The Far-Fetched Infidelity Detection Hypothesis of Oral Sex

Theories about the evolution of human sexuality have spawned some intriguing ideas. One of the more peculiar ones is that oral sex has an evolutionary function, namely to detect recent infidelity by one's partner. Cunnilingus for example, is supposed to allow a man to detect the presence of another man's semen in or around the woman's vagina. A recently published study aimed to test this theory and found that a man's interest in performing cunnilingus was correlated with his partner's attractiveness. The authors argued that more attractive women are more likely to be targeted by other men for mate poaching, and that partners of such women have more reason to be concerned about sperm competition, and therefore use oral sex to detect possible infidelity, albeit unconsciously. They concluded that their results confirm their hypothesis that oral sex functions to detect infidelity. Although interesting, their results are inconclusive because they did not appear to consider a more obvious explanation for their findings.

 Is cunnilingus just about pleasure or does it have a darker purpose? 

According to many evolutionary psychologists, men have been concerned with detecting and counteracting infidelity by their partners through human history. Sperm competition occurs when the sperm from two or more males occupy a woman’s reproductive tract at the same time, and hence compete to fertilise her ovum. Scholars have claimed that men have evolved a variety of mechanisms to deal with the threat of sperm competition (Pham & Shackelford, 2013). For example, some research has found that men ejaculate a greater volume of sperm when they have been separated from their partner for a good period of time compared to when they have been in each other’s company for the same amount of time. This is presumed to occur because there is a greater risk that the woman may have been unfaithful in her partner’s absence.

Pham and Schackelford (2013) argued that men with more attractive partners are at a greater recurrent risk of sperm competition because other men are more likely to woo them into having affairs. Therefore, men with more attractive partners have more reason to be concerned about and more likely to engage in behaviour aimed to detect infidelity. The idea that cunnilingus, oral sex performed on a woman, could function to detect infidelity was proposed in a 2006 book, but this study is the first to test this empirically. The idea is that oral sex may allow a man to detect the presence of another man’s semen through smell or taste. Pham and Schackelford’s study did not test whether men can actually detect semen in this manner (admittedly a difficult thing for a research study to test). What they did test were the hypotheses that men with more attractive partners (presumed to present a greater “recurrent risk of sperm competition”) would be more interested in performing oral sex, and that they would perform it for a longer duration “to better detect rival semen.” Contrary to what has been claimed elsewhere, the authors did not claim that men consciously perform oral sex because they think their partner has been unfaithful. It is possible for a behaviour to serve an evolutionary function without a person knowing what that function is. They simply need to want to do it, even if they do not know why.

As side-note I’d like to point out that there is a common misconception often advanced by people who really ought to know better that evolutionary psychology assumes that everything that people do is somehow an evolutionary adaptation and that evolutionary psychologists cannot or will not acknowledge that some behaviours are simply by-products of other adaptations with no special function of their own. This is a gross misrepresentation of what evolutionary psychology is about^[i] and in fairness to the authors of the study they were attempting to actually test whether or not their hypothesis about the adaptive function of oral sex is valid, rather than just assuming it is. It is quite possible that oral sex has no evolutionary function in itself. Humans are a highly sexed species compared to most mammals (Diamond, 1998) and engage in many non-procreative sexual acts, perhaps for pleasure alone. Oral sex might simply be a by-product of this interest in sex that humans have. However, if it can be shown that this particular behaviour appears to serve a definite purpose that has an evolutionary history, a reasonable case can be made that it has an adaptive function.

To test their hypotheses, the authors recruited heterosexual males in committed relationships that had lasted at least one year. These were asked a series of questions about how attractive they thought their partners were (to themselves and to other men); about their relationship satisfaction; and their most recent sexual experience. Participants were asked to rate their interest in and duration of oral sex compared to what is “typical” for them. I thought the wording of these questions was somewhat peculiar. One man’s “typical” level of interest in oral sex might be quite different from another man’s, so asking the questions in this way would seem to make individual responses difficult to compare. Their reasons for asking about the participants’ most recent experience in particular was also not made clear.

The results were much as the authors’ expected. “Recurrent risk of sperm competition” (attractiveness) predicted interest in performing oral sex independently of relationship length, relationship satisfaction, and duration of intercourse. The latter three were not significant when recurrent risk/attractiveness was taken into account. Recurrent risk and duration of intercourse each predicted duration of oral sex independently of relationship length and relationship satisfaction. This indicates that the more attractive a man found his partner, the more interested he was in performing oral sex, and the longer he performed it for. The authors took this as evidence in support of their hypothesis that oral sex functions to detect infidelity when recurrent risk of sperm competition is high. However, there is an alternative explanation seems more obvious that the authors seem to have overlooked. This is that the more attractive a man finds his partner, the more interested he would be in performing sex acts in general with her. That is, greater attraction would produce greater sexual excitement generally, and hence greater willingness to engage in a variety of sexual acts.

I think it is also worth noting that recurrent risk/attractiveness had rather modest sized correlations with interest in oral sex and duration of performance (.26 and .24 respectively). These are not trivial sized correlations compared to most findings in psychology, but they do suggest that other factors besides partner attractiveness are related to a man’s willingness to perform oral sex. For example, it has been argued that heterosexual men demonstrate their masculinity through their ability to “master” women’s bodies, and that this may be manifested by skill in bringing a woman to orgasm through oral sex (Backstrom, Armstrong, & Puentes, 2011). Additionally, reciprocity may play a role. That is, men perform oral sex with the expectation of receiving it in return.   

