News, March 2006

London bombings trauma victims still being found

MONTHS after the suicide bombings that shook London on 7 July last year, psychologists working with the NHS Trauma Response Team are continuing to identify and offer treatment to people traumatised by that day's terrible events – not only those directly injured, but also witnesses, the bereaved and emergency responders.
By the end of January, the team had contacted 395 people using a brief 10-item trauma questionnaire delivered by post or telephone. This asks people whether they have had certain experiences twice or more during the past week, such as 'upsetting dreams about the event' or 'acting or feeling as though the event were happening again'. Two questions about depression and one about travel phobia were also included. Of those people screened, 117 have been referred on for psychological treatment, including trauma-focused cognitive behavioural therapy and eye-movement desensitisation and reprocessing therapy, as per the NICE guidelines for post-traumatic stress disorder published last year (tinyurl.com/b6f6l).
However, psychologist Mary Robertson, a member of the steering group overseeing the project, said that based on past research, of the approximately 4000 people affected by the London bombs, around 1120 are likely to have gone on to develop post-traumatic stress disorder. To continue identifying trauma sufferers who have yet to receive help, the project is using police witness lists, and is working with occupational health departments, the Health Protection Agency, the NHS Direct helpline, GPs, accident and emergency departments, and the media.
The response programme is a collaboration of various trauma services with welfare agencies, local government, emergency services and trauma experts. The London Development Centre for Mental Health is providing support and is helping to coordinate the project.
Robertson told The Psychologist: 'This is something new that will be evaluated so that we can learn how best to respond to mental health needs in the event of future major incidents.' Professor Chris Brewin at UCL is heading the evaluation of the project.
On a related note, as part of a three-year project examining crowd behaviour during emergencies, Dr Christopher Cocking and Dr John Drury at Sussex University are seeking people caught up in the 7 July bombs who are willing to share their experiences via an online questionnaire (tinyurl.com/7c8zq).
'The research takes the premise that current crowd models used by emergency planners are flawed in that they assume that large crowds of people are unthinking and prone to panic, and therefore cannot be trusted during any emergencies,' Dr Cocking told us (and see www.bps.org.uk/tiny/n50dz5 for an article from the Psychologist archive). 'However there is very little evidence to support this "panic model", and studies of disasters over the last three decades have found that rather than descend into irrational, selfish panic in emergencies, cooperative and ordered behaviour within social norms is much more likely.'
It's hoped the research could lead to improved measures for the control of crowds. Dr Cocking again: 'To this end we have attracted interest from both local and national government and private sector organisations involved in crowd management. We have also done consultancy work for these bodies which has been very well received, and have also had contact from private sector groups interested in developing our virtual reality simulation [of crowd emergencies] as a training tool for the emergency services.' See www.sussex.ac.uk/affiliates/panic for more information.     CJ

