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The Mental Health Bill: substance abuse; bullying; the educational psychology funding crisis; and a new learning curriculum for toddlers

20 May 2007

Visible differences and relationships

Changing Faces – the national disfigurement charity – has launched a new Guide to Intimacy and Relationships, written by counselling psychologist Bernadette Castle. The guide explores some of the concerns that people who have disfigurements have around intimacy and developing relationships, and introduces a cognitive-behavioural approach to address them. Although aimed at adults with disfigurements, it is also a relevant resource for health professionals.

- To download the guide for free, see the Adults and Families section of www.changingfaces.org.uk.

 
Steady as you go

Participants moving during functional magnetic resonance imaging can cause real problems; and researchers at the Fraunhofer Institute for Computer Graphics believe they may have the answer. Their PROMO technique monitors head position 60 times a second and so allows any 'motion artefacts' to be compensated for immediately. Before now, such artefacts could only be compensated after a delay, or even after the scan. The system requires participants to bite onto a bar with reflective markers, the position of which is automatically determined by an optical recognition system (see www.igd.fhg.de).

 

Lost childhood?

The Conservative Party has announced a formal inquiry into lost childhood in Britain. Advisers will include Sir Richard Bowlby, president of the Centre for Child Mental Health (and John Bowlby's son). The group will look at advertising, the decline of extended families, and the relationship between fathers and sons. It will also examine 'stranger danger' and 'growing up in a flat world' in which children are given little chance to play unsupervised due to health and safety fears of teachers and the threat of litigation. The review will report in October 2007.
 

Evaluating substance abuse

Leading scientists have proposed a new system for categorising recreational drugs, based on 'scientific evidence' rather than 'prejudice and assumptions'. Writing in The Lancet medical journal, the group, including psychopharmacologist David Nutt and MRC chief executive Colin Blakemore, said the government's current system, which categorises drugs into three classes according to the harm they cause, had 'evolved from somewhat arbitrary foundations with seemingly little scientific basis' (see tinyurl.com/2tlrne).The scientists' proposed system assesses drugs according to the physical harm they cause (acute, chronic, and intravenous), how addictive they are (intensity of pleasure, psychological and physical dependence), and the harm they cause to society (via intoxication, other social harms and healthcare costs). To test the system, David Nutt and colleagues asked 29 consultant psychiatrists, as well as a separate group of experts including chemists and legal professionals, to apply the new criteria to 20 substances.The results, which were in broad agreement between the two groups, contrasted strikingly with the government's official classification system. For example, alcohol and tobacco, which don't even feature in the government's current system, were ranked as the fifth and ninth most dangerous drugs, respectively. Ecstasy, which is grouped in the most dangerous 'A' category by the government system, was only ranked 18th out of 20 according to the scientists' criteria. In a press statement, Professor Blakemore said: 'At present there is no rational, evidence-based method for assessing the harm of drugs. We have tried to develop such a method.' Professor Nutt added: 'Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse.'However, some commentators have raised concerns about the conclusions of the Lancet paper. Psychologist Dr Philip Murphy (Edge Hill University), an expert on Ecstasy, told us there is a complex literature on the potential cognitive deficits caused by taking Ecstasy (e.g. tinyurl.com/2upaa7), which under the proposed classification system would be measured against a four-point scale under the subcategory of 'physical harm: chronic'. He said: 'You have to ask: Is that robust enough to serve as a measure for such a complex body of literature, and such a complex set of variables?' The Lancet paper says that the experts who tested the new classification system were provided with 'recent review articles' to help them. However, Dr Murphy pointed out that some of these were slightly dated, with one published in 1983 and another from 1993. Crucially, the groups were not given two recent reviews on mortality figures, which report a death a fortnight, on average, related to Ecstasy use (e.g. tinyurl.com/39bcxh).
Dr Murphy told us that while the Lancet paper was an interesting and potentially useful step, 'it is not an end point'. He said it was important that all perspectives were taken on board, 'rather than approaching a complex multidisciplinary problem from just one perspective, here predominantly a medical one'.
In related news, the National Institute for Health and Clinical Excellence has just published new guidance on reducing substance misuse among children and young people (http://guidance.nice.org.uk/
PHI4
).    CJ