 To their credit, the authors do consider some alternative explanations of their findings that could be considered in future studies. One of these is that men perform oral sex to increase the woman’s sexual satisfaction. Research has found that women are more sexually satisfied the more frequently they receive oral sex. Other research has found that the more sexually satisfied a woman is, the less likely she is to be unfaithful. Female sexual satisfaction was not assessed in this study, and the authors acknowledge that future research should consider whether the relationship between attractiveness and male interest in oral sex remains after taking into account desire to satisfy the partner. This seems to me like a very reasonable alternative explanation.

The other alternative they considered, which I consider to be much more speculative, is based on the idea that a woman retains more sperm in her uterus when she has an orgasm. Hence men might perform oral sex to increase the chance the woman will have an orgasm, and therefore retain more of the man’s sperm. This idea is based on a study by Baker and Bellis (1993) which actually claimed to have found that female orgasm increased sperm retention, but only when it  occurred between one minute before and 45 minutes after ejaculation. Orgasm occurring more than one minute before ejaculation had no effect on sperm retention according to this study. If Baker and Bellis are correct, performing oral sex would not be effective in increasing sperm retention unless the timing was very specific.[ii] In any case, Pham and Shackelford did not assess whether female orgasm occurred.

I would argue that although the Pham and Shackelford study is an interesting one, the results are an inconclusive test of their hypotheses because there are alternative explanations for their findings. Some of these alternative explanations, such as those involving female satisfaction, and my own hypothesis that female attractiveness generally increases male interest in sexual activity seem like more obvious explanations. This does not necessarily mean that the authors are incorrect, only that more research is needed to test these different explanations. For example, studies might assess whether men with more attractive partners are also more interested in other activities associated with sexual foreplay, such as kissing and so on. It would then be possible to test whether interest in oral sex is independent of interest in these other activities. It is also possible that oral sex might serve a combination of functions and that all of these hypotheses have a grain of truth.

Finally, it might be a good idea to consider the woman’s perspective. Pham and Shackelford seem to portray women as passive recipients of male interest and do not appear to consider female agency. For example, they talk about attractive women as targets for mate poaching and consider “recurrent risk of sperm competition” purely in terms of the woman’s attractiveness to other men. While it may be true that men are more likely to target attractive women for affairs, it is also the case that the woman actually has a say in the matter. Some women are more likely to be unfaithful than others and this may be related to her character and choices as much as her looks. Furthermore, if the function of cunnilingus was to detect whether a woman had been sexually active with another male, it would seem reasonable that if she had in fact been unfaithful she might try to avoid receiving cunnilingus to avoid detection. Pham and Shackelford’s study does not consider the woman’s desires and her actual willingness to be unfaithful. Future studies might consider whether men are more likely to perform oral sex on a woman who may present a “recurrent risk of sperm competition” due to her own desires and her actual willingness to be unfaithful.    

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Footnotes

[i] Stephen Jay Gould seems to have originated this particular canard about evolutionary psychologists being “pan-adaptationists” who are too blind to see that many features of the human psyche have no evolutionary function in themselves. See this article by Tooby and Cosmides, leading figures in the field, which shows how Gould completely misrepresented their work, in which they explicitly stated that most human behaviours are probably by-products without an evolutionary function.

[ii] It is also worth noting that the Baker and Bellis study has been strongly disputed by Elisabeth Lloyd on the basis that the sample size was too small to draw any reliable conclusions. The findings by Baker and Bellis do not appear to have been replicated so their claims might be taken with a grain of salt. 

Further reading

Pham and colleagues performed a companion study considering women's interest in fellatio, with rather different results. I have written a critique of this study here. 

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© Scott McGreal. Please do not reproduce without permission. Brief excerpts may be quoted as long as a link to the original article is provided. 

This article also appears on Psychology Today on my blog Unique - Like Everybody Else.

Other posts about sex and psychology

Porn Stars and Evolutionary Psychology

The Personalities of Porn Stars

Are Sex and Religion Natural Enemies?

The Pseudoscience of Race Differences in Penis Size

Semen an Antidepressant? Think Again

References

Backstrom, L., Armstrong, E. A., & Puentes, J. (2011). Women's Negotiation of Cunnilingus in College Hookups and Relationships. Journal of Sex Research, 49(1), 1-12. doi: 10.1080/00224499.2011.585523

Baker, R. R., & Bellis, M. A. (1993). Human sperm competition: ejaculate manipulation by females and a function for the female orgasm. Animal Behaviour, 46(5), 887-909. doi: http://dx.doi.org/10.1006/anbe.1993.1272

Diamond, J. (1998). Why Is Sex Fun? : Basic Books.

Pham, M., & Shackelford, T. (2013). Oral sex as infidelity-detection Personality and Individual Differences, 54 (6), 792-795 DOI: 10.1016/j.paid.2012.11.034

Could sexbots one day give people longer life? Dream on!