European citizens deliver proposals on brain science

ONE hundred and twenty-six citizens, nine languages, 72 hours, 75 support staff, and 48 translators and facilitators – the Europe-wide Meeting of Minds project (see News, December) culminated at a convention in Brussels on 23 January. The citizens panels from nine European countries had come together to share their recommendations for the future of brain science, marking the end of what's thought to have been the largest-ever public consultation on science.
After consulting with their countries' leading psychologists and neuroscientists, participating citizens agreed on 37 recommendations that organisers of the project hope will inform the European Union's forthcoming Green Paper on Mental Health, and the European Commission's Seventh Framework Programme, its principal instrument for funding research and development.
'Meeting of Minds is an important achievement, establishing that citizens' participation is not only possible but also highly desirable,' said Janez Potoc?nik, EU Commissioner for Science and Research. 'I'm convinced that this will contribute to more robust European policies.'
Breakthroughs identified by the project as being likely to raise ethical questions in the near future included the use of deep brain stimulation for treating mental illnesses like depression (with such powerful treatment, might it come to be seen as a social disease to be compulsorily treated, rather than as a personal medical problem?); the development of pacifying drugs that could be used to control behaviour; the use of cognitive enhancers with implications for fairness in tests, and the inevitable pressure on people to use them to meet work demands; and genetic profiling. 'We ask for the explicit right of citizens to choose whether or not they want to receive early testing or be informed of an early diagnosis,' the citizens declared.
Amid concerns that advances in brain imaging could threaten individual privacy, another recommendation made by the citizens was that the police should not be allowed to use brain imaging as part of their investigations. Professor Axel Cleeremans, director of the Cognitive Science Research Unit at the Free University of Brussels, explained the rationale behind the recommendation: 'There is a genuine possibility that we might not be able to hide anything from others in the future,' he said. 'Methods for assessing brain activity will become sufficiently sophisticated that one will be able to find specific and reliable markers for recognition memory, lying and various emotional states.'
Other recommendations of interest to psychologists include a proposal that greater emphasis be placed on the prevention of mental illness; that efforts should be made to help people learn how to learn; that NGOs should be given extra help educating the public about the brain sciences; and that there should be greater clarification and education about healthy diversity and variation in populations. 'Public campaigns and TV programmes should be developed to provide people with better information to prevent stigmatisation. There need to be more experts whose fields are education and school psychology,' the final report says.    CJ
- The project's final proposals can be read in full at www.meetingmindseurope.org.

Psychologists best in stocks

AN investigation into share-dealing behaviour has shown that psychologists make particularly skilled dealers on the stock market. Researchers from the Bank of England, the corporate consultants McKinsey and the universities of Bonn and Heidelberg used an internet share-dealing game with real cash prizes to test the buying behaviour of 6500 participants, including psychologists, economists and physicists. On average, the psychologist participants managed to earn three times as much as physicists and economists, largely because they seemed to be aware of how the irrationality of other people's buying behaviour was affecting share prices.'Psychologists tended to decide against buying shares precisely when a lot of other players had bought them,' explained co-researcher Dr Andreas Roider of the University of Bonn's Economics Department. 'They were more sceptical about the prospect of a stock when its price was rather high,' he told The Psychologist. 'In such situations they frequently preferred to invest in what seemed to be cheaper investment opportunities. As the higher profits they earned document, they seem to have had a better grasp that recent trends might to a certain degree have been driven by irrational behaviour of earlier investors.'     CJ
- The findings are published in the December issue of the American Economic Review.  

SOCIAL SCIENCE WEEK

FOR the fourth year running the ESRC is holding Social Science Week. But this year for the first time it has been scheduled to coincide with National Science Week, 10–19 March 2006. The event is intended to give an insight into some of the country's leading social science research and its influence on our social, economic and political lives – both now and in the future. 
- For details see the website at http://www.esrcsocietytoday.ac.uk/ESRCInfoCentre/about/CI/events/FSS/2006/

Physical therapists providing psychological support

FROM a survey of 354 physiotherapists, chiropractors and osteopaths, Dr Tamar Pincus at Royal Holloway, University of London and colleagues found that at least 10 per cent of physical therapy practitioners continued long-term treatment with patients, even after three months or more without demonstrable improvement. Follow-up interviews with 42 of the surveyed practitioners suggested this proportion was an underestimate, and revealed how many physical therapists see it as their responsibility to provide psychological support and health advice to patients.
Quotes from interviews with the physical therapists demonstrated how wide-ranging they perceived their responsibilities to be. 'I am actually going to help her through her time of need,' one physiotherapist said of a long-term client. 'I feel as if there is a missing link, somewhere in that jigsaw something hasn't fallen into place and…I don't think we should be focusing on the pain,' said another.
Despite international guidelines for the treatment of lower back pain in primary care recommending that patients be referred back to their GP in the absence of any improvement, it was also clear from the interviews that the physical therapists were unhappy to discharge patients, and were uncertain about what would happen to their clients once they had left their care. 'You can actually upset patients by trying to get them off treatment,' an osteopath explained. 'She wants the service and I cannot deny her that service,' said a physiotherapist.
In light of the findings, lead researcher Tamar Pincus told The Psychologist her team would like to see cognitive behaviour therapy (CBT) techniques taught to physical therapists in the early years of their training, under the careful supervision of trained chartered psychologists. They would also like CBT training introduced under supervision at postgraduate level, as part of physical therapists' continuing professional development. 'Not all physical therapists would opt for these, but it would create an excellent body of "experts" within the professions,' Pincus said.
'We also believe that training should include an aspect of acceptable discharge, so the clinicians learn to contract to end treatment in a way that is acceptable to clients,' Pincus added. 'Our study shows that many clinicians find that avoiding conflict by continuing to treat is easier than confronting the patient. However, a training component informed both by clinical psychology and psychology of management should be able to assist both patients and clinicians to create an empowering contract that enhances self-management, without a sense of desertion or betrayal.'    CJ
- A report on the findings appears in the January issue of the European Journal of Pain.

