Letters, January 2011

Happiness – a distraction from economic fairness

We note with dismay that the political enthusiasm for 'happiness' that began with the previous Labour administration is to continue under the current government. In mid-November, the press reported plans to concoct a questionnaire measure of 'general well-being' and use this – rather than measures of income or wealth – to inform planning and future policy.

We have previously described the follies and flaws of this approach – both in The Psychologist ('Questioning the science and politics of happiness', July 2007) and elsewhere. Psychologists since Wundt have rejected the notion that introspection upon our own subjective experience is a reliable way of generating knowledge. Most scholars of emotion recognise the inadequacy of simple self-report measures for gauging affective states, understanding how such procedures reify a presumed 'inner' experience whilst obscuring the demand characteristics associated with their deployment. Many scholars also question the assumption that such measures index a unitary quality of experience called 'happiness'. Similarly, many take issue with the singularly Western pre-occupation with 'positive' emotions and highlight the adaptive value of unhappiness as a signal that something is fundamentally wrong with the world in which we find ourselves.

We already have multiple indices of unhappiness in the form of referrals and prescriptions for mental health treatments. Whilst these indices also have many flaws, they are scientifically more robust since they reflect actual practices, are generated from numerous sources, and at least partially open to external verification. But a government implementing spending cuts that will greatly increase inequality is unlikely to appreciate these advantages, because such indices consistently show that unhappiness is strongly associated with social inequality, and always concentrated amongst the swelling numbers of the marginalised, excluded and dispossessed.

So we question the motives of a government whose 29 cabinet members include at least 18 millionaires, and yet seemingly want us to believe that happiness – rather than economic equality – is the most valid indicator of societal well-being. We strongly urge psychologists to be wary of further debasing their discipline through any association with this pernicious and cynical project.Jon Cromby, on behalf of the Midlands Psychology Group

The deeply personal mystery of sexuality

On behalf of the Division of Clinical Psychology's Faculty of HIV and Sexual Health, Sylvia Kapp (Forum, December 2010), states: 'The Faculty believes that healthcare professionals who attempt to change sexual orientation may be committing human rights violations'. The implication seems to be that some practitioners may set out with an intention of somehow 'changing' a person's sexual orientation – perhaps a bit like the behavioural aversion therapists of the 1960s and early 70s. I doubt there are many of those around these days.

However, is it considered unethical to assist a person in exploring their thoughts and feelings? Sometimes people are uncertain of their sexual orientation. It can happen that a young person may conclude, in the course of therapy, that his or her sexual orientation has a less fixed and rigid quality than they may previously have thought, and may choose to explore other aspects and forms of sexual expression. Of course, stigmatisation of homosexuality can give rise to deep distress. On the other hand it is often our human attachment to rigid identities – all ultimately illusory, false and culturally shaped – that can create psychological prisons that cause misery.

Regarding the Bartlett study quoted by Kapp, it would be easy to draw a misleading inference that if a psychotherapist or counsellor were to say he or she had 'helped' a lesbian, gay, or bisexual person reduce their sexual feelings, this must mean it was the therapist's intention to do so, rather than it being simply one outcome of the client's self-exploration. Sexuality is perhaps more fluid and multifaceted, and identity less fixed, than Kapp's letter (paradoxically) implies. I suggest we need to respect developmental autonomy and the evolution of the unknown self – core values, it seems to me, that can help to provide a protected psychotherapeutic space for reflection on the deeply personal mystery of sexuality.
Phil Mollon
Stevenage
Herts 

Sex differences – a welcome dialogue 

I would never stereotype Cordelia Fine, or indeed anyone. To stereotype is to view an individual not as an individual but purely in terms of their group membership. Stereotyping is wrong because an individual may not be representative of the group, and therefore the characteristics ascribed to the group may not apply to the individual. My comments about Cordelia Fine's book (Book reviews, November 2010) are simply based on my reading of her book. My reading of it is that it is anti-biology, and fuses politics with science. Other readers can decide for themselves. These are in my view the two weaknesses in what otherwise is an excellent and welcome review of the social psychological literature on sex differences.

