News, November 2010

Psychologists speak out against cuts

By the time you read this, the coalition government will have announced the results of its comprehensive spending review, setting departmental budgets for several years to come. The Department for Business, Innovation and Skills, which is responsible for science funding, has been warned, like other departments, to expect cuts of up to 25 per cent.

UK scientists, including psychologists, have reacted with alarm to the prospect of severe funding cuts, especially at a time when other countries, including the USA, China, Sweden and Germany, are increasing their science funding. Dr Emily Holmes, a Senior Research Fellow at Oxford University and member of the British Psychological Society's Research Board, was on the advisory group for a Royal Society report published earlier this year that called on UK science to be protected from cuts. She told us the planned cuts pose not an imaginary but a real threat to the future of UK science. 'Psychological science in its many forms will be affected,' Holmes said.

'We need to speak out against the planned cuts. Also, we all need to help politicians understand how vital basic science is to human health, wealth and happiness. Psychology has so many examples to draw on, such as the huge inroads CBT (grounded in cognitive science) has made in improving mental health. There is no avoiding the fact that if these cuts occur, the continued success of psychology in the UK is under threat.'

In a speech in September, the Business Secretary Vince Cable described the UK situation. 'We have to operate in a financially constrained environment,' he said, adding that he recognised the value of science and innovation to the UK's economic grown. The government currently invests £6 billion a year in science and research, he claimed.

'The question I have to address,' he said, 'is can we achieve more with less? … My preference is to ration research funding by excellence. We back researchers and research teams of international quality regardless of where they are and what they do, and screen out mediocrity.' He also called for stronger links to be forged between research and business, to help exploit the economic potential in science.

In another speech given in September, the Science and Universities Minister David Willetts echoed Cable's comments about the valuable contribution made by science to the economy, but he also warned: 'Yes, cuts are coming. And – yes – sadly there will be some pain. But if we are smart and courageous and work together we can emerge with a stronger and better sector.'

Responding to these announcements, Sarah-Jayne Blakemore, Professor of Cognitive Neuroscience at UCL, told us she fears the UK is going to suffer  a brain drain of scientific talent to other countries.

'The level of cuts being discussed in the UK, together with increased science budgets in other countries including in Europe, North America, China and India, will inevitably lead to some of the UK's best scientists taking up job offers in other countries,' she said. 'This would destabilise the scientific community, and the UK would risk losing its reputation as a world-leader in science. It would be very difficult to recover from this.

So the proposed cuts could seriously damage UK science and innovation in the long term.'

At the time of writing the Science is Vital campaign has received support from over 11,000 signatories, with a march planned for 9 October (see http://scienceisvital.org.uk).Dr Gerry Mulhern, President of the British Psychological Society, said: 'We stand full square behind the campaign and hope that it will not only persuade government to re-think its proposed cuts to science, but will unite all scientific disciplines in relation to the fundamental need to enhance the UK science base.' cj

Special educational needs 'over-identified'

The Office for Standards in Education, Children's Services and Skills (Ofsted) caused controversy in September when it published a report claiming that schools were over-identifying special educational needs. It said that over one fifth of all school children in England are now classified as having a special educational need (SEN) – this includes a large majority who are assessed and supported by their school and a minority who receive external assessment and more specialist support.

Ofsted's claims will be of interest to educational psychologists who are involved in the assessment and support of children with special educational needs, especially in more severe cases. Ofsted said that schools were guilty of using the SEN term too widely, when really they should place more effort on raising overall teaching standards. They also claimed that too much attention was given to the identification and statementing process (which unlocks extra specialist resources for children in need), whilst assessment of the quality of support and outcomes was neglected.

Dr Harriet Martin, Chair the Society's Division of Educational and Child Psychology told us the news headlines prompted by Ofsted's report reinforced the 'generally unhelpful' view that a child with special educational needs always has an inherent problem. Martin explained that the difficulties some children have in learning in school are in fact best understood from an interactionist perspective.

'The child's own strengths and difficulties, the quality of the teaching and the level and appropriateness of support all contribute to the success or otherwise of the child in school,' she said. 'The Ofsted review rightly identified that professionals need to continue to develop their knowledge and understanding across the board – e.g. improving the quality of assessment, ensuring additional support is effective and focusing on outcomes for children and young people. This includes developing the quality of teaching. It is likely to be more productive to focus on how this development of knowledge and understanding can be achieved rather than blame schools for mis-diagnosis.'

Martin added that 'the headlines also distracted people's attention from much of the review's content, most of which is sensible, although not necessarily surprising to psychologists and other professionals who work in the field of special educational needs.'