Not so SureStart?

'SURESTART, I do believe, has made a real difference to people's lives' – that was Tony Blair's verdict on his government's investment of half a million pounds in 500 small, highly disadvantaged areas in England, aiming to give children aged up to three years a better chance in life (see www.surestart.gov.uk).
But early findings from the National Evaluation of SureStart (NESS: see www.ness.bbk.ac.uk) have been far more equivocal. Comparing 16,502 families in SureStart areas with 2610 control families on a raft of social, educational and health measures, NESS found only one modest improvement in child functioning – the three-year-old children of non-teen mothers in SureStart areas exhibited fewer behavioural problems. On parental measures, there was also just one modest improvement – mothers in SureStart areas were more accepting of their children's behaviour, and so slapped and scolded them less.
In some cases, the programme was associated with negative outcomes. For example, in SureStart areas, mothers with 36-month-olds rated their communities less favourably than mothers in control areas. And the children of teen mothers in SureStart areas showed more behavioural problems than equivalent control families. However, the NESS report recommends treating these early, cross-sectional findings with caution: 'Stronger grounds for drawing definitive conclusions about SureStart Local Programme (SSLP) effectiveness will exist once longitudinal data on the nine-month-olds and their families in SSLP areas who are included in this report are followed up at 36 months of age and thus have been exposed to SSLPs for a much longer period of time.'
However, Dr Stephen Scott, who directs a parenting research programme at the Institute of Psychiatry, King's College London, and heads the child antisocial behaviour clinic at the Maudsley Hospital, told us that in terms of immediate effects on the life trajectories of children born in poor areas, it was clear SureStart had not worked. 'Given such an appealing, visionary project and the apparent obvious goodness of the idea of getting in early, this is a painful conclusion to stomach,' he said. 'The study was thorough, the measures adequate. Some have argued that improvements may show up later, but this has not reliably occurred in any previous prevention project where there was no initial effect,' he warned.
But Scott also told us that SureStart need not be a waste of time and money if lessons are learned and appropriate changes made: 'Firstly, specific aims are needed – locality goals were far too wide, including reduction of speech delay, teenage pregnancy and maternal depression, meaning resources got spread too thinly. Secondly, screen for need: even in the poorest areas, the majority of people are functioning quite well – resources should be allocated to those who most need them. Thirdly, use evidence-based interventions, not a mixed bag of effective and ineffective ones. Fourthly, insist on weekly supervision of workers to ensure fidelity to the therapy and a high level of skill – training staff this way is emerging as key to getting reliable change. Fifthly, use simple evaluations locally as you go along, and modify interventions in the light of this. Finally, employ high-quality senior management to coordinate elements – SureStart forbade this, yet the evidence is clear it is crucial.'
Dr Scott concluded: 'If lessons are learned, then SureStart will have been a pioneering step towards giving children fairer opportunities. If, however, people carry on in the same way, or quietly shelve it, it will have been a failure.'
Professor Edward Melhuish, at the Institute for the Study of Children, Families & Social Issues, Birkbeck, who heads the NESS assessment, declined to comment at this stage.    CJ
- National Evaluation of SureStart early findings: www.surestart.gov.uk/_doc/P0001867.pdf.

