News, media, and the next big questions

Including heart attack survivors; online CBT; climate change; publication of Rorschach images; a special feature on the next big questions in psychology; and more.

What becomes of the broken-hearted?

The British Heart Foundation (BHF) has called for better funding of rehabilitation for heart attack survivors following publication of research in the British Journal of Health Psychology (BJHP) that documented rates of post-traumatic stress disorder (PTSD) symptoms in patients recovering from a heart attack (http://bit.ly/YSUtR).

Dr Susan Ayers at the University of Sussex and her colleagues surveyed 74 patients who’d had a heart attack in the previous 12 weeks and found that 16 per cent of them met formal diagnostic criteria for acute PTSD, whilst 18 per cent reported moderate to severe PTSD-related symptoms.

Patients who believed that their heart attack would have a permanent, negative effect on their lives and who resorted to ineffective coping strategies based on avoidance, tended to have more PTSD symptoms. Other factors, less strongly associated with PTSD symptomatology, included the perceived severity and danger of the heart attack and a prior history of psychological problems or trauma. The research was cross-sectional, so it’s possible, for example, that PTSD symptom severity influences coping styles and perceptions about the long-term consequences of the heart attack, rather than the other way around.

In the UK the normal channel for receiving psychological care after a heart attack is via so-called cardiac rehabilitation. Government targets outlined in 2000 were for 85 per cent of patients to be referred to rehab programmes. However, in August the British Heart Foundation released the results of an audit showing that just 34 per cent of 83,540 heart attack sufferers in England, Wales and Northern Ireland had taken part in a cardiac rehabilitation programme. Moreover, just 9 per cent of these programmes met the minimal requirements for psychological support. Dr Mike Knapton, Associate Medical Director at the BHF, said: ‘Recovery from a heart attack isn’t over when a patient leaves hospital, and heart patients should be receiving the ongoing support they need. Referral to cardiac rehabilitation should be a routine part of treating heart patients, and until this happens they will continue to miss out.’

‘This [BJHP] study adds to the substantial evidence that psychological factors are important in recovery and mortality following myocardial infarctions,’ Dr Ayers told The Psychologist. ‘Our study is one of a few that suggest anxiety symptoms may be as prevalent among heart attack survivors as symptoms of depression. The impact of these symptoms on recovery therefore warrants further investigation. Screening programmes should consider screening for anxiety symptoms, such as PTSD, as well as depression, after myocardial infarction.’

Ayers added: ‘Rehabilitation programmes that include some aspect of psychological intervention appear to be effective at reducing anxiety and depression, and possibly non-fatal reinfarctions – but not mortality.’
 

Facebook and jealousy
There’s an awful lot written about the potential psychological dangers of websites like Twitter and Facebook, most of it based on conjecture rather than research. But now an actual study has been published providing tentative evidence that time spent on Facebook is associated with increased romantic jealousy (Cyberpsychology and Behaviour: http://bit.ly/4ovLcE).

Amy Muise and colleagues at the University of Guelph in Canada surveyed 308 undergraduates (231 female; aged 17 to 24) and found that even after controlling for pertinent personality variables such as trait jealousy and low self-esteem, and relationship variables such as commitment, time spent on Facebook still independently accounted for 2 per cent of the variance in the amount of Facebook-related jealousy. ‘This finding is notable considering the predictive power of trait jealousy,’ the researchers said. The researchers surmised that the more time students spent on the site, the more jealousy they experienced, thus triggering another bout of Facebook time.

Open-ended questioning of the students appeared to back up the quantitative data. ‘I was already a bit jealous and insecure, but I think that Facebook has definitely made me much much worse,’ one student said.

Muise’s team said it would be interesting to investigate whether similar findings would apply with an older sample outside of a university context. ‘One thing is sure,’ they said ‘Facebook providesa superb forum for the study of relational jealousy, and our study only serves as a starting point.’