Recently, I came across an article on a transhumanist website that made the amazing claim that in the not-so-distant future, people will improve their life expectancy by having sex with robots programmed to give them ‘super-orgasms.’ Transhumanists believe that it will one day be possible to vastly expand the human lifespan through technology. Various means of extending human longevity have been proposed but this seems like one of the wackier ones. The author of this article is not alone in the belief that human lifespan can be extended through sex. Celebrity medic Dr Mehmet Oz goes so far as to advise people that if they have 200 orgasms a year they will extend their life by six years. While there is some evidence linking more frequent orgasms to longer life, the claims by Dr Oz and (some) transhumanists extrapolate far beyond the available evidence.

Image courtesy of Victor Habbick at FreeDigitalPhotos.net

There have been a number of research studies linking sexual activity with longevity, but these findings need to be interpreted with a certain amount of caution because a statistical association between sex and longevity does not necessarily prove that one leads to the other. Additionally, the relationship between sexual activity and longevity may be different for men and women. For example, there have been studies linking frequency of orgasm (Smith, Frankel, & Yarnell, 1997) and of sexual intercourse (Palmore, 1982) in men to longer life. The study by Smith et al. controlled for factors such as age, smoking, social class, and baseline coronary heart disease, and remarkably still found that men who had the most frequent orgasms (twice a week or more) had a 50% lower mortality rate compared to men with the lowest frequency of orgasm (less than once a month). However, this study did not take relationship status into account. Additionally, for women, frequency of intercourse did not predict longevity, but past enjoyment of intercourse did (Palmore, 1982). Palmore suggested that quantity of sexual activity may be more important for men’s health, whereas for women the quality is of more importance. The author admitted though that we cannot say for sure whether more frequent or better sex is what actually leads to longer life. An alternative possibility is that people who are in better health have more frequent sex and/or enjoy it more. If this is the case, better health might explain the association between sexual activity and longer life. It is worth noting that in Palmore’s study health ratings were the strongest predictors of how long people lived.

Although Palmore’s study found that in women frequency of intercourse generally was unrelated to longevity, another study found a relationship between frequency of orgasm during intercourse and longevity in women (Seldin, Friedman, & Martin, 2002). There is considerable variability among women in whether and how often they reach orgasm during intercourse. Some women reach orgasm regularly, others occasionally, and others not at all. (See this post for further discussion of these differences, and this post discussing possible reasons why this occurs.) Seldin et al. found that women who described themselves as less neurotic and those who tended to drink more alcohol had a somewhat higher frequency of orgasm during intercourse. In fact, the relationship between orgasm frequency and longevity only approached significance after taking neuroticism and alcohol use into account.[i] It is possible that individual differences in the ability of women to achieve orgasm during sex might be related to longevity. That is, women who are more orgasmic might be healthier in other ways that affect their life expectancy. 

According to Howard Friedman, one of the authors of the Seldin et al. paper, frequency of orgasm in women was linked to their sexual satisfaction, and sexual satisfaction was linked to marital satisfaction. Dr Friedman was careful to point that although all these factors were correlated we do not have enough information to know what was causing what. It might be that more orgasms lead to greater sexual satisfaction which in turn improves marital satisfaction. However, the converse could also be true. That is couples who are more satisfied with their marriages generally might have more frequent sex, leading to greater sexual satisfaction. Couples who are unhappy in their marriages, e.g. if they fight frequently, have little intimacy, poor communication, etc. will probably have less frequent sex and less sexual satisfaction. So there is probably a two-way relationship between sexual satisfaction and marital satisfaction. Therefore, marital satisfaction might be as important for longevity as orgasm frequency. People who are in stable loving supportive relationships may be healthier and live longer than those who are in disharmonious relationships. This seems applicable to the studies on male sexual frequency cited earlier, which did not address why some men are more sexually active than others. Men who have more frequent sex might be in better quality relationships (or in a relationship at all) than men who have infrequent sex.

Although there is evidence of a connection between orgasms and longer life, there is simply not enough information available to justify statements by Dr Oz to the effect that if one has a certain number of orgasms a year, one will increase one’s life expectancy by a certain number of years. Similarly, claims by transhumanists that using sex robots to induce “super-orgasms” will induce longer life overlook the human factors involved. Whilst it may be conceivable that people in the future may use robots to enhance sexual pleasure, similar to the way some people use sex toys, it hardly seems likely that people will use them as substitutes for marital partners. Without the element of marital satisfaction, it is debatable whether orgasms alone will produce the same benefit to life expectancy.

Another difference between robot and human partners that might be important is that of intentions. Robots are designed to just do what they are programmed to do, and do not have desires of their own. Humans on the other hand do have desires and intentions, and this affects how their behaviour is perceived by others. In particular, there is evidence that one’s perceptions about the intentions of another person can affect how physical pleasure is perceived. That is, an experience may be perceived as more enjoyable if one believes that the person providing the experience actually intends for one to experience pleasure than if they do not. This was tested in an experiment in which participants received a back massage from a specially designed chair (Gray, 2012). When participants believed that the chair was being controlled by another person who had freely chosen to give them a massage they perceived the experience as more pleasurable then when they thought it was being randomly administered by a computer. In actuality, in both cases, the decision to administer massage was determined by a computer, but the participants were led to believe otherwise. Although not yet tested it may be possible that people may perceive sexual activity as more pleasurable when it is performed with someone they believe is actually intending to give them pleasure, as compared with similar activity with a machine that has no feelings about the matter. Perhaps, the health benefits associated with sexual activity are tied up with the sense of being cared about by another person. Machines may not be able to provide this sense of caring. Of course, if it ever comes to pass that robots are invented that are indistinguishable from real human beings, much like in the film Blade Runner, machines might actually replace humans as both sexual and marital partners. Personally, I don’t think this will happen any time soon. In any case, before such an event does occur, people would need to decide if such a situation is even desirable. 

