News, May 2011

Expert witness immunity lost
Expert witnesses will no longer be immune from litigation brought against them in civil courts by their clients. The change in law follows a UK Supreme Court decision, announced in March, which was triggered by a case involving a clinical psychologist.

A man struck and injured by a car – the appellant – had been diagnosed as suffering PTSD by his psychologist, liability had been accepted by the driver, and damages were due to be awarded. However, the psychologist subsequently signed a joint agreement with the driver's psychiatrist, who was acting as an expert for the defence, in which they both agreed the man had exaggerated his symptoms – he therefore received significantly reduced damages. Because of this, the appellant attempted to sue his psychologist for negligence – a case that was thrown out because of expert witness immunity. The man appealed, the case went to the Supreme Court, and the law has now been changed.

Professor Graham Davies of the University of Leicester is on the British Psychological Society's Advisory Group on Expert Witnesses. 'This narrow decision by the Supreme Court removes at a stroke the 400-year-old immunity which experts have enjoyed in our courts,' he told us. 'Though the expert in the case appeared clearly at fault in ignoring the content of  their own report in signing up to a joint report, the wholesale removal of immunity runs a serious risk that psychologists and other experts could be the subject of formal complaints or time-consuming litigation by disappointed clients, as emphasised by the minority opinion on the court.'

In related news, the Law Commission has published recommendations and a draft Bill regarding the admissibility of expert evidence in courts in England and Wales. These developments follow a consultation that started in 2009, to which the BPS was a contributor.

The main thrust of the draft Bill is that a new test should be established to ensure that expert evidence is reliable and impartial. According to Professor Davies, specific features of the draft Bill consistent with the Society's submission include a recommendation that judges should be more proactive in ensuring that expert witnesses are not lured away from their areas of expertise under cross-examination, and that judges should be given new powers to consult with external experts to help them determine whether expert evidence is reliable or not.

Professor Jane Ireland, head of the BPS Advisory Group on Expert Witnesses, said the draft Bill is very welcome, especially since the English legal system has lagged behind other countries on this issue. 'If the Bill comes to fruition as it is hoped, then it will for the first time more clearly assist judges in what makes good "psychological science" versus either "specialised knowledge" or "junk science",' said Ireland, who holds positions at the University of Central Lancashire, Mersey Care NHS Trust High Security and Åbo Akademi University, Finland. 'The latter [junk science] has unfortunately enjoyed some presence in the admissibility of evidence from experts. More attention is certainly being given to the admissibility and quality of expert evidence, with the judiciary also currently funding a study into the quality of expert psychological assessments.'

What about the implications for Society members who work as expert witnesses? 'Experts need to keep a sharp focus on the importance of this Bill and use it to assess the quality of the measures that they are applying in Court so that they do not mislead the Court into a judgment that is later appealed or may lead to the expert being disciplined,' Ireland advised. 'Experts carry considerable weight in a number of cases and their methods will at last be open to more detailed scrutiny prior to its admission.'

 - Access the draft Bill at tinyurl.com/3rfv3qp; further information on the Supreme Court decision at tinyurl.com/3e8ccvz

'Nappy curriculum' softened
A review of the Early Years Foundation Stage (EYFS, nicknamed the 'nappy curriculum'), commissioned by the Coalition government last summer, has recommended that the scheme be radically slimmed down and made more flexible.The EYFS was launched by the previous government in September 2008, setting out a compulsory framework for nursery staff and child minders to assess the development of young children in England aged up to five years. With a 112-page guidance document and 69 developmental milestones, critics argued the scheme was intrusive and overly complicated.

The vast majority of parents and professionals surveyed for the new review in fact said the EYFS was successful, but 30 per cent also said there was too much paperwork and bureaucracy.

Led by Dame Clare Tickell, Chief Executive of Action for Children, the review suggests revising down the number of early learning goals to just 17, and proposes a new focus on three prime areas: personal, social and emotional development; communication and language; and physical development.

'It has been apparent from the start of the review that the EYFS has had a positive overall impact on children in early years settings,' Tickell said, but she added: 'The current EYFS is cumbersome, repetitive and unnecessarily bureaucratic. And it isn't doing enough to engage parents in their child's development or to make sure children are starting school with the basic skills they need to be ready to learn.'