Online CBT
Despite having the weight of science and government behind it, cognitive behavioural therapy (CBT) remains difficult for many to access. Information technology has the potential to ease this problem, as CBT does not need to be delivered face-to-face and is adaptable to self-help materials. Computerised CBT programmes, although effective, can be difficult to tailor to individual patient needs, and are associated with low rates of adherence. Another option is to conduct CBT in real time online – a method that a new randomised control trial published in The Lancet (see tinyurl.com/mzh3da) has shown to be effective.

David Kessler (University of Bristol) and his team recruited 297 individuals with a confirmed diagnosis of depression from general practices in Bristol, London and Warwickshire. They found that 38 per cent of people assigned to an online intervention condition recovered from depression at four-month follow-up, compared with 24 per cent of those on the waiting list receiving usual GP care. These gains were maintained at eight months, and quality of life and measures of functional health status showed improvement at both follow-up points.

‘The number of patients for whom online CBT is feasible and attractive will grow,’ the authors wrote. ‘It could be useful in areas where access to psychological treatment is scarce, and for patients whose first language is not English. It could make access to psychotherapies more equitable by providing a service to patients in areas or even countries where psychological treatment is not readily available. Real-time online CBT offers the flexibility and responsiveness of face-to-face CBT and is appropriate for people with severe symptoms. It affords an opportunity for reflection and review as part of the therapeutic process, which could enhance its effectiveness.’

Participants in the treatment condition received up to 10 sessions of CBT, delivered by psychologists working for the organisation PsychologyOnline. The company was set up in 2001 by British Psychological Society members Sue Wright and Nadine Field. They welcomed the findings, telling The Psychologist: ‘We have persevered with PsychologyOnline because we believed that the method was effective, although we knew that the research was needed to prove this as it was so radical. We are hoping that, because we have seen it help so many people so far, it can be recognised by NICE in order to be implemented more widely within the NHS.’

Working memory predicts learning outcomes
Working memory is a better predictor of children’s later academic success than IQ, according to a paper that’s currently under review at the Journal of Experimental Child Psychology.

In 2001 Tracy Alloway, now at the University of Stirling, and Ross Alloway at Edinburgh University measured the working memory and IQ of 200 children aged approximately five years. Verbal working memory was measured using the Automated Working Memory Assessment (AWMA), which involves verifying the truthfulness of between one and seven sentences (e.g. ‘bananas live in water’), whilst also remembering the last word in each of the sentences. Six years later, the researchers again measured the children’s working memory ability and IQ and also observed their reading, spelling and maths performance. Of all the measures taken, verbal working memory at age five was the strongest predictor of learning outcomes at age 11, accounting for between 10 and 20 per cent of variation in performance.

The new results are consistent with recent research by Alloway involving students with learning difficulties who were tested at two-years follow-up; children with dyspraxia; and children with reading difficulties.

Alloway told us she believes testing working memory has this predictive power because it measures people’s potential to learn, not what they have already learned. ‘If a student struggles on a working memory task, it is not because they don’t know the answer, it is because their working memory “space” is not big enough to hold all the information in,’ she explained.

‘On a related note,’ she said, ‘there is evidence to suggest that working memory may be a culture-fair measure of cognitive ability. For example, it’s relatively impervious to environmental influence such as the quality of social and intellectual stimulation in the home, the number of years spent in pre-school education and financial background.’ Indeed, the new results showed that whereas IQ was associated with social background (as measured by a mother’s years in education), working memory was independent of this factor.

Alloway told The Psychologist that her findings have clear implications for education. ‘At present, working memory problems tend to be misdiagnosed, with teachers labelling students as “unmotivated” or “lazy”,’ she said. ‘However, with the availability of standardised tools for educators – for example, the AWMA – it is now much easier for teachers to quickly identify working memory problems.’

She added: ‘There has also been exciting evidence of the efficacy of training working memory to see transfer gains in IQ and academic attainment. This offers real hope to students who might otherwise have been dismissed as “not bright”.’