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[1] For the statistically minded, this effect was described by the authors as “marginally significant” (p < .10) and hence did not actually reach a conventional level of statistical significance.

Post Script
It has come to my attention that some transhumanists consider that transhumanity.net, the source of the article that inspired this post, is not a credible source of information about their views. Therefore, the remarks in my blog post should be taken as being in response to a specific article on that website, rather than a broader reflection on what transhumanists in general believe. 

Follow me on Facebook, Google Plus, or Twitter.

© Scott McGreal. Please do not reproduce without permission. Brief excerpts may be quoted as long as a link to the original article is provided. 

This article also appears on Psychology Today on my blog Unique - Like Everybody Else.

Other posts about sex and psychology

Porn Stars and Evolutionary Psychology

The Personalities of Porn Stars

Are Sex and Religion Natural Enemies?

Does Oral Sex have an Evolutionary Purpose?

The Pseudoscience of Race Differences in Penis Size

Semen an Antidepressant? Think Again

References

Gray, K. (2012). The Power of Good Intentions: Perceived Benevolence Soothes Pain, Increases Pleasure, and Improves Taste Social Psychological and Personality Science, 3 (5), 639-645 DOI: 10.1177/1948550611433470

Palmore, E. B. (1982). Predictors of the Longevity Difference: A 25-Year Follow-Up. The Gerontologist, 22(6), 513-518. doi: 10.1093/geront/22.6.513

Seldin, D. R., Friedman, H. S., & Martin, L. R. (2002). Sexual activity as a predictor of life-span mortality risk. Personality and Individual Differences, 33(3), 409-425. doi: http://dx.doi.org/10.1016/S0191-8869(01)00164-7

Smith, G., Frankel, S., & Yarnell, J. (1998). Sex and Death: Are They Related? Findings From the Caerphilly Cohort Study The Journal of Urology, 160 (2) DOI: 10.1016/S0022-5347(01)62990-2

Twitter versus the Grim Reaper: Extraverts but not introverts use Twitter to ward off existential anxiety

As Twitter has grown in popularity, a number of research studies have examined motivations for using this microblogging platform. A recent study drawing on the framework of Terror Management Theory, made the intriguing finding that when confronted with a reminder of one’s eventual death, extraverts increased their Twitter usage while introverts avoided it altogether. Extraverts and introverts appear to have different ways of coping with existential threats that could affect their use of social networking. This might shed some light on the purpose of a large amount of apparently “pointless” communication that occurs on this site.

Grappling with ultimate concerns in 140 characters or less?

Twitter differs other social networking sites such as Facebook in that messages are restricted to very short lengths (up to 140 characters) and messages are generally immediately visible to the general public, not just a user’s followers. This contrasts with typical Facebook usage, where users generally only allow mutual “friends” to see their status updates and their personal profiles. Thus people’s Facebook profiles tend to be more private, whereas typically a person’s Twitter profile can be viewed by anybody.

So what exactly are people on Twitter sharing with the wider world? According to one survey of Twitter, the most common type of content shared (over 40% of all tweets) was “pointless babble,” that is, banal updates about day-to-day activities (e.g. “ate a salad”). Some commentators have disputed this description, arguing that such updates are better described as “social grooming” or “peripheral social awareness.” That is, even though they may seem pointless to outside observers these messages may fulfil some meaningful function for the person. What exactly this function is remains unclear. A recent study explored two possible functions that Twitter usage might serve: restoring a sense of social inclusion after ostracism, and alleviating existential threat (Qiu et al., 2010).

This study involved two experiments, in both of which participants were given access to a pre-existing Twitter account with 30 followers and given opportunities to send brief messages if they wished. The experimenter created the impression that other users were currently online and able to read the participants’ messages by sending two updates about mundane activities (e.g. “helping a friend”). Additionally, participants were assessed on their Big Five personality traits (extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience).

The first experiment tested whether participants who had been experimentally ostracised would send more tweets compared to those who had not. Most people experience ostracism, or deliberate social exclusion as highly aversive and following ostracism people become motivated to restore a sense of social connection. However, the experimenters found that ostracised participants sent no more tweets than non-ostracised ones, contrary to expectations. The authors thought this indicated that sending brief messages to strangers does not satisfy a person’s need for social inclusion after being ostracised. Perhaps this is because users do not expect random strangers to respond to their tweets. After all, is there a point to communicating if others do not respond? The second experiment suggested another possibility.

The purpose of the second experiment was to test the effects of a reminder of one’s own mortality on Twitter usage. A large body of research known as Terror Management Theory (TMT) has found that being reminded of the fact that one will eventually die creates a sense of existential threat that people attempt to cope with in a number of ways (Hart, Shaver, & Goldenberg, 2005). The most well-researched coping methods are cultural worldview defence (e.g. “My country, my people, are really great!”), bolstering self-esteem (“ I'm great!”) and seeking closeness with loved ones (“someone cares about me”). These coping methods seem to provide a buffer against existential anxiety by reinforcing a sense that one is special, important, and connected with something larger than one’s self, and not merely an insignificant creature with a fleeting existence.