Professor Trisha Maynard, Director of the Centre for Research into Children, Families and Communities at Canterbury Christ Church University, told us she broadly welcomed the new recommendations, particularly the recommendation for the guidance to be simplified so that it is accessible to all those who work with children. 'I welcome, also, the recognition of the vital role played by parents and carers as partners in young children's learning; the significance of young children's personal, social and emotional development; the appropriateness of a play-based approach to learning; and the importance of highly qualified staff who, sensitively and skilfully, are able to extend young children's play, thinking and understanding,' she said.

However, Maynard, who is chair of the Association for the Professional Development of Early Years Educators, also had some concerns – particularly in relation to assessment being tied to early learning goals and developmental milestones, albeit that the list of these has been slimmed down. 'This is likely to constrain practitioners' thinking and practice in a way that a focus on young children's interests and capabilities would not,' she said. 'Importantly, it does not capture the complex and non-linear nature of young children's development and learning.'

 - Access the review: tinyurl.com/6xcbka7

Comenius ethos lives on
British Psychological Society member and Spearman Medal winner Dr Emily Holmes has been selected as one of the two winners of the Comenius Early Career Psychologist Award 2011.

The award was given to the European Federation of Psychologists' Associations (EFPA) by the Union of Psychologists' Associations of the Czech Republic, to be awarded to a young psychologist from Europe who has made an original contribution to psychology as a science and profession.

The selection committee noted: 'Dr Holmes is one of the foremost researchers in trauma, cognitive and emotional processing, and memory… Her distinctive theoretical contribution has been to link the limited field of imagery and cognitive psychology to the rich clinical and experiential material of emotional memories following trauma.'

Dr Holmes told The Psychologist: 'I am very honoured to receive this award from the European Federation of Psychologists' Associations and for the support of the BPS. It comes as a real encouragement for my team's research in experimental psychopathology. Interestingly, Comenius was a theorist and practitioner from the 1600s in the area of education research and learning. Our work seeking to better understand and modify psychopathology embraces "learning" in the domain of emotional processes, and it is exciting to see that the ethos of combining theory and practice is still strong four centuries on!'

Memory clinic Prize
The Croydon Memory Clinic, part of South London and Maudsley NHS Foundation Trust (SLaM), has won an award for the best evidence-based psychosocial intervention for people with dementia and their caregivers. The service's clinical director Professor Sube Banerjee was presented with the award at the Annual International Conference of Alzheimer's Disease International (ADI) held in Toronto in March. The Clinic involves family members in its rapid assessment and diagnosis and also provides support and advice to patients and their carers. SLaM have also just launched a new Developmental Neuropsychological Service for children, which will be accepting a wide range of referrals including for neurodevelopmental disorders like ADHD, acquired brain injury cases, and memory, attention and language problems with an unknown cause.

Put yourself on the science map
The Science Council is calling people who are using science, maths, engineering or technology as the foundation for their work or career to come out and help them show just how much science is used every day all over the UK, and the amazing range of different jobs there are out there. You can put yourself on the 'Hidden Science Map' at www.hiddensciencemap.org, launched as part of 2011 National Science and Engineering Week.  

Kids behaving badly
Jon Sutton reports from an event in Whitehall.

'Three years ago, my site manager was put on the Christmas party list of the local glaziers', said Geoff Allen, Headteacher at Westfield School in Bucks. 'That's not a joke. I had to do something – I could not watch any more of my staff being seriously injured. But this stuff works, it really works.'

Allen was speaking at 'Kids behaving badly: How neuroscience can help', an event in Whitehall organised by the Learning Skills Foundation and Centre for Educational Neuroscience. The two bodies are working together to raise the profile of research and provide a bridge to practical application, and it was heartening to hear such positive reactions from those on the 'front line'. 

The first talk had come from Essi Viding, Reader in Developmental Psychopathology at University College London and the Centre for Educational Neuroscience. She showed how charting the neurocognitive profile of different subtypes of children with antisocial behaviour may give important clues for intervention. Of particular interest are those children displaying callous-unemotional (CU) traits: a lack of empathy and remorse, and a shallow and insincere affect. Antisocial children who do not display CU traits may be impulsive, learn from 'time out' anger management training and are heavily influenced by parenting style. But CU kids are more premeditated, severe and persistent in their antisocial behaviour, show little link to parenting style and do not benefit from 'time out'. As Geoff Allen would say later, 'a few years ago our approaches were often not more subtle than a chapter in a Dickens novel – if you are nice to people they'll be nice to you. But these children don't give a monkey's. They don't want a reciprocal relationship, they want to be in control. We learnt not to use those approaches.'