 
Virtual war therapy

A new form of virtual exposure therapy for traumatised soldiers is being taken to the next level by researchers at the University of Reading. The 'Virtual Iraq' project was developed in the US by Professor Albert 'Skip' Rizzo of the University of Southern California and colleagues, and involves traumatised troops gradually being exposed to the sights, sounds and smells of the Iraq War via virtual reality (VR). VR provides an ideal way of gradually re-exposing troops to traumatising stimuli. Stimulation can start out unrealistic and non-threatening and then gradually more visual and multisensory realism can be introduced. Psychologists are on hand to ensure participants are not exposed too rapidly. So far a handful of people have been treated in this way and Rizzo reports initial results have been promising.However, there are concerns that the VR goggles used to display the virtual environment might remind troops of the night-vision goggles they use for combat operations, thus causing heightened anxiety too early in the exposure programme. It is hoped the solution could lie with the University of Reading's Visualisation Centre which has a 3m x 3m 'virtual room' – a kind of 'mini Imax'. 'The VR goggles resemble night-vision goggles and they also block the participant's view of their own body, which can cause heightened anxiety,' says Professor Paul Sharkey, Director of the Visualisation Centre. 'Our VR room provides an immersive, 3D environment, filling 270 degrees of a participant's view, but they don't have to wear glasses or any other equipment.'
Professor Rizzo adds: 'Our collaboration will provide us with new information as to how best to deliver virtual worlds that maximise the therapeutic effects of virtual Iraq for those in need. Our aim here is not to re-traumatise people, but rather to re-expose them to relevant traumatic events in a graduated way that they can handle.'
The virtual room at the University of Reading is also being used for other psychological applications, for example to investigate how people shop and to experiment with different ways of displaying statistical data (see www.rvc.reading.ac.uk).    CJ

 

Mental Health Bill concern

The Mental Health Bill had its second reading in the House of Commons in April, with the British Psychological Society remaining concerned about recent amendments and their effect on the work of clinical and forensic psychologists. Following two draft Mental Health Bills in the past five years, the Department of Health last year decided to go for a direct amendment of the 1983 Act and published a proposed Bill (see tinyurl.com/2qd3bt). During its earlier passage through the House of Lords, the Bill was substantially amended. The Society supported certain changes, such as the presence of the guiding principles on the face of the Bill, safeguarding exclusions related to the definition of mental disorder, and the inclusion of the 'impaired judgement' and 'therapeutic benefit' criteria.However, the Society was extremely concerned that the Lords voted to require that the responsible clinician consults with a registered medical practitioner, if they themselves are not one, before renewal, extension or revocation of compulsory powers. Peter Kinderman, Chair of the Society's Mental Health Legislation Working Party, said: 'The proposed amendments undermine the professional ability of psychologists and other members of the multidisciplinary teams in mental health services to carry out clinical assessments and duties which are clearly within their competence. We recognise and welcome the requirement to consult other professionals concerned with the patient's care. Such a requirement already exists in the 1983 Act. However, the differentiation between classes or types of mental health professionals explicit in the proposed additional amendment is unjustified.'Following its Commons second reading, the Bill goes to committee to be debated and possibly amended. The Society continues to brief government; for more information and a lobbying letter, see www.bps.org.uk/polpar and www.bps.org.uk/mhb.    JS

In brief from BPS journalsJon Sutton on the latest batch of Society journals. See www.bpsjournals.co.uk for more.

