News, May 2005

The right to know where you came from

HOW would you feel if a person born from your donated sperm or egg 18 years earlier, turned up on your doorstep proclaiming you to be their long-lost parent? That scenario became a real possibility from April this year, when the law changed allowing children born from donated sperm, eggs and embryos to trace their biological roots once they reach of the age of 18.

This move brings the rights of such children in line with those of adopted children, although the law will not apply retrospectively: the estimated 37,000 people born from donated cells in the UK before April 2005 will still not have the legal right to trace their unidentified biological parent(s). The first people to exercise the new rights will be able to begin tracing their origins in 2023, by which time they will be 18.

The Human Fertilisation and Embryology Authority (HFEA; www.hfea.gov.uk), which maintains the database of all such donations, has welcomed the law change, but other experts fear the new law will cause a drop in the number of donors coming forward at a time when demand already outstrips supply. For example, a study published in the March issue of Reproductive BioMedicine, reported a survey by Ian Craft and colleagues at the London Fertility Centre in which 36.4 per cent of 504 former egg donors said they would not have donated without anonymity.

Clinical psychologist and BPS Fellow Professor Robert Edelmann told The Psychologist: 'There may well be an initial decline in donors, but research in other countries suggests this is not necessarily an enduring problem.' The experience in Sweden supports this view. In 1985 Sweden changed their law to allow donor-conceived children the right to trace their biological roots, and although there was an initial drop in donors, levels soon returned to normal. 'The rights of the hoped-for child should take precedence over those of the donor or prospective parents,' Professor Edelmann continued. 'Without this information being available, one of the major problems is that parents often – about 66 per cent of cases – do not tell the child the nature of their origin. While this is not necessarily a problem, it can be for the few who find out by chance, and such a secret in a family is not necessarily the healthiest of environments for child rearing, psychologically speaking. Fortunately problems are very rare – none the less, identity information being available may encourage more openness in families about donor insemination and their child's origin.'

Dr Olga van den Akker (Aston University) concurred: 'From our adoption experiences, we know that children brought up in adoptive homes who find out later that their parents are not their biological parents, feel that they have lived a lie and that 'something is missing' – there are reports that it affected their identity. And when a gamete-donor parent has confided in some but not all friends or relatives, any one of those could be responsible for a child finding out inadvertently how it was conceived. There is evidence to show that these children have suffered from this information. Contrary to this, no reports of adverse effects on donor offspring who had their true genetic origins disclosed to them have been reported.'

But what of the psychological impact of this change of law on egg or sperm donors? 'Little research has been carried out to find out their feelings about any potential offspring they may have,' Dr van den Akker said. 'We do know a certain amount about their motivations, which are generally summarised as "altruistic" versus "financial gain" [donors are currently paid a maximum of £15 plus reasonable expenses]. But new research is urgently needed to determine a donor's feelings about any potential offspring wishing to contact them.'

Nor is there any information about how potential parents using donated sperm or eggs will react to this change of law, the majority of whom currently choose not to reveal to their children the truth about their biological origins. 'There's no mechanism in place to prevent people wishing to use anonymous donated gametes travelling to countries where this is still legal, so that they will not feel the need to reveal the genetic origins to the resultant child,' Dr van den Akker said. In fact, at the time of print, a UK-based sperm donation service called mannotincluded.com has already set up a procedure for circumventing the new law. In response, the HFEA are seeking legal advice and their chief executive Angela McNab told BBC radio the errant service will involve 'great risk and uncertainty' because it will have 'none of the important health checks and balances' and 'no independent regulation taking place'.    CJ

Improving student writing skills 

TWO Society members have won a grant of over £3 million to improve student literacy by focusing on how student writing is assessed.

James Elander (London Metropolitan University) and Lin Norton (Liverpool Hope University College) were successful in the latest and largest round of learning and teaching funding from the Higher Education Funding Council for England (www.hefce.ac.uk/learning/TInits/cetl/). The funding will establish Writing Centres at both universities, where students from all disciplines will be able to consult writing specialists, attend workshops on writing, and access a range of web-based and hard-copy resources.

James Elander said: 'The emphasis in all this is on helping students understand the criteria against which their writing is assessed so they can improve their work. The assessment criteria for coursework and examinations, for example, often include terms like "critical evaluation", "development of argument" and "use of evidence" – very abstract attributes that markers themselves often understand only through an implicit understanding of what makes a piece of work qualify for one grade rather than another. Students often struggle much harder to understand what the criteria mean, making it difficult for them to know how to improve their work. The Writing Centres will focus on helping students firstly understand what makes a good piece of student writing and then develop the skills required to demonstrate qualities like "critical evaluation" and "use of evidence" in their writing.'

