Archives of Sexual Behavior ‚ Vol. 27 ‚ No. 2‚ 1998

Effects of Positive an d Negative Mood on Sexual Arou sal in Sexually Fun ction al Males William B. Mitch ell ‚ B.A.‚ 1 Patricia Marten DiBartolo ‚ Ph .D.‚2 ‚3 Tim oth y A. Brown ‚ Psy.D. ‚1 an d David H. Barlow ‚ Ph.D.1

Effects of positive an d negative m usical m ood indu ction on subjective an d objective sexual arousal were exam ined in a grou p of sexually fun ction al m ales (N = 24). Su bjects evidenced significan tly greater objective an d subjective sexual respon se in the positive m ood in duction con dition relative to both baselin e an d a neu tral con trol con dition . In con trast‚ the negative m ood in duction con dition yielded sign ifican tly less objective sexual arou sal than baselin e and a neu tral control condition . Data provide addition al empirical support for the hypothesized im pact of m ood on sexual arou sal. KEY WORDS: sexual functioning; mood induction; se xual arousal; musical mood induction.

INTRODUCTION Current conce ptualizations of many psychological disorde rs emphasize the role of affective response s as a ke y compone nt in the etiology and mainte nance of these conditions. For e xample ‚ Barlow ’s (1986) theory of sexual functioning conside rs affect to be an important variable in both functional and dysfunctional sexual pe rformance . According to this model‚ in a sexual conte xt where a public e xpe ctation for performance has bee n e stablishe d ‚ the sexually functional individual responds with positive affect. In contrast ‚ dysfunctionals respond to the sexual context with ne gative affe ct. The se negative affective reactions to se xual stimuli may actually pre date the dysResearch Proje ct ‚ Boston Unive rsity‚ Boston‚ Massachusetts. Departme nt of Psychology‚ Smith College ‚ Clark Science Center ‚ Northampton ‚ Massachusetts 01063. Ele ctronic mail via Internet to pdibarto@ science.smith.edu. 3 To whom correspondence should be addre ssed. 1 Se xuality 2

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1998 Plenum Publishing Corporation

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function and re pre sent a relative ly consiste nt and pervasive association to sexual cues (Barlow ‚ 1986) . Pre sumably ‚ these dive rge nt affective reactions set the stage for othe r mediators of sexual performance (e .g.‚ attentional focus ‚ autonomic arousal) that determine whe ther succe ssful performance results. A varie ty of data provide e vide nce for the se diffe ring affe ctive states betwee n sexually functional and se xually dysfunctional men (e.g.‚ Abrahamson et al.‚ 1985; Be ck and Barlow ‚ 1986; Byrne ‚ 1983; Heiman and Rowland ‚ 1983; Rowland et al.‚ 1995) . Previous inve stigations have indicate d that certain negative affective states seem to have contrasting effects on sexual arousal. Data gathered on anger reflect this emotion’s potential to facilitate sexual arousal (e.g.‚ Yates et al.‚ 1984) ‚ although there is e vide nce that ange r may diminish sexual de sire and disrupt responding (Bozman and Beck‚ 1991). Similarly‚ anxiety‚ unde r certain conditions ‚ has also been shown to increase sexual arousal in sexually functional individuals (e.g.‚ Barlow et al.‚ 1983; Hoon et al.‚ 1977; Wolchik et al..‚ 1980). However‚ the e ffects of de pre ssion may decrease sexual arousal (Meisle r and Carey‚ 1991; Wolchik et al.‚ 1980). Pre vious data (cf. Me isler and Carey‚ 1991) sugge st that the lack of positive mood paire d with a negative mood state (as is the case with a de pre ssive state ) may be most reliably associate d with disrupte d se xual performance . In fact ‚ Barlow (1986) describe d the affective state of se xually dysfunctional individuals as be ing most similar to depression. Thus‚ conside ration of both positive and ne gative mood may be important to our unde rstanding of the phe nomenon of ere ctile dysfunction (Barlow ‚ 1986) . The present inve stigation attempts to manipulate mood as an inde pendent variable . The purpose of the experiment was to examine the possible effects of increased positive and negative mood on sexual functioning using a within-subje cts design. Corresponding to the extensive theoretical and empirical work of many researchers (e.g.‚ Clark and Watson ‚ 1988; Watson et al.‚ 1988a ‚ 1988b) ‚ positive and negative mood were conside red orthogonal constructs in this study. The experimental hypothe ses were (i) negative mood would decrease subje ctive and obje ctive measures of sexual arousal relative to a control condition; and (ii) positive mood would increase subje ctive and obje ctive measures of sexual arousal relative to a control condition.