 

Praise pays

A THREE-hour training package that encourages teachers to focus on praising pupils who are behaving well in class, rather than on admonishing naughty pupils, has been shown to successfully improve class discipline, according to research presented at the BPS Division of Educational and Child Psychology's annual conference in Bournemouth.
Dr Jeremy Swinson and Professor Alex Harrop of Liverpool John Moores University, together with educational psychologist Richard Melling, trialled the training programme on 19 teachers from six primary and secondary schools in Trafford and Salford. Before the training 54 per cent of teachers' verbal feedback to pupils was classed as praise, compared with 46 per cent as admonishment. After the training, they averaged 85 per cent praise versus 15 per cent admonishment. And crucially, 94 per cent of the pupils were deemed obedient after the training compared with 78 per cent before.
'Many teachers were unaware of the skills needed to deal with unruly classes and over-relied on telling pupils off, which in the long run has very little effect on the pupils' behaviour,' Swinson said.     CJ

ART AND MIND FESTIVAL

AN Art and Mind Festival 'Space, Architecture and the Brain' will take place in Winchester 10–12 March 2006. The event will consider space and our relationship to it through the sciences and the arts, from an evolutionary perspective to contemporary neuroscience, and through its use and expression in architecture and the arts.
- For details: www.artandmind.org.

Examiners sought

High-quality examiners are crucial to the success of the GCSE and A-level system, and boards are currently recruiting for 2006.
In 2004 a MORI survey found that more than eight out of ten examiners, moderators or markers said they were satisfied with the role and nearly nine out of ten would recommend it to colleagues. Both new and experienced psychology teachers say that examining is a key aspect of their professional development, and a good way to learn while earning.
- See www.examinerrecruitment.org for details.

Sense about MRI scans

PSYCHOLOGISTS using magnetic resonance imaging (MRI) are being encouraged to show how important it is to their work, in the face of proposed legislation that threatens the technique's future.
In 2004 a European Union directive was passed that sets limits on occupational exposure to electromagnetic fields. These limits, when incorporated into UK law in 2008, will make many procedures using MRI illegal or very difficult. Leading scientists responded critically to the Secretary of State for Health, and in January a meeting was held with the Health and Safety Executive.
Tracey Brown, Director of the charity Sense About Science, told us: 'It was a shock to discover that the scientific justification for this directive was even more tenuous than initially thought. The limits turn out to be based on the deliberations of a group of scientists who discussed weak electric fields some time ago. This group, on finding out the use of their deliberations, have written to HSE and others to indicate that guidelines could not be founded on that discussion.
'The EC Directorate for Employment, Social Affairs and Equal Opportunities, is now considering meeting with European representatives of scientists, manufacturers and clinicians to review the problem. This would be a great development and a sharp turnaround from the Commission's earlier dismissals of the clinicians' complaints. We would encourage all the clinical groups and research scientists who use MRI to contact their European representative bodies to ensure that they inform the Commission of the impact of restricting MRI on particular areas of healthcare and R&D across Europe.'
The government's Science and Technology Committee will also be looking at the topic as part of an inquiry into the government's use of scientific advice (including the social sciences). It will test the extent to which policies are 'evidence-based'.    JS
- For more information see www.senseaboutscience.org.uk/MRI.

RAE criteria published

The Research Assessment Exercise (RAE) criteria and working methods by subject panels have been published, and are available at www.rae.ac.uk/news/2006/criteria.htm.
A period of consultation resulted in over 500 responses from higher education institutions, subject associations, learned societies, research councils and other bodies. Ed Hughes, RAE Manager, said:
'A number of changes to the criteria were made to ensure that the assessment would be consistent across related subject areas.' Sir Howard Newby, HEFCE chief executive, said: 'The criteria address a number of policy areas which are important to the funding bodies – for example, their commitment to equal opportunities; the full and fair assessment of applied research, practice-based research and interdisciplinary research; and the sustainability and vitality of the research base through the support of early career researchers.'     JS

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