News, June 2009

Therapists still attempting to 'treat' homosexuality

A Wellcome Trust-funded survey has shown that a minority of mental health professionals are still attempting to provide 'treatment' for homosexuality, despite negligible evidence that this is ever effective and ample evidence that to do so can cause harm (BMC Psychiatry: text at tinyurl.com/cvj4c8 .

Michael King, professor of psychiatry at the Maudsley Hospital, and colleagues, received completed surveys from 1328 mental health professionals, including psychologists, counsellors and psychiatrists. The results were mixed. Only 4 per cent of those surveyed said they would attempt to change a client's sexuality, and yet 17 per cent said they had previously helped at least one client reduce or change their homosexual feelings. Moreover, there was no evidence that these instances had become rarer between the 1970s and the present day. Such attempts were more likely amongst male and older therapists, and members of the British Psychological Society and United Kingdom Council for Psychotherapy rather than members of the Royal College of Psychiatrists (the Society has made a statement concerning this and the media coverage, at www.bps.org.uk/ihrp).

Among those therapists who reported having offered 'treatment' for sexual orientation, justifications given included: client distress; the client's right to choose the aim of their treatments; a history of sexual abuse; and a belief that the client is confused about their sexuality. There appeared to be little awareness of the harm that such attempted interventions can cause.

'Treatments to change sexual orientation do not appear to have become completely a thing of the past,' the researchers concluded. 'Guidelines on appropriate approaches to clients who are confused or upset about same-sex desires could be useful.' Professor King said: 'The best approach is to help people adjust to their situation, to value them as people and show them that there is nothing whatever pathological about their sexual orientation.'

Publication of the findings coincided with the launch of a website that features oral histories from people who have undertaken such therapy, as well as from professionals who have devised and provided it (see tinyurl.com/qnunjn). CJ

 

New psychology award
The British Academy has joined forces with publishers Wiley-Blackwell to create a new prize for an outstanding contribution to psychology. The Academy's new annual Wiley Prize in Psychology, worth £5000, will recognise excellence in research in psychology – alternately rewarding lifetime achievement by an outstanding international scholar and promising early career work by a UK-based psychologist.

The first award, for 2009, will be awarded to one of the leading pioneers of modern psychology – Professor Martin Seligman, currently Albert A. Fox Leadership Professor at the University of Pennsylvania and Director of the university's Positive Psychology Center. Professor Seligman is a world-renowned expert on depression and happiness. He will receive the prize in September at the British Academy's annual ceremony, and he will also give the 2009 British Academy/British Psychology Society's Annual Lecture.

The President of the British Academy, Baroness O'Neill, said: 'I am delighted to be able to announce this important new collaboration. It is vitally important that we celebrate major scholarly achievements in fields such as psychology, which has such a profound impact on all our lives. And no one demonstrates that better than Martin Seligman.' Philip Carpenter, Managing Director, Social Science and Humanities publishing at Wiley-Blackwell, said: 'We offer our warmest congratulations to Martin Seligman, whose influence on modern psychology has been immense.' Martin Seligman commented: 'I am grateful for this splendid honour.'

The 2010 Wiley Prize will be awarded to a UK-based psychologist whose early career (defined as within five years of receipt of doctorate) shows outstanding promise. Nominations are invited tinyurl.com/rdepmb.  JS

 

Increasing self-screening
A simple intervention can boost breast self-examination tenfold, psychologists have shown (American Journal of Health Promotion: tinyurl.com/dgl67w). Between 1998 and 2001 Nangel Lindberg and colleagues at Kaiser Permanente in California followed 600 women, some of whom received the training intervention whilst the others received dietary advice only. The breast self-examination training involved a 45-minute session, including a video and practice on a silicon dummy, plus follow-up phone calls one and two months after the session. A year later 59 per cent of the women who had received the training were still performing effective monthly self-examinations, compared with just 12 per cent of the control group. Most previous studies have failed to find effective ways to encourage self-examination. 'Many women avoid breast self-exams because they are worried about doing them correctly; however, our study showed that with a relatively simple intervention, women can learn the proper technique, and once they feel confident they will continue to do their exams,' Lindberg said. Breast cancer is the most common form of cancer in women and some evidence suggests that early detection, via regular self-examination and mammograms, can increase survival rates. The researchers said their intervention could be adapted to other forms of self-checking, for example for testicular cancer.