The centre will also promote greater student involvement in decisions about the assessment of their work, and promote greater staff awareness and appreciation of the issues that influence the assessment of student writing, for example by providing a master's course in student assessment. James and Lin hope that 'the centre will continue and extend the long tradition of psychologists helping to improve university education, within and outside our own discipline'.    JS

- For more information see www.londonmet.ac.uk/csl-cetl. The work builds on Assessment Plus, a previous project that used assessment criteria to help students learn (see www.assessmentplus.net).

New PTSD guidelines 

THE National Institute for Clinical Excellence (NICE) has urged improved recognition, screening and treatment of post-traumatic stress disorder (PTSD) in their new guidelines.

Up to 30 per cent of people experiencing a traumatic event may develop PTSD, but the condition remains frequently unrecognised, according to the report (see tinyurl.com/6lg2z.).

A key recommendation is that single-session interventions, often referred to as debriefing, should not be routinely offered as an initial response. NICE recommends that for people experiencing mild symptoms present for less than four weeks following a trauma, clinicians should consider 'watchful waiting' as a way of managing the symptoms. Individuals with more severe or persistent PTSD symptoms should be offered trauma-focused psychological therapy (such as cognitive behavioural therapy (CBT) or eye movement desensitisation and reprocessing), usually on
an individual outpatient basis. Children and young people suffering from PTSD should also be offered trauma-focused CBT, adapted to suit individual needs and development.

NICE cautions against using drugs, such as paroxetine or mirtazapine, in the first instance, unless sufferers prefer not to engage in psychological treatment or if medication is used in addition to therapy to treat comorbid problems, such as depression.

The guidelines also emphasise the importance of prevention. They advise adequate disaster planning, suggesting that the responsibilities of healthcare workers involved in the disaster should be clearly set out in advance.

Pamela Dix, a Guideline Development Group member who lost her brother in the Lockerbie crash, said: 'The publication of the PTSD guideline is a real milestone, which should lead to a greater understanding of PTSD and also highlight the effectiveness of appropriate treatment…People with PTSD should not have to struggle to get their condition recognised.' Exactly how these recommendations will be implemented into already stretched NHS systems remains to be seen.

Tess Browne
(King's College London)

In brief

A sample of the latest BPS journals
The cleverer you are at the age of 11, the more chance you have of seeing retirement. That's according to a study linking individuals' childhood IQ from the Scottish Mental Survey 1932 to mortality up to 69 years later. For deaths occurring up to age 65, there was a 36 per cent increased risk per standard deviation decrease (15 points) in childhood IQ, which was reduced to 29 per cent after adjusting for social class and deprivation category. There was no significant relationship between childhood IQ and deaths occurring after the age of 65. (BJHP, May)

Health promotion leaflets might not have much effect on attitudes on their own; but give people an incentive, and the information starts to sink in. Barbara Krahe (University of Potsdam, Germany) and colleagues gave students a 'Safer sex…for sure' leaflet. Those simply told to read it carefully subsequently changed their attitudes less than those who were also informed that they could join a prize draw if they found the right answers to a number of questions using information contained in the leaflet. (BJHP, May)

Just five minutes of exposure to distorted bodies can change subsequent perceptions of attractiveness and normality. In two experiments, participants chose pictures of much thinner women as the most attractive and most normal-looking after viewing a picture that had been distorted to half of its original width. However, the most attractive and most normal-looking bodies did not change reliably after exposure to wide bodies. (BJP, May)

In a test of the powers of five mediums certified by the Spiritualists' National Union, five sitters each received five readings and then rated their accuracy. Ratings assigned to their own readings were not significantly different from the ratings they assigned to others sitters' readings. The authors claim that the methodology could be used to examine conceptually similar claims being made within clinical, forensic and occupational contexts. (BJHP, May)    JS
- See www.bps.org.uk for more information.