METHOD Particip an ts Twenty-four men reporting no difficulty with se xual functioning volunte e red for the study. Participants were recruited via a local ne wspape r

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adve rtisement reque sting involve ment in a research program aime d at investigating the possible cause s of se xual dysfunction in men. Each was paid $50 for his participation. The men range d in age from 21 to 60 ye ars (x = 38.5) . All were heterose xual and all but 1 had an available sexual partne r. Participants were scre ene d for an absence of history of sexual proble ms using a se mistructure d interview (Sakhe im et al.‚ 1987). To rule out the pre se nce of psychopathology ‚ all subje cts were also administe red the Psychiatric Diagnostic Inte rvie w (O thme r et al.‚ 1981) . Measures G enital Measurem ent. A mechanical strain gauge (Barlow et al.‚ 1970) place d midway down the shaft of the penis was used to measure change in penile circumfe re nce . Change s in e lectrical output caused by expansion of the strain gauge were recorde d via a continuous d-c signal. Both be fore and afte r each expe rimental session ‚ the strain gauge was calibrate d using a metal cone with pre de te rmined circumference settings. This calibration proce ss allowe d transformation of the data into meaningful units (i.e .‚ millime te rs circumference ). Subjective Measurem ent. During each condition ‚ a mechanical leve r that move d through a 180 ° arc was use d by subje cts to provide continuous ratings of their fe e lings of se xual arousal. This lever produce d a continuous d-c signal calibrate d on a scale from 0 (not at all sexually arou sed) to 100 (m axim ally sexually arou sed). Use of this device has bee n shown not to inte rfe re with sexual arousal ‚ except at very low levels of re sponding (Wincze et al.‚ 1980) . State Affect Measu rement. The state version of the Positive and Negative Affe ct Scale (PANAS; Watson et al.‚ 1988b) was comple ted by the subje cts before and afte r e ach e xpe rime ntal condition. This measure is a reliable and valid measure of mood (Watson et al.‚ 1988b) . Stim u lu s Mater ials Film s. Four 5-min sexually e xplicit color vide otape segme nts matched for arousing qualitie s and validate d as highly arousing to he terose xual male s in e arlie r piloting were employe d. Music. For both the positive and ne gative mood induction conditions ‚ two musical segments each were playe d alte rnate ly for a 10-min period. The musical pieces for the positive mood condition were Eine Klein e Nach tm usik (5 min 10 sec) and Dive rtmento No. 136 ( 4 min 10 se c) ‚ both by Mozart. For the negative mood induction condition ‚ Albinoni ’s Adagio in

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G Minor (6 min 32 se c) and Barbe r’s Adagio pour Corde s (5 min 33 se c) were use d. All pie ces of music have bee n used in othe r e xpe rime nts (e .g. ‚ Eich and Metcalfe ‚ 1989) and have be en reliably shown to have the ability to alte r mood in the de sire d manne r. Neutral Attention Control. Participants comple ted a neutral attention control procedure during e ach e xpe rime ntal se ssion. This procedure consiste d of having the men liste n to an audiotape of random lette rs for 5 min. The y were instructe d to pre ss an atte ntion control button whe never the y he ard the lette r “ t.” Manipu lation Check. In addition to the pre- and postinduction measure s of mood ‚ the y were thoroughly de briefed. As part of this proce dure ‚ subje cts were asked to hone stly report if their mood had change d. Other researchers (Clark and Te asdale ‚ 1982) have also used this technique as a manipulation che ck.