Psychologists and torture
A newly declassified report of the Senate Armed Services Committee into the treatment of detainees in American custody, combined with the declassification of four CIA memos, has turned attention once again to the role played by psychologists in interrogation practices during the Bush era. The documents make it clear that psychologists, along with other health professionals, were closely involved in the design and application of interrogation practices, including waterboarding (simulated drowning) and stress positions.

In response, American Psychological Association President James Bray reiterated his organisation's policy towards interrogation, which includes prohibiting members from working in detention settings where international law is violated, and the explicit condemnation of named interrogation techniques, such as waterboarding. Bray named two CIA-employed psychologists identified by the media as having been involved in designing interrogation techniques – James Mitchell and Bruce Jessen – but said they cannot be punished by the APA because they are not members. 'It is also my fervent hope that the American people ­– and the world – will not judge all psychologists by the few who were involved in this sorry chapter in our history,' Bray concluded, 'but by the tens of thousands of psychologists who spend their professional lives working for the public good.'

Meanwhile, Psychologists for Social Responsibility (PsySR), an independent organisation based in Washington, has called on the Obama administration to launch an 'independent, nonpartisan commission to fully investigate US torture and prisoner abuse under the Bush Administration', and for the commission to include a special focus on the role played by psychologists in interrogation. In their statement, PsySR encourages all psychologists to sign an online petition (see tinyurl.com/akcqxu), organised by Physicians for Human Rights, which calls for just such a commission. 'Foremost, as a profession we must confront the mindsets and networks – of power, privilege, and influence – by which our own core healing principles were abandoned for purposes that evoke our outrage, our bewilderment, and our shame,' said PsySR's president-elect Roy Eidelson.  CJ

 

Genetic links to autism
Three new studies published simultaneously at the end of April have provided the strongest evidence to date for the genetic basis of autistic spectrum disorders (ASDs). The two studies in Nature (tinyurl.com/pzem2v; tinyurl.com/of4hrp) and another published in Molecular Psychiatry (http://tinyurl.com/omwgd5) involved thousands of children with ASD and thousands of controls. All three papers identified new common genetic variations that seem to be associated with an increased risk of developing ASD. In other words, these are genetic variants which are often seen in the normal population but seem to be disproportionately more prevalent among children with ASD.

Nearly all the implicated genes are known to either influence communication between neurons or influence the growth pattern of neurons during brain development. The team leader on the Molecular Psychiatry paper, Professor Tony Monaco of the University of Oxford, said: 'This does seem to fit with what we know from brain scans – that people with autism may show different or reduced connectivity between different parts of the brain. This new knowledge allows us to focus our studies on developing new treatments and intervention therapies for the future.' Although he welcomed the new findings, psychologist and autism expert Professor Simon Baron-Cohen at the University of Cambridge said genes were just one part of the puzzle. He told New Scientist: 'The challenge for future research will be to establish which aspects of autism they [the genes] can explain, how many of these genes are necessary and sufficient to cause autism, and how they may interact with environmental factors.' JS

Cognitive training in schizophrenia
Less apparent than the hallucinations and delusions are the cognitive deficits associated with schizophrenia. And yet it is often these impairments in learning and memory that can be the most debilitating. Now two new studies suggest intensive computer training in basic sensory and learning tasks can lead to sustained improvements in global cognitive functioning among patients with schizophrenia, leading ultimately to improved quality of life.

Sophia Vinogradov at the University of California and colleagues had 29 patients with schizophrenia undertake 50 hours of computer-based training for 10 weeks. Twenty-six control patients spent the same amount of time, and received the same amount of supervision, playing computer games.