 

GENES AND DYSLEXIA

IT'S taken seven years, but now a team of researchers at Cardiff University has become the first in the world to identify a gene associated with susceptibility to dyslexia.
The researchers, led by Julie Williams, Professor of Neuropsychological Genetics, compared DNA variants in genes on chromosome 6, between 300 children with developmental dyslexia, and 300 children with no reading problems. They found a number of differences in DNA variants between the groups, most of which came from a single gene called KIAA0319.
'We know the gene expresses a protein in the brain,' Professor Williams told The Psychologist, 'but beyond that we really know very, very little. When genes associated with other conditions have been identified, often a lot has already been known about them because they've been implicated in other disorders. With KIAA0319, however, this just isn't the case.'
Professor Williams cautioned that people shouldn't see this as a 'gene for dyslexia' – 'First of all, it's likely there will be a number of genes associated with the condition, and it's not that a gene or genes code for dyslexia per se, but rather they will form part of a complex relationship involving other genes and environmental factors.'
'It's really too soon to speculate about possible therapies,' Professor Williams told us, 'but this discovery gives us an excellent platform from which to understand the molecular and neurobiological aspects of dyslexia, to complement the cognitive and behavioural advances that have been made… It brings another level of information into play.'
'This discovery has been a team effort; I'd like to thank everyone's hard work and the families who took part,' Williams added.
The findings appear in the April issue of the American Journal of Human Genetics. The team's next step is to identify how the gene KIAA0319 functions and what role its associated protein plays in the brain.     CJ

Collaborative care on trial

A NEW approach to treating patients with depression in primary care is to be trialled in the UK for the first time. Known as 'enhanced' or 'collaborative' care, the method is popular in America where 36 randomised controlled trials are currently under way.
Patients with moderate depression will be referred by their GP to a case manager –
a nurse, counsellor or graduate mental health worker – who will telephone the patient as soon as possible to arrange a meeting. 'Mental health services vary widely around
the country, so the role of case manager will be filled by whoever is available in a particular service. What is important is not their particular job title or background, but whether they have the skills and training necessary,' lead investigator David Richardson (Professor of Mental Health at York University) told The Psychologist.
'It is the early stage that is most critical in helping people with depression,' Richardson explained, 'so the idea is that there will be no waiting lists; that the patient will see their case manager as soon as possible. After the initial face-to-face meeting, most subsequent contact will probably be by telephone, whereby the case manager will provide brief psychological help in the form of behavioural activation. This aims to help people re-engage with the things they've stopped doing since becoming depressed – re-establishing social contact, for example. Patients will also receive a pack to work through at home. The case managers themselves will be under the supervision of mental health experts.'
Case managers will also help patients manage their antidepressant medication, if any has been prescribed, and to cope with potential side-effects. 'Half of all patients prescribed antidepressant medication abandon it within a week', Richardson said, 'often because of early side-effects.'
The research project is funded by a £170,000 grant from the Medical Research Council and will involve academics at York, Leeds and Manchester Universities. Patients treated under the new enhanced care system will be followed for three months and their progress will be compared with patients undergoing standard treatment from their GP.
'This is the first trial of enhanced care for depression in the UK,' Richardson said, 'so our initial challenge has been to adapt the method for use within the UK health system. Ultimately we hope to establish longer trials all over the country.
'There is an awful lot of misery out there in the world and we need to do everything we can to help people with the best treatments we have available'.    CJ

 

Social psychologists lead research

The Economic and Social Research Council Identities and Social Action Programme had its public launch on 14 April at the Royal Society of Arts in London. Baroness Amos hosted a reception to welcome this major new research investment, followed by a keynote address from Lord Anthony Giddens on emerging trends in identity. Giddens, the author of third-way thinking, and often described as Tony Blair's guru, explored the impact of globalisation on British people's sense of identity.
Programme Director Professor Margaret Wetherell (Open University), said: 'The Identities Programme is a multidisciplinary effort but 9 of the 25 research teams are led by social psychologists. Their projects are investigating, for example, the identity conflicts of persons with a learning disability, the role of emotion in national identity, mothering under pressure in Tower Hamlets, intergroup conflict in Northern Ireland, transsexual identities and community conflict and neighbour relations.'
o Holders of externally funded grants with an identity theme who would like to affiliate their project to the Programme can contact Professor Wetherell on [email protected]. See www.identities.org.uk for more information.