Did boys perform better in the 1999 SAT comprehension test because it was about a 'boy friendly' subject – spiders? To find out, Jane Oakhill and Alison Petrides (University of Sussex) gave 9- to 10-year-old boys and girls that test, and the previous year's test about leaving home in wartime. The boys expressed a greater interest in reading the spider test, and showed significantly better comprehension of it. The girls showed superior comprehension for 'Leaving home', again in line with their stated preference. Although both boys and girls benefited from reading the text they thought they would find more interesting, the effect was considerably larger for the boys. (BJP, May)

In a pilot study, Lion Shahab (Institute of Psychiatry) and colleagues gave smokers attending a cardiovascular outpatient clinic either a print-out of an ultrasound image of their carotid artery showing atherosclerotic plaque alongside an image of a disease-free artery, or routine verbal feedback. The image led to increases both in engagement in smoking cessation behaviours and intentions to stop smoking (the latter only in people with higher levels of self-efficacy in stopping smoking). (BJHP, May)

A study of parents and adolescents from 173 Swiss families found that aches and pains are reported most in the morning and evening and least in the middle of the day. On weekends, participants reported fewer complaints in the evening. Women reported more symptoms throughout the day. Adolescents show an earlier and more pronounced increase in symptom reporting towards the evening. (BJHP, May)

People's willingness to incur a significant genuine cost (pain) for the direct benefit of others is a direct function of biological relatedness. According to Elainie Madsen (University College London) and colleagues, their studies provide 'the first unequivocal experimental evidence that kinship plays a role in moderating altruistic behaviour'. The researchers also found evidence to suggest that, in deciding whether to behave altruistically, women may rely less on kinship cues than men do. They suggest that this may be because, in traditional societies, males form patrilinearly related groups that exchange women. As a result, in such societies, women spend most of their reproductive lives in groups where they have few genetic relatives (other than their own children).
(BJP, May)

Research funding?

The National Endowment for Science, Technology and the Arts (NESTA) has launched the Innovation in Mental Health scheme to support local ideas for improving mental health services in the UK. It aims to find and develop innovations that have the potential to grow into national projects. Applications for the £500,000 fund are welcome from frontline workers, carers or people with direct experience of mental distress. The deadline for applications is 18 May 2007.

Further details: www.nesta.org.uk/mentalhealth

 

The Department of International Development and the ESRC have issued the third call for funding to support scientific research on issues relating to economic development and quality of life in less developed countries. Projects should have the potential to impact on policy and practice that leads to poverty reduction. The closing date for nominations is 5 June 2007. 

Further details: tinyurl.com/ypklrm

The Nuffield Foundation offer a Social Science Small Grants Scheme; up to £7500 to cover social science research expenses. Priority is given to applications that develop research capacity and advance social well-being. Applications, from those working at a UK institution, can be made at any time.

Further details: tinyurl.com/3d3v2x

 

NC3Rs (National Centre for the Replacement, Refinement and Reduction of Animals in Research) are offering Small Grant Awards (up to £2000) to support the acquisition of new 3R or animal welfare information and skills. Assistance for the developing training resources, attending training courses and exchange visits is available. The closing date for applications is 26 October 2007.

Further details: www.nc3rs.org.uk/page.asp?id=51

 

The Caledonian Research Foundation is offering European Visiting Research Fellowships in the area of Arts, Humanities and Social Sciences between Scotland and Europe. Fellowships are available to academic, or academic-related staff in Scottish HEI, to enable them to spend a period of up to six months, doing research and participating in seminars in both the host institution and elsewhere. The deadline for applications is 2 November 2007

Further details: www.calres.co.uk/european.htm

For more funding opportunities go to www.bps.org.uk/funds
Funding bodies should e-mail news to Elizabeth Beech on [email protected].