I disagree with Fine that there is no evidence for sex differences in 'theory of mind'. To take just one example, typical males show decreased activity bilaterally in the inferior frontal gyrus during the 'Reading the Mind in the Eyes' Test relative to typical females (Baron-Cohen et al. 1999). Of interest, people with autism spectrum conditions show even less activity in this region during this task (Baron-Cohen et al. 2006). We use dimensional measures to test for individual differences in theory of mind (including sex differences) since categorical measures lack the sensitivity to detect a wide range of scores and may be prone to ceiling effects (e.g. if used in typical populations after the age of four years).

Regarding the newborn babystudy, we made every effort for the experimenters to be blind to the sex of the baby. We succeeded in them remaining blind in at least 95 per cent of cases. Cordelia Fine is right that it would have been nice if this had been 100 per cent of cases, but this is real-world research: running experiments in a maternity ward, with 24-hour-old babies. The handful of cases where the experimenters may not have succeeded in remaining fully blind to the baby's sex are unlikely to have affected the results. As will be apparent below, I do not 'summarily dismiss' her criticisms or 'shut the door first'. Rather, I think she makes some excellent points that might help us think about how to design future experiments. Indeed, I would like to thank her for her careful reading of our experiment, which prompts the following reaction to her suggestion.

The only way we could have removed any risk of the sex of the baby influencing the stimuli (human face vs. mechanical mobile) would have been not to use 'live' stimuli and instead present them via a computer. That way the stimuli would have been presented in an identical fashion every time. We took the decision that it is hard enough to get the attention of a newborn baby at all, and that a live person's face – a more ecologically valid stimulus – was more likely to succeed in eliciting 'natural' responses from the baby than a computer-presented image of a face, especially given the limits of what
a newborn baby can see. However, it would make sense to repeat the experiment but this time presenting the stimuli on computer screens, so that all babies saw the very same stimulus.

Fine asks for more information about the newborn baby experiment, which I am happy to provide here. The order of the face and mechanical mobile was counterbalanced: half the babies saw the face first, and half saw the mechanical mobile first, and babies were randomised into of these two orders they received. This was precisely to guard against order effects, such as fatigue. This design ensured that if such effects had occurred, they could not have affected one sex more than the other. Finally, she asks about those babies who were excluded because they were unable to remain calm enough to be tested. I can confirm that the number of male and female babies who were excluded did not differ significantly.

Fine is right to ask probing questions of research. Science needs critics like her. Good researchers remain open-minded to the possibility that their results could be explained in different ways. Fine fears she failed to impress me with her intellectual charms, but the opposite is true. A lively dialogue such as the one she has stimulated is precisely what we seek in research. I thank her for her important contribution. Lastly, she may be surprised to learn we both share the same political agenda, which is to aspire to equality for the sexes. But politics and science are two separate endeavours. One's personal politics should have nothing to do with the scientific question of whether there are essential sex differences.
Simon Baron-Cohen
Autism Research Centre
Cambridge University

References
Baron-Cohen, S., Ring, H., Chitnis, X. et al. (2006). fMRI of parents of children with Asperger syndrome: A pilot study. Brain and Cognition, 61, 122–130.
Baron-Cohen, S., Ring, H., Wheelwright, S. et al. (1999). Social intelligence in the normal and autistic brain: An fMRI study. European Journal of Neuroscience, 11, 1891–1898.

Male psychology – well worth exploring

Further to Martin Seager's letter 'In pursuit of a Male Gender Section' (December 2010), I believe he faces a brick wall: the view that men do not experience a psychological life worthy of interest. This is a situation I have come across regularly in my training as a clinical psychologist, and my practice in a child and family setting. I would, however, vehemently argue the opposite.

I have run antenatal and parenting groups for fathers, undertaken research with father charities, supported male colleagues working in female-dominated settings and undertaken individual therapy with men. I have found it to be a most intriguing and fulfilling experience, yet it seems like a secret world.

