha, Shiva, Kuan Yin, and Elohim. Even so, Singer believed that the sexes were naturally differentiated: that males are generally aggressive, dominant, hard, and logical, and women are passive, compliant, soft, and intuitive.
In 1974, Sandra Bern published the Bern Sex Role Inventory (BSRI), a self-test listing 20 socially desirable female traits, 20 socially desirable male traits, and 20 considered to be neutral. Male traits included "forceful," "analytical," and "self-sufficient"; female traits included "sympathetic," "loyal," and "compas-sionate"; and neutral items included "truthful," "sincere," and "friendly." Scores revealed the respondent's self-reported possession of socially desirable, stereotypically masculine and feminine personality characteristics. An individual who received high scores for both female and male traits was defined as androgynous, whereas one with low scores in both was described as undifferentiated. Gender traits had little correlation with the ascribed sex of participants. Like Singer and Jung, Bern believed that people who had androgynous psychological traits were the most effective and well-functioning individuals in society.
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At this time, Constructivism claimed that gender was socially constructed and could therefore be changed at will. Resistance to gender binaries and heterosexuality took the form of transvestitism, or performances as drag queens or drag kings. Kate Bornstein, having performed as a cross-dressing performance artist and encouraged the self-construction of "who you are," used surgery to change herself in 1998 to a "male-to-female lesbian transsexual" but has now settled into being neither male nor female, a gender outlaw.
To describe a born male as "lesbian" indicates some of the conceptual change required by this new gender fluidity, but it did not necessarily accommodate androgyny. A medical category, gender identity disorder, was created to describe those who felt incompatibility between their felt identity and their anatomy. Improvements in surgical processes made it possible to normalize anatomies as normalized male or female, and medical research sought to explain sex "transgres-sions" (gender identity disorder, cross-dressing, or homosexuality) physiologically in order to remove blame and effect a "cure." A few transsexuals, like female-to-male Jamison Green, rejected such normalizing "cures" and accepted their androgynous status to the extent of having hormone treatment but not requiring a surgically constructed penis or denying their past.
Despite a relatively low level of sexual dimor-phism in humans, Charles Darwin had naturalized the sex binary in The Descent of Man by referring to naturally selected sex differences between male and female in gonads, sex organs, body mass, amount and placement of body hair, intelligence, psychological traits such as aggression, and child-rearing practices. But he tended to overlook the high amount of androgyny in the natural world, for instance, in worms and snails. About 30% of the fish species on a coral reef start out as males and end as females, or vice versa, or are both male and female at the same time. Could humans be naturally androgynous?
In 1993 in Bodies That Matter, Judith Butler argued that even though we construct gender, our material bodies sometimes prevent us from conforming to social norms. Earlier in Gender Trouble, she claimed that drag queens in their "queer performativ-ity" demonstrate resistance to being required to "perform" normal dichotomous roles of male or female which they do not feel. The existence of physically androgynous humans challenges those dichotomies at an even more profound level.
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Anne Fausto-Sterling estimates conservatively that 1 in 1,000 persons is born with androgynous physiological features. Previously called hermaphrodites, they are now medically defined as intersex, a term, like androgyny, applied to any person with characteristics determined as neither exclusively male nor female, or combining features of both. The most common cause of so-called sexual ambiguity is congenital adrenal hyperplasia, an endocrine condition in which the adrenal glands produce unusually high levels of virilizing hormones. In genetic females, this leads to an appearance that may be slightly masculinized (large clitoris) to quite masculine. Another form of intersex is andro-gen insensitivity syndrome, in which people born with masculinizing Y chromosomes do not develop male morphology. Other physiological androgynes show chromosome variations such as 47XXY, 45XO, or mosaics. Far from being revered as complete or ideal persons, such anatomical androgynes are usually classified as male or female sex at birth and surgically or hormonally transformed into either male or female in childhood, with remaining variations of the male-female binary seen as transgressive.
Bern and Fausto-Sterling argue that the danger of perpetuating the male-female binary lies in the fact that cultural roles and norms remain dictated by males and highly polarized male values. The placement of the androgyne at the center of our understanding of physical and cultural humanness and our acceptance of complex combinations of male and female defuse current hegemonies.