Qiu et al. argued that Twitter usage could help alleviate existential anxiety by providing participants with a means to affirm their own existence, that is, to announce to the world in effect “I am alive!” To test this, participants were asked to write either a brief essay about their own death (mortality salience condition) or about a neutral topic (control condition). Then they were provided with a series of opportunities to tweet messages if they wished. What the researchers found was that there was an effect of mortality salience but this depended on the personality trait of extraversion. Specifically, after mortality salience highly extraverted participants sent more tweets (nearly 10 on average) compared to their counterparts in the control condition  whereas highly introverted participants sent less (about zero on average). In the control condition there was no difference between extraverted and introverted participants in number of tweets sent (3 – 4 on average).  

Qiu et al. did not attempt to explain why extraverted and introverted participants responded to existential threat so differently, or even why their Twitter usage did not differ in the control condition. Extraversion is associated with greater sociability so the fact that in the control condition extraverts did not make greater usage of this social networking tool seems a little surprising. However, previous research has found that social motives do not predict how much time a person spends using Twitter (Johnson & Yang, 2009), suggesting that under routine circumstances a person’s sociability may not be that important to how much they use this medium. However, this might change when a person experiences an existential threat. Extraverts might see Twitter usage as a good way to proclaim their existence to other people, even if these others are complete strangers who may have little interest in the minutiae of one’s life. Introverts appear to adopt a different strategy, so perhaps they feel a need to turn inward and be within themselves as a way of reaffirming their own existence. For introverts experiencing an existential threat, sending banal messages to strangers might seem like a superficial distraction from deeper concerns. For extraverts, such a distraction might be just what they need. The fact that they are strangers might seem less important to them than that they are a potential audience.  

Some limitations of the study are worth noting. Participants were assigned a pre-existing Twitter account with random strangers as followers. This may not adequately reflect how people use the service in real life. Additionally, the researchers assessed participants on five personality traits yet presented results relevant to only one of them. With five sets of results, the odds are increased that statistically significant findings could occur by chance alone. Additionally, the outcome measure was the number of tweets sent and their content was not assessed. It would be interesting to explore whether message content after mortality salience differed from the control condition based on personality traits. For example, people high in neuroticism might have been more disturbed than others by writing about death and their tweets might perhaps have reflected this (e.g. “I’m freaking out about this experiment!”). Additionally, it would have been interesting to see if participants’ messages after mortality salience involved efforts to bolster self-esteem or defend their cultural world-view, which are also known to help buffer against existential threat.

This study is the first one that I know of to apply principles of TMT to social networking usage. As social networking continues to gain in popularity I would welcome more such research. I think this study shows that what may appear to some to be “pointless babble” may actually serve a deeper purpose, depending on one’s personality and momentary needs.

Other articles concerning social media:

Is there something wrong with people who don't use Facebook? What research really says about non-users. One of my most popular posts!

The Misunderstood Personality Profile of Wikipedia Members Contrary to a widely reported study, Wikipedians are not close-minded at all. 

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© Scott McGreal. Please do not reproduce without permission. Brief excerpts may be quoted as long as a link to the original article is provided. 

This article also appears on Psychology Today on my blog Unique - Like Everybody Else.

 

References

Hart, J., Shaver, P. R., & Goldenberg, J. L. (2005). Attachment, Self-Esteem, Worldviews, and Terror Management: Evidence for a Tripartite Security System. Journal of Personality and Social Psychology, 88(6), 999 - 1013.

Johnson, P. and Yang, S. , 2009-08-05 "Uses and Gratifications of Twitter: An Examination of User Motives and Satisfaction of Twitter Use" Paper presented at the annual meeting of the Association for Education in Journalism and Mass Communication, Sheraton Boston, Boston, MA Online. 2012-06-20 from http://www.allacademic.com/meta/p376367_index.html

Qiu L, Leung AK, Ho JH, Yeung QM, Francis KJ, & Chua PF (2010). Understanding the psychological motives behind microblogging. Studies in health technology and informatics, 154, 140-4 PMID: 20543286

The effectiveness of placebo treatment for pain is related to personality traits

Medical researchers have long known that placebo treatments can produce real effects, such as pain relief. Personality traits are also known to influence a person’s response to treatments for certain conditions. A recent study has found that personality traits appear to influence how strongly a person responds to a placebo treatment for pain. Personality traits associated with self-control and the regulation of anger in particular were associated with greater pain relief. This raises the possibility that improving a person’s self-control and ability to manage anger could also improve their ability to control pain.

Image courtesy of Michal Marcol at FreeDigitalPhotos.net

In this study, volunteers received a series of four injections while receiving PET scans to monitor brain activity (Peciña et al., 2012). Two of the injections were designed to be painless and the other two were intended to be quite painful. Participants were not told in advance which injection they would receive so as not to bias their expectations. After receiving one of the painful injections they were administered a substance that they were told would relieve the pain but which was actually an inert saline solution with no analgesic properties. This placebo treatment produced a significant reduction in pain. Pain was rated both subjectively (by self-ratings of pain intensity) and objectively (changes in opioid receptor function observed through PET scans). Pain relief tended to be stronger in participants who rated themselves higher in the personality traits of ego resiliency and agreeableness and lower in neuroticism. Agreeableness and neuroticism each consist of a number of narrower facets that were also examined. The facets that predicted placebo response most strongly were high altruism and straightforwardness (facets of agreeableness) and low angry hostility (a neuroticism facet that is also related to low agreeableness).