I believe that psychologists working with men are ill-equipped and unsupported, yet also pioneering. Male/gender issues are frequently raised within The Psychologist, such as the discussion around Cordelia Fine's Delusions of Gender (December 2010) and Eirini Flouri's article 'Fathers' behaviours and children's problems' (October 2010),
and I believe a Male Gender Section would be a credit to the BPS.
Tom Grange
The Northgate Clinic
Edgware Community Hospital
Middlesex

HPC – not a professional body

In the opinion piece on 'Occupational psychology in
a changing world' (November 2010) Ivan Robertson suggests the Health Professions Council is a professional body that he has been forced to join. Whilst Binna Kandola says he struggles to see what the HPC has to offer occupational psychologists.
To clarify the HPC is not a professional body like the BPS where you have an option to join. It is a statutory regulator that keeps a register of professionals who meet our standards for their training, professional skills, behaviour and health.
The HPC opened its Register to this profession on 1 July 2009 and now regulates the following psychological titles: clinical psychologist; counselling psychologist; educational psychologist; forensic psychologist; health psychologist; occupational psychologist; practitioner psychologist; registered psychologist; sport and exercise psychologist.
Therefore anyone practising using any of the above titles including occupational psychologist is legally required to be registered with the HPC.
Michael Guthrie
Director of Policy and Standards
Health Professions Council

 

Forum - web chat
Apart from thinking the earth is flat and that the sun orbits us,
what other erroneous scientific beliefs were held for a long time? This was Richard Thaler's (behavioural economist and Nudge co-author) question in a special event for the Edge website, known for
its annual thought-provoking questions about the future. As usual, several psychologists took to their keyboards with thoughtful replies.

Consistent with the playground 'bird brain' insult, Irene Pepperberg (Harvard University) said that experts used to be unanimous in their belief that all birds are stupid, partly because neurobiologists were unable to find anything in the bird skull that resembled a neocortex. Also on an animal theme, Rob Kurzban (University of Pennsylvania) noted how resistant people were to the idea that whales are mammals, not fish, probably because categories serve a useful purpose in supporting inferences. 'In this case' he said 'phylogeny just happens to violate what usually is a very good way to group animals (or plants), leading to the persistence of the incorrect belief'.

Another theme was mistakes that are born out of prejudice.
Joan Chiao (Northwestern University) discussed the belief among pioneering anthropologists that culture evolves in linear stages from savagery to civilisation – a view 'which ultimately became tied to colonialist ideology and social Darwinism'. Gary Klein (Founder, Klein Associates) noted the widespread, mistaken belief that cholera and yellow fever are caused by miasma and filth. 'I think this was sustained by a natural repugnance when entering homes that smelled bad,' he said, 'a feeling of "wow, that can't be good – I need to get out of here as soon as possible".'

Ex-parapsychologist Sue Blackmore, a rare British contributor, highlighted the once popular belief in an 'élan vital' or life force – the idea that living things are distinguished from non-living things by having some special energy. Part of the reason for the popularity of this idea, Blackmore explained, is that 'human beings are natural dualists. From an early age children begin thinking of themselves not as a physical body but as something that inhabits a physical body or brain.'

This was a theme picked up by developmental psychologist Alison Gopnik (University of California, Berkeley) who observed that children spontaneously develop many beliefs, such as in the 'élan vital', that historically have proven particularly resistant to counter evidence. For example, she said, even children 'with an explicitly atheist upbringing develop ideas about God as an explanatory force at about the age of seven'.

Other contributions might be seen by some as more controversial. Jonathan Haidt (University of Virginia) said that the closest thing in psychology to a flat earth belief was the idea that experiences in early childhood shape adult personality. '[T]he idea that relatively short-lived experiences in the first few years – even traumatic ones, and even short-lived sexual abuse – will have powerful effects on adult personality...this just doesn't seem to be true,' he said. Meanwhile Judith Rich Harris repeated her oft-cited claim that nurture (i.e. parenting style) isn't the important factor most people continue to think it is. 'Nature + nurture is wrong,' she said, 'it's nature + something else.'
I     Check out the Edge website tinyurl.com/2f39e8g to read all the contributions by psychologists and others

Christian Jarrett is staff journalist on The Psychologist.
Share your views by e-mailing [email protected].