Felicity Ann Haynes







EDITOR Neil J. Salkind
Copyright © 2008 by SAGE Publications, Inc.

American Indians and Alaska Natives 2.

The 21 st Century
Today, the U.S. Census Bureau reports that the First Nations are a young population as compared with other ethnicities, with just less than half living on a reservation or federal trust land and a little more than half living in urban areas. First Nations persons are overrepresented within the numbers of negative social and economic indicators of disparity. Though rates vary widely between tribes and geographic regions, the First Nations find themselves with many of the most disparaging statistical measures of societal success. Economically, they lag behind other ethnic populations, having high poverty and unemployment rates and disproportionately low educational opportunities and graduation rates at all levels. Physical health disparities include high rates of diabetes and heart disease. Mental and behavioral health disparities include depression, posttraumatic stress disorder, and alcohol abuse for the First Nations as a whole.
First Nations children and youth receive disproportionately low levels of prenatal care as compared with other populations. They are exposed to alcohol in utero at higher rates and thus suffer rates of fetal alcohol syndrome disproportionately. As a group, First Nations youth endure disproportionate rates of diabetes, obesity, inner ear infection, cancer, and toxin exposure. The lack of accessible culturally competent health care compounds the negative impact on First Nations health. Suicide and homicide are among the top 10 causes of death for First Nations youth ages 5 through 14 years, and loss and grief follow this young population as a whole, given the historical and persistent struggles with which it is faced. Emerging public health issues for the First Nations include high rates of pregnancy for young women and girls who have insufficient access to prenatal care, escalating rates of sexually transmitted disease (including HIV/AIDS), and an explosion of gang involvement, even in reservation areas.
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Health, Resiliency, and the Balance way
The disparities and impacts of coloniztion with which many First Nations struggle is best conceptualized through an Indigenous worldview. The situation then becomes historically bound and has been framed by First Nations elders and tradition keepers as transcending time in a spatial fashion and experienced both individually and collectively. Thus, historical events are experienced in real time by individuals and their communities. Healing occurs through communal support and recognition of suffering and ritual interventions. In this way, suffering is acknowledged by the individual and his or her support system, and assessment, diagnosis, and treatment occur via a vehicle that emphasizes both individual and group strategies. First Nations scholars and clinicians advocate for an intervention framework that recognizes the inter- and multigenera-tional nature of the loss, stress, and trauma to which American Indians and Alaska Natives are exposed. Such a framework is congruent with the First Nations concept of time and healing and draws upon the use of traditional concepts and strategies.
Assessment, Diagnosis, and Treatment: First Nations Values and Ancient Knowledge
Despite the breath of diversity within the First Nations population, pan-cultural values and worldview perspectives exist. One commonly held view is that of time as cyclical and spatial versus linear, as conceived by the mainstream. Emphasis is on process rather than product. Contextual space or environment is often closely tied with experience and thus with healing. The First Nations see all as connected, whether celestial, elemental, mineral, fauna, animal, or human. Relationships are not compartmentalized along blood lines but rather viewed as broad connections that invoke relational roles. For example, siblings and cousins may be seen as equivalent relationships for an individual, and both will be referred to as brothers or sisters. In this spatial worldview, conceptions of wellness and ill health, life and death are grounded in the idea of keeping balance internally and with the world around one's self, and moving from one time-space domain to the next, respectively. Traditional healers utilize place (e.g., sacred locations) and integrate the help of other elements (e.g., plants, animals) to aid in helping the indi-vidual rebalance. Given the value placed on process and the cyclical nature of existence, all human experiences are held as important. Events such as dreams, visions, and premonitions are integrated into the healing process and not pathologized in the vein of mainstream psychology. Traditionally, there is a broad acceptance of difference and individual diversity, and thus a strategy of relative noninterference exists. Persons are supported through change individually with a healer and/or communally, and they are encouraged to find their own path to meaning and balance, utilizing their own gifts and strengths in doing so. This idea of individual difference and noninterference is quite divergent from mainstream thinking and is particularly evident in mainstream socially constructed concepts, such as that of gender or sexual orientation/preference. Pan-culturally, First Nations persons traditionally view gender as discrete from sexual orientation, identity, and preference.