 

Pay attention – new consciousness finding

Here's how you probably think your brain works: You've got a limited amount of attentional resources, so if your brain is busy doing other things, irrelevant stimuli won't be processed and you won't be conscious of them. By contrast, if your brain isn't so busy and has spare capacity, the irrelevant stimuli will be processed and you will be conscious of them. The basic underlying idea is that attention and consciousness go hand in hand.Think again. Bahador Bahrami and colleagues at UCL have now shown the brain doesn't work like that. In a nutshell, whether irrelevant information gets processed does indeed depend on whether you have spare attentional capacity, but just because you do, and the information gets processed, doesn't mean you will be conscious of it. The finding is a clear refutation of the claim by pioneering American psychologist William James that 'We are conscious of what we attend to – and not conscious of what we do not attend to.'The researchers scanned the brains of seven participants who performed easy and difficult (more attentionally demanding) versions of a task that involved spotting target letters in a stream of irrelevant letters. At the same time, special glasses were used to present participants with two faint drawings of household tools to one eye, while bold flashing images were presented to their other eye. Throughout the experiment, these continuously flashing images rendered the drawings of the household tools invisible – a technique known as 'continuous flash suppression' – as confirmed by the participants' inability to say where the household tools were located.Although the household tools, such as an iron or spanners, were always invisible to participants, the crucial finding is that whether or not they triggered associated activity in primary visual cortex (V1) depended on the version of the letter-spotting task the participants were concurrently occupied with. If they were engaged with the easy, less attentionally demanding version, then the invisible household items triggered related brain activity in visual cortex (without a conscious percept). But if they were performing the harder version, greatly reduced or zero neural activity was observed in visual cortex.Writing in the journal Current Biology, the researchers concluded: 'The present findings are the first to show that neural processes involved in retinotopic registration of stimulus presence in V1 depend on availability of attentional capacity, even when they do not evoke any conscious experience. These findings challenge the previous suggestions that attention and awareness are one and the same, or that attention acts as the gate-keeper to awareness.'The findings also have implications for the effectiveness of subliminal advertising, which is banned in the UK but still permitted in the USA. The effect of a subliminal message may depend on how occupied a viewer's brain is – that is how much attentional capacity they have left. Presumably television viewers or cinema visitors could protect themselves by engaging in a demanding mental activity during advertising breaks. 'These findings point to the sort of impact subliminal advertising may have on the brain', says Dr Bahrami. 'What our study doesn't address is whether this would then influence you to go out and buy a product. I believe that it's likely that subliminal advertising may affect our decisions but that is just speculation at this point.'    CJ

 

Bullying – lack of data?

A house of Commons Education and Skills Select Committee report published in March calls for more long-term studies of bullying in schools. A concern is that schools are failing to record instances of bullying because they want to protect their reputations, and that this is impeding the development of anti-bullying policy. The report, which features comprehensive input from the Society, states: 'We have become convinced that a lack of accurate reliable data on bullying is one barrier to more effective anti-bullying work.'
But can it really be the case, that after so many decades of bullying research, we still don't know which anti-bullying measures work? According to Dr Tiny Arora, a bullying expert and contributor to the Society's submission to the Select Committee's report, there is plenty of evidence about which anti-bullying policies work. Rather, the crucial problem is how to implement and maintain these policies.
'What matters is that a school gives its anti-bullying policy a high priority, as part of a caring approach to staff and pupils, and maintains that policy through a process of year-on-year reviews,' Dr Arora told us. 'In that case, bullying is likely to be reduced substantially. Such a policy would need to include the monitoring and recording that is mentioned in the committee's report, as well as all the other elements outlined in the Society's submission. We know from our data that anything less will not have a lasting effect.'
The report also says that schools should ensure staff are comfortable dealing with 'disability-related, faith-based and homophobic bullying', and it highlights the worrying tendency for schools to focus too much on changing the behaviour of bullying victims rather than bullies.    CJ

 