Investigating 22q deletion

ONE of the most common genetic sources of mental retardation, and yet little researched until now, is chromosome 22q11.2 deletion syndrome, which occurs in one in 4000–5000 live births. Now for the first time, researchers have begun detailed investigations into the cognitive impairments, and associated brain abnormalities, shown by children with 22q deletion. The team at the University of Pennsylvania School of Medicine, and the Children's Hospital of Philadelphia (see tinyurl.com/4on6z), hopes that such research will lead to therapies, and might also further our understanding of normal brain functioning and development.
Children with 22q deletion exhibit a delay in early cognitive, motor and language development, with a typical IQ between 70 and 85. They have particular difficulty with visuospatial and numerical tasks, with comparatively stronger verbal test performance. Physical manifestations of the syndrome include cleft palate, T-cell abnormalities and facial dysmorphisms, including a prominent nasal bridge and ear abnormalities. There is also a once-fatal congenital heart defect which has hampered previous research, as has the prior lack of a genetic test. But many more children with the syndrome now survive infancy, thanks to advances in heart surgery, and modern testing has shown that 22q deletion is in fact responsible for both DiGeorge syndrome (see tinyurl.com/5vkjx) and velocardiofacial syndromes (see tinyurl.com/5adwf).
A study by Dr Tony Simon's team published in the April issue of the journal Cortex reports that, compared with healthy controls, the specific pattern of deficits shown by 12 children with 22q deletion on visuospatial and numerical tasks (including cued attention, counting, and distance-effect tasks), are consistent with the children having a posterior parietal lobe dysfunction, and are not explicable by a global deficit. Take the distance-effect task. Normally, people take longer to state whether a given number is larger or smaller than a target number (e.g. 5) when the given number is closer in size (e.g. 4) to the target, rather than more distant (e.g. 1) – an effect linked to parietal lobe function by imaging and lesion studies. However, the children with 22q deletion didn't show this effect.
'Studies with adults have shown that damage to posterior parietal lobe impairs a person's visuospatial and numerical thinking,' Dr Simon said. 'These findings strengthen the evidence for a similar relationship in children.'
A complementary structural brain-imaging study by Simon's team published in NeuroImage, of 18 children with 22q deletion, revealed the children have a brain reduced in volume by 8–10 per cent relative to healthy controls, mostly explained by reduced volume in parietal and inferior areas. Moreover, the team found differences in the size, shape and location of the corpus callosum in the 22q deletion children relative to controls.
'It may be that [for children with 22q deletion] the basic problem lies in how parts of the brain are connected,' Dr Simon explained. 'It's like having a fuzzy signal on your cell phone – the phone is working but the connections are defective.'     CJ

 

Children's discovery of the mind

A stone's throw from St James's Park, amid the history-drenched grandeur of the British Academy, Judy Dunn, Research Professor at the Institute of Psychiatry, gave the fourth annual lecture co-sponsored by the BPS and BA. The theme was children's 'discovery of the mind' – how early relationships help children as young as two and onwards develop an understanding and representation of other people's perspective and feelings.
Hundreds of recent studies using purpose-designed psychological tools like the false-belief task have indicated children develop an understanding of others' perspective between the age of four and five years. But observation of children in a natural setting betrays an emotional precocity not tapped into by these tests. Children change rapidly from 18 to 36 months: they start teasing, deceiving, comforting and, perhaps most importantly, sharing in pretend fantasies – all of which points to a developing understanding of other people's feelings and perspective.
Indeed, naturalistic research has shown a measurable increase in young children's preoccupation with other people's feelings, so that whereas two-year-olds ask questions mostly about where people are or what they're doing, by three years, most of their questions are about people's inner states. Other work shows children talk appropriately about emotional states like happiness and fear, months earlier than they talk appropriately about cognitive states like remembering or knowing. This makes sense, because theirs is an emotionally-charged world – findings show that 21 per cent of their interactions with a sibling, and 11 per cent with their mother, are characterised by intense emotion.
Professor Dunn's work has also shed light on how a child's family environment predicts their later emotional awareness. A longitudinal study in Pennsylvania showed that having a cooperative relationship with a sibling, or a sibling and mother in relationship conflict, or a family that talks a lot about feelings, all predict a child's subsequent success at the false-belief task. Moreover, the amount of shared pretend play a child engages in, predicts how much they will talk about thoughts and feelings. Other work shows children use their understanding of the mind differently in different relationships – they might appear emotionally precocious with a sibling but naive with their mother. Sadly, when this kind of fertile emotional environment is lacking, things go wrong: Romanian orphans rescued after the age of six months have later problems making friends and rarely talk about feelings.     CJ
o Next year's lecture will be given by Professor Miles Hewstone.