Amazon recommendations
There seems to be no way to tell Amazon's engine that yes, I am interested in (Jewish) biblical texts and Hebrew, but this does *not* mean I'm interested in Greek or Christian texts. There seems to be no way to tell it that I'm (currently) uninterested in books about C++, though Java and general programming are interesting. There seems to be no way to stop getting it to offer me baroque, classical, and modern music (or books on music) just because I'm interested in medieval and renaissance music. I have no idea if the copious "not interested" indications actually feed into the data pool, or if they merely act as a filter on what to show on the list.
As long as I'm going on about the recommendations scheme: there are different flavors of "not interested", and there seems to be no way to capture that. I might be uninterested because of the subject -- e.g. don't offer me books about football. I might be uninterested because I own something else that fills the same niche -- a different, similar text on Hebrew, or a compilation album that contains most of the good stuff from the CD offered. In the latter case, I don't want it to draw broad conclusions about the genre/topic (she's not interested in Hebrew any more, or she no longer likes Eric Bogle, etc). If I check "not interested" in those cases, am I sabotaging myself down the road?
I do, by the way, sometimes send questions/suggestions like these to Amazon via their feedback form, but there is absolutely no way for me to tell if that's effective (or welcome).
recommendations
The recommendation feature is not critical. Therefore, it makes sense to keep the UI as simple as possible. Adding buttons for things like "I like things like this but I'm not interested in THIS item" may make the UI too confusing for ordinary users.
As a mostly book and music store, it's in their best interest if your interests keep expanding. That is, if given the choice to display a CD that they -know- you'll like or to display a CD that you -might- like, they might be better off in the long term to make the riskier recommendation, particularly if it looks like you're "just looking around".
There's also the issue of sample size, particularly with things like medieval music. It could well be that most people who are into medieval music are also into other classical music. Therefore, your "not interested" clicks are simply lost in the crowd of classical music fans who do like both genres.