Proced ure Participants were told that the y would be listening to music and imagining eve nts that might make them fe el elate d or depressed. After signing a consent form ‚ the subje ct was brought to the e xpe rime ntal room whe re he was instructe d to disrobe ‚ place the strain gauge on appropriate ly‚ and inform the expe rimenter whe n the proce dure was comple ted. The subje ct was then give n instruction on use of the subje ctive le ve r and comple tion of the que stionnaire s. The e xpe rime nte r le ft the room and allowe d the subject to adapt to the surroundings for 5 min. Through communicatio n by an inte rcom system ‚ the subje ct was instructe d to comple te the pre stimulus PANAS. Next‚ in a fully counte rbalance d fashion resulting in e ight possible expe rimental orders‚ the subje ct was pre se nte d with e ithe r one of the mood induction proce dures (i.e.‚ positive ‚ negative ) or the neutral atte ntion control procedure . If the subje ct first re ceived one of the mood induction procedures‚ the se cond film of the session would be preceded by the neutral atte ntion control procedure . Conve rse ly‚ if the neutral control procedure was conducte d first‚ the se cond film of the se ssion would be accompanie d by one of the mood induction procedure s. Participants were informe d that they would be listening to music that should he lp the m develop an elate d/happy (depressed/sad) mood. In addition ‚ the y we re instruc te d to think about some thing that made the m elate d/happy (depressed/sad) while listening to the music. Subje cts were told to concentrate on pe rsonally re levant e xpe riences congrue nt with the requisite mood state and to attempt to re create the se expe rience s in gre at

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detail. For the ne xt 10 mins ‚ the expe rimente r playe d the mood-approp riate music at a comfortable liste ning volume . For the ne utral atte ntion control condition ‚ participants were informe d that the y would be listening to an audiotape that would foste r an ave rage ‚ neutral mood. The y then listene d to a tape consisting of random le tters and were told to push a button whe never they he ard the le tter “ t.” The tape was playe d at a comfortable listening volume for 5 mins. For each condition (ne utral attention control and both mood inductions) ‚ subje cts listened to the audiotape s through a pair of Sony-HD50 he adphone s. Afte r the mood induction or ne utral control condition had finishe d ‚ the subje ct again comple te d the PANAS. Afte r the se tasks ‚ subje cts watched a 5-min se gme nt from a se xually explicit film. If a mood induction condition pre cede d the film ‚ the music was playe d during the film. Films that followe d ne utral control conditions had no sound accompanying the m. The same gene ral procedure was followe d during the se cond se ssion which was conducte d on a se parate day. During this session ‚ participants re ceive d the mood induction condition that the y had not re ceive d during their initial se ssion (e .g. ‚ if the y previously had a positive mood induction and ne utral control condition ‚ they would ge t the ne gative mood induction and neutral control proce dure during the se cond se ssion) . Thus ‚ the two mood induction proce dure type s (i.e.‚ positive and ne gative ) were ne ve r pre sente d toge the r during one expe rime ntal session. Inste ad ‚ e ach was accompanie d by‚ and counte rbalance d with ‚ a neutral atte ntion control condition. Thus ‚ in total ‚ e ach subje ct re ceive d one ne gative mood induction ‚ one positive mood induction ‚ and two ne utral control tasks. All induction and control conditions were followe d by an asse ssment of mood and one of four se xually explicit films. Film orde r was random ize d ‚ so that e ach subje ct re ceive d a diffe rent orde r prese ntation of the four films. At the e nd of the se cond e xpe rime ntal se ssion ‚ subje cts we re thorough ly de briefe d.

Data Sam plin g an d An alysis Pe nile strain gauge and subje ctive lever data were recorded by a Grass polygraph and were simultane ously sample d and proce sse d by an LSI-11 microproce ssor. Subje ctive le ve r data were score d on a 0 to 100 scale . Penile data were scored as millime ters change in circumfe re nce from base line . Each 5-min condition was divide d into 20 ‚ 15-se c epochs for statistical analyse s.