Martin emphasised that educational psychologists have a key role to play 'supporting school staff to develop their assessment, monitoring and evaluation techniques and their understanding of evidence-based strategies and provision, including high-quality teaching for all'.
'Focusing on the diagnostic element of assessment is a retrograde step and will not help us improve outcomes for children and young people very much,' Martin told us. 'Although improving teaching standards for all is clearly important, it is only part of the continuing development in our education system which will improve the chances of success for those who struggle to learn and achieve their potential.' cj

-    The Ofsted report The Special Educational Needs and Disability Review is at http://tiny.cc/gvuji

Intensive care diaries

The sedation, delirium and sleep deprivation experienced by intensive care patients make them particularly vulnerable to one of the key risk factors for post-traumatic stress disorder (PTSD) – failing to fully process a traumatic experience. Indeed, patients usually have only fragmentary, delusional memories for what happened to them. According to one estimate, one in ten patients in intensive care for more than 48 hours go on to develop PTSD. A new study suggests that an effective way to help reduce this risk could be via the use of a daily text and photo diary kept by the patient's nurse and family.

Christina Jones at the University of Liverpool and her colleagues recruited hundreds of intensive care patients across six European hospitals. Only those who were in intensive care for more than 72 hours and on a ventilator for more than 24 hours were eligible. This left 352 patients who participated and therefore had daily hand-written diaries plus photos of their intensive care stay kept for them by a nurse and their families. The patients were then randomly allocated to receive the diary one month after discharge(on receipt of the diary, a doctor or nurse explained its contents but didn't instruct the patient in how to use it) or to act as controls. PTSD symptoms were recorded both at this one-month stage and two months later, at which point the controls also received their diary.

The key finding was that just 5 per cent of patients in the diary group went on to develop PTSD between one and three months after their discharge compared with 13 per cent of patients in the control group. Patients' comments about the diaries were also overwhelmingly positive – 49 per cent said the text was most helpful, 36 per cent said the text and photo combination, and 15 per cent highlighted the benefit of the photographs.

'Diaries are not without cost,' the researchers acknowledged in their report published in Critical Care (tinyurl.com/24ms28f), 'there has to be a commitment from the staff to write something in the diary every day and take photographs when important changes happen. In addition an experienced nurse is needed to go through the diary with the patient to ensure that they understand its contents, but this is not significantly more than might have been provided by an unstructured discussion in the past. Compared with providing formal therapy to all patients struggling to cope with their experiences, diaries are likely to be highly cost-effective.'

In related news, two new studies by Dr Alex Mitchell, a consultant psycho-oncologist at Leicestershire Partnership Trust, suggest that nurses in the front line of patient care often struggle to detect depression in patients (International Journal of Nursing Studies: tinyurl.com/39e3du9; and Psycho-Oncology: tinyurl.com/248smnq). 'Most nursing staff receive little training in mental health and report low experience in this area. It may be unrealistic to expect nurses to remember complex criteria for detection of depression or to apply lengthy screening tools,' Mitchell said.

His team are currently developing short, simple methods for identifying mood problems (free at www.psycho-oncology.info). cj

 

Veteran services 
The government has announced plans to provide extra mental health nurses and a counselling helpline dedicated to caring for combat veterans experiencing mental health difficulties.

The news comes on the heels of a report by Dr Andrew Murrison MP, 'Fighting Fit –A Mental Health Plan For Servicemen and Veterans' (see tinyurl.com/38owrjx), which makes several recommendations including the incorporation of a structured mental health systems inquiry into existing medical examinations performed whilst serving, and the trial of an online early intervention service for serving personnel and veterans.

Cam's den
A new interactive emotional well-being website for children, Cam's Den, has been launched by the Tavistock and Portman NHS Foundation Trust with support from the British Psychological Society's public engagement grant scheme.

The Trust's clinical staff worked with children, parents, teachers, web designers and animators to address a gap in mental health and well-being education for primary school children, promote the development of coping skills and combat mental health stigma by raising awareness about what actually happens in a therapy session and how common emotional difficulties are.

Clinical Psychologist and Project Lead Dr Sally Hodges said: 'We are proud of the fact that this project has been led by children in Camden who have helped us develop the content at every step of the way, which we think makes the site unique. Children were especially helpful in developing our understanding of what kinds of issues primary school children are preoccupied with and how best to get information across to them.' js
I    See www.camsden.co.uk

Scourge of the 'halfalogue'

The overheard mobile phone conversation is a scourge of modern times. Why is it so irritating? According to a team of psychologists led by Lauren Emberson at Cornell University, at least one reason has to do with the relative unpredictability of what they call a 'halfalogue' – hearing just one side of a conversation. This unpredictability, they explain, makes the overheard phone call more attentionally demanding and therefore distracting (Psychological Science: tinyurl.com/27ogcyj).

Twenty-four undergrads performed two attention tasks while simultaneously listening to: a conversation between two people; a monologue, in which one person recalled both sides of a conversation; or a halfalogue, in which they heard just one side of a conversation. A silent condition acted as a baseline.

Only the halfalogue was found to impair performance on the two tasks – one of which involved using a computer mouse to track a moving on-screen target; the other was a choice reaction time task in which participants had respond as fast as possible to four letters whilst ignoring any others.