RESEARCH FUNDING NEWS

The ESRC has now launched its new Postgraduate Training and Development Guidelines. Part of the new Postgraduate Training Framework is the creation of Doctoral Training Centres (DTC) and Doctoral Training Units (DTU) that will provide all future postgraduate training for subjects within the ESRCs remit, including psychology. The application process for institutions to apply to be a DTC or a DTU is now open. The closing date for applications is 11 March 2010. tinyurl.com/rc74v7

The National Institutes of Health (US) have a call out for research into the Role of Human–Animal Interaction in Child Health and Development (R01). This seeks to develop the research base on how children perceive, relate to and think about animals; how pets in the home impact on children’s social and emotional development and health; and whether and under what conditions therapeutic uses of animals are safe and effective. UK researchers are eligible to apply. The deadline for Letters of Intent is 19 October 2009 and for full applications, 19 November 2009.
tinyurl.com/mb9vr3

Grants are available to support Starting Independent Researchers from the European Research Council. The grant scheme aims to support up-and-coming research leaders who are about to establish or consolidate a research team. Grants are available for life science research (application deadline 18 November 2009) and social science and humanities (application deadline 9 December 2009).
tinyurl.com/5yuh5b

The British Academy has a variety of funding opportunities:
Overseas Conference Grants. Up to £900 towards travel expenses for scholars delivering a paper at an international conference. Deadline for submissions 16 November 2009.
International Visits and Joint Projects. Funding to either visit or undertake joint projects in many European, Commonwealth or other nations. Deadline 18 November 2009.
Small Research Grants. Funding of between £500 and £7500 for individual or collaborative projects. Deadline 23 November 2009.
Postdoctoral Fellowships. Fellowships to allow outstanding early career researchers to strengthen their experience of research and teaching in a university environment. Deadline 26 November 2009.
Visiting Scholars Grants. Grants to allow early-career scholars from overseas to undertake research visits to the UK. Deadline for submissions 3 December 2009.
Conference Support Grants. Grants to support key speaker expenses and other conference related expenses. Deadline 1 December 2009.

For further details of all the schemes see the British Academy website www.britac.ac.uk/funding/index.cfm

The Parkinson’s Disease Society provides Training Fellowships for health and social care professionals to undertake research training relevant to Parkinson’s disease. Applicants should be aiming to gain a high degree like a PhD or MPhil and must be linked with a research unit or department with a proven track record in Parkinson’s research. The closing date for applications is 4 December 2009. For further details see the website.
tinyurl.com/lhqhh5

Blots to consider

Fall-out from the online publication of the Rorschach ink-blots on Wikipedia has continued late into the summer. Recent reports claim the Canadian doctor, James Heilman, who posted the Rorschach images online, is to be investigated by his local authorities, after formal complaints by psychologists. The saga first drew media attention when Heilman posted all 10 inkblots on Wikipedia in July, together with common responses to them. His controversial posting followed months of online debate over whether or not a single Rorschach inkblot should be published.

The Rorschach continues to command a far larger following among psychologists in the United States than in the UK, and advocates there were outraged, with many complaining that the publication of the inkblots and common answers would render the test useless, thus undermining years of research building up normative data on people’s responses to the images. However, research-oriented psychologists were largely unmoved.

Professor James Wood of the University of Texas at El Paso is co-author of an authoritative meta-analysis of projective tests (http://bit.ly/g8BGH), including the Rorschach, published in 2000, and continues to publish widely on the topic. He told The Psychologist: ‘It’s hard to see how the exposure of this generally useless test on the web is likely to cause much harm to anyone.’

The current situation has arisen because the original Rorschach inkblots are nearly 90 years old and no longer protected by copyright. ‘The obvious solution,’ Wood said, ‘would be to update the test and create a new set of copyright-protected stimuli, as happens routinely with other major psychological instruments. However, devoted Rorschach users have long resisted this solution.’

Modern scoring of the inkblots accords to John Exner’s ‘Comprehensive System’ developed in the 1970s. An updated review of the scientific evidence supporting use of this system was published by Wood and colleagues in 2006, showing that whilst the Rorschach displays validity for 20 scoring categories, including schizophrenia and bipolar disorder, a further 160 scoring categories lack validity (http://bit.ly/2g6ZPQ).