 

Detecting cognitive impairment

I welcomed the research reported in The Psychologist (News, December 2010) of the brief screening tool that can be used relatives/friends to identify Alzheimer's and is more sensitive than the Mini Mental State Examination (MMSE). Could I suggest that clinical and health psychologists could do well to learn from such research? My own experience as a clinical neuropsychologist suggests many of those working in health settings (where the majority of patients are older people) seem to be unable to recognise the basic signs
of cognitive impairment.

It would be somewhat ironic if relatives became better at detecting cognitive impairment than psychologists with extended, often doctorate-level, training, with rigorous CPD requirements and monitoring by the HPC etc.

The research is unequivocal: there is clear evidence of a high incidence of cognitive impairment in people with ill health, some 52 per cent in one study of non-delirious patients admitted directly to a medical service (Schillerstrom et al., 2005). Furthermore, we have a current service context of psychological therapies being rolled out to older people (Improving Access to Psychological Therapies) with therapists delivering cognitive behaviour therapy who are likely to have even more limited training about cognitive impairment.

One element of the solution for improving practice in this area is inexpensive and relatively straightforward. Every psychologist or therapist working with older people should ensure they are able to use a well-recognised brief screening tool for cognitive impairment with a high sensitivity and specificity. One example of a simple algorithm is the 6-Item Cognitive Impairment Test (6-CIT), which requires minimal training, is much quicker to administer than the MMSE, and in mild dementia has a sensitivity of 79 per cent versus the MMSE sensitivity of 51 per cent (and the same specificity) (Brook & Bullock, 1999).
It is my view that improving care for people with cognitive impairment
is less about weighty documents such as the recent Dementia Care Strategy 2009 (I note that already minimal service in my locality has just been cut further as a cost improvement saving!), but more about meaningful improvements in professional practice of those working with people who are at a raised risk of cognitive impairment. I hope a few more clinical and health psychologists will step up to the mark and improve their practice.
Michael Church
Warwick

References
Brook, P. & Bullock, R. (1999). Validation of a 6-item cognitive impairment test with a view to primary care usage. International Journal of Geriatric Psychiatry, 14, 936–940.
Schillerstrom, J.E., Horton, M.S., Schillerstrom, T.L. et al. (2005). Prevalence, course, and risk factors for executive impairment in patients hospitalized on a general medicine service. Psychosomatics, 46, 411–417.

 

Undergraduate dissertation resource

Teachers, researchers and lecturers in psychology will be interested to hear of a recent initiative by the Psychology Department at Manchester Metropolitan University. MMU Psychology Journal (Dissertations) UK was published for the first time in September 2010 and is available at tinyurl.com/stummu.
This journal has been developed as part of the department's strategy for enhancing the student experience in terms of providing online resources enabling UK undergraduates to view excellent work – and, hopefully to strive to achieve similar standards. The journal also rewards excellence by publishing the work of high-achieving students throughout the UK.

All UK psychology departments were invited to submit (up to)
two undergraduate dissertations for publication. In 2010, 23 UK universities participated and a total of 40 reports were published.
Colleagues throughout the UK are invited to submit students' work for publication in September 2011, and are urged to make their current final-year students aware of the website. Contact me for further information.
Andy Bell
Department of Psychology & Social Change

 

On tuition fees, student deband mental health 

There has been considerable controversy around plans to increase undergraduate students' fees from their current level of £3290 a year up to £6000 or even £9000 a year. A number of lines of argument for and against this change have been suggested. However, one that seems not to have been given due attention is the potential impact that such a rise will have on students' mental health.

Undergraduate students have more symptoms of poor mental health than non-students of the same age, and the number of with serious mental health problems has increased in recent years (Royal College of Psychiatrists, 2003). Half way through their degree, 9 per
cent of previously healthy students report clinically significant levels of depression and 20 per cent have similarly severe anxiety (Andrews & Wilding, 2004). Such problems considerably disrupt studies and predict poor academic performance (Andrews & Wilding, 2004; RCP, 2003). Emotional problems in students have been linked to a number
of stressors, such as the transition from home to living independently, academic pressures, and financial problems (RCP, 2003).