Campaign to tackle funding crisis

The British Psychological Society has called on the government to tackle a funding crisis in the training of Educational Psychologists.
A funding distribution error by the Local Government Association (LGA) has meant that currently only 79 out of the 150 training places for this coming year can be paid for.
The Society wrote to Ministers, urging the government to underwrite the shortfall. Professor Pam Maras, President of the Society, said: 'If the money is not available then sufficient numbers of professionals will not be able to begin their training. This would mean there was not enough trained staff coming through the system to meet the needs of vulnerable children and young people. That is why we hope that some appropriate 'joined up' response from the relevant government departments to this serious situation can quickly be identified.'
The Local Government Employers' Steering Group for Educational Psychology Training, of which the Society is part, has already passed a vote of no confidence in the LGA's management of the funding scheme. So the Society is joining with the Steering Group to ask the government to identify a coherent set of future funding arrangements to provide the secure supply of educational psychologists the country needs.    SH

 

Dyscalculia findings

A new study has linked dyscalculia – a problem processing numbers – with abnormal functioning in the right-hand parietal cortex, a finding that has implications for diagnosis and management of the condition (tinyurl.com/yogrvh).Roi Kadosh and colleagues at UCL presented participants with dyscalculia, and control participants, with several pairs of numbers that differed in physical and numerical size. Their task was to indicate as quickly as possible which was the larger number in each pair, based either on physical or numerical size, depending on the trial. Because magnitude processing is typically so quick and instantaneous, people usually find this task easier when one of the numbers is both physically and numerically bigger, rather than being bigger physically but smaller numerically or vice versa. Crucially, however, this all changed when transcranial magnetic stimulation (TMS) was applied to the right intraparietal sulcus of the control participants, thus disrupting neural activity in that region. In this case, the control participants' reaction times no longer benefited from the numerical and physical size of a given number being congruent – that is, TMS caused their performance to resemble that of the participants with dyscalculia. Dr Kadosh said: 'This provides strong evidence that dyscalculia is caused by malformations in the right parietal lobe and provides solid grounds for further study on the physical abnormalities present in dyscalculics' brains. It's an important step to the ultimate goal of early diagnosis through analysis of neural tissue, which in turn will lead to earlier treatments and more effective remedial teaching.'    CJ

 

New learning curriculum – too much too young?