So what's going on in the brains of these children? We might have known that the pesky amygdala would be implicated: it seems to be getting a bad press in all sorts of areas these days. Viding and colleagues, as well as other research groups, have found lower amygdala activity to fearful emotional faces in adolescents with CU traits, as compared with healthy comparison adolescents and those with ADHD. Children with high levels of CU also focus less on the critical eye region when they process fear – could this be at the root of their problems with emotional reactivity? Other research looked at the prefrontal cortex, finding abnormal activity when punished during a trial, along with increased grey matter suggestive of a maturational delay. All of this research suggests a neural basis for why antisocial children with CU lack empathy for others' distress, make poor behavioural choices and have difficulty learning from their mistakes. Importantly, it leads to a very different intervention approach compared with that traditionally used with emotional behaviour disordered children, becoming more about instant rewards for good behaviour – a focus on what good behaviour 'gets the child' – and less about relying on empathy.

Next up was Norah Frederickson, Professor of Educational Psychology at UCL and CEN, and Senior Educational Psychologist for Buckinghamshire County Council. She pointed to a new Green Paper Support and Aspiration: A New Approach to Special Educational Needs and Disability, which states: 'We want to ensure that assessments of SEN and any assessments of children displaying challenging behaviour, by any professional, identify the root causes of the behaviour rather than focus on the symptoms.' So are the characteristics associated with CU traits considered in planning bullying prevention and intervention programmes? Not according to Frederickson. Those seeking to utilise awareness of the distress caused and engage empathy are doomed to fail with CU children, 'zero tolerance' sanctions have little impact on those who are unable to learn from punishment, and skills training runs the risk of giving skilled social manipulators further ammunition.

Surveillance and incentives, said Frederickson, have the best chance with CU children. In Westfield Primary, staff trained by educational psychologist Laura Warren and led by senior teacher Tara Deakes have introduced strategies that include short targets for good behaviour with immediate rewards; 'emotional thermometers' to help children recognise the impact of their emotions on their body and readiness to term; and SMART thought chains to encourage accurate, helpful and socially desirable cognitions. Externalising problems (conduct, aggression, hyperactivity) are down significantly in the high CU group.

For anyone feeling uncomfortable about a focus on brain and biology, discussant Uta Frith (Institute of Cognitive Neuroscience) had a simple and confident message: 'We do much better for some children in recognising the biological bases of their behaviour.' And from Geoff Allen's passionate perspective, befitting a headteacher: 'What this team has done has allowed me to employ another teacher rather than replacing windows.'

Troublesome teens

Researchers at the University of Cambridge have performed the largest ever study to look at the brain structure of teenagers diagnosed with conduct disorder (American Journal of Psychiatry: tinyurl.com/63exz4l).

 

Graeme Fairchild and colleagues at the University of Cambridge scanned the brains of 65 male teenagers (average age 18 years) with a conduct disorder diagnosis and 27 male, age-matched teenage controls. The results, published online in March, found reduced amygdala volume in teenagers with conduct disorder, but no differences in brain structure according to age of onset of the disorder.

The amygdala result matches findings using functional brain scans and the presentation of fearful faces (see 'Kids behaving badly' report), but the lack of correlations between brain structure and age of onset undermines a popular theory in the field (the developmental taxonomic theory), which proposes the condition consists of two subtypes – an early-onset version associated with neural abnormalities, and a later-onset version triggered by peer influence.

The study also uncovered a correlation between insula volume and severity of conduct disorder. Given previous research on the function of the insula, this anomaly is possibly associated with a diminished ability to process other people's emotions and an insensitivity to punishment. Reduced volume was also observed in the dorsomedial prefrontal cortex, involved in executive control and reasoning about other people's mental states.

In contrast to previous research, no correlation was observed between amygdala volume and callous/unemotional traits. But there was a positive correlation between these traits and increased volume of caudate nucleus and ventral striatum – perhaps reflecting a greater sensitivity to reward in these teenagers.