‘Perhaps most importantly,’ Wood told us, ‘findings from more than 70 studies have now confirmed that the child and adult norms for Exner’s Comprehensive System for the Rorschach are seriously in error and tend to mistakenly identify most individuals as psychologically disturbed.’

However, the President of the British Rorschach Society, Dr Justine McCarthy Woods, said: ‘I would question whether it is appropriate for lay editors without any expertise in psychology to decide unilaterally the validity or utility of a professional instrument,’ she said. ‘It could set a precedent for information from other psychological tests being posted on Wikipedia.’

She challenged Professor Wood’s claim that the test was useless: ‘The overwhelming consensus of scientists and practitioners is that the Rorschach is an important tool in the psychological assessment armamentarium, and that it possesses validity comparable to other…psychological tests and even to many commonly used medical instruments [see http://bit.ly/6FnRt].’

Dr McCarthy Woods also disagreed with Wood’s assertion that the Rorschach mistakenly identifies most individuals as psychologically disturbed. ‘This has been previously refuted in The Psychologist, in March 2008, and new norms have been developed [see http://bit.ly/M08uE],’ she said. ‘In fact, the Rorschach is a psychological tool which serves a vital functionin mitigating human suffering and helping people identify the sources of their mental confusion and emotional pain.’

Opposition to state regulation
The Alliance for Counselling and Psychotherapy – an organisation established earlier this year to oppose the planned statutory regulation of counselling and psychotherapy – claims that over 2000 psychotherapists and counsellors have now signed their petition opposing state regulation. Counselling and psychotherapy are due to be regulated by the Health Professions Council (HPC), the same body that recently assumed the statutory regulation of psychologists.

The news comes as a letter with over 30 signatories was published in the July issue of Therapy Today, the monthly publication of the British Association for Counselling and Psychotherapy (BACP), seeking clarification from the organisation that it will continue to support members who opt not to join the HPC.

‘[W]e are not against regulation per se but are opposed to the model imposed by the Government’ the correspondents said. ‘We do not believe HPC regulation will add anything of significant value to the work of therapists nor to the experience of clients, certainly nothing sufficient to outweigh the damage it is likely to inflict, damage already being done in three closely related government initiatives in the psy-domain: NICE guidelines, the IAPT scheme and Skills for Health’s “competences in development” for the psychological therapies.’

‘To be clear,’ the letter continues, ‘some of us are considering refusing to register with HPC – a conscientious objection of sorts – supported in our stance by principle, evidence and reasoned argument.’
BACP Chair, Dr Lynne Gabriel of York St John University, told The Psychologist that her organisation wants the best possible model for regulation, but that the model proposed via the Professional Liaison Group acting on behalf of the HPC ‘is not right for us or for the profession’ – a view she has shared in a letter to BACP members.

Gabriel said: ‘The proposed Standards of Proficiency present unexamined differentiation between counsellors and psychotherapists – differentiation that enhances myths and assumptions that abound in relation to the statutory regulation of counselling and psychotherapy. One unhelpful impact of the differentiation is that it is likely to confuse the public and current or future clients/patients, as well as employers of counsellors and psychotherapists.’

She added: ‘In support of our circa 32,300 practitioner members, as well as our circa 1150 organisational members, we see it as crucial that we offer evidence and reasoned argument in response to the HPC consultation and aim to dispel the many unexamined myths that undermine individuals’ capacity to make informed choices about statutory regulation.’ 

Climate change
The American Psychological Association has published an authoritative task force report on climate change: Psychology and Global Climate Change: Addressing a Multi-faceted Phenomenon and Set of Challenges. Task force chair, Janet Swim of Pennsylvania State University, said: ‘What is unique about current global climate change is the role of human behaviour. We must look at the reasons people are not acting in order to understand how to get people to act.’

The report is partly a summary of the existing psychological research into human behaviour and climate change and partly a call to arms, including the provision of advice on how psychologists can make their input more influential.