The computerised training focused on improving the patients' basic auditory skills and learning. Example tasks included distinguishing between easily confusable syllables, and recalling conversations. 'The basic notion is that by improving the speed and accuracy of information processing in the auditory system, higher-order functions such as verbal encoding and verbal memory retrieval have more reliable signals on which to operate,' the researchers explained.
A key facet of the training was that it exploited the fact that procedural learning appears to be intact in schizophrenia. The training was therefore deliberately sustained and rewarding, with difficulty continually adjusted so that patients achieved an approximately 85 per cent correct response rate.

Crucially, the patients who received the training showed improvements not just in their auditory skills but on global measures of cognition, as compared with the control patients (in press at American Journal of Psychiatry). A sister study followed up 32 of these patients for six months – 10 from the control condition and 22 from the training condition. Twelve of the training patients received a further 50 hours training, which broadened out to include visual and cognitive control exercises (Schizophrenia Bulletin: tinyurl.com/pzsf4m).

The exciting finding at six months was that improvements in cognition appeared to be sustained, and that these improvements were associated with gains in quality of life. Cognitive improvements were broadest among those patients who received the more sustained and comprehensive training package.The researchers said their results provided 'tantalising early evidence' for the effectiveness of computerised, neuroplasticity-based cognitive training. However, significant hurdles remain. For example, few prior studies have involved such extensive training, which makes it hard to tell whether the outcomes were due to the content of the intervention or its intensity. That same intensity also places a question mark over the practicality of this intervention in real-life settings – a caveat compounded by the fact the patients in these studies were all clinically stable. CJ

New research centre targets child abuse

Psychology professor Antonia Bifulco at Royal Holloway, University of London, has become co-director of a newly launched research centre dedicated to helping prevent crimes against children. The Centre for Abuse and Trauma Studies (www.cats-rp.org.uk), which launched at the end of March, aims to 'further the understanding, treatment and policy implications of abuse and trauma and its consequences'.

The Centre's other director is Professor Julia Davidson, a criminologist from Kingston University. This month the Centre will begin a 30-month Europe-wide investigation into the behaviour of men who seek to groom children and young people online. Professor Davidson said: 'We hope the results of this very innovative study will be used to inform preventative advice for parents and schools to reduce risks to children from internet abuse.'

Other research projects include evaluating social learning interventions in previously abused young people in residential care, and interviewing child victims of sexual abuse about their experience in police investigations. The Centre also undertakes workshops and training for CPD for psychologists and social workers.

Last month the Centre held a 'Route Mapping' event at the House of Lords on the current crisis in child protection services, attended by around twenty academics and experts from different children's service agencies. Professor Bifulco said: 'Our aim was to highlight some practical ways forward to influence policy and practice in this very difficult area following from recent cases such as the death of Baby P. Psychologists can play a central role in working with children and families around abuse issues, and psychology research is fundamental in understanding the consequences for abuse on disorder across the lifespan.'  CJ

Special school links

In a move that it's hoped will bring advantages to all involved, the Experimental Psychology Department at the University of Bristol has formalised its relationship with the nearby Fosse Way School for students with special educational needs. Together, the Psychology Department, the National Autistic Society, members of the local community and the school now form the Fosse Way School Trust.

Dr Chris Jarrold, a reader in the department, helped set up this arrangement and is now one of four Trust directors. Another lecturer, Dr Liz Pellicano, has become one of the school's 15 governors.

'We've had a long-standing relationship with Fosse Way School for the last ten years or more,' Jarrold told The Psychologist. 'We've worked with children there who have autism or Down syndrome and others who don't have a particular diagnosis. We've also previously given talks at the school about our work. Now the school has decided to formalise its relationship with us – to get us more involved, not in the day-to-day running or management of the school, but in the direction of it.'
'We are also looking to do joint research projects with the school to see if we can tailor our research more around things the school will find useful – carry out more educationally minded research,' Jarrold said. The Psychology Department also hopes to support the school in writing grant proposals for funding from educational trusts and charitable bodies.