'Our results…support the proposal that both forms of conduct disorder [early- and later-onset] may stem from dysfunction in neural circuits involved in emotion processing, contrary to the developmental taxonomic theory,' the researchers said. CJ

Not too few to mention
Lost loves and unfulfilling relationships have come top of the list in a US survey of people's regrets. Women were particularly likely to mention romantic regrets; men more often focused on career or education (Social Psychological and Personality Science: tinyurl.com/436u55d). Mike Morrison at the University of Illinois at Urbana-Champaign and Neal Roese at Northwestern University used random telephone dialling to interview a representative sample of 370 adults (207 women). A finding that contrasted with earlier research, nearly all of which depended on student samples, was that regrets about things done and regrets about missed opportunities were equally prevalent, rather than the former being cited more often. Regrets involving inaction tended to be longer-lasting but regrets involving actions were more intense.
Another novel detail was that people's stated regrets were associated with their life circumstances – for example, participants who lacked a higher education or a romantic relationship tended to have regrets in those areas. Also, those with high levels of education had the most career-related regrets. 'Apparently, the more education obtained, the more acute may be the sensitivity to aspiration and fulfilment,' the researchers said.  CJ

Regulation plans in doubt
Current plans for the statutory regulation of counselling and psychotherapy by the Health Professions Council – the same body that regulates practitioner psychologists – are in doubt following the publication of a Department of Health paper in February.

The Command Paper Enabling Excellence Autonomy and Accountability for Healthcare Workers, Social Workers and Social Care Workers outlines the Coalition Government's plans to reduce the costs of regulation in health and social care, including devolving greater autonomy to existing regulators, increasing their accountability, and encouraging mergers. The document also proposes that professions not yet under statutory regulation should instead be encouraged to form voluntary registers.

'A system of assured voluntary registration is a more proportionate way of balancing the desire to drive up the quality of the workforce with the Coalition Government's intention to avoid introducing regulation with its associated costs wherever possible,' the Command Paper says.

In a joint statement, the British Psychoanalytic Council (BPC) and the UK Council for Psychotherapy (UKCP) welcomed the new proposals: 'BPC and UKCP now wish to work with CHRE [the Council for Healthcare Regulatory Excellence, the body which will accredit voluntary registers] to help develop a robust, credible and flexible regulatory framework based on the government's proposals for assured voluntary registration.'

However, the Command Paper does also say that 'there are limitations to the model of assurance for some groups of workers and, particularly for self-employed practitioners, there may be no team or employer present… In a limited number of cases therefore, statutory regulation may be the only way of effectively mitigating against risks to people using services…' JS

The Guantanamo way
There was confusion last month over whether or not Larry James – the army psychologist who, it is alleged, failed to intervene to prevent abuses at Guantanamo and Abu Ghraib – had been appointed to a White House task force called 'Enhancing the Psychological Well-Being of The Military Family'. It was reported in March that James, now based at Wright State University, claimed in a recent e-mail circular that he'd been appointed by Michelle Obama to the task force and would be meeting with her and others at the White House. According to the respected online magazine Salon, however, the White House made contact to deny that James had been appointed, and to clarify that he would not be attending the White House meeting.

In a related development in April, a New York court heard the case against another army psychologist, Dr John Leso, who stands accused of designing abusive interrogation techniques used at Guantanamo. The case arrived at the court at the request of the New York Civil Liberties Union and the Centre for Justice and Accountability, after the New York State Office of Professional Discipline chose not to investigate the complaints made against Leso, stating that incidents at Guantanamo were beyond its remit. As we went to press, the judge Saliann Scarpulla had yet to rule. The Wall Street Journal reported that she empathised with the human rights advocates but also quoted her as saying she was unsure 'the judicial process is the right way to do this'.