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RESULTS Mood Man ip ulation PANAS score s for positive and negative mood were analyze d using a three -leve l re peate d measure s analysis of variance (ANOV A) e xamining base line score s (pre induction) ‚ postinduction scores for the ne utral control condition ‚ and postinduction scores for the mood induction condition. The first three -leve l ANOV A analyze d pre induction score s‚ neutral attention control postinduction score s‚ and positive mood postinduction scores. A significant e ffect for Condition on positive PANAS score s was found ‚ F(2 ‚ 46) = 13.62 ‚ p < 0.001. Post hoc te sting (Sche ffé tests) re ve aled that this effe ct was pre se nt due to significantly highe r score s (p < 0.05) in the elation induction condition (x = 34.96; SD = 8.30) ‚ relative to both preinduction score s (x = 29.33; SD = 8.36) and neutral atte ntion control score s (x = 29.71; SD = 8.81) . The e ffect for Condition on negative PANAS scores approache d significance ‚ F( 2‚ 46) = 2.65 ‚ p < 0.09 (x = 13.00 ‚ SD = 3.84; x = 11.83 ‚ SD = 2.73; and x = 11.88; SD = 2.52 for the pre induction ‚ neutral attention control and postinduction conditions ‚ respectively) . A similar thre e-le vel ANOV A was used to analyze PANAS score s for the preinduction ‚ neutral control ‚ and negative mood induction conditions. A significant effe ct for Condition was found on positive PANAS score s‚ F(2‚ 46) = 32.99 ‚ p < 0.001. Post hoc te sting (Scheffé tests) indicate d that negative mood induction (x = 23.92; SD = 10.43) significantly de creased positive mood (p < 0.05) in comparison to the preinduction (x = 32.25: SD = 8.72) and neutral attention control (x = 30.33; SD = 9.67) conditions. Also‚ Condition was associate d with significant change s in negative PANAS scores‚ F( 2‚ 46) = 18.47 ‚ p < 0.001 ‚ with post hoc te sting re ve aling that this e ffect was due to significantly highe r ne gative mood in the negative mood induction condition (x = 15.63; SD = 4.38) re lative to both the preinduction (x = 12.54; SD = 3.18) and ne utral control (x = 12.21; SD = 2.64) conditions.

Gen ital Measure an d Su bjective Lever Data Effe ct of session order on strain gauge and subje ctive leve r data was examine d. First ‚ a change score of genital and subje ctive re sponding was calculate d by subtracting the mean response of the control condition from the mean re sponse of the mood induction condition for e ach e xpe rime ntal session. The n ‚ a 2 ´ 2 mixed-mode l ANOVA was conducte d using O rder (Negative Mood Induction at first session vs. Positive Induction at first ses-

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sion) as the betwee n-groups factor and Condition (Negative Mood Induction vs. Positive Mood Induction) as the repe ated measure s factor. All session orde r effe cts were nonsignificant (ps > 0.05) for both genital and subje ctive re sponding. Thus ‚ a 2 (Condition) ´ 15 (Epoch) ANOV A was use d to analyze the strain gauge and subje ctive le ve r data. Strain gauge data (measure d in mm circumference change ) were first analyze d for the neutral control and positive induction conditions. These results indicate d a significant e ffect of Condition ‚ F(1 ‚ 23) = 5.66 ‚ p < 0.05 ‚ due to greate r penile responding in the positive mood induction condition (x = 24.84; SD = 17.08) compare d to the ne utral atte ntion control condition (x = 17.89; SD = 15.64). Analysis of the strain gauge data for the negative mood induction and its neutral atte ntion control condition resulte d in a significant e ffect for Condition ‚ F(1‚ 23) = 11.74 ‚ p < 0.01 ‚ due to le ss penile responding in the negative mood induction condition (x = 10.08; SD = 14.20) relative to the neutral atte ntion control condition (x = 20.55; SD = 16.52). Subje ctive le ver analysis for the elation induction condition and its neutral attention control re vealed a significant effe ct for Condition ‚ F(1 ‚ 23) = 12.21 ‚ p < 0.01 ‚ due to heighte ned subje ctive response in the positive mood induction condition (x = 39.49; SD = 26.42) in comparison to the neutral control condition (x = 20.83; SD = 18.86) . Analysis of the subje ctive lever data for the neutral control and depressive mood induction indicate d an effe ct of Condition that approache d significance ‚ F(1‚ 23) = 3.20 ‚ p < 0.09 ‚ wherein scores tende d to be lowe r during the ne gative mood induction condition (x = 15.94; SD = 19.79) versus the ne utral attention control condition (x = 25.16; SD = 22.50) . Finally‚ correlational analyse s were conducte d of the re lationship between subje ctive and genital re sponding within each condition. Significant positive correlations were found be tween genital strain gauge and subje ctive le ve r data for all e xpe rime ntal conditions: the positive mood induction condition (r = .95 ‚ p < 0.001) ‚ the ne gative mood induction condition (r = .70 ‚ p < 0.01) ‚ and the control conditions from e ach session (r = .93 ‚ p < 0.001; and r = .99 ‚ p < 0.001 for the positive and ne gative control conditions ‚ re spe ctive ly).