Neuroticism is a trait associated with negative emotionality People high in neuroticism tend to report more physical symptoms and complaints, such as headaches and muscle tension and so on, than less neurotic individuals (Ode & Robinson, 2007). People high in neuroticism cope with pain more poorly than other people probably because they tend to over-react emotionally. There is evidence linking physical pain and negative emotions as neuroimaging studies have found that endogenous opioid activity in a number of brain regions modulate both the experience of physical pain and of negative emotions. Angry hostility was the neuroticism facet that most strongly predicted (poor) placebo response in this study. The authors stated that there is research evidence linking anger to lower opioid receptor system functioning so this result was not surprising (Peciña, et al., 2012).

Agreeableness is an interpersonal trait associated with cooperativeness and concern for others. The authors of the study noted that patients who are highly agreeable tend to have a better relationship with their doctors as they take a frank and collaborative approach. Agreeable patients may therefore respond more readily to treatment, even if the treatment is a placebo. Additionally, agreeableness has been linked to placebo responses to acupuncture. They also noted that PET scans showed that the placebo response (that is, opioid receptor function) occurred in brain regions that respond to observing pain in others, and therefore play a role in empathy. Agreeable people tend to be empathetic to the suffering of others, so this overlap between the brain regions associated with the placebo response and with empathy might help explain the connection with agreeableness, particularly the altruism facet.

Altruism is associated with selflessness and self-sacrifice for the benefit of others. Perhaps people who are self-sacrificing are better able to control pain? Perhaps, being able to suppress pain when needed facilitates self-sacrifice because the pain and inconvenience of foregoing one’s own interests for the benefit of another person becomes easier to bear. Straightforwardness, the other agreeableness facet that predicted the placebo response, is associated with honesty and openness in one’s communication with others. One possible explanation for its connection with the placebo effect is that people who are naturally honest may have been more likely to believe the researcher when they were told they were being given a treatment that would provide pain relief.

Agreeableness is also related to effortful self-control, in particular the ability to control the expression of anger (Ode & Robinson, 2007). As noted previously, anger has been linked to the opioid system, so this may another reason that agreeableness is linked to the placebo effect. Another personality trait linked to both self-control and the placebo effect is ego-resiliency.

Ego-resiliency might be described as flexibility in self-control. That is, a person can inhibit their impulses when required by the situation, and yet also allow him or herself to be spontaneous and uninhibited when this is permitted. That is, the person can adapt their level of self-expression to the demands of the situation. This in contrast to people who are either chronically over-controlled – that is, unable to loosen up when they need to – or under-controlled, unable to restrain their impulses when expected to do so. Ego-resiliency assists a person in adapting to stress and adversity as over-controlled individuals tend to respond in a stiff, repetitive manner, whereas under-controlled people respond in a chaotic and unfocused manner (Letzring, Block, & Funder, 2005). The researchers argue that ego-resiliency is associated with positive emotions and adaptive changes in areas of the brain related to reward and emotional processing. Specifically, there is evidence that this trait may be associated with lower levels of activation of the dopamine system during expectation of reward, and lower levels of dopamine in turn has been associated with greater activation of endogenous opioid receptors during a painful stressor (Peciña, et al., 2012). 

The findings that the placebo effect is linked to personality traits associated with self-control, i.e. agreeableness and ego-resiliency, suggests that the placebo effect is influenced by a person’s capacity to regulate how they respond to adverse experiences. Even though the placebo effect would seem to be outside of conscious awareness, it appears that people who have developed the ability to regulate their emotions may also have a greater ability to regulate pain. This might be because the brain regions that modulate responses to pain (the opioid receptor systems) also are involved in regulating negative emotions. Additionally, it could be the case that people with greater self-control may take an attitude of active engagement to treatment, even placebo treatment, as opposed to passively waiting to see what happens. As a consequence they might respond more effectively. Emotional regulation is a trainable skill. That is, psychologists can teach people strategies to regulate how they experience and express their emotions to cope more effectively with stress. Psychologists already teach anxiety management strategies to people with chronic pain. It seems possible that training in emotional regulation, such as anger management, could actually effect changes in the opioid receptor system, resulting in a stronger placebo effect. This might have implications for how people manage pain. Future research, such as PET studies could determine whether training could have such an effect on the brain and whether this assists in coping with pain.

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© Scott McGreal. Please do not reproduce without permission. Brief excerpts may be quoted as long as a link to the original article is provided. 

This article also appears on Psychology Today on my blog Unique - Like Everybody Else.