Sharing the secrets of the mind
Catherine Loveday (University of Westminster) reports from 'Psychology For All', the Society's public engagement event organised by the BPS London and Home Counties Branch

While there may have been a time when psychologists preferred to keep the mysterious secrets of the mind to themselves, the current climate is quite the opposite, with psychologists being called on to comment on anything from the meaning of Katie Price's body language to the devastating psychological effects of a natural disaster. With funding cuts all around us and an increasing emphasis on impact, there has never been a time when public engagement with psychology has felt so vital to the health and development of our profession. It was therefore very exciting to see that the second Psychology For All event was once again a sell-out. As Gerry Mulhern explained in his welcoming address, this is our chance to share our science with the general public and to stimulate an interest and awareness in the many ways in which psychology contributes to society.

Luck
Richard Wiseman kicked off his keynote address with a simple but slickly delivered magic trick, generating an enthusiastic applause accompanied by a kind of nervous buzz. 'Ah, I can smell your disbelief!', Wiseman quipped but went on to reassure us that we were right to be sceptical because what we see in our mind's eye is often not what's really there. He explained that it was a chance sight of an illusion in a psychology textbook that convinced him in his teens he wanted to learn more about how to unpack the mysteries of perception. Wiseman continues to be intrigued and fascinated by the way in which context can fool our brain, and he illustrated this with an array of brilliant and entertaining illusions and a little more magic.

What did this have to do with 'The Luck Factor' – the title of his talk? Well, according to Wiseman, a very similar perceptual mechanism is behind why some of us consider ourselves lucky and some unlucky. Again, context is everything. Our notion of whether we're lucky or unlucky, says Wiseman, is all to do with where our attentional spotlight lies, the extent to which we spot opportunities and the context in which we place events that happen to us. A person caught in a raid and shot in the arm might consider themselves lucky to have only been shot in the arm rather than the heart, while a £4m lottery winner that Wiseman interviewed during his research considered himself unlucky because he'd had to split the £8m prize with another winner! This highly entertaining and informative lecture closed with Wiseman providing practical suggestions on how to make our own luck.

Love and lust
Wiseman was followed in the main auditorium by Lisa Matthewman, who attempted to unravel the mysteries of love and lust. She began by defining love and debunking some of the love myths before moving on to explain Sternberg's theory that love is a combination of intimacy, passion and commitment.

Matthewman addressed the role of hormones and neurotransmitters, describing these as the 'love brigade' that underlie many of the emotional and physical aspects of love and lust. She explained how these fluctuate throughout the days, weeks, months and even decades, suggesting that each period brings its own rewards and challenges in terms of love-making. The lecture concluded with a discussion around the compatability of love and sexual styles and an illustration of how this can feed into relationship coaching.

Stress
Rona Moss-Morris gave an excellent balanced and informed overview of the role that stress plays in illness, explaining how social and psychological factors influence our physiology via the autonomic nervous system and hypothalamic pituitary axis. She outlined a number of landmark studies in the area, showing that daily hassles and longer-term stressors, as well as perceived stress, each influence different aspects of illness development and recovery.

Moss-Morris concluded on a positive note, suggesting that management of stress and social support can both provide significant buffers.

Body language
The event closed with Geoff Beattie's keynote address 'Get the edge: Understanding the body's little secrets', which was so popular that a video link to a second auditorium had to be activated. Beattie began by challenging some of the more stereotypical ways of reading body language, such as those presented by Allan Pease in his book Body Language (1991). He used his own research to argue that bodily communication cannot be easily interpreted from static pictures because the real meaning lies in the dynamics and micro-expressions, the small fleeting changes. For example, a genuine smile has bilateral symmetry with gradual onset and a slow fade; a fake smile tends to be asymmetrical and to fade abruptly. A fascinating clip of Gordon Brown 'smiling' at Tony Blair demonstrated this perfectly and also illustrated Brown's use of 'self-adaptors' – small strokes to the face that are used as self-comforting gestures.

Beattie also stunned the audience by showing us how the change in use of self-adaptors revealed the point at which Charles Ingram began to allegedly cheat on Who Wants to Be a Millionaire?.

Beattie went on to discuss his more recent interest in hand and arm movements as an integral part of communication, showing us that speech and gesture are significantly more powerful in combination than either on their own. Again he used clips to elegantly demonstrate how subtle differences in use of gesture can give away lying behaviour  and how unnatural use of gesture in advertisements makes us distrust the actor or character.

Beattie rounded off this very compelling lecture by showing that consistency between speech and gesture supports our memory of what has been communicated, a finding that has many applications.

All in all, a great day for the 450 attendees.