DISCUSSION Data from the prese nt inve stigation indicate that positive and negative mood induction has diffe re ntial effe cts on both mood and se xual functioning. The e lation condition ‚ relative to base line and control conditions ‚ resulte d in significantly highe r leve ls of positive mood. These highe r le ve ls

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of positive mood in turn were associate d with significantly gre ater penile tume scence and subje ctive sexual arousal. The re was only a trend toward a decrease in negative mood during the positive mood induction condition. Although it is possible that an e lating mood induction has little e ffect on negative mood ‚ subje cts’ low ne gative mood scores at pre induction (x = 13.0 ‚ with a minimum score of 10) may have had little room to decrease ‚ the re by producing a floor e ffect. In contrast ‚ negative mood induction le d to significant de crease s in positive mood and a significant increase in ne gative mood relative to control conditions. The affective change s in the negative mood induction condit ion occurre d con com itan tly with a signif icant de cre ase in pe nile tume scence . The se data are in contrast to the results of a similar study by Me isler and Carey ( 1991) that found significant de crease s in obje ctive se xual arousal in functional men following anothe r mood induction te chnique . Subje ctive sexual arousal ‚ on the othe r hand ‚ did not appe ar to be significantly impacte d by the ne gative mood induction. Howe ve r‚ it is possible that men were ove rre porting their subje ctive response s. Certain data from the se xual functioning lite rature have provide d e vide nce that functional males tend to subje ctively ove rre port their e re ctile re sponse (cf. Barlow et al.‚ 1996; Sakhe im et al.‚ 1987). It may be that individuals without sexual difficultie s ove re stimate their obje ctive se xual response be cause they are resistant to cognitive sets associate d with dysfunctional performance (Weissberg et al.‚ 1994) . Ove re stimating arousal may be reinforce d by an increased freque ncy of approach behaviors directed at se xual contact (e .g. ‚ if an individual re ports and/or e xperie nce s gre ate r le ve ls of ere ctile response ‚ he may fe e l he is re ady to perform and conse que ntly see k out se xual inte ractions) . Although this propositio n is spe culative ‚ it has some explanatory power whe n conside ring why functionals may continue to report similar leve ls of sexual arousal unde r control and ne gative mood induction conditions de spite decrease d le ve ls of tume scence in the negative mood condition. In fact ‚ during debrie fing ‚ some subje cts fe lt that they should have bee n able to “ be at ” the ne gative mood induction condition and still respond well se xually. One subje ct state d that he expe cted to perform well re gardle ss of how he fe lt. These results sugge st the possibility that subje cts’ expe ctancie s may have impacte d upon the ir re sponse s to the e xpe rimental manipulation . More spe cifically ‚ it is possible that participan ts reporte d the re quisite change s in mood state s be cause of the de mand of the instructions to change the ir mood. Furthe rmore ‚ there is the possibility that subje cts could have determined the study’s hypothe se s‚ such that e xpe rime nter de mand may have unwittingly bee n introduce d. In fact ‚ pre vious re se arch (cf. Heiman