‘Psychologists can be dramatically more effective if they connect psychological work to concepts developed in the broader climate research community and collaborate with scientists from other fields,’ the report says. ‘Although psychologists have been doing work on climate change and related subjects for decades... the relevance of psychological contributions is not yet established or widely accepted.’

Among the specific recommendations made to psychologists working in this field, the report suggests using the language of the wider climate research community. For example, whereas psychologists typically report their findings in terms of statistical significance or effect size, the report says that what matters for the climate change field is the strength of effects or causes in environmental terms. ‘For example,’ it advises, ‘a good indicator of the importance of psychological variables for understanding human contributions to climate change is the amount of GHG [greenhouse gas] emissions they can explain.’ www.apa.org/releases/climate-change.pdf

 

A-level results
Psychology overtook General Studies this year to become the fourth most popular A-level subject in the UK, taken by 52,872 students, up from 52,706 in 2008. Only English, Maths and Biology were taken by more students – 91,815, 72,475 and 55,485, respectively. Unlike many other subjects, there was actually a small reduction in the proportion of Psychology A-level students obtaining an A grade: 19.2 per cent this year compared with 19.3 per cent last year. However, in line with most other subjects, there was an increase in the number of psychology students who achieved a C grade or above: 68.8 per cent this year compared with 67.7 per cent in 2008. Among the other science and maths subjects, Chemistry, Physics, Maths and Further Maths all showed increases in student numbers.
I    The full results are at www.jcq.org.uk 

 

NEWS FEATURE - The next big questions in psychology

Christian Jarrett and Jon Sutton report on a recent special issue of the journal Perspectives on Psychological Science

The same American journal that earlier this year asked psychologists how their discipline could be improved (see www.bps.org.uk/persp) – Perspectives on Psychological Science –  has since published another round of brainstorming contributions, this time on  ‘The next big questions in psychology’. With a few nips and tucks, we’ve summarised the majority of the contributions into four themes: how we can improve ourselves; why people vary; social interaction; and approaches to psychology. See what you think, then send your ideas to [email protected]

Improving humankind
Perhaps the boldest of the contributions was offered by Scott Lilienfeld and colleagues at Emory University in relation to reducing cognitive biases. Their argument is that extremism is fuelled by mental flaws, such as the ‘confirmation bias’, in which we disproportionately attend to information that supports our current view. ‘At the risk of sounding hopelessly idealistic,’ they write, ‘one might... be so bold to suggest that if researchers found debiasing to be efficacious and implemented it on a grand scale, it could prove to be psychology’s most important contribution to reducing ideological extremism and both inter- and intragroup conflict.’

On a near identical note, Katherine Milkman at the University of Pennsylvania and her colleagues argue that after years of successful research exposing the flaws in our thinking, much of it by Nobel Laureate Daniel Kahneman, the time has come to focus on how decision making can be improved. The modest amount of prior research on this topic has formed two types, they say: interventions, such as taking an outsider’s perspective and considering the opposite view, which are designed to switch a person from an automatic, impulsive way of thinking to a more conscious, considered style of thought; and environmental changes, as espoused by books like Nudge, which create a ‘choice architecture’ whereby people’s inherent decision-making biases lead to desired outcomes (for example, making organ donor schemes opt-out rather thanopt-in).

Also on the topic of judgement and decision making, Martin Seligman and Michael Kahana at the University of Pennsylvania say there is promise in the idea of using virtual simulations to teach expert intuition that would normally emerge only from years of experience.

Daniel Bernstein and Elizabeth Loftus propose that the next big question in their field is how to tell whether a memory is true or false. Prior research has revealed neural correlates of true and false memories, but has tended to involve pallid material (rather than juicy real-life memories) and has depended on averaging over hundreds of trials. There’s been modest success with identifying false memories in the form of deliberate lies, they explain, but less with untruths told by a ‘liar’ who believes what they’re uttering. A final approach has been to look at ways that true and false statements differ in content, with the former tending to contain more sensory detail. Crucially, none of these methods are reliable enough to be used without independent corroboration. Being reconstructed and pieced together, ‘in essence, all memory is false to some degree,’ Bernstein and Loftus write. ‘Our job as memory researchers and as human beings is to determine the portion of memory that reflects reality and the portion that reflects interference and bias.’