Emberson and her colleagues say halfalogues are more unpredictable than full conversations because we're unable to use the unheard conversational partner's utterances to predict what the overheard conversant is going to say next. To test this claim, a second study was similar to the first but this time the halfalogue, dialogue and monologue speech was low-pass filtered, rendering the content incomprehensible (it sounded like speech under water) whilst retaining the acoustic 'on/off' properties. Under these conditions, the halfalogue was no longer distracting.

Emberson told us she hopes the results will encourage a reconsideration of mobile phone etiquette. 'Having conducted this study, I have certainly changed my own cell phone use to avoid talking on phones in situations where others are working and listening (e.g. in the laboratory) or in the presence of a captive audience (e.g. on public transport),' she said.

'The other implication of our study that might have an effect on cell phone use is the idea that paying attention to an overheard cell phone conversation is reflexive or beyond our control,' Emberson added. 'When talking on a cell phone, one can often have a feeling of privacy, that no one is listening in. However, our results show that likely everyone is listening in to the point where their attention is disrupted in other tasks. If people know that their phone conversations are being heard, perhaps this will also act as a deterrent to talking on a cell phone in public.' cj

Awards for psychologists

Professor Vincent Walsh of the Institute of Cognitive Neuroscience is among the recipients of this year's round of prestigious Royal Society Wolfson Research Merit Awards. Jointly funded by the Wolfson Foundation and the Department for Business, Innovation and Skills, these awards are appointed by the Royal Society and are intended to attract or retain outstanding scientists working in the UK. Walsh is a pioneer in the use of transcranial magnetic stimulation as a cognitive neuroscience tool, whereby stimulation is used to excite neurons or to induce temporary 'virtual lesions'.

'It's particularly rewarding to be encouraged to step into new conceptual areas,' Walsh said. 'Science funding and scientists reviewing are conservative forces usually rewarding one for doing more of the same. The Royal Society has the flexibility to encourage risk taking and I'll be doing all I can to extend my work into adult plasticity.'

Congratulations are also due to the psychologists Professor Graham Towl at the University of Durham, Professor Michael West at Aston Business School, Professor Halla Beloff at the University of Derby, and Professor Joe Elliott at Durham University, all of whom were conferred the award of Academician by the Academy of Social Sciences in August. This award recognises those who have made a distinguished and significant contribution to UK social science and its promotion. cj

Treating insomnia

There is dearth of psychological help available for people in the UK with insomnia. That's according to a consensus statement on evidence-based treatments for insomnia and related conditions published by the British Association for Psychopharmacology in the Journal of Psychopharmacology (tinyurl.com/2vb23p7).

The statement says that CBT-based psychological treatments are as effective as pharmacological treatments in the short-term and, unlike drug treatments, continue to be effective even after active treatment has ended. Other studies have shown increased effectiveness when CBT and pharmacotherapy approaches are combined. Yet the statement warns: 'Provision of psychological treatments for insomnia in the UK is an issue, as there are few trained therapists and insomnia
is not a priority for psychologists in the National Health Service.'

The authors of the consensus statement, including the psychologists Chris Alford at the University of the West of England, Colin Espie at the University of Glasgow, and Chris Idzikowski at the Edinburgh Sleep Centre, propose a stepped-care approach to delivering psychological insomnia treatments, from self-help administered CBT for moderate problems all the way up to the involvement of specialised professionals for more severe cases. 'This would enable this relatively scarce resource to be applied in a cost-effective way to achieve best clinical care,' they said. cj

An effin' rollercoaster

Psychology has a habit of doing well at the Ig Nobel awards – designed to recognise research that makes you laugh, then think – and this year was no different. At a glittering ceremony at Harvard University, the psychologists Richard Stephens, John Atkins and Andrew Kingston from Keele University walked away with the Peace Prize for their research showing the analgesic benefits of swearing (NeuroReport: tinyurl.com/mlobq9). Meanwhile, the psychologists Simon Rietveld of the University of Amsterdam, and Ilja van Beest of Tilburg University earned the Medicine Prize for their research showing that asthmatic symptoms canbe alleviated by the emotional effects of a rollercoaster (Behaviour Research and Therapy: tinyurl.com/26sgzdu).

'As psychologists doing research with people we are ethically bound to disseminate findings widely, and the prize certainly has drummed up plenty of publicity,' Stephens told us, adding that there is real substance to the swearing research. 'Having shown that swearing can help people better tolerate pain we are now attempting to find out how. Our working hypothesis is that, by swearing, people provoke an emotional reaction in themselves in the form of a low-level fight or flight response. Watch this space, as they say!'

As for the Medicine Prize, van Beest said he and Rietveld felt honoured that the prize will draw attention to people who suffer from asthma. Their research showed that positive and negative emotion could lead people with asthma to under- or over-report their breathlessness, respectively. 'In practical terms,' van Beest told us 'this implies that people who suffer from asthma may use too much medication when they feel bad, but too little medication when they feel good. We think that this latter finding in combination with the fact that we used a rollercoaster to induce positive and negative emotions struck a chord with the judges.' cj