Given the historical context within which the fields of psychology and education have developed and the current statistics the First Nations face, it is clear that pervasive cultural competence is lacking in assessment, diagnosis, and treatment of this population. Stereotyping, stigma, and discrimination pervade the intervention process with the First Nations and are highly correlated with low rates of contact and retention within the helping professions. Clinicians must consider the possibility of institutional distrust on the part of First Nations clients. Accommodation must be made for cultural differences present between the client and the clinician as well as between the client and the system of service. Language can pose a particular roadblock to intervention, regardless of whether the client speaks English as a second or a first language. Previous generations pass down the cultural worldview housed in Indigenous languages. First Nations languages are relational and descriptive in nature and do not accommodate compartmentalization as English does. Most Indigenous languages provide an understanding of the world as either animate or inanimate, not living or dead. Gendered language too is relatively nonexistent in the fashion of Western-mainstream languages. A close examination of popular standardized assessment and diagnostic tools quickly reveals their inability to competently accommodate First Nations clients. The vast majority of such tools, including the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision) (DSM-W-TR), have been developed through a linear, White mainstream worldview, and few have been standardized or explored in relationship to their use with the First Nations.
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Learning: indigenous Science and Knowledge Acquisition
American Indians and Alaska Natives have had sophisticated systems of hypothesis testing and knowledge acquisition for thousands of years. This knowledge has persisted in oral, written, pictorial, and ritual traditions. Unfortunately, systemic racism, discrimination, and ignorance have all played a role in the perpetuation of the stereotype of First Nations science as a proto-knowledge, a less sophisticated form of Western-mainstream constructs. It is in this atmosphere that First Nations persons are educated by mainstream institutions of learning. Acculturation and assimilation pressures are significant for First Nations children in educational settings and persist through higher education.
Preschoolers may encounter difficulties adjusting to their new setting and its demands. Traditionally, First Nations youth are raised with close attention to attachment building and may share a bed with their primary caretaker(s), may be breastfed until they are 3 or 4 years old, and may enjoy the attention of multiple caretakers regardless of blood ties. Children entering ele-mentary school are often encountering mainstream culture for the first time and can be shaken by the shift in worldviews within which they must function. Boys may be ridiculed for keeping their hair traditionally long, and all youth are subject to defending themselves against the onslaught of holidays and practices celebrated in school systems that may be Christian-focused or U.S. nationalist. Language issues can be a particular challenge, and children may be required to shift from an experientially based traditional educational focus at home to a more linear, prescribed learning style in the educational setting. By middle and high school, First Nations youth often confront the full force of stereotyping and discrimination, as well as the aforementioned risk factors. They may encounter existential crises, struggling to integrate traditional spiritual beliefs with mainstream culture. The risk for internalized oppression is great, as teens strive for identity and self-preservation. A traditional adolescent may attend a school that promotes stereotyping and demeans the spiritual worldview of First Nations persons via Indian mascots or the promotion of, and forced participation in, Christian-based activities. This pressure mounts as those First Nations youth who do graduate from high school attempt to make their way to college. College students may have to travel great distances from their tribal communities and lands, deepening existential struggles. In higher education they find few First Nations mentors, little funding, and can struggle greatly to resolve the rift between their traditional worldview and that of the Western mainstream.
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Indigenizing the Mainstream
Best practices with American Indians and Alaska Natives mandate the integration of traditional knowledge, practices, community, and tradition keepers. Successful strategies and programs are individualized and recognize the potential for divergent worldviews and diversity within this group. Legitimate ways of knowing and healing are held within the First Nations culture and have been utilized for thousands of years to educate and heal this group. The educational psychologist will find a wealth of helpers within the commu-nity's natural supportive structure. Elders, traditional healers and mentors, extended family, and many others can be of assistance for case conceptualization and treatment. Traditional knowledge and values can be found in a group's original instructions (creation story) and provide a useful framework for conceptualizing a client's struggle, as well as his or her ethnic identity. Finally, policies that support the integration of understanding between the mainstream and First Nations may be supported by educational psychology as socially just objectives that promote healing and understanding for both groups.
Leah M. Rouse Arndt




EDITOR Neil J. Salkind
Copyright © 2008 by SAGE Publications, Inc.