A number of studies on UK students suggest a relationship between financial difficulties and health problems. Roberts et al. (2000) found that poor mental health was related to financial problems and time spent working outside of university for financial support. In addition, those who had contemplated dropping out due to financial difficulties had worse mental and physical health, poorer social functioning and were more likely to be heavy smokers. Jessop et al. (2005) similarly found that levels of financial concern significantly predicted mental health, emotional problems, physical health and social functioning. Cooke et al. (2004) found that students at all stages of study had poorer mental health if they were concerned about debt. Finally, Andrews and Wilding (2004) found that after controlling for mental health symptoms prior to university, financial difficulties predicted depression half way through studies. Financial problems were related to poorer academic performance, an effect that was mediated by increased rates of depression.

Thus it is important to consider the clinical implications of any changes tothe way that universities are funded. Increasing levels of debt may have a negative impact on students' mental health, physical health and psychosocial well-being. This in turn may lead to impaired academic performance, and increased pressure on university health and counselling services.
Thomas Richardson
Peter Elliott
University of Southampton

References
Andrews, B. & Wilding, J.M. (2004). The relation of depression and anxiety to life-stress and achievement in students. British Journal of Psychology, 95, 509–521.
Cooke, R., Barkham, M., Audin, K., et al. (2004). Student debt and its relation to student mental health. Journal of Further and Higher Education, 28(1), 53–66.
Jessop, D.C., Herberts, C. & Soloman, L. (2005). The impact of financial circumstances on student health. British Journal of Health Psychology, 10, 421–439.
Roberts, R., Golding, J., Towell, T. et al. (2000). Mental and physical health in students: The role of economic circumstances. British Journal of Health Psychology, 5, 289–297.
Royal College of Psychiatrists (2003). The mental health of students in higher education. London: Author

 

On tuition fees, student debt and mental health

There has been considerable controversy around plans to increase undergraduate students' fees from their current level of £3290 a year up to £6000 or even £9000 a year. A number of lines of argument for and against this change have been suggested. However, one that seems not to have been given due attention is the potential impact that such a rise will have on students' mental health.

Undergraduate students have more symptoms of poor mental health than non-students of the same age, and the number of with serious mental health problems has increased in recent years (Royal College of Psychiatrists, 2003). Half way through their degree, 9 per
cent of previously healthy students report clinically significant levels of depression and 20 per cent have similarly severe anxiety (Andrews & Wilding, 2004). Such problems considerably disrupt studies and predict poor academic performance (Andrews & Wilding, 2004; RCP, 2003). Emotional problems in students have been linked to a number
of stressors, such as the transition from home to living independently, academic pressures, and financial problems (RCP, 2003).

A number of studies on UK students suggest a relationship between financial difficulties and health problems. Roberts et al. (2000) found that poor mental health was related to financial problems and time spent working outside of university for financial support. In addition, those who had contemplated dropping out due to financial difficulties had worse mental and physical health, poorer social functioning and were more likely to be heavy smokers. Jessop et al. (2005) similarly found that levels of financial concern significantly predicted mental health, emotional problems, physical health and social functioning. Cooke et al. (2004) found that students at all stages of study had poorer mental health if they were concerned about debt. Finally, Andrews and Wilding (2004) found that after controlling for mental health symptoms prior to university, financial difficulties predicted depression half way through studies. Financial problems were related to poorer academic performance, an effect that was mediated by increased rates of depression.