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and Rowland ‚ 1983) has shown that expe rimente r demand can affe ct sexual arousal or performance . The re are a numbe r of factors that argue against the role of e xpe ctancy or e xpe rime nter demand in fully e xplaining these study results. As note d above ‚ all subje cts were aske d at debrie fing if their mood had hone stly change d and all re porte d that it had. Additionally ‚ instructions to all subjects were to attempt to create the requisite mood state but no instructions were give n to achie ve a certain patte rn of subje ctive or physiological responding. Arousal le ve ls were allowe d to fluctuate with mood change s (cf. Eich and Me tcalfe ‚ 1989). Last ‚ response s in the negative mood induction condition cannot be e xplaine d fully by an e xpe ctancy mode l because subjective and physiological responding were discordant. Thus ‚ if participants were e xpe cting to beat the negative mood induction condition ‚ we would not have found de crease d penile re sponse . Similarly‚ if participants were expe cting re duced arousal give n the e xpe rime ntal instructions ‚ we would not have found a lack of significant diffe re nce s in subje ctive response between the control and ne gative mood induction conditions. Prior theoretical ‚ clinical ‚ and empirical work has often e mphasize d the contribution of negative mood ‚ usually conceptualize d as anxie ty‚ in the e tiology and mainte nance of se xual dysfunction (e .g. ‚ Kaplan ‚ 1981; Maste rs and Johnson ‚ 1970) . The se assum ptions conce rning the role of negative mood ofte n have bee n clinically based and have lacke d rigorous empirical verification. Thus‚ Barlow ( 1986) and Cranston-Cue bas and Barlow ( 1990) have que stione d clinical lore in the arena of anxie ty and sexual functioning ‚ noting that data e xist showing that anxie ty has bee n associate d with incre ase d se xual arousal unde r certain conditions. One probable re ason why clinicians and theorists continue to assume a re lationship be tween anxie ty and se xual functionin g conce rns the difficulty in distinguish ing among compone nts and ele ments of anxie ty. Recent e vide nce sugge sts that what is “ pure ” about negative affe ct can be separate d from othe r components of anxie ty‚ such as anxious arousal and certain aspe cts of self-focuse d atte ntion ‚ such as interoceptive aware ne ss (Barlow et al.‚ 1996) . In fact ‚ it may be that the e ffects of the musical mood induction proce dure are attributable to change s in physiological arousal le ve l. In the ir study using this same technique ‚ Eich and Me tcalfe (1989) found that se lf-re porte d arousal was positive ly correlate d with positive mood. It may be that mood affects arousability which then impacts upon sexual re sponsivity. Negative mood induction may have decrease d arousal le vels ‚ the reby inhibiting tume scence le ve ls. This explanation sugge sts that only negative moods associate d with decreased arousal le vels (e.g.‚ de pre ssion) will interfe re with sexual functioning. This mode l may he lp to integrate the conflicting results of various studie s on the diffe rential effe cts of ne gative moods on se xual functioning.

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In any case ‚ our unde rstanding re garding the dive rse influe nce s of emotional state s will not be advance d until theoretically and psychome trically sound e xpe rime ntal methods are adopte d. As outline d earlie r‚ increase d ne gative mood is conside re d a key compone nt in dysfunctional sexual pe rformance . O ur findings indicate that positive mood may also play a promine nt role in sexual arousal for functional sexual performance ‚ particularly give n the association of incre ase d subje ctive and obje ctive sexual arousal with concomitant increases in positive mood during the e lation condition. In fact ‚ a study by Rowland et al. (1995) indicate d that positive affect was significantly greate r for functional ve rsus dysfunctional males during periods of erotic stimulation ‚ but not during the base line pe riod. This finding sugge sts that functional male s’ characte ristic re sponse of a positive mood whe n faced with a sexual situation may be what differe ntiate s the m from dysfunctional male s (see ‚ also Barlow ‚ 1986) . More re search is ne eded conce rning the role of positive and negative mood in se xual functioning. Future work should inve stigate the validity of laboratory procedure s such as this in elucidating the e ffects of mood on se xual arousal and re sponse . Dire ct comparisons be tween various mood state s are warrante d ‚ especially those e xamining anxie ty and de pre ssion. Presumably ‚ alte ration of mood will impact othe r factors involve d in sexual functioning (e .g.‚ atte ntional allocation ‚ autonomic arousal ‚ and cognitive inte rfere nce). Rese arch should systematically addre ss these issue s. Also ‚ te sting the effe cts of musical mood induction procedure s in dysfunctional populations could provide information useful in the de ve lopme nt of ne w tre atment compone nts for sexual dysfunction.

ACKNOWLEDGMENT We thank two anonymous re viewers for their he lpful comments on an earlie r draft of this manuscript.

REFERENCES Abrahamson ‚ D. J.‚ Barlow ‚ D. H. ‚ Sakheim ‚ D. K.‚ Beck ‚ J. G.‚ and Athanasiou ‚ R. (1985) . Effects of distraction on sexual responding in functional and dysfunctional men. Behav. Ther. 16: 503-515. Barlow ‚ D. H. (1986) . Cause s of se xual dysfunction: The role of anxiety and cognitive interfere nce . J. Consult. Clin. Psychol. 54: 140-148. Barlow‚ D. H.‚ Be cke r‚ R.‚ Leitenberg‚ H.‚ and Agras ‚ W. S. (1970). A mechanical strain gauge for recording penile circumfere nce change. J. Appl. Behav. Anal. 6: 355-367.

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