Fosse Way School is located in Norton-Radstock, has 145 pupils with a range of learning difficulties, and has consistently been rated as outstanding by Ofsted. Jarrold said the new Trust was the latest example of the school's forward-looking approach. 'This is a chance for us to give something back to a school that's been very supportive of us in the past,' he added.  CJ

First for Scotland
The Brain Injury Rehabilitation Trust (BIRT) is set to open its first centre in Scotland within the next few months. There's currently a shortage of brain rehabilitation services in Scotland but it's hoped the new 25-bed hospital, located in Glasgow, will help plug that gap. The new centre will cater for patients with severe cognitive, physical or emotional problems following acquired brain injury, providing intensive neurobehavioural assessment and rehabilitation. It will be led by psychologists and follow a behavioural model of rehabilitation rather than the medical model. Mike McPeake of the Disabilities Trust is leading the project on behalf of BIRT. He said: 'We have been very keen to establish a presence in Scotland for some time and from our discussions with colleagues in the field of brain injury in Scotland we knew that there was likely to be a significant demand for any such service.' JS

Autism and talent
An issue of Philosophical Transactions of the Royal Society B: Biological Sciences entitled 'Autism and talent', organised and edited by Francesca Happé and Uta Frith, follows a joint British Academy and Royal Society Discussion Meeting on the same subject where contributors from psychology, psychiatry, neuroscience, history and sociology explored aspects ranging from the history, origin and prevalence of exceptional talent to its basis in the brain, from cognitive theories to the representation of talent and autism in biography and fiction. Some of the challenging questions addressed in this special issue include: Are great artists fundamentally different from the rest of us? Is there a price to pay for exceptional ability in one domain? What is the role of practice? And, finally, could we all become savants (see also our report at www.bps.org.uk/nov08news)

- All articles are available online at tinyurl.com/pquuv2

Gobet's opening gambit on the RAE 

Inspired by their recent investigation into chess expertise, a team of psychologists has written to the Times Higher Education Supplement voicing concerns about assessment procedures used as part of the recent Research Assessment Exercise (RAE) – a UK-wide review that influences how much funding universities receive.

Professor Fernand Gobet at Brunel University, Dr Merim Bilali´c at Tübingen University, and Dr Peter McLeod at Oxford University, specifically challenged the assumption that panels of experts in a given subject area are equipped to review accurately research from an area outside their particular specialisation. The finding that chess experts' performance declines when solving problems outside their specialisation 'sheds some worrying light on this assumption', Gobet's group wrote.

The study with chess players involved asking an expert in one particular opening style to remember and solve chess situations both related and unrelated to their favourite opening style. The results showed that operating outside one's specific area of expertise diminished performance by about one standard deviation or 'class level', relative to completing the same feats within one's area of expertise. So, for example, a 'grandmaster' would perform to the typical, lesser standard of 'international master' when operating outside his or her favoured domain (Cognitive Science: tinyurl.com/rxvxnv).

The idea of extrapolating from these findings to the RAE came from Professor Gobet, who was in charge of the psychology RAE 'return' at Brunel. He'd noticed how reviewers often wildly disagreed about the quality of submitted papers, even when they all came from the same domain of specialisation.

Gobet explained to The Psychologist how the problem of expertise transfer would apply to the RAE: 'Say one panel member is a world expert in research into problem solving, a subfield of cognitive psychology, and that she has mostly used standard behavioural experiments in her research. She would be the equivalent of a top chess grandmaster specialising in the French defence, to use one kind of player we had in our paper. Now she has to evaluate papers say in clinical psychology. That would be the equivalent of finding a good move in a Sicilian position. So our claim is that, while she would be the equivalent of a grandmaster in evaluating papers in her field of problem solving, she would be the equivalent of an international master when evaluating papers in clinical psychology. Still an expert, but now very far from the top experts.'

Gobet said that in all likelihood the situation would actually be worse in the RAE than in chess because the gap between domains of psychology is greater than between different opening styles in chess. 'The cognitive psychologist using behavioural experiments in problem solving research would have a very hard time to evaluate papers on perception using brain imaging – although both domains belong to cognitive psychology,' he explained.

So how could the next research assessment (the so-called Research Excellence Framework) be improved? 'That's the tough question,' Gobet said. 'Using information about citations or other type of bibliometric information is clearly a step forward, but there are issues as well with this. Given the huge cost of the RAE, one should consider the option of doing away with it entirely, and using other ways of allocating money. But here, I'm well beyond my domain of specialisation.' CJ