The Department for Skills and Education has published a new framework, coming into effect in September 2008, that sets out early learning goals and standards for children in England from birth through to age five. Announcing publication of the new Early Years Foundation Stage (EYFS), Minister of State for Children, Beverley Hughes said: 'We want to make sure that whatever setting parents choose, they can be confident their child will get the best possible start in their learning and development.'The EYFS will require by law that all providers of care for young children, including schools, nurseries and childminders, provide a suitable learning environment and that they assess the progress made by children under their care. The stated aim of the EYFS is 'to help young children achieve the five Every Child Matters outcomes of 'staying safe, being healthy, enjoying and achieving, making a positive contribution, and achieving economic well-being'.A detailed 112-page guidance document for practitioners is organised according to learning goals, and directs carers to 'look, listen and note' how children in their care behave. It states this guidance 'should not be used as checklists' but is intended to support 'the continuous assessment that practitioners must undertake'.
For example, to progress under the 'Self-care' category, the guidance states that between birth and age 11 months, babies should 'express discomfort, hunger or thirst'. Under 'Language for communication', it states babies up to 11 months should 'communicate in a variety of ways including crying, gurgling, babbling and squealing.' For progress in reading, children aged 40 to 60 months and older need to be able to 'read a range of familiar and common words and simple sentences independently.' In the framework's final year, when children are aged five, carers and teachers are expected to record each child's level of development against 13 assessment scales derived from the early learning goals.
The prescriptive nature of the framework has provoked criticism from some quarters in the media (The Guardian newspaper counted 69 early learning goals and over 500 developmental milestones). Dr Sylvain Sirois, director of the Babylab at the University of Manchester, told us that the EYFS guidance was unhelpful when the behaviour of babies and children is so varied. 'What's the point of setting targets that children don't need to meet – and many won't – to grow up normally? What good would that do? Probably more harm than good,' he said.
However, John Oates of the Open University, who wrote some of the EYFS framework, defended the detailed guidance. 'The EYFS states that "every child is a unique individual" and that "babies and young children mature at different rates", so there is explicit attention drawn to the importance of individual variations in development,' he said. 'At the same time, there is a need for those responsible for the care and education of young children to be aware of the significant steps that mark developmental progress, and to be alert to delays that might mean that extra support would be beneficial.'
We also spoke to chartered psychologist Professor Donald Christie, Director of the Applied Education Research Centre at the University of Strathclyde. He told us he saw no problem with the guidance document, which he said was helpful, informative and sound, but he raised concerns about the emphasis of the EYFS on assessment. 'The statutory guidance is couched in terms that might push early years providers towards more formal elements of learning too soon.' He explained that while some children will be capable of handling this, other children won't be developmentally ready, especially boys and children from socially disadvantaged backgrounds. 'Emphasising formal elements can effectively introduce failure into the regime, which for some children is hard to recover from,' he said.
Professor Christie also pointed out the contrast between the EYFS, and the moves in Scotland and Wales to relax the first two years of the school curriculum. It is expected that five- and six-year-olds in Scotland and Wales will be taught the use of sounds, phonetic awareness and will engage in practical activities involving, for example, counting, but there will be less emphasis on formal recording of literacy and numeracy and more emphasis on learning through play. 'In Scandinavian countries, where they wait until children are aged six or seven before introducing formal elements of reading and writing, those children who could have learned earlier are not disadvantaged. They learn really quickly and smoothly and their subsequent skills compare very favourably with standards in other nations.'
However, John Oates said assessing children's progress was not an end in itself and is not to do with success or failure. Rather the emphasis is on understanding each child's specific developmental needs. 'The detailed descriptions of developmental steps in the EYFS help practitioners to understand how literacy and numeracy are based on a whole variety of prior experiences with materials and in the acquisition of 'cultural tools', to use Bruner's term, within relationships that foster development and learning. Assessing children's progress needs to be seen in this context.'    CJ

 

Annual Conference Reports

In brief from york 2007

Around 90 per cent of prison inmates suffer mental health problems, and depression is often considered the norm in prison life. But a study by Lesley Maunder and colleagues (Northumberland, Tyne and Wear NHS Trust) suggests that anxiety is more prevalent than depression amongst male prisoners, by a ratio of 5:1.

A questionnaire study suggests that UK teachers are less satisfied with their jobs today than they were 45 years ago. Colin Anderson (independent researcher) and Robert Klassen (University of Alberta) surveyed 152 teachers and compared their responses to data collected from a similar sample in 1962. As well as giving lower ratings of job satisfaction, present-day teachers reported different reasons for dissatisfaction than their 1962 colleagues. Forty-five years ago, the most pressing concerns were material matters like salaries and inadequate buildings. The most common complaints of teachers in 2006 are lack of time, teaching load, and pupils' behaviour.

Agency or official support following the 2004 Indian Ocean tsunami was perceived as poor by British survivors. That's according to Vivien Norris (The Zito Trust) and colleagues, who surveyed survivors using a range of qualitative and quantitative methods. They concluded that there is a need for improved planning of coordinated, flexible, multi-agency responses to traumatic events.

The aroma of the essential oil of rosemary could lead to an enhancement in everyday prospective memory (roughly speaking, remembering to remember). Bryony Vallance (Northumbria University) and colleagues found that ambient rosemary aroma led to significantly better performance on prospective memory tasks than ambient basil aroma or no-odour control conditions.

Preferences for social engagement can be modulated by apparent health of faces, and there is systematic variation among individuals in the extent to which this modulation occurs. Claire Conway (University of Aberdeen) and colleagues found that low-anxiety individuals showed a preference for facial cues associated with social engagement (viewer-directed smiles) for healthy but not unhealthy faces. In contrast, high-anxiety individuals preferred social engagement with both healthy and unhealthy faces.