   

References

Letzring, T. D., Block, J., & Funder, D. C. (2005). Ego-control and ego-resiliency: Generalization of self-report scales based on personality descriptions from acquaintances, clinicians, and the self. Journal of Research in Personality, 39(4), 395-422. doi: http://dx.doi.org/10.1016/j.jrp.2004.06.003

Ode, S., & Robinson, M. D. (2007). Agreeableness and the self-regulation of negative affect: Findings involving the neuroticism/somatic distress relationship. Personality and Individual Differences, 43(8), 2137-2148. doi: http://dx.doi.org/10.1016/j.paid.2007.06.035

Peciña M, Azhar H, Love TM, Lu T, Fredrickson BL, Stohler CS, & Zubieta JK (2013). Personality trait predictors of placebo analgesia and neurobiological correlates. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 38 (4), 639-46 PMID: 23187726

The Mental Health Troubles of the "Spiritual but not Religious"

Scholars have increasingly investigated the relationship between spirituality and/or religion and mental and physical health in recent years. It almost seems to have become conventional wisdom that spirituality is associated with better health, mental and physical. However, a recently published British study found that people who consider themselves spiritual but not religious are more likely to have a mental disorder compared to conventionally religious people and to those who are neither religious nor spiritual. Conventionally religious people and those who were neither religious nor spiritual did not differ in their mental health status, suggesting that being religious offers few advantages in terms of mental health. The reasons for this are still unclear. Studies on the psychology of spirituality offer some clues as to why spiritual but not religious people might be prone to poorer mental health although more research is needed to fully explain the relationship.

Recent scholarship has criticised claims that “spirituality” is beneficial for mental health (see this article for example) based on the fact that definitions of spirituality have been broadened so much that they imply mental health by definition (Koenig, 2008). Spirituality traditionally had a narrow definition centred on belief in supernatural spirits such as God. However, mental health services  have become increasingly interested in addressing the “spiritual” needs of consumers in recent times, and as a result attempts have been made to redefine the term in a way that would be maximally inclusive, so as to apply to people from diverse religious backgrounds and to those with no religion (Koenig, 2008). Many studies have broadened the term to incorporate a wide range of positive psychological concepts, such as purpose in life, hopefulness, social connectedness, peacefulness and well-being in general. This becomes problematic for research attempting to assess the relationship between “spirituality” and mental health because by most definitions good mental health implies that a person has some purpose in life, is hopeful, socially connected and has peace and well-being. Thus it becomes a meaningless tautology to say that spirituality is associated with better mental health when the term is defined this way (Lindeman & Aarnio, 2007).

A recent British study looked at the relationship between spirituality and mental health using a more traditional understanding of the term to avoid this problem of tautology (King et al., 2013). The study involved in-depth interviews with over 7000 people in England. Participants were sorted into those whose understanding of life was predominantly religious, spiritual, or neither. These terms were explained in the following way:

‘By religion, we mean the actual practice of a faith, e.g. going to a temple, mosque, church or synagogue. Some people do not follow a religion but do have spiritual beliefs or experiences. Some people make sense of their lives without any religious or spiritual belief.’

Participants were also interviewed in depth about their mental health, alcohol and drug use, social support, psychotropic medication usage, gambling, and were asked about their overall happiness. 

The results showed that religious participants were similar to non-religious/non-spiritual ones in regards to their mental health in most respects, although the religious were less likely to have used or been dependent on drugs in the last year. However, there were striking differences for those in the spiritual but not religious category. Compared to people who were neither religious nor spiritual, spiritual but not religious people were more likely to take psychotropic medication, to use or be dependent on recreational drugs, to have a generalised anxiety disorder, phobia, or any neurotic disorder, or to have abnormal eating attitudes. These differences still held even when taking into account social support and physical health, as well as age, sex, and ethnicity. None of the groups differed in their overall happiness though.

The authors concluded that people who are spiritual but not religious in their understanding of life are more vulnerable to mental disorders than other people. The nature of the causal relationship between spirituality and mental disorder is currently unknown. An earlier British study had similar findings and the authors noted that it is possible that not having a religious framework for one’s beliefs could lead to mental disorder in people who have a need for a spiritual understanding of life (King, Weich, Nazroo, & Blizard, 2006). Alternatively, having a mental disorder might prompt a person to engage in a spiritual quest in the hope of mental healing or deeper understanding of one’s problems.

Previous findings concerning the personality traits associated with “spirituality” and religiosity might shed some light onto the relationship between spirituality and mental disorder (Saucier & Skrzypińska, 2006). Spirituality in this study was defined as “quest for meaning, unity, connectedness to nature, humanity, and the transcendent.” Note that this definition focuses on subjective and mystical understandings of life, in contrast to more conventional religiosity which emphasises adherence to orthodox belief systems. Although many people describe themselves in terms of both conventional religiosity and subjective spirituality, people who were more focused on subjective spirituality and less interested in religiosity tended to have distinctly different personality characteristics compared to those with a more orthodox religious orientation. People who described themselves in conventional religious terms tended to be fairly conservative in their attitudes and beliefs. Those who were more spiritual and less religious tended to be more non-conforming and even peculiar in their outlook and personal traits. For example, they were more likely than other people to describe themselves as weird and crazy. Additionally, they tended to believe in a range of “alternative” ideas (such as psychokinesis, reincarnation, astrology, witchcraft, and psychic powers), say that they “respect the power of magic,” and scored highly in measures of magical thinking, fantasy proneness, and absorption[1].