Thus it is important to consider the clinical implications of any changes to the way that universities are funded. Increasing levels of debt may have a negative impact on students' mental health, physical health and psychosocial well-being. This in turn may lead to impaired academic performance, and increased pressure on university health and counselling services.
Thomas Richardson
Peter Elliott
University of Southampton

References
Andrews, B. & Wilding, J.M. (2004). The relation of depression and anxiety to life-stress and achievement in students. British Journal of Psychology, 95, 509–521.
Cooke, R., Barkham, M., Audin, K., et al. (2004). Student debt and its relation to student mental health. Journal of Further and Higher Education, 28(1), 53–66.
Jessop, D.C., Herberts, C. & Soloman, L. (2005). The impact of financial circumstances on student health. British Journal of Health Psychology, 10, 421–439.
Roberts, R., Golding, J., Towell, T. et al. (2000). Mental and physical health in students: The role of economic circumstances. British Journal of Health Psychology, 5, 289–297.
Royal College of Psychiatrists (2003). The mental health of students in higher education. London: Author

 

Obituary

David Fontana (1934–2010)

It is with great sadness that we report the death of David Fontana, the Founding Chair of the Section of Transpersonal Psychology. David was first and foremost a great scholar, a fine man, a loving father and deeply loyal friend. He, together with Ingrid Slack and Martin Treacy, established the Section in 1996 and he continued to be an inspirational presence in the Section over the past 15 years, contributing actively to its growth.

His achievements and interests were wide-ranging, yet each was at a depth many of us could only aspire to. David began his career in teaching and moved into academia as a developmental psychologist, first at Leeds, then Birmingham, and finally Cardiff University, where he was honoured on his retirement with the title of Distinguished Fellow. In addition, he held professorships at two universities in Portugal and was Visiting Professor at Liverpool John Moores University (the first in transpersonal psychology in the UK). He was President of the Society for Psychical Research, a subject close to his heart and one on which he wrote extensively. David was a prolific author, having written 44 books and been translated into some 26 languages. The breadth of his erudition is well reflected in the diversity of subjects on which  he wrote, which include education, Buddhism, meditation and mindfulness, dreams, symbols, the psychology of religion, Christianity and survival.

A man of profound human qualities, David was excellent company, his immense general knowledge, sense of humour, gentleness and genuine interest in everything was always admired. He could talk with authority about anything from sport, especially cricket, to politics, art and literature. He could quote aptly from poetry for any occasion, with such love of the spoken word that was both moving and enchanting. He loved art and drew well, planning one day, to further improve his water colour painting skills. His love of music ranged from Haydn to ragtime and brass bands. He played piano, sang and cut a fine figure on the dance floor. David applied himself completely to everything that he did be it DIY, scientific investigation of the paranormal or educational psychology. He was a deeply religious man, who endeavoured – with much success – to integrate his broad knowledge of religions and mysticism with contemporary scientific psychology. There is no doubt that he touched the lives of many, including those who knew him personally, those whose contact with him was though his teaching and supervision, and those who knew him only though his writing. He communicated a huge amount to many people, and gave to others selflessly.

David's family was always his first priority and he and his loving wife Elizabeth raised two lovely children to become fine adults. David was very proud of them, loving them and his grandchildren beyond words.

He was also very touched by friendship and was deeply moved by the loyalty and kindness that he saw amongst men in the army, where he had once been an officer.

David was, in short, a man of enviable intelligence, immense kindness and gentleness, a loyal friend and a true 'all-rounder' who was loved and admired by so many people. He was an inspiring leader of people as well as an excellent team player. I cannot speak too highly of him. His 'transition', as he termed it, has left an irreplaceable gap in the lives of many. It is as though a great light has gone out, but, as David always said, 'nothing of value is ever lost'. It was very important to him to feel that his life had been useful, and it most certainly was.
He was totally prepared and peaceful at his passing and, convinced of the afterlife, as he was, is probably still with us.
Ingrid Slack
Chair, Transpersonal Psychology Section

Obituary

Douglas Frederick Hooper (1927–2010)

Douglas Hooper, a Fellow of the British Psychological Society, and his wife, Mavis, died in a car crash on 25 October, six weeks after celebrating their Diamond Wedding. Douglas was emeritus professor of social work at Hull University. Born in 1927, he was the youngest of four children. He had rheumatic fever as a baby and was not expected to survive. When he was two his father died, and although he remained with his mother his three siblings were taken into an orphanage.
H