Meanwhile, Timothy Wilson at the University of Virginia says he hopes psychology will finally get over its ‘Freudophobia’ and start getting to grips with self-knowledge. To date, efforts in this field are disjointed and there are big gaps, he argues. ‘I am unaware of any research on how well people can predict how their personalities will change as they age,’ Wilson gives as one example. Research that helps people understand themselves better would be beneficial,he says, given that people with larger discrepancies in their implicit and explicit self-concepts tend to be more anxious and less happy.

This theme of improving the way we live is encapsulated by Nansook Park and Christopher Peterson at the University of Michigan in their clarion call for more positive psychology. Besides studying distress and pathology, ‘[w]e still need to know much more about the rest of the human condition and those parts that make life most worth living,’ they write. ‘The good life is not the troubled life avoided or undone,’ they argue, adding that in uncovering what it means to live well, psychology needs more longitudinal studies, more collaboration between specialisms and more focus on behaviours rather than processes.

Why people vary
Untangling the relative contribution of nature and nurture to human development has occupied the careers of countless psychologists. Based on several of the contributions to the special issue, it’s a project that remains as pertinent and daunting as ever.

Jay Belsky and Michael Pluess at Birkbeck University of London highlight the fascinating issue of individual differences in children’s sensitivity to their environment. Normally this is discussed in terms of some children being more vulnerable than others to adverse circumstances, but Belsky and Pluess review a range of behavioural and genetic research showing that the same children who are affected by negative circumstances also tend to thrive in quality conditions. In other words, children vary in their responsiveness to the environment, be it positive or negative. What’s more, other research shows that this tendency is influenced by conditions in the womb, which, in turn, are affected by maternal experiences, including stress. In one final twist, whether or not a fetus responds to these influences in utero, potentially becoming more sensitive to the environment in early childhood, could depend on their genetic make-up, thus bringing the role of nature back into play.

On a related note, Kenneth Dodge says one of the most important questions facing psychology is to elucidate the mechanisms underlying the way that the MAOA gene interacts with exposure to maltreatment in childhood, thus leading to increased risk for the development of conduct disorder. Dodge highlights possible mechanisms in the brain, in social cognition and autonomic arousal, leading him to predict that ‘the greatest possible contributions to science in the coming decade will be made by scientific teams that are able to combine multiple disciplinary perspectives and methods to understand how psychopathology develops.’

This view was echoed by Janice Kiecolt-Glaser in her contribution about psychoneuroimmunology. We already know that stress and depression affect health – just consider the finding that wounds take longer to heal when people are stressed – but there are many unanswered questions about how stress and psychopathology interact with environmental factors like diet and pollution to affect our immune systems and ageing processes, Kiecolt-Glaser says. ‘We need to put greater emphasis on cross-discipline training for our students,’ she argues, ‘underscoring the importance of getting a strong foundation in basic biological science.’

Gregory Smith at the University of Kentucky provided a clinical psychologist’s perspective on this theme of how nature and nurture interact to influence a person. ‘One fundamental task for clinical psychological science,’ he says, ‘is understanding why different individuals progress along different life trajectories.’ Smith adds that progress in genetics has opened up exciting new possibilities but that psychology needs to catch up by providing ‘sound theories and precise measures of coherent, homogenous, elemental psychological constructs.’ In particular, Smith says there is a need to abandon psychiatric diagnostic categories as the basis for clinical science research because, he argues, many of them ‘consist of sets of moderately or weakly related symptoms that often appear to have different aetiologies from each other.’

Social interaction
Others believe psychology should turn the spotlight outwards, to our interactions with others. Sheldon Cohen and Denise Janicki-Deverts at Carnegie Mellon University point out that ‘we have known about the importance of social integrati

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