"Unfiltered anger" by Louis Dyer

Characteristics such as magical thinking and so on have been linked to a set of traits known as schizotypy, or proneness to mildly psychotic thinking. Schizotypy refers to a cluster of cognitive, emotional, and behavioural traits that are similar to but generally milder than those exhibited in schizophrenia. It is associated with unusual beliefs about reality (e.g. that it is possible to harm other by thinking bad thoughts about them) and the tendency to have odd perceptual experiences (such as feeling that strangers are reading one’s mind). Other research has found that "New Age" beliefs and practices (in this study this term encompassed such things as yoga, Reiki, astrology, and Tarot) are associated with schizotypy (Farias, Claridge, & Lalljee, 2005). Schizotypy tends to be associated with high levels of anxiety and depression (Lewandowski et al., 2006). It could be the case that people with schizotypal tendencies and associated proneness to anxiety and depression may find unconventional spiritual ideas to be particularly appealing. It is also possible (and I admit this is speculation) that adherence to such ideas exacerbates their existing mental imbalances. (It should be noted though that many people with schizotypal tendencies are otherwise well-adjusted. Schizotypy has also been linked to artistic creativity.)

Whether unconventional spiritual pursuits are harmful to mental health is not yet known. In some respects, the association between spirituality and mental disorder seems contrary to the benefits that many spiritual traditions claim to offer. Spiritual fulfilment is supposed to lead to inner peace, even bliss. In fact certain mystics have gone so far as to claim that spiritual “work” can lead to an inner transformation that will result in “True wisdom and perfect happiness”! The very idea of “perfect happiness” seems like an impossible mirage, although a more charitable interpretation is that the term is intended as a poetic metaphor rather than a literal reality. So why are so many spiritual people so troubled? It may be that some people are simply not that successful in pursuing whatever spiritual fulfilment they are seeking. King et al. (2013) found that those who were spiritual but not religious rated the strength of their belief and the importance of the practice of their faith somewhat lower than the religious participants in their study. This might indicate a lack of dedication or self-discipline on the part of those who claim to be spiritual but not religious. More detailed studies are needed to determine if this is the case.

Another limitation of the study by King et al. was that it did not examine the specific content of the beliefs and practices of the spiritual but not religious. The content of one’s spiritual beliefs could well affect one’s mental health. For example, belief in the interconnectedness of things might be relatively beneficial, whereas more “superstitious” beliefs such as in the “evil eye” could be harmful to one’s mental health.  Research could examine whether certain particular spiritual practices are more associated with mental disorder than others. For example, yoga and meditation are generally thought to be beneficial to one’s well-being, but more bizarre practices (such as “regression” to before one’s birth) might encourage a person to hold peculiar ideas that may not serve them well in real life.

An additional puzzle is why the three groups in the King et al. study did not differ in their overall happiness even though one group was more prone to mental disorder. Happiness was assessed with a single question, whereas mental health status was assessed with a clinical interview, so a more detailed assessment of well-being might provide a more nuanced picture.

Considering the increasing prominence in modern society of people who consider themselves spiritual but not religious, more in-depth research is needed to understand fully why this group seems to be particularly vulnerable to mental illness.

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© Scott McGreal. Please do not reproduce without permission. Brief excerpts may be quoted as long as a link to the original article is provided. 

This article also appears on Psychology Today on my blog Unique - Like Everybody Else. Check out my latest articles!

Other blog posts related to spirituality

Psilocybin and personality

Psilocybin and brain function

Psilocybin for anxiety and depression in cancer

DMT, aliens and reality – part 1

DMT, aliens and reality – part 2

Precognition and the search for the soul – part 1

Precognition and the search for the soul – part 2

The Spirituality of Psychedelic Drug Users

References

Farias, M., Claridge, G., & Lalljee, M. (2005). Personality and cognitive predictors of New Age practices and beliefs. Personality and Individual Differences, 39(5), 979-989. doi: 10.1016/j.paid.2005.04.003

King, M., Marston, L., McManus, S., Brugha, T., Meltzer, H., & Bebbington, P. (2012). Religion, spirituality and mental health: results from a national study of English households The British Journal of Psychiatry, 202 (1), 68-73 DOI: 10.1192/bjp.bp.112.112003

King, M., Weich, S., Nazroo, J., & Blizard, B. (2006). Religion, mental health and ethnicity. EMPIRIC – A national survey of England. Journal of Mental Health, 15(2), 153-162. doi: doi:10.1080/09638230600608891

Koenig, H. G. (2008). Concerns About Measuring "Spirituality" in Research. The Journal of Nervous and Mental Disease, 196(5), 349-355 310.1097/NMD.1090b1013e31816ff31796.

Lewandowski, K. E., Barrantes-Vidal, N., Nelson-Gray, R. O., Clancy, C., Kepley, H. O., & Kwapil, T. R. (2006). Anxiety and depression symptoms in psychometrically identified schizotypy. Schizophrenia Research, 83(2–3), 225-235. doi: http://dx.doi.org/10.1016/j.schres.2005.11.024

Lindeman, M., & Aarnio, K. (2007). Superstitious, magical, and paranormal beliefs: An integrative model. Journal of Research in Personality, 41(4), 731-744. doi: 10.1016/j.jrp.2006.06.009

Saucier, G., & Skrzypińska, K. (2006). Spiritual But Not Religious? Evidence for Two Independent Dispositions. Journal of Personality, 74(5), 1257-1292. doi: 10.1111/j.1467-6494.2006.00409.x

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[1] I discuss absorption and its relationship to mystical experiences occasioned by psychedelic